Latest / Senior Pet Talk | for dogs + cats / 7. How to Prepare for Your Senior Dog's Vet Visit

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7. How to Prepare for Your Senior Dog's Vet Visit · Senior Pet Talk | for dogs + cats

• Amanda Steffen: You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pets' senior years are their best years yet. I'm Dr. Amanda Stefan. Let's get started. Hello, thank you for tuning in to another episode of the Senior Pet Talk Podcast. I am Dr. Amanda Steppen, integrative in-home senior dog and cat veterinarian. And I want to talk to you today specifically about senior dogs. And I want to talk to you about what to expect and what tests and things to discuss with your vet when you go in for your veterinary visits. I know that the vet visits that you take your senior pets to can be one of the most stressful events. That's for a lot of reasons. Maybe your pet does get stressed when they go and that's one reason, but you are typically sitting there going, ⁓ my gosh, are they going to find something wrong? Is there going to be something wrong this time? Is this going to be the time they tell me that there's cancer or that he has something, you know, that I need to do a surgery for or that there's something I can't fix, you know, is have I been doing everything I need to do? There's a lot of that caregiver burden where you're saying, like, am I doing everything right? Are they gonna say that I'm doing an awful job? You know, you may think, like, ⁓ gosh, I know his teeth kind of smell. And am I not doing the right things? And I want to just give you a moment and I know those things are still gonna come, but I want you to try and give yourself some grace because. You are doing a great job. And your veterinarian will not and should not judge you for what you have been doing. So that means I want you to bring all the information. I want you to bring all the supplements that you've started or tried. I want you to bring some information about what diet you're feeding. Take a picture of it. That's the best thing you can do is take a picture of the food that you're feeding so that it's easy. I want to make sure that you know you are doing a good job before you even walk into that clinic. Okay. Give yourself a big couple breaths and know that you are doing a good job. Okay. So that's step one. Step two is the things that you bring with you. And I alluded that, alluded to that a little bit. I want you to bring in what dog food you're feeding. I want you to talk about how good they're eating that food. Are you having any concerns or questions? I would like for you to write those things down. It can be on a notepad if you're old school like me, or it can be in a notes app on your phone, or you can voice detect it. I don't care. But I just want to make sure that you have a list of your concerns, if there are any, written down somewhere, because it never fails that you're going to walk into that clinic and your dog's a little stressed out and you're a little stressed out and you don't know what's going on and you're going to forget all your questions. And we're gonna stand there for a few minutes. And I wanna say, okay, well, I guess call me if you think of them. And then you're gonna think of them as you walk out of the door, right? And then you're like, well, I can't go back in. My appointment's over. So write down the questions that you have. I want you to write down any supplements that your pet is taking. It may not seem like a big deal, but it is a big deal. I did an episode on what is a good supplement. And in that I talked a little bit about the fact that. If you're doing certain supplements, they can actually be detrimental if you're mixing a bunch of supplements together and you don't know what they all do. So you can have multiple supplements that are all thinning the blood and you don't realize that because how would you know? And how do we assume that a supplement can actually be as strong or worse than like a medication, right? So bring all the supplements, bring all that information with you. And then I want you to listen very carefully to what your vet says about your pet and what their concerns are. And I want you guys to come up with solutions to those problems. And if there's a lot of them, we can always rank them and say what needs our attention first and second and third. And we kind of go through things that way. But I want you to know that there's a lot that has to go into a short amount of time in these vet visits. So you coming prepared. is not going to be obnoxious or stressful or anything for your veterinarian. I love a good list. When somebody comes into the office and sees me and they have like a one page handwritten note, often that's the wife sending the handwritten note with husband, but you know, or you have it, that's fine. But if you have that note with you, man, I could kiss you in the lips, I promise. I won't, but I could because it's just so helpful to know what we need to focus on and what your main concerns are and what you're saying at home. Because I'm not going to see signs of dementia in a vet visit. I'm not going to see often I'm not going to see the normal signs of aging that you're going to see at home. You're going to be noticing what their appetite's like, what their thirst is like. How they're getting up and down the stairs now, how they're getting around the house, if they have any signs of cognitive decline or dementia, that like really weird little twitch that they get in their back legs once a month. Write those things down and bring them all in with you to that visit. Okay. Those are really important things. And a lot of times we don't realize it in the moment, but just pull out your phone. When something like that happens, make a notes app that says, emits concerns for the vet visit and put it in there. Okay. So we're gonna talk about what diagnostics and other things that I want you to ask your vet about. And then we're gonna talk about the cost of these things too. There's no way around this. It does cost money to own a senior pet and it is getting more and more expensive as time goes on. I believe that most things are getting more expensive. If you haven't bought a dozen eggs in a minute, that is atrocious. But in the vet world, a lot of this is going to be a very small tangent. Veterinary clinics are being bought out by private equity and corporations. Those guys are jacking our prices. Somebody somewhere saw that clinics and said, ⁓ my gosh, there's so much money here and they're not doing it right. And started buying them up like a Pac-Man and raising the prices. And the vets are no longer in charge. So we can't really do much about it. And there is a push. A lot of my friends are starting their own clinics. I'm so happy about this. There's another friend of mine who helps. Vets start their own clinics and run their own clinics. I'd love to see this comeback that we're having, but imagine someone who has, you know, maybe can get a loan for five hundred thousand dollars versus a private equity company that can come in with thirty million dollars. And if you have a veterinarian who is retiring and you have this vet who's gonna offer them five hundred thousand dollars for their clinic. But wants to run it from a family-owned perspective, or you have this private equity who can come in and say, well, here's $10 million, they would be insane not to go with the $10 million. Like we do have to look out for ourselves in that regard too. So it's become very hard to find privately owned veterinary clinics, but we're working on it. We're we're making a comeback. I have a lot of faith in that. However, that being said, It does get expensive when we go through all these tests. And it is okay if you cannot do them all at at the first visit or at one visit or even at all. And you need to save up for those things. I understand that. We as vets understand that. You know, there's a lot of times we can't even afford the care that we would like to give to our pets at this stage. But I think that we're all doing the best that we can. So I want to go through these things with you. And I do understand there's an expense to them. I do understand that triggers people. However, I want you to try and not get triggered by this and really just take it at face value of what it is and what would be ideal for the health care of your pet. And then we're going to do the best that we can because I'm going to promise you that they would choose to live with you happily, lovingly, over living with someone who could pay millions of dollars for all the care that they need. And not giving them any of that love and attention, right? You are their person for a reason. You were given that dog for a reason. For some reason, the world brought you together. I am a huge believer in spirituality and manifestation and things coming together for a particular reason. Floyd, my heart dog, was brought into my life for a very specific reason. He was meant to change my world and to change my career and to change how I help people. And I believe that your pet is meant to be with you too. So understand that they always are living their best life with you, regardless of what that means you can or cannot do financially. Okay. So there was a study done on senior dogs. That came in for routine wellness visits with no clinical signs and said, Okay, yeah, let's do some routine blood work on my pet. Two out of every five of those dogs had significant findings enough to change their care plan. That's 40% of these dogs who seemed completely fine had significant enough findings that they needed to have intervention in their medical care. So it is extremely important that we take into consideration the testing that goes along with having a senior pet. Just because they look normal does not mean that everything is normal on the inside. Things like kidney disease are not gonna show up outwardly until we're farther along in that or have a flare-up of it, right? We have pets that come in with bladder stones and they have no clinical signs. You know, they can have masses in places and have no clinical signs. So it's really important to make sure that we are trying to do the appropriate tests to help our senior pets and keep them around as long as possible in a healthy way, which is exactly what we're going for, right? We want them here healthy as long as possible. So dogs generally are going to cover up pain and mask this dysfunction until they cannot mask it anymore, which is why we need to make sure that we are trying to do some of these preliminary tests and things like that, even if we're not seeing clinical signs, right? So I want to talk to you first before the tests component about two things I want you to ask your vet about when you go in for that visit. Number one, their body condition score. Nobody likes to hear That their dog is overweight. I get it. I was told Floyd was overweight at the vet school when he used to go there. And it it stings a little, right? Because you feel like you're not doing something right. It is hard sometimes to get weight off of our pets. However, I do want you to know what number they sit at on this body condition scale. The body condition scale for dogs goes from a one, which means like Skin and bones, very emaciated, you know, probably a dog you would think of as like a stray or something who's been neglected or something like that, to a nine, which means very round. And what we want to see is somewhere around four or five. Four and five are kind of like ideal body condition. Four is a little bit underweight. Five is kind of ideal. And I'm gonna be honest with you, our seniors should trend a little bit on the like four to five