Choosing a Veterinarian
Choosing a veterinarian is easy if you already have one you like and that respects you. Most vets love to give referrals to people they know. However, some vets do not understand the devotion of pet owners with disabled dogs and merely "humor us" thinking we are nut cases. If your vet "just doesn't get it" you may have to look elsewhere. On the other hand, with a little education most vets can understand why you are going to such lengths to make your pet comfortable and happy and are more willing to work with you. When I explained to our vet that Hoover still liked playing with his squeakies, lived for a licked dish and hung out in the main area of the house so he could be included in everything we do - he realized Hoover's life was not so bleak after all. It's important to have your vet "on board" because you will need answers to your questions and a variety of medications for your dog that may range from simple vitamins to narcotics.
A vet that will come out to your home to see the dog is also a plus. You are more likely to find these sorts of vets in rural areas, only because they are more likely to be set up for house calls due to the number of horse/farm visits they do. Often they will have a vehicle that contains all the necessary equipment at the ready even for an emergency. The difficulty of getting your disabled large dog into your vehicle is multiplied when he is unable to even help you a little. A vet that can come to you is a big plus.
You'll also want to have rappor with the veterinary staff as they are the ears of the vet. I know a very good vet who himself, is awesome. But his staff is horrible - and every time I need to get meds or talk to him it becomes an exercise in frustration. I no longer go there for even the most routine items - I go to the vet with the friendly, accomodating staff. It makes a big difference. Often the staff, when they know your dog, will go to bat for you so that you can get an increase in dosage without a difficult office visit and it's wonderful not having to explain your dog's entire life story every time you call. A staff that remembers you and your dog is wonderful.
State laws vary, but a vet that is willing to dispense common medications for things such as minor eye infections, topical treatments, and mild pain killers are worth their weight in gold. It's often hard to transport a disabled pet so avoiding the expense and difficulty of an unnecessary exam for something that is chronic makes sense. It may even make the difference of the dog being treated or not getting the medicine he needs. Disabled pets can be more prone to minor problems due to a weakened immune system.
New Vet or Old Timer?
Young vet or old? Young vets are often aware of the latest greatest treatments available for your dogs problem. On the other hand, they may never have SEEN the problem and may need to research it before feeling comfortable making recommendations. Whereas, an older seasoned vet has seen your dog's problem before and probably has a typical treatment regimine already worked out that he's had success with. I've found older seasoned vets ultimately cost me less for the same things - they don't have to do as many unnecessary tests to make a diagnosis and also realize not every patient can afford the "latest and greatest" treatments. And just because we can't afford the latest and greatest, doesn't mean we love our pets any less!
If you are moving to a new area, the best way to find a new vet is to ask your current vet. That didn't help as we were moving far away so our vet couldn't recommend anyone. Don't be afraid to call all the vets that are nearby and ask his staff some difficult questions. Ask how often they deal with geriatric dogs, or situations pertinent to your situation. Then schedule some basic appointments (shots, ear infection, annual heartworm) so that you can get to know his style and staff before there is an emergency. You want to find a vet that respects the knowledge you've already acquired with your disabled dog, and has had at least reasonable experience with the disabilitiy you're dealing with. Find out how emergencies are handled in the new area. We went from an area of several 24/7 Emergency clinics to an area where each vet was "on call" for his own emergencies. In other words, you can't wait until things get critical when the closest vet is an hour away and needs to be called into the office first. Often you may need more than one vet - sometimes vet A is good with puppies but vet B is great with geriatrics...so don't be afraid to spread yourself around. You'll get to know several vets that can act as backup for each other, and you can use them for what they are particularly good at.
Which brings me to practicality...how much effort, time, money and emotion do you put into your disabled dog? As much as you can afford to of course. But consider that for every expensive treatment there is probably something just as good that might not make that much difference in your dog's quality of life. My philosophy is that if the test/treatment is not going to change anything, it's probably not worth putting your dog through it (unless you just have to know what is causing the problem). Often expensive testing will tell you nothing more than you already know. You'll be left wondering just as you did before, except you'll be broke.
You want a vet that understands your pockets are not endless, and will find a working solution for you at a reasonable cost. You should not have to go to the poor house because your dog is disabled. You should not have to feel you must put the dog down because you can't afford his medications. There are many fine treatments, medicines and equipment that will make him quite comfortable for less. Spend what you save on some special treats for him. He'll appreciate that more than being poked and prodded endlessly looking for a "cure" when there isn't one.