As the number of veterinary speciality hospitals in North America increases, access to speciality care for pets is growing. However, without enough neurologists to go around, how can these speciality hospitals offer advanced imaging to their patients? A neurologist can’t be everywhere, but their care can be thanks to telehealth.
Our guest author, Samantha Vitale, DVM, MS, DACVIM (Neurology), takes an in-depth look at teleconsulting, a form of telehealth that enables two licensed veterinarians to collaborate on a case and enhance the level of care provided to the patient. For veterinary practice focusing on neurology and orthopaedics, Magnetic Resonance Imaging (MRI) is key to obtaining a definitive diagnosis.
Veterinary MRI for neurology and orthopaedics
MRI has become an invaluable tool in veterinary medicine since its introduction in the late 20th century. The first veterinary MRI systems were developed in the 1980s, primarily for use in research and specialised practices. The development of high-field MRI systems provided enhanced imaging quality, making it easier to detect subtle lesions that traditional imaging techniques might miss. By the 1990s, MRI began to be integrated into routine veterinary practice, particularly in speciality clinics focusing on neurology and orthopaedics.
However, purchasing an MRI for your veterinary clinic is a lot more complicated than purchasing an x-ray machine, or at least it used to be. Typically, adding an MRI to your practice required a large space, special construction, a considerable financial investment, and astronomical maintenance, operational, and electricity costs. Additionally, running and interpreting MRIs is not covered heavily in the vet school curriculum and often requires additional training on the part of the technicians and veterinarians that are providing this diagnostic.
Increased access to speciality care
For these reasons, MRI has been considered a luxury afforded to only the most prestigious veterinary speciality hospitals and veterinary teaching hospitals in North America. In addition, there is an unwritten requirement that – in order to install an MRI – a hospital must employ a board-certified veterinary neurologist. With only 300 or so veterinary speciality hospitals in North America in the early 2000s, pets across the continent were left without access to this life-saving diagnostic modality.
As the number of veterinary speciality hospitals in North America has grown to 800+ in recent years, access to speciality care is increasing for pets. Recent data shows a notable increase in demand for specialty care as pet parents continue to prioritise their pets’ health. Insurance claims for canine neurology conditions have risen by 47% in the period 2019 – 2024, with the diagnosis and treatment of meningitis, intervertebral disc disorder (IVDD) and vestibular disease high on that list.
However, access to MRI is still lagging behind other diagnostic and treatment options provided at these hospitals. This is likely in part due to the stigma of MRI being expensive to obtain and challenging to operate, as well as the fact that there are still only about 550 veterinary neurologists who are board-certified by the American College of Veterinary Internal Medicine (ACVIM).
Without enough neurologists to go around, how can all of these specialty hospitals offer MRI to their patients? There are companies offering solutions to this problem.
Remote operations service
Pioneers in advanced imaging technology, Hallmarq Veterinary Imaging has solved many of the barriers typically associated with the installation and operation of MRI. Upfront costs, space, and magnetic shielding often prove a barrier to entry for practices looking to add this diagnostic tool to their hospital.
With Hallmarq however, the traditional route to offering MRI at your practice has been carefully reconsidered to make life easier. With a solution designed to reduce the cost, complexity, and commitment of offering 1.5T MRI to your patients, installing and operating your MRI need not prove a headache. Take for example, their Remote Operations Service (ROS)*.
ROS removes the need to employ a specialist MRI Tech to run your MRI system. Day-to-day staffing costs are reduced with access to Hallmarq-licensed MRI Technicians who can remotely operate the MRI system for you. This specialist service helps maximize image quality and minimize scan times. What’s more, by bringing remote expertise in-house and extending the capabilities of your team, ROS removes the cost of recruiting and training an MRI Tech whose annual cost can exceed $100,000.
Virtual veterinary neurology service
Teleconsulting is a form of telehealth that enables two licensed veterinarians to collaborate on a case and enhance the level of care provided to that patient.
When a veterinary specialist consults directly with another veterinarian, they do not need to be licensed in the patient’s state, nor do they need to develop a Veterinarian Client Patient Relationship (VCPR) with the patient and their pet guardian. This enables one veterinary neurologist to remotely assist with hundreds of patients across the continent, and even the world!
By utilising teleconsulting platforms, such as Stratocyte, veterinary neurologists can review a patient’s records, conduct video exams, and communicate with the veterinary team caring for a patient:
- Neurologists can help the presiding veterinarian conduct their exam, which helps determine the neurolocalisation, or part of the nervous system that is causing the deficits.
- They can help determine a list of differential diagnoses, as well as what diagnostics or treatments may be indicated.
- If MRI is recommended, the neurologist can view the images as they are acquired in real time, ensuring that a complete diagnostic study is obtained.
- The neurologist and a radiologist can then collaborate on the MRI images and help the presiding veterinarian obtain a diagnosis and a case management plan.
- The neurologist can even be available for follow up as that case progresses.
Thanks to technology and telehealth, you no longer need to have a neurologist in your building to provide quality neuroimaging services.”
Telehealth for collaborative care
The most common use case for this type of technology in its early days has been collaborative care between a surgeon in house and a virtual neurologist for dogs and cats with spinal cord injury. The most common cause of paralysis in dogs is intervertebral disc disease (IVDD), in which the discs between the vertebrae herniate or bulge, pressing on the spinal cord and resulting in pain and varying degrees of weakness.
IVDD is commonly treated with surgery, and this surgery is typically performed by either a veterinary neurologist or a veterinary surgeon. However, there are many other causes of spinal cord injury in dogs, and veterinary surgeons appreciate the ability to collaborate with neurologists to confirm their diagnosis and surgical plan, or to develop an appropriate case management strategy if the MRI shows a condition other than IVDD.
Telehealth for every patient everywhere
As the awareness of remote MRI and teleconsulting services grows, this technology can be utilised by veterinarians in emergency, urgent care, internal medicine, surgery, and even general practice settings to evaluate patients with seizures, spinal cord injury, and orthopedic conditions.
The need for advanced imaging extends beyond the physical reach of just 550 people. However, thanks to technology and teleconsulting, veterinary specialists can bring their care and expertise to every patient everywhere.
*Currently available in North America only