range, we don't really want them getting overweight because that's putting more strain on their bones and their joints. And it's not as ideal for them, right? So we do know that obesity is directly linked to a shortened lifespan. It does shorten lifespan by about two years on average in a study that was done on dogs. So it is important to keep them at an ideal weight to the best of our abilities. Now that can be very difficult and I understand that. But it is worth asking your vet, like, hey, where do they land on the scale? I want to know because I want to make sure that we can proactively do what everyone needs to do to get them in a good place, right? The second thing I want you to ask your vet about is their muscle condition score. So this is generally just rated on like a normal muscle condition, mild, moderate, or severe waisting. And What we're looking for here is frailty or sarcopenia or whatever you want to call it, basically muscle wasting. That's what we're looking for. Are they starting to lose muscle mass on their back, on their legs, on their head? Are we noticing a decrease in their muscle tone and their muscle mass? That is also directly correlated to a shorter lifespan. The other things that frailty can complicate would be like if they need a surgery or they need chemo radiation or something like that, they're not going to bounce back from those things as effectively if they don't have as much muscle mass. That is a component of being frail. Just like you would think of like your grandma being more frail and she falls, she's more likely to break her hip because there's not a lot of muscle covering it than the teenage boy who's running around sliding into the baseball Mats and and things like that. Like he's probably not gonna break his hip, right? Because he has a lot of muscle covering those bones. So it's important to make sure that we're asking about muscle condition scoring because there is so much we can do about muscle loss. And this is at one of the tangents I will go on. Give me a moment. We can help muscle wasting. We can combat muscle wasting. We can improve muscle wasting. I have in so many of my patients. It is not something where we say, okay, well, their muscles lacking and that's just gonna progress now and it's gonna get worse and worse and worse over time. Not the answer. There are muscle builders. We can change their diet to add more protein to it. We can make sure that they're getting enough calories in general. We can make sure that they're having good rehab exercises and things like that. There's so much we can do to help build muscle mass back. And I never want you to think that any of the things that are going on with your senior dog are things that have no answer because I have yet to find a lot of things where I say, okay, well, now we're at our wit's end. That used to be the case with only Western medicine because I did not have a way to treat a lot of like autoimmune diseases or things like allergies or certain cancers or things like that. And now mixing in Chinese medicine into that, I just feel Like I have a whole new world of medicine opened up to me and my patients, and it's amazing. I have a patient who is a 14 year old golden retriever. She has multiple different tumors. She has some on her liver and she has a bladder tumor. We started her on an herb once we found out about her bladder tumor. She also gets acupuncture and eastern from me. We started drawing two different herbs, actually. And her tumor at her first recheck had actually gotten smaller. She did not do any chemo, no radiation, no nothing. They declined doing all of that. And her oncologist, who I know was a good friend of mine, was amazed. And she was like, How is this smaller? Because she's on herbs and we are helping. Now, her most recent visit, which I believe is her six month from diagnosis, the tumor is a little bit bigger than when they started, but definitely not growing as quickly as the oncologist anticipated. So how amazing is that? There are a lot of things we can do to help patients and our pets. And I just always urge you, if someone tells you there's no more answers, find someone else or come come ask me. We can figure this out, man. I have my program for this exact reason. I had so many people reach out to me and say, I don't know what to do about this, what should do about this. And it's really hard to get the whole picture from just like a direct message on social media. So I started to do consults and then I was like, Well, people really want to know this information. They want to know how to be the best caregiver or the best member of their pets medical team, honestly. So I started teaching that program, which teaches you to basically be that that most important part of their your pets care team. And it's amazing to see the results that have come out of that, as well as my in person clients. I just I love the people that I get to help. And I I appreciate all of you so much. I appreciate you listening to this podcast. And I'm just in so much gratitude all the time about How many pets I get to help all the time. So Have you ever left the vet with more questions than answers? And then you drive home and you go straight on to Google. Yeah, I hear that a lot. And honestly, it's exactly why I created my senior pet virtual consultations. Imagine we have 45 minutes where we go through everything, your pet's full history, their specific challenges, their daily life, no rushing. We're gonna cover nutrition, integrative options, whole modifications, and quality of life. And I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog Loki feel better. This is the conversation that your senior pet deserves. And honestly, The one you deserve to. The link is in the description. I'd love to help you. Small tangent, but so ask for body condition score and muscle condition score. We'll