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1. Cancer care poppycock
Just this week I've been asked three times about the use of ivermectin in cancer care for pets. Moreover, just two weeks ago my practice saw a patient that expired after receiving feed store-sourced ivermectin injections. Just tragic.
Cancer care is probably the most popular subject for which our clients hit up the web for advice. Ads for foods, supplements, drugs, and other products that purport to either prevent or vanquish cancer abound. Social media posts attesting to excellent outcomes after employing these measures are altogether too prevalent. And, sadly, some people buy this drivel wholesale.
Meanwhile, I continue to tell my clients the number one cause of cancer is genetically driven. Unfortunately, however, it's never popular to recommend your clients steer clear of purebred pets (upwards of 80 percent of my canine patients and 20 percent of my feline patients are purebreds). FYI, this opinion never goes over well unless it's delivered obliquely—and only after a client directly asks what caused their pet's cancer: "We don't know, but we do know purebred genetics play an outsized role."
2. Random remote telehealth queries
Telehealth is all over social media. It's also become normalized by human medicine via services where my clients seek out specific medications their GPs aren't likely to recommend (weight loss drugs are big in my area). Plus, the pandemic made it almost mandatory. Unfortunately, telehealth isn't exactly my bag. I hate my phone and detest Zoom or FaceTime even more.
So when clients call demanding telehealth services, especially the random, remote calls I receive from other states (and even Latin American countries), I always politely decline. The wrath I once incurred by requesting a reasonable sum for a teleconsult proved conclusively that it just isn't worth the stress.
Take a hint: If you never plan on becoming a regular client and you can't pay $250 for 30 full minutes of our time then you shouldn't be asking a brick-and-mortar vet for one-off telehealth appointments. Find an online service instead.
3. Unmerited vaccine exemption requests
It never ends, this relentless slide into anti-vax hysteria. Sure, vaccines aren't for every pet. For example, my pug has an MUE and can't get near a vaccine. Nor will I vaccinate pets with specific chronic diseases or previous serious vaccine reactions. Giving in to a client's demand for a rabies vaccine exemption because their Facebook group claims it causes cancer is neither ethical nor legal.
4. Anesthesia-free dental care demands
We've seen this industry grow and prosper, partly as a reaction to an online proliferation in overblown reports citing the danger of anesthetics. The newest concern is anesthesia leads to long-term cognitive decline, which has thus far proven impossible to tease out in human medicine (procedure, drugs, and pre-existing conditions are confounding variables).
Much though we may discuss the facts surrounding anesthesia-free dentistry (considered merely cosmetic) and the real-world risk of anesthesia (especially for shorter procedures), the path forward for routine anesthetic dentistry, in particular, is increasingly strained by anecdotal and incomplete evidence.
5. Health certificate expectations
Most clients expect their regular vets to handle their international health certificates—which they assume aren't necessary now that their pet is a "service animal."
Since I practice in one of the most international cities in the country, these requests come fast and furiously. Unfortunately, though, the pandemic screwed up everything as countries added more stringent requirements. Plus, now that the USDA has been decimated by cuts, it's become a veritable nightmare to get some certificates through on the first try.
Hence, I now refuse to issue these—at any price. The legal and reputational stakes are simply too high should things go wrong (and they will.) Which is why I let my USDA certification lapse and work with a mobile doc who's happy to get the referrals.
6. Continued high demand for cosmetic surgery
Why in 2026 are we still cropping ears, docking tails, removing dewclaws, and performing declaws in cats? In dogs we can chalk it up to purebreedism and AKC standards. In cats we can only call it cruelty. While the latter is on the decline, not so much on the U.S. breed standard thing. For example, convincing a Giant Schnauzer breeder to keep her latest litter dock- and dewclaw amputation-free took an act of God (and a lot of EU pics to prove they really do look great with tails and toes intact).
7. Reproductive care queries
By now you know how it feels to look at your list of appointments and see "spay consult" on your docket for the day. The spay/neuter conundrum that's come out of the past decade has made the subject a messy and convoluted (yet necessary) one. I now preempt the visit with a handout I'll email them before the visit. Keeps the visit quicker and sometimes eliminates the need for a pre-surgical appointment.
8. Continued decline in parasite control product compliance
Parasite control is another casualty of online culture. Which I find interesting given those who demand ivermectin for cancer care overlap significantly with those who refuse to administer tiny doses on a monthly basis. Weird, right?
How I handle the frustration
To manage all of these discussions, I preface my answer by explaining veterinarians are scientists who expect to see credible evidence before making recommendations. I tell clients our job is to manage the risks and rewards and hope they trust us enough to give them the best information available.
Honestly, there's not much more we can do except behave empathetically, even when we want to throw our stethoscope across the room and storm out. Indeed, after my third ivermectin conversation last week I nearly lost it. The pause was long and uncomfortable but I recovered and explained the research. I even invited them to hit up Chat GPT for advice on the subject. "But, sure, if you want to treat your dog with a malignant melanoma with ivermectin, it's a great question to ask the oncologist." (Unsaid: "Just leave me out of it.")
Sometimes you just have to take a deep breath and curse online culture later. Our profession—and our professionalism—demands nothing less.
Patty Khuly, VMD, MBA, runs a small animal practice in Miami and is available at drpattykhuly.com. Columnists' opinions do not necessarily reflect those of VPN Plus+.
