Does Your Dog Need to See a Veterinary Specialist?

Just like you might receive a referral to a specialist, dogs sometimes need care from a veterinary specialist who focuses on a particular field of veterinary medicine. For example, your dog may see a specialist to rule out certain medical conditions. Or they might need a specific type of treatment for a persistent or worsening issue.

In This Article

• • Primary vs. Specialty Care
  • When to See a Specialist
  • Working With a Specialist
  • Preparing to See a Specialist
  • Finding a Specialist
  • Understanding Pet Insurance
  • Preparing for Your Visit
  • Reducing Visit Stress
  • FAQs About Veterinary Specialists

Unless your dog requires emergency care, the best place to start is your primary care veterinarian. They can provide a thorough physical examination, initiate treatment, and advise you on whether your dog needs specialist care. Below, we talked to a veterinarian about the types of veterinary specialties, the referral process, and what to expect at a specialist appointment.

How Does Primary Care Differ from Specialty Care?

Becoming a general practice veterinarian requires a four-year undergraduate degree, followed by graduating with a Doctor of Veterinary Medicine (DVM) from a veterinary school that’s accredited by the American Veterinary Medical Association (AVMA).

To become a veterinary specialist, they must complete rigorous training, such as a residency at a veterinary university or a high-volume practice where they’re seeing lots of cases and receiving mentorship in their specialty, says Dr. Kate Elden, DVM and Chief Medical Officer at Dutch. Additionally, they have to pass a national exam to become board-certified in their field.

The AVMA recognizes 22 veterinary specialty organizations, which comprise 48 distinct veterinary specialties. Examples include internal medicine, neurology, cardiology, oncology, ophthalmology, and surgery . After completing advanced training, education, and examinations, a veterinarian can obtain certification in one or more of these specialty organizations. Some specialists go on to do a fellowship or conduct research.

“We’ve gotten more specialized in veterinary medicine and that’s because the quality of care is so good,” she says. Along with medical advancements, she’s seen an increase in veterinarians referring patients to specialists. The type of specialist depends on your dog’s health issues. Veterinary specialists may work with primary care veterinarians, human medical professionals, researchers, and public health officials.

When Should Your Dog See a Veterinary Specialist?

Apart from emergencies, it’s best to start with your primary care veterinarian, who knows your dog’s medical history. Dr. Elden says that a veterinary specialist may not be the right fit for every pet or situation. “Not every pet owner can afford or has access to specialists.”

Often, it comes down to a personal decision between each pet parent and vet when it’s time to initiate treatment or make a referral. Here are some situations where a veterinary specialist can be helpful.

Emergency Care

“You never need a referral to an emergency or urgent care clinic,” she says. “If you think your pet is having an emergency, go straight to the emergency clinic.”

Both general practice and emergency clinics can handle breathing issues or accidental swallowing of toxic foods.

Other signs that warrant emergency care include:

• Bleeding
• Trouble breathing
• Dry or pale gums
• Trauma, such as dog attacks or being hit by a car
• Pain or bloating after eating, especially in large breed dogs

Especially in the summer months, you don’t want to take chances with heat stroke. “Your general practitioner could also see you, but if you’re worried and you’re close to an ER, go there and call when you’re on the way,” she explains.

Chronic Issues

Let’s say your dog has a recurrent ear infection. If their ear canal feels pliable, the vet is likely to treat the infection themselves. “But if the ear canal feels hard, like a rock where it’s stenotic (abnormal narrowing), that pet might need surgery,” she says.

The average general practitioner may not provide this kind of surgery and instead refer your dog to a dermatologist.

Comorbid Conditions

Comorbidities refer to having one or more medical conditions alongside a primary diagnosis that affects your dog’s health. As Dr. Elden explains, internal medicine includes many subspecialties.

A primary care vet might work with an internist when there are comorbid conditions, such as Cushing’s disease, kidney disease, and a heart murmur. They might also consult an internist when deciding among conflicting therapies or medications.

Eye Health

One scenario is an eye issue that’s not getting better, such as glaucoma. Perhaps your veterinarian has tried the most common first-line treatments, and still, there’s no improvement. In such cases, they have the option of referring your dog to a veterinary ophthalmologist for treatment or an advanced procedure.

It really depends on the veterinarian and what they feel comfortable treating. With cataracts, for example, the vet may perform surgery themselves or recommend a referral. Another reason to see an ophthalmologist is for a deep ulcer or one that’s not responding to treatment, she adds.

Nutrition

Some owners are keen to feed their dogs a diet made of fresh or minimally processed ingredients. Dr. Elden recommends choosing a veterinary-formulated food that’s frozen or dehydrated. “I say that in a shame-free space because it’s expensive to feed those foods,” she says. “A well-balanced kibble can be a great diet, and pets can live a long time eating those.”

A general practice veterinarian can offer guidance if you’re supplementing a dry or frozen food with fresh ingredients. However, if you’re cooking at home for your dog, this is a good time to have a consultation with a veterinary nutritionist. These specialists often work virtually and help people create a homemade diet for their dogs’ needs.

Cancer

Depending on the type of cancer, primary care veterinarians can manage issues like a mast cell tumor, she says. “Most general practitioners can do that surgery and aftercare in the clinic.” Veterinarians can also treat certain types of lymphoma, especially in the case of oral therapy.

