Section 6: Consultations and Referrals
Top 3 Takeaways
- Referring veterinarians who proactively reach out to the specialty team before their first referral will be in the best position to establish an evolving relationship between the referring veterinarian, specialist, and client, sharing the goal of providing the best possible care and service along an efficient timeline for patients and clients.
- Collaboration between specialists and referring veterinarians to develop postreferral plans will optimally aid each client and patient.
- Veterinary telehealth is a versatile and powerful adjunctive tool that improves access to specialty care through teleconsultations.
In This Resource:
General practitioners often refer patients who have a diagnosis of neoplasia to their local board-certified veterinary oncologist. Direct and open communication, advice seeking, and eventual referral ought to be a stress-free, collaborative, and fluid process between the referring veterinarian and the oncologist, as well as a seamless, tension-free process in the eyes of the client. 1
Referrals occur when a referring veterinarian, who is the patient care provider before and during the referral process, transfers a patient’s care to a receiving veterinarian, who is then the one providing care from the moment the referral is complete until an appropriate endpoint.2
Collaboration, communication, and shared goals are essential for a working relationship among all individuals involved in the referral process, which includes not only clinicians but also veterinary technicians, referral coordinators, and client service representatives. A working relationship between teams committed to the highest quality of care, education, and service enhances the client’s experience and the patient’s outcome during a referral. Factors to consider when referring are listed in Table 6.1.
The recommendations in Table 6.1 include direct and open communication with the oncologist, which is vital to a successful referral. Such communication must be welcomed at both ends of the referral process. Telecommunication via the telephone or an online referral portal are immediate, direct, and convenient methods to initiate a referral and clarify what all parties need and expect. For additional guidance on well-ordered referral processes, see the 2025 AAHA Referral Guidelines at aaha.org/referral.
Telehealth Consultations in Oncology Cases
Veterinary telehealth is the overarching term that defines remote care using telecommunication technologies between two individuals who are in two different geographical locales. 3 Veterinary telehealth is now a commonplace, versatile, and powerful adjunctive tool to in-person brick and mortar practice that promotes contextualized care while improving access to specialty care through teleconsultations. 4,5,6
For more information on telehealth for small animal practices, see the AAHA/AVMA Telehealth Guidelines at aaha.org/telehealth.
TABLE 6.1 Referral Considerations for Oncology Cases
Referral Considerations |
Example |
|---|---|
Determine whether the desired oncological services are provided by the oncologist. |
A patient who needs radiation therapy is referred to a facility that provides it. |
Outline the costs of the referral consultation and the anticipated recommendations for the patient, which helps inform client expectations and clarify the purpose of the referral. |
A client desires a referral oncologist consultation to discuss their pet’s palliative treatment options because financial limitations preclude them from pursuing an ideal intervention of re-excision surgery followed by chemotherapy. |
Balance the urgency of the referral with the oncologist’s availability to accept that referral within the appropriate timeline. |
A lymphoma patient who requires immediate chemotherapeutic induction because of upper airway obstruction from submandibular lymphadenopathy is referred to an oncologist who can accept the patient that same day. |
Transfer the medical documents for the referral before the referral appointment. |
Blood work, radiographs, and cytology results are provided (e.g., via email, online portal, other online platform) to the oncologist before the referral appointment, including specialist interpretations (e.g., radiologist, pathologist) where applicable. |
Collaborate to ensure proper and timely postreferral care. |
Per the oncologist’s recommendation, the client approves adding immunohistochemistry to the biopsy sample that the referring veterinarian submitted. The laboratory requires the practice that submitted the sample to approve the test and receive the results. The oncologist must inform the referring veterinarian of the added test, and the referring veterinarian must approve the test in a timely manner and share the results with the oncologist upon receipt. |
Provide complete oncologist medical records and availability for follow-up questions to the referring veterinarian in a timely manner. |
Timely receipt of referral letters can avoid issues if chemotherapy-induced complications arise. |
The 2026 AAHA Oncology Guidelines for Dogs and Cats are generously supported by CareCredit, Hill’s Pet Nutrition, Merck Animal Health, and Zoetis.
Citations
- Burney D, Jones G, Byers C, et al. 2025 AAHA Referral Guidelines. J Am Anim Hosp Assoc 2025;61(2):28–45.
- Burney D, Jones G, Byers C, et al. 2025 AAHA Referral Guidelines. J Am Anim Hosp Assoc 2025;61(2):28–45.
- AVMA. Veterinary telehealth: The basics. 2024. Available at https://www.avma.org/resources-tools/animal-health-and-welfare/telehealth-telemedicineveterinary-practice/veterinary-telehealth-basics. Accessed May 21, 2025.
- Simonsen A. States must lift restrictions on telemedicine: Veterinary telemedicine saves lives, alleviates suffering and preserves the human-animal bond. June 12, 2023. Humanepro.org. Available at https://humanepro.org/blog/blog-states-must-lift-restrictions-telemedicine. Accessed May 21, 2025.
- ASPCA. Position Statement on Veterinary Telemedicine. 2024. Available at https://www.aspca.org/about-us/aspca-policy-and-position-statements/position-statement-veterinary-telemedicine. Accessed May 21, 2025.
- VVCA. 2024 Industry Report: Embracing the Future of Veterinary Care: Virtual Care. February 21, 2024. Available at https://vvca.org/embracingthe-future-of-veterinary-care-virtual-care/. Accessed May 21, 2025.