want you to know those two numbers, okay? Or for muscle condition, normal, mild, moderate, severe. And for body condition a one through nine, we want to be about a four or five, right? Okay. So the blood tests. So we're gonna start with going through like some blood urine samples that may be recommended at your vet visit. The first one is our CBC, so our complete blood count. This is gonna check for white blood cells for signs of things like infection or inflammation, red blood cells for things like anemia and for platelets, so how well our body can clot. This is typically part of a bigger panel. So typically, if your clinic has what we call like a senior wellness panel, they're usually gonna put a couple of these things in there. If they're doing in-house blood work, it's gonna be usually a C B C chemistry. And that gives us a good general overview of what's happening, but not all of the answers. So that's where I'll go through some of these nuances with you. So CBC, our complete blood count, white blood cells, red blood cells, and platelets, chemistry panel. So this is looking at our organ function. So our pancreas, our liver, our glucose checking for things like diabetes, our electrolytes, and our kidney values. So we're gonna get a good overview of how well all the organs are functioning with this test. It is very important for people to know that blood work can be perfectly normal and pets can still have cancer. And I don't tell you that to scare you. I just want you to know, as someone who also works in emergency medicine, that the amount of times I have people come to me and I diagnose their pet with a tumor. or cancer in the emergency room internally in their abdomen or their chest or something. And they say, well, their blood work was normal a month ago. Yep. And it will be. And it probably still is today. It's different. So the body compensates really well. You can have a tumor on your liver and your liver can compensate for a long time before it's going to actually elevate those liver enzymes with a cancer. Okay. So it is important to have these values the C B C and the chemistry because it gives us a lot of really good data. Kidney disease does happen in a lot of these guys. You know, we can see diabetes in a lot of older pets as well, things like Cushing's disease, Addison's disease, these like excess steroids or decreased steroids in the body. A lot of these things can happen. So they're very good values to have. I just want you to know that little nuance of things. With The CBC chemistry, I always recommend having a urine sample tested as well. So we look for a urinalysis. This is going to help us get a complete answer on the kidney function. If our kidney values are elevated on our chemistry panel, it doesn't always mean that it's the kidneys causing that elevation. So the urinalysis helps us to complete that. It also is going to look for UTIs or any signs of like stones or you know concerns about diabetes spilling over into the bladder or anything like that. The next test that I always recommend doing is a book pressure. This is one that is very simple, but I would say 90% of vets don't do on senior pets. And it can be a little bit user, not specifically user error, but like it's difficult to do as vets because usually these pets are not always going to want to lay still. While this blood pressure cuff inflates and deflates and we hold something on their foot, right? Not a lot of pets enjoy that. And sometimes they, if they get stressed out, they can falsely elevate their blood pressure. And then we're like, well, is it real? Is it not? We don't know. However, it's still something I really recommend doing because 10% of senior dogs have high blood pressure or hypertension. And that can cause a lot of other problems. It can cause organ disease and the kidneys and the heart. It can cause Eye problems, so like vision loss, things like that. So I still think it's a very important test to evaluate, regardless of whether it's a little bit difficult to do, and it may be one that you specifically have to ask your vet about doing. Okay. And some breeds or types of pets may be more prone to that than others. So it's always something to have a conversation with your vet about. The next one. This is often on a wellness panel for senior pets as well, but if it's not, I recommend checking it. So a thyroid panel, ideally, we're checking T4, T3, and TSH. These are three different, basically. Thyroid is formed and made in a certain way, your thyroid hormones. So we want to make sure that it's forming the right way. And sometimes we can have a normal value. on one of those numbers, but the other ones are elevated or lowered. And that can still mean that we have low thyroid disease. Dogs typically are going to be low thyroid. So that means they're usually pretty sluggish, they're overweight, they don't eat very well, but their thyroid is not producing and breaking down metabolizing the way that it needs to. So we're actually having them have a decrease in their metabolism essentially. I believe there's a stat that's like up to 60% of dogs are gonna come up low on that thyroid test. So it's a pretty important one to check. Another one that we look at is the SDMA. So this is a new kidney marker. The kidney values on our chemistry panel show up elevated when we have about 75% damage to our kidneys. I know it sucks. It's just the way that it is. What we check for on blood work are enzymes and markers. And they're not always going to tell us when things are a little bit off. They're not gonna start climbing until they're really far off. So this SDMA is actually gonna tell us when there's DMH to the kidneys at just 25% DMH to the kidneys. So it's gonna catch this 50% earlier than our traditional markers do. It's really wonderful to have this test, and I definitely recommend asking your vet. If