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Referrals expand the array of options to meet pets’ diverse needs

Banfield’s veterinary practices offer a wide variety of services, including diagnostics and treatments. But when pets have needs that go beyond primary care, they may be referred to 24-hour hospitals or specialty practices. Referrals have become more common in veterinary medicine with advances in diagnostic and treatment approaches and the growth of the veterinary profession. Referrals can offer clients the broadest range of options for veterinary medical care, as demonstrated in an example from a Banfield hospital in Eugene, OR, that was recently published in JAVMA1.

What this means for veterinary teams
Working closely within an ecosystem of veterinary practices enables veterinary teams to solve unusual cases and ensure that pets receive the best care possible.

Solving a case of abdominal distention
In this example, a 7-year-old, 16.1-kg spayed female Miniature Australian Shepherd dog presented to Banfield’s clinic in Eugene, OR, with a 1.5-week history of progressive abdominal distension, lethargy, hyporexia (reduced appetite), and vomiting. Dr. Victoria Harvey ordered a complete blood count and serum biochemical analyses to seek a possible cause, but the results were unremarkable. Dr. Harvey then performed thoracic radiography, which revealed a soft tissue opacity on the cardiac silhouette and widening and subjective tortuosity of the caudal vena cava. Dr. Harvey suggested that a diagnostic ultrasound of the heart (echocardiography) could help to further investigate the cause and referred the client to the veterinary teaching hospital at Oregon State University (OSU). Echocardiography revealed a large mass associated with the wall of the right atrium that obstructed blood flow. The associated increase in pressure in the caudal vena cava resulted in the abdominal distention.

There were several possibilities discussed for the origin of the mass, though it was unfortunately highly suspected to be a malignant tumor. Banfield’s Dr. Harvey and the partnership with OSU clinicians were instrumental in arriving at a working diagnosis for the cause of the abdominal distension in this dog.

Referrals on the rise
Referrals like the one described here are increasingly common in veterinary medical care. Continuing progress in medical technology has led to the development of sophisticated approaches requiring expertise or equipment that might not be available in a primary care practice. In tandem, the scope of veterinary specialization has expanded, with the American Veterinary Medical Association now recognizing more than 40 specialties and subspecialties2. As a result, more specialty hospitals and referral practices exist today than in the past. Guidelines covering when and how clients should be referred to specialists are available from the American Animal Hospital Association3 and others in the veterinary profession. Considerations on where and to whom clinicians refer clients depends upon factors such as geographic proximity, operating hours, and capabilities of the referral hospitals, among others.

Many types of cases, many options for care
The example presented here also calls attention to the diversity of cases that primary care practices can encounter. Each unique case will have a range of potential diagnostic and treatment options for clients to consider, and referrals can expand this range substantially. Primary care teams can help clients weigh the benefits, accessibility, and affordability of each option to map out care plans that best meet their needs.

1. Gouws, M. E., LeBlanc, N. L., Chong, D., Owens, E. J., & Löhr, C. V. (2022). What Is Your Diagnosis? Journal of the American Veterinary Medical Association 259(S1), 1-3.
2. AVMA. What do board-certified veterinary specialists do?
3. AAHA. 2013 AAHA Referral and Consultation Guidelines.