Which cases should be referred for further investigation and treatment?

Which cases to refer for further investigation and treatment is a complex situation which cannot be answered in the same manner for every case. Many factors must be borne in mind when attempting to answer this question. One of the first factors to consider is the owner’s wishes and financial situation – what is the outcome that they wish and do they have the finances to support this. Have the owners been given all available treatment options? (RCVS Code of Conduct, 2014) [1]. With most dental conditions there are a number of different treatment options which will allow for a Plan A, Plan B and Plan C, all of which the owners should be made aware of. Another important consideration is what are the facilities, equipment and expertise available in-house rather than having to refer externally. If the facilities for treatment are in place and only a definitive diagnosis is lacking, then referral for advanced imaging and diagnosis before subsequent treatment by the referring vet is appropriate. Horses refractory to initial treatment attempts are often better referred for further investigation and treatment at an early opportunity before finances become restricted. Instances where referral to an individual with more dental expertise may be appropriate are outlined below. […]