Televeterinarian

When the Mr. Mo Project decided to rescue a French bulldog named Mercury in October, they expected to have a tough year ahead of them. Four months prior, Mercury had been diagnosed with a spinal compression, which had left him with severely limited mobility in his hind legs. The project saved him in order to give him a fighting chance at life but their hopes rested on whether or not they could get him to even stand.

Briefly, after a course in puppy school with his new canine mobility cart, Mercury was walking on all-fours, said Mariesa and Chris Hughes, co-founders of the Mr. Mo Project. But as Mercury grew, his spinal compression worsened. By December, he was pretty much paralyzed in his back legs, said Mariesa. 

Surgery wasn’t an option because Mercury’s condition was too severe, so continuing his physical rehabilitation was his only hope. But it was taking a financial toll on the organization.

”He’d done rehab and water therapy at a vet’s office prior to COVID, but it’s very expensive to do. It was 1,200 dollars for 10 sessions, and they wanted him to go two to three times a week. It was also 45 minutes away,” Chris Hughes said. “We did that for a couple of months and then we decided to get our own unit.”

To cut the cost of his therapy, the couple purchased an underwater treadmill for animals. They said that it seemed like a worthwhile purchase since they currently house 19 dogs and care for 103 in total. But they quickly realized that they lacked the essential know-how when it came to helping their pet use the machine; they still needed professional guidance. Then, just as Mercury’s first consultation date at the Cornell University Hospital for Animals approached, the hospital closed its doors to non-essential procedures.

Normally, this would’ve spelled defeat for Mercury and dogs facing similar obstacles. But on March 24, the FDA announced that it would temporarily loosen “certain requirements in order to allow veterinarians to better utilize telemedicine to address animal health needs during the pandemic.” 

Dr. Meg Thompson, Associate Dean for Hospital Operations and Corporate Relations for the Cornell University School of Medicine, said that the changes to the law effectively allow vets to offer telemedicine to animals for purposes such as consultations and follow-ups.

Prior to the temporary adjustment, laws regarding veterinary medicine only allowed for teleconsultation to occur vet to vet. The VCPR (veterinarian client-patient relationship), the basis for standard interaction between veterinarians, patients and clients, required that veterinarians have a basic personal familiarity with the animal of concern. This meant that any veterinarian who served as a clients primary contact for all veterinary services was expected to be familiar with their client, their livestock/animals, and their operation. The law primarily pertained to livestock, but limited all animal medicine equally.

“The interesting part about the VCPR is that the FDA said that it’s okay, in the [context of the] pandemic you can do what you need to do,” Thompson said. “It was felt by us that we needed to provide care as best we can for people who cannot travel, or who we don’t want to travel because they live in NYC.”

For Mercury and the Hughes family, who reside three hours away from the Cornell hospital in Clifton, NY, the new temporary adjustment is a godsend. They’re now able to access Mercury’s doctor for consultations and perform his therapy at home without having to make the long drive to Ithaca.

“We were very lucky to connect with Dr. Frye when we did because he told us what speed to put the treadmill at, how to keep Mercury’s legs from crossing, how long to do each session, what exercises to do before and after,” Chris Hughes said. “To be able to have access to [Cornell vets without having to make the three-hour trip every time is really an awesome opportunity.”

Teleconsulting isn’t a perfect alternative to in-person appointments, said Dr. Christopher Frye, who is overseeing Mercury’s treatment. The appointments take longer because instead of assessing the patient’s problem through personal observation and a feel that he’s gained over the years, he relies heavily on his client to tell him what they’re noticing and perform tests the way he needs them to. He described the experience as similar to playing a game of Helping Hands.

“I think a big obstacle for me is describing how I want the family to move and position the patient for my visual assessment and then to try to get feedback from them: ‘how does the dog feel to you in this position? Is he able to maintain balance or do you have to help him a lot?’” Frye said. “It’s interesting to try to get someone to describe that in words as feedback when normally I would do it in seconds myself and know exactly what it is.”

He said the process required a lot of patience. Using his own dog on camera to model what he wanted the Hughes family to mimic with Mercury was a great advantage. 

“The family was really capable of doing a described task,” Frye said. “I would demonstrate it on my own dog in front of the camera and then they would mimic that, and I could watch them and give them suggestions on how to improve their technique, and they were very responsive to that. I thought that was fun, and we had to think a little bit out of the box, and it worked.”

Since his first consultation in early April with Dr. Frye, Mercury’s hind leg strength has improved significantly. 

“I don’t think Mercury will ever walk but he’s got strength in his back legs now,” Hughes said. “He’s able to stand for quick seconds.”

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