“If it is a more aggressive type of cancer that needs radiation, that’s a referral to an oncologist,” she says. However, the diagnosis process will start with your regular vet doing bloodwork and testing.

Heart Issues

If your vet detects a heart murmur, they’ll recommend a test called an echocardiogram. Some veterinarians will perform this test, while others will refer your dog to a veterinary cardiologist. Typically, this is an internal medicine specialist who is board-certified in cardiology, Dr. Elden explains.

Neurologic Symptoms

For neurologic symptoms, your regular vet can do a thorough physical exam and bloodwork to screen for diseases. Next, it’s common to refer your dog to a neurologist, especially if they’re having seizures or motor abnormalities. A neurologist can do more thorough imaging of the brain, including a CT scan or MRI.

Among dogs with a long spine, such as a Pembroke Welsh Corgi or Dachshund, a neurologic symptom might be dragging their toes or walking with an unusual gait. Your regular vet can treat spine issues or prescribe antiseizure medications. In addition, they might recommend seeing a neurologist to further investigate neurologic deficits and rule out less common causes, such as a brain tumor.

Dental Care

Dr. Elden recommends annual anesthetic dental cleanings for dogs 25 pounds and under. Small breeds such as Yorkshire Terriers and Chihuahuas are more prone to dental disease. “Large dogs don’t necessarily need these cleanings as often, but once they’re middle-aged, they should be getting them,” she says.

The average general practitioner can do extractions and preventative dental cleanings. For more complicated procedures, such as crowns and root canals, your dog needs to see a specialist who is board-certified in dentistry. In addition, a regular vet might not take dental X-rays during dental cleanings.

“There is no substitute for full mouth dental X-rays because you cannot see below the gum line, especially with non-anesthetic dental cleanings,” she says. A dog’s teeth may look normal from the outside, but there could be fractures below the gum line. Another reason to see a specialist is if your dog has an underlying condition that makes anesthesia riskier or requires more intensive sedation. Veterinary specialists tend to work faster, meaning less time under anesthesia.

Working With a Veterinary Specialist

Getting a referral for advanced care can feel overwhelming, especially if it’s your dog’s first time seeing a specialist. Here’s what to expect at each step of the process, from finding the right provider to walking into the appointment prepared.

Finding a Qualified Provider

As Dr. Elden says, the best specialist is the one you can access most easily. She recommends searching online within a 30-mile radius or a distance you can reasonably drive. If you’re seeking a specialized procedure or clinical trial, you can search the AVMA site for specialists in that field. For a complicated dental procedure, you can search for a board-certified veterinary dentist in your area.

Understanding Pet Insurance

People often pay out of pocket for veterinary care, even if they have pet insurance. Most policies reimburse owners after a visit rather than billing the clinic directly, so the upfront cost is still due at the time of service.

When a veterinary specialist asks for a referral, usually, this has less to do with pet insurance and more to do with obtaining your dog’s medical records, she notes says. Coordinating those records helps the specialist and your primary care veterinarian stay aligned if follow-up care is needed.

Typically, insurance policies have a list of pre-existing conditions. If you’re unsure what’s covered, you can check your policy or call the insurance provider and ask about your plan. If your policy doesn’t cover specialty care, you can discuss alternate treatment plans with your general practice veterinarian.

Preparing for a Specialist Visit

There are several things you can do to prepare for a specialist visit:

• Send your dog’s medical records and lab results to the specialty clinic before your appointment
• Ask the clinic whether your dog needs to fast before the visit, since specialists may also order bloodwork
• Confirm whether your dog can eat a small amount of food with medication if fasting isn’t required

Oftentimes, the symptoms and behaviors you see at home might look different at the clinic, especially if your dog is anxious and full of adrenaline. Accordingly, it helps to take pictures and videos of your dog’s symptoms. This is especially true if they’re seeing a specialist for a behavioral or neurologic issue, breathing pattern, or a heart problem. Likewise, pictures can be helpful for a dermatology consult or a telemedicine appointment.

Managing Stress During Visits

Before any specialist appointment, ask the clinic whether your dog should take pre-visit pharmaceuticals. These include anti-anxiety medications such as trazadone or gabapentin. If your dog has already been prescribed these medications, confirm whether you need to withhold these drugs before the appointment because of bloodwork or other reasons.

Keep in mind that specialist appointments are often longer than the average veterinary visit, and there’s usually follow-up care, like multiple visits or repeat bloodwork.

The exact follow-up care needed varies by specialty:

• In dermatology, repeat skin testing is common
• For diabetes management, the specialist may offer virtual care or advise you to check in with your regular vet
• When managing a heart condition, a cardiologist might order a repeat echocardiogram and bloodwork in six months or a year, depending on the result

Finally, it’s worth emphasizing that not every dog has access to specialty care. “I don’t want people to think that if they can’t see a specialist, their general practitioner can’t help them, because we really can do a lot,” she says.

If you have any concerns about your dog’s health, don’t hesitate to talk to your regular vet. If they don’t feel comfortable treating your dog, you can get a second opinion from another vet who is willing to manage your dog’s care. “We all have our strengths,” she adds.

Frequently Asked Questions