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vetmom4
vetmom4, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1916
Experience:  30 years as cat and dog veterinarian, 28 years as practice owner, Past President of SCAV
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One veterinarian conducted a physical examination of my cat,

Customer Question

One veterinarian conducted a physical examination of my cat, and another veterinarian who was not present at the physical examination wrote a diagnostic assessment in his patient record and recommended a prescription renal diet.
If a veterinarian did not conduct a physical examination and was not present at the physical examination, has a Veterinarian-Client-Patient Relationship (VCPR) been established?
Is it legal and ethical for the veterinarian who did not conduct a physical examination to proceed to diagnose him and recommend treatment for a medical condition?
Is a diagnostic assessment a general or preliminary diagnosis?
Is a recommendation to start a prescription renal diet a recommendation for a treatment?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry that your question wasn't answered in a timely manner. To answer you directly, there's no prohibition for another vet to offer a second opinion about a case including care not previously mentioned. This is good standard of care in multiple vet practices. The primary vet can elect to follow new recommendations or not and so the VCPR isn't broken. This is no different than "having rounds" in a human hospital. Please note that the second vet can offer a diagnosis and recommend treatment but neither the initial vet nor you is bound to accept that diagnosis or treatment. A diagnostic assessment, then, may involve one or many vets including specialists asked to become involved in the case. Yes, a prescription renal diet may be part of a new review and recommendations but once again neither the initial vet nor you is bound to follow that recommendation. Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
There is no need to apologize for that. I compared your response with my questions to see if you answered a "yes" or "no" to them, and as it turns out, none of my questions were answered. I would like a different expert to answer.
Expert:  vetmom4 replied 1 year ago.

It is legal to prescribe the diet based on objective data such as blood work and urinalysis. I would expect the original veterinarian to speak with you unless there is an extenuating circumstance. Neither do I think it is unethical. Hope that helps. Vetmom4

Customer: replied 1 year ago.
You answered one question with "yes." From the VCPR FAQ on AVMA's website, "If a VCPR is established but your veterinarian does not regularly see your pet afterward, the VCPR is no longer valid and it would be illegal and unethical for your veterinarian to dispense or prescribe medications or recommend treatment without recently examining your pet." Regardless of the data you could see on my pet, you, an online veterinarian, cannot recommend a treatment for a medical condition, because VCPR cannot be established online. The physical examination, VCPR, and subsequent diagnosis and treatment are closely connected and I do not see how a sequence of events could diverge much from this course without raising a medical ethics (AVMA) or legal (state law) issue. If you have any further insight, feel free to share it with me. Could you answer the other questions?
Expert:  vetmom4 replied 1 year ago.

You are correct on that Practice Laws vary from state to state. You may to contact your state Board of Veterinary Medical Examiners for a definitive on the legal aspect in your state. That being said prescribing a prescription diet like K/d based on just a physical would be a preliminary diagnosis in my opinion. SMDA. BUN, creatinine and urinalysis would be necessary to give a definitive diagnosis. K/D diet is both a recommendation and a treatment. That is why it is a prescription. It is contraindicated in some life stages. The protein is classified as low quantity, high quality. Veterinarians can only recommend. Treatment is up to the owner. Let me know what else I can answer. Kindly. Vetmom

Customer: replied 1 year ago.
You did not answer the other questions. Refer these questions to another expert. Here are the questions,If a veterinarian did not conduct a physical examination and was not present at the physical examination, has a Veterinarian-Client-Patient Relationship (VCPR) been established?
Is it legal and ethical for a veterinarian without a valid VCPR to diagnose a pet with a medical condition and recommend treatment?
Is a diagnostic assessment a general or preliminary diagnosis?
Is a recommendation to start a prescription renal diet a recommendation for a treatment?Additional question,
Is it ethical for a veterinarian to recommend treatment for a medical condition without first diagnosing the medical condition?