How well do veterinary clients assess urgency?

It is eleven at night and a client’s dog has vomited twice since dinner. He is a little quieter than usual but still wagging his tail, still drinking water. The client is trying to decide whether to call the practice, search the symptoms on her phone, or wait until morning.

This is the kind of decision veterinary teams see play out again and again. A new study from the Royal Veterinary College set out to understand how clients make that call, and how often their instinct lines up with what is clinically appropriate.

That 2026 study, published in PLOS One, surveyed 1,772 people across the UK who have a dog, using 30 hypothetical scenarios drawn from real clinical histories in VetCompass, a UK database that pools anonymized veterinary health records from thousands of practices to track disease patterns at a population level.

For each scenario, participants said what condition they thought the dog had and how urgently they believed it needed veterinary care. Their answers were then compared against the judgment of 14 experienced veterinarians.

Two separate skills, not one

The study’s central finding was that recognizing a condition and judging how urgently it needs treatment turned out to be two very different skills.

“I think this finding tells us that recognizing a problem and deciding what to do about it are two distinct processes,” said Rowena Packer, BSc (Hons), PhD, PGