New RVC study first to reveal impact of vet-owner relationship on canine epilepsy management

New research from the Royal Veterinary College (RVC) explores the role of vet-owner relationships in the experience of owners of dogs with epilepsy. The study found that clearer owner expectations for treatment outcomes and the condition’s management alongside more reliable resources outside of the consult room are needed to support positive vet-owner relationships.

Owners who reported positive experiences with their vets described the value of comprehensive initial explanations of their dog’s condition, seeing the same veterinary surgeon for each consult, and individual attributes of vets, including current knowledge on epilepsy management and good communication skills. These factors are likely to contribute to improved two-way vet-owner communication, owner satisfaction and adherence to care instructions. Resultingly, this partnership approach to care benefits all involved parties.

The implications of a negative relationship were also highlighted. Owners’ dissatisfaction with perceived insufficient expertise from their general practice vet (resulting in referrals to specialists), and when referred, poor communication between referral specialists and their primary care vet.

Owners’ pre-existing views and values were identified as drivers of negative experiences including strong dog-owner bonds leading to extremely high expectations for veterinary care. Another factor was pre-existing distrust and perceived biases of the veterinary pharmaceutical industry. Owners who had a more negative experience with veterinary surgeons were found to be more likely to perform their own personal research. This approach puts owners at higher risk of being influenced by the large volume of misinformation present online.

Canine epilepsy effects over 60,000 dogs in the UK and is the most common, chronic neurological disease in dogs. The condition can not only negatively impact affected dogs but can also significantly impact owners’ quality of life. Owners who not only endure the stress of witnessing their dog’s seizures but have the complex task of managing their dog’s condition on a daily basis.

Vets often report that they find epilepsy challenging to manage, particularly as a high proportion of dogs do not respond sufficiently to available medications. This study aimed to help provide a better understanding of owners’ wants and needs. Vet care can therefore be more empathetic, nuanced and benefit both the owner and the dog’s quality of life.

This qualitative investigation involved in-depth face-to-face interviews with 21 owners exploring the decision-making process behind the management of their dog’s epilepsy.

The results of the study led researchers to share their top tips for vets in order to improve care and management of canine epilepsy cases. This included advice on information delivery, particularly in early stages of care and the provision of resources for reliable information or support such as peer support groups.

Dr Rowena Packer, Primary supervisor on this study and Lecturer in Companion Animal Behaviour and Welfare Science at the Royal Veterinary College, said:

"Epilepsy is a challenging condition to manage for dog owners and veterinary surgeons alike. Owners’ emotions often run high due to the trauma of witnessing their beloved dog’s seizure, and the ongoing stresses of caregiving for their dog. In tandem, vets can feel frustrated at not always being able to reduce seizures as much as they’d hope. Combined, the capacity for disappointment and conflict is high.

"Forging strong, trusting partnerships of care between owners and vets is key to maintaining wellbeing for all three members of the ’treatment triangle’ - affected dogs, owners and vets. The first step towards this is striving for mutual understanding; the results of our novel study offers vets practical ways to achieve this."

Amy Pergande, Royal Veterinary College Veterinary graduate who conducted this research as part of her Master of Research degree, said:

"Our research highlights the need for collaboration within our profession to ensure that both pet owners and our veterinary colleagues alike have access to necessary support and resources, especially when managing such an unpredictable, chronic condition like epilepsy. Improving availability of reliable information sources for epilepsy management could help veterinary teams to confidently prescribe ’information prescriptions’ that boost owner confidence and help them to feel empowered to contribute more actively in decision-making for their dog, in partnership with their vet."

Dr Zoe Belshaw, EBVS Recognised Specialist in Small Animal Medicine, of EviVet Evidence-based Medicine Research Consultancy and co-author of the study, said:

"It’s easy, as vets, to assume we understand owners’ experiences in the consulting room, but as this study demonstrates there are often relatively simple things we can change that can make a huge difference to their satisfaction.

"Our research suggests owners really value vets taking the time, once the initial shock has receded, to share information, answer questions and signpost to external resources, including peer-to-peer support forums. Ensuring that owners feel confident and competent about caring for their dog with epilepsy is likely to benefit the dog, its owners and the veterinary team providing their ongoing care".

Pergande, AE, Belshaw, Z, Volk, HA, Packer, RMA. Owner perspectives on the impact of veterinary surgeons upon their decision making in the management of dogs with idiopathic epilepsy. Vet Rec. 2022;e2482.­/vetr.2482

Available at: https://bvajournals.onlin­elibrary.w­­oi/10.1002­/vetr.2482