this is included on their typical commission panel. At this point, it typically is, but I want you to know what you're paying for. Like if you're going in there and you're gonna be dropping $500 to $1,000, which you probably are, if you do these things on your senior pets visit, like I want you to know what you're getting in all of these tests and what it all means. So that you can again be the most important member of your pets care team. Cause that's what we're here for, right? Okay. So what are we actually looking for in these tests? I covered it a little bit, but you know, in a good physical exam, we're looking for things like heart disease. We're also looking for crepitus and like joint damage, any lumps or bumps all over the body. So we're checking for do they have masses that are just like old dog skin tags or do they actually look like concerning tumors that we need to take a sample of, things like that. Heart disease happens in about 25% of dogs over the age of 10 and 35% of dogs over the age of 12. So this is really important to get a good listen to their heart and get those things evaluated. There is a test that we can do specifically for damage to the heart muscles. It's called a Pro BMP. It's a good first step if your vet hears a murmur and you're not at a place where you can afford a full cardiac workup yet with a cardiologist. That does typically run somewhere between $700 and $1,200 for cardiac workup. So if you're that hears a heart murmur, you can always talk about a Pro BMP test first. This is a good early indicator of damage to the heart muscles. And a pet can have a murmur without needing medication. So it's always important to make sure we get that evaluated. Okay. We talked about cancer not being detected on blood work. Now I'm gonna talk to you about there are two tests. One is a urine test called Oncotect, and the other one is a blood test called NoQ. These do test for a couple of the most common cancers that we see in senior dogs. Now, I say that with a grain of salt because these tests are great. They do typically give us like markers of like low, medium, or high risk for these diseases. And I have done one on my own dog when she had a mouse cell tumor and it did come up positive, which was really nice to know, but it can falsely alarm people. So it can make you nervous about something that's not really there. And then you do a very expensive workup and don't find anything. The other thing that we can see with this is that it doesn't always catch cancers. So the sensitivity of these tests is. I believe somewhere around 50%, depends on what we're testing for specifically. So it's not gonna pick up on a lot of these cancers, even these specific cancers that it says it checks for. So these are tests that are nice. I think the new cue, if your vet has it as included on like their senior panel, that's great. Or if you're a pet parent who's just like, I really want to make sure, you know, my pet has a high risk of something like hemangiosarcoma. Or mastle tumors or something like that, then you want to do these tests every three to six months. I think that's a great idea. My own dog had two mastle tumors already. So we do check those tests on her to try and evaluate do we have another one we should be worried about or anything like that. But they are available, just something that doesn't give us all the answers yet. We're also looking for kidney disease, which is gonna affect 10 to 30 percent of senior dogs. Again, that low thyroid disease. And then in general, again, arthritis is gonna affect 80% of dogs over the age of eight and essentially all dogs over the age of like ten to twelve. Like we never say all, but I believe probably ninety-five percent of dogs are gonna have arthritis, you know, by the time they're 10 or in their seniorhood. So I think it's important that we get a good idea of where those things exist. Now, with arthritis, are we going to X-ray to look for arthritis? Typically not, unless we can decide where that issue is, right? So when we're talking about like further testing, I think it's important for us to understand that in order to evaluate for where arthritis is in the entire body, we're gonna be looking We're gonna be doing full body x-rays. And those can get really expensive really quickly. Right. So if we are going to be checking for arthritis, typically it I believe it's better done on a good physical exam. And if we have severe limping on a certain area or a lot of pain in one specific area or something like that, then great, let's do some x-rays. If I say, Hey, he's really sensitive when I try and extend his hips. Let's take some hip x-rays because I want to know what those hips look like. Do we have hip dysplasia that was undiagnosed as a younger dog and now we need to evaluate that further? Or, you know, is there something else going on? Is there spinal pain that's leading over into that hip pain or something like that? So if we can define a certain area, yes, let's take some x-rays of it. But if not, then in general, we're gonna do that based on a good physical exam. So that being said, let's talk about. Imaging testing. One of those things is x-rays or radiographs, however you know them. So the pictures that we take that are a 2D image of the bones and the soft tissue. So we know that x-rays are going to light up bones really bright white. And that's really the best thing for us to see on x-rays. We're going to look at the bones, arthritis, things like that, look for like bone cancers or anything crazy. We don't see inside of the organs. We can see the organs. So I can see a kidney on an x-ray of the abdomen. And I can say if it looks like it's the normal size and shape. And I can see if there's like a stone in it or something. But we can't always see the functionality of the kidneys or the inside of the kidneys on an X-ray. Same with