Are ‘Recheck’ Appointments Actually Needed?
Your dog’s ears are red and inflamed and he has been shaking his head and scratching at his ears. The doctor looks into the ears to find both ear canals are swollen with a dark wax inside. She gets a sample from the ear canals and performs cytology with a microscope diagnosing a mixed infection of bacteria and yeast. An ear cleaner and antibiotic ointment are prescribed and she tells you that she wants to recheck the ears in 2 weeks.
You administer the medication as prescribed and in about 10 days all the symptoms are gone and you reason that there is no need to return for a recheck/progress visit.
Fast forward 6 weeks. The symptoms return with a vengeance; they are worse now than before. So, you return to the vet only to learn that once again yeast and bacteria are found and medication is prescribed. Another recheck examination is scheduled in 2 weeks, but the ears respond to the medication and again you reason that there is no need to have the ears rechecked.
We know what you are thinking, and understand your frustration.
Imagine this scenario repeats itself several times and you become frustrated that the problem keeps recurring over and over, so you call and just ask for a refill of the medication. When told that an examination and cytology needs to be done before prescribing medication, you become even more frustrated telling the receptionist or doctor, “Every time I come in it’s the same thing, so I don’t see why I can’t just get the medication – after all, it seems to work every time.”
This situation occurs more often than you might think because most ear infections and skin infections in dogs are caused by allergies to either food on something in the environment. Allergies aren’t necessarily curable, but can be controlled.
Let’s look at this problem from the veterinarian’s perspective. When she keeps seeing the same problem every 2 or 3 months, but notes that none of the recheck appointments have been kept, she is also frustrated because she doesn’t know if each recurrence is a new infection or the original infection that never completely cleared up. You see, a dog can become symptom free and yet still have residual infection in the ear or on the skin. Only another examination and cytology at the proper time can reveal this. And sometimes, the bacteria causing the infection may change or become more resistant requiring different medications than those previously prescribed.
Even once it looks like the infection is gone, it may not actually be.
This is why the recheck examination and repeated cytology is so important. Some of those recurrences might have been avoided if proper followup had been done. This is not to say that your dog will never have another ear infection again, but hopefully, the number of recurrences and visits required for treatment will be reduced saving you time and money as well as the dog experiencing less pain and suffering.
Recheck examinations allow the doctor to determine if further treatment is needed or not. Some ear and skin infections require treatment longer than 2 or 3 weeks even though the dog appears to be symptom free. If the infection is cured or controlled, the doctor can outline a maintenance plan to prevent frequent recurrences. Sometimes a plan for determining if an underlying allergy or hormonal problem is behind recurrent infections is warranted. Expectations and prognosis in managing the problem long term can help alleviate frustration down the road.
In addition to ear and skin infections, eye problems, urinary tract infections, and any chronic disease such as diabetes, Cushings disease, thyroid diseases, heart or kidney failure all require recheck (progress) examinations to minimize symptoms and maximize your pet’s quality of life.
So, the next time you are tempted to skip a recheck appointment- save yourself and the doctor some potential frustration and keep the appointment. Your pet will thank you.
