General practice veterinarians are the first line of defense, and increasingly need to refer clients to specialists for more advanced diagnostics and care. The book lists the veterinary schools in the United States, where many specialists practice. You can also get a good idea from the book as to whether a specialist might be able to do something for your ailing companion animal that your general practice veterinarian cannot do. This will then empower you to ask your veterinarian for a referral.

Veterinary Specialty Colleges are organizations of veterinary specialists who are board-certified in certain areas. The book gives contact information for these Veterinary Specialty Colleges (many of these have websites to help you locate the board-certified practitioners nearest you; the Veterinary Information Network also maintains a listing of specialists in the US and Canada at http://www.vetquest.com/):

* Theriogenologists (reproduction) * Anesthesiologists * Behaviorists (There are only 23 board-certified veterinary behavior specialists in the world, 19 in the United States, with another half-dozen a year expected to be certified.) * Dermatologists * Veterinary Internal Medicine (includes Cardiology, Neurology, Oncology, Endocrinology and more) * Nutritionists (these are mostly in academia or the pet food industry) * Opthamologists * Radiologists * Surgeons (There are nearly 1000, over half of them in private practice or referral centers.) * Dental Specialists

Among the advances in medical tools are ultrasound, or echocardiography, for cardiac patients. This noninvasive procedure has largely replaced cardiac catheterization. In neurology, CT scans ($100 to $400) and MRIs ($300 to $1000), mostly available in veterinary schools and secondary private referral centers, have spawned the biggest advances in recent years.

Endoscopy can now view the respiratory, digestive and urinary tracts, and well as some areas of the abdomen or chest. Arthroscopic procedures that cause less trauma than larger incisions are now available for dogs and cats. Lasers are used in dermatology, skin cancer therapies, glaucoma, retinal detachment repair and other surgeries and diagnostic procedures.

Remote-access diagnostic procedures allow some tests to be done in the general practitioner's office and analyzed by a distant specialist. Nutritional advances include therapeutic diets available only through veterinarians, to help manage various health conditions. Vaccination advances include genetically engineered vaccinations which should be safer than older forms.

Advances in medications include artificial blood transfusions, ACE inhibitors, pain management, a resurgence in compounded medications (more precise dosing and easier to administer to your dog or cat), and behavior medications. Chewable buffered aspirin is now available in a dog-appealing flavor.

Physical therapy for pets is enhancing the benefits of surgical procedures, and in some cases replacing surgery. Over half of veterinary surgeries are orthopedic procedures, and advancements in techniques (such as the Tibial Plateau Leveling Osteotomy for ruptured cruciate ligaments in dogs) are improving results. Organ transplantation as well as limb-saving bone grafting are on the increase, as well.

Eyeglasses and hearing aids are available for dogs. Feliway is aromatherapy for cats that can calm the urge to spray in the house, and help veterinarians handle frightened felines. Perianal urethrostomy (P/U) surgery for male cats who become blocked (from crystals mixed with mucus in the urinary tract) removes the penis, in order to shorten and widen the male urethra. The WoundWear Body Suit prevents a pet from injuring a wound or surgical site, while not interfering with freedom of movement as an Elizabethan collar does.

Shojai doesn't shy from discussing the ethical issues of cutting-edge medicine. The cost of some procedures is out of reach for many owners. The quality of life for an animal being kept alive by heroic measures must be taken into consideration, especially since it is increasingly known that animals feel pain, but do not show it in the same ways people do. Is it ethical to sacrifice some dogs and cats in order to develop treatments that may save others? How do you feel about tissue being harvested from euthanized laboratory and shelter dogs and cats to be used in treatments for companion animals?

The true stories of cutting-edge treatments used on real dogs and cats will give readers much food for thought. In the end, Shojai's words say it best: " When you make a decision from the heart that is based on the best information available to you at the time, it cannot be wrong." The book Pet Care in the New Century: Cutting-Edge Medicine for Dogs and Cats will help you find that best information.

Copyright 2003 by Kathy Diamond Davis. Used with permission. All rights reserved.