the liver, spleen, the GI tract, everything like that. So when it comes to looking for like cancers, We're typically going to be talking about an ultrasound instead, unless it's a big glaringly obvious mass inside of the body somewhere. We are usually looking for an ultrasound of the abdomen. And that's looking at the inside of those organs and seeing what they look like. X-rays of the chest are typically pretty helpful with things like heart disease or lung disease or anything like that. So if we're looking for anything like that, we're just typically doing x-rays of the chest. Now, x-rays start to add on a good bit of money. Ultrasound, not even all family veterinarians have ultrasound, nor do they all have the capability to do a complete ultrasound in the hospital setting. That's often done at a specialty hospital by a radiologist. So these can start to become a little bit more expensive as the tests go on. And then we talk about what would next steps be from there. So if your pet has a heart murmur, cardiology workout, echo, EKG, those types of things. If we're having some neurological symptoms, so like seizures that are new or dragging a limb and not having a nerve function or something like that, you know, we're talking about going to see a specialist for like an MRI or a CT scan, those things obviously can get into the thousands of dollars. But I don't think those things are things that we need to do for every pet or every year or anything like that. I think that the x-rays would be great if we can do those, you know, once a year, at least on an area that we're more concerned about. If your pet is a pet who's more prone to certain cancers, we can check that area of the body. If they are more prone to heart disease, we'll check the heart and lungs. You know, we we kind of just navigate those based on what we're more concerned about. And ultrasound would be something where if your vet offers that, if you want to do that, want to work that up, that would be great if you can and want to, but it's not always going to be feasible in a lot of general practices. And I understand that. So when we're talking about these things, we're talking about the cost of them. So we're talking about like blood work and urine on those types of things. We are typically talking. Somewhere in the realm of 250 to 600, $700, depending on your location. Radiographs tend to run around 200. Ultrasound tends to run anywhere from 300 to 800, depending on where you're at. So these things do add up. It's something I want you to have a very open conversation with your vet about what's best for your pet. So to recap on all of this. I want you to make sure that you're bringing the appropriate information into your vet visits. So make sure you're bringing the information about the food, the supplements, anything you want to give or have given, any concerns that you have. If you have videos of them doing anything abnormal or concerning, definitely have that and bring that information in. Any questions that you have that you want to make sure you get answered. And then ask about body condition score, muscle condition score. And then I want you to make sure that you are going through any concerns that your vet may have and you guys are coming up with a plan that fits within your budget at that time based on what your concerns are and their concerns are together, right? That is the whole idea of a really good vet client-patient relationship and what we all as veterinarians strive for. So if you are not feeling heard or understood or anything like that, and you In a place where you can get another vet's opinion or something like that. We are not going to be upset with you if for some reason I've had plenty of people who just don't, them and I are personalities, don't jive. And that is perfectly okay. I am not everyone's cup of tea. That is perfectly fine. There are also people that don't like tea, and that's okay. The thing is. I would rather you go somewhere where you feel a connection with that veterinarian and you feel comfortable and confident enough in having a conversation with them than you stay with me and we can't have the open conversation that you need to have to take best care of your pet. Because the most important thing to me is the care of your pet. And that is the most important thing to your veterinarian. So if you feel like that's not top of mind for everybody. Then I urge you to have a conversation about that with your vet if you're comfortable with it, or just find someone who you do feel like your personality meshes with because your pet's going to get the best care when they're in a situation where you feel the most confident in the care that's being given as well. So yeah. You are doing such a good job. I just want you to remember. This can be hard to hear and listen to about all these different tests that we talk about here and saying, ⁓ my gosh, I don't know that I can do all that. And I just want you to know that you are doing a great job. And the whole hope of this is that we find the thing that works for you and for your pet and gives them the best quality of life and makes you feel the most confident and comfortable in their care. So I hope that this episode helped and explained some things to you and made it make a little bit more sense. If you have any questions, please comment below on the podcast or please leave a rating or review. I would really appreciate that. If you love this podcast and you want to give us five stars, I really, really appreciate it. It means so much to me and to getting this out to other people. And if you have a question, you can always send me a DM on social media as well, dr.amanda.bet. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at senior petconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. And I am just here to give you more of it. See you next week.