The Importance of the Recheck Exam
When treating medical conditions, the veterinarian will sometimes recommend a recheck exam to assess the outcome of the therapy. Recheck exams can be performed for a variety of conditions but they are almost always recommended for skin, ear and eye problems. Why?
The short answer is that these conditions can be difficult to treat. There is no “one size fits all” therapeutic approach. Recheck appointments for assessment of the response to therapy and then revision of the treatment based on how things are going is not only important but in many cases, absolutely critical to a successful outcome.
Let’s use an example to illustrate the point. Duke is a 3 year old chocolate lab that came in for shaking his head. During his physical exam, the doctor discovers that he has an ear infection. Checking a sample of the wax reveals abundant numbers of yeast. The doctor discusses potential causes of otitis and Duke is sent home with ear cleaner and a topical medication to reduce inflammation and to kill the yeast overgrowth. A recheck is recommended for 2 weeks to assess Dukes response to the recommended therapy. Duke and his owners return two weeks later reporting that he is much more comfortable and they are no longer seeing dark debris when cleaning. An otoscopic ear exam reveals 90% improvement. Excellent! An ear swab is taken and low and behold there are still large numbers of yeast organisms. At this point, if treatment were stopped it would just be a matter of time before the ears were uncomfortable again. The steroid in the ear medication helped the inflammation and so Dukes ear feels better. The medication has also been effective at partially clearing the infection; however, the ears are not “fixed”. At this point a decision needs to be made as to continuing therapy longer, changing therapy or looking for an underlying cause for the persistent infection.
Without recheck appointments, we basically are left with assumptions that the pets get better. This is a fine approach as long as they really do. Unfortunately, especially with chronic and frustrating conditions like skin and ear disease, there is just no way of knowing, and ultimately of helping, unless we look again.