Telemedicine Transcends Distance for a Faster Diagnosis

Although used with some frequency in human medicine, telemedicine is relatively new to most veterinary practices. Using information technologies, such as telephone lines, the Internet, or other networks, telemedicine enables veterinarians to transmit digital medical information to a board-certified specialist in another location. As a result, the veterinarian can consult with the specialist, arrive at a diagnosis, and begin treatment that much faster.

Belle, an 11-year-old cocker spaniel, was no stranger to the veterinary hospital. She’d had a litany of problems, from skin conditions and ear infections to orthopedic issues. Still, when owners Robert and Charlotte Stone brought her to Sunnycrest Animal Care Center in Fullerton, California, they weren’t expecting her to need life-saving emergency surgery. But that’s just what happened, thanks to a veterinarian who referred the case to a specialist 100 miles away.

According to Charlotte, “Belle had been having trouble standing, and we thought she might be having problems with her hips.” After reviewing x-rays of her hips and spine, Dr. Richard Glassberg recommended that they transmit the digital radiographs to a specialist for a consultation. “I thought someone with more experience in this area should review her x-rays,” says Dr. Glassberg, “someone who looks at x-rays eight hours a day.”

THE SHORTEST DISTANCE BETWEEN MEDICAL PROFESSIONALS

Dr. Glassberg transmitted the digital radiographs to Dr. Seth Wallack, a board-certified radiologist with the Insight Radiology telemedicine service in San Diego. Within seconds, Dr. Wallack was able to pull up Belle’s x-ray images on his computer screen. He called Dr. Glassberg immediately. Although the x-rays focused on the hips and lower spine, Dr. Wallack was concerned about a small portion of the spleen that was barely visible at the top of the x-ray.

Within half an hour, Dr. Glassberg called the Stones with the news. There was a mass on the spleen that was slightly smaller than a tennis ball, and Belle needed surgery as soon as possible. “Because Belle had neurologic symptoms, I was concentrating on the spine in the x-rays,” says Dr. Glassberg. “I would have missed the spleen.”

Belle was taken into surgery, where the surgeon, Dr. James Grimes, removed a hematoma, which is similar to a blood blister. If left untreated, a hematoma can rupture and cause internal hemorrhaging. “The surgeon told us that after he removed the spleen, the mass burst in his hand—it was that delicate,” reports Charlotte. “Belle may be our pet, but she’s like one of our children. We’re grateful that Dr. Glassberg had the insight to recognize that something wasn’t right and recommend that a specialist take a look.”

A FASTER WAY TO GET A SPECIALIST’S OPINION

Because many veterinarians have other ways to get assistance with tough cases, not all veterinarians offer telemedicine services to their clients. According to a 2008 American Veterinary Medical Association (AVMA) survey, 29% of veterinarians currently offer some kind of telemedicine, with almost 10% planning to add those services in the next few years. Although digital x-rays were transmitted in this case, telemedicine can also be used to send video ultrasound clips, photographs, and digital patient records.

“I used to send x-rays to radiologists by mail,” says Dr. Glassberg. “It would take three to four days to get a consultation report back.” Since installing a digital radiography system, he is able to transmit x-rays in seconds. “Now I receive a report in a few hours, and often in as little as 20 minutes,” he says.

“We’re grateful that we could get the advice we needed quickly,” says Charlotte. “It could have been one of those situations where we had to get in the car with the x-rays and drive 40 minutes. When it’s a life-threatening situation, you don’t have time to waste.”

* * *

Two years after her surgery, Belle is doing great. “So far, Dr. Glassberg has given us an extra two years with Belle, and to us, that’s huge,” reports Charlotte. “We are very attached to her, and the longer we can keep her with us, the happier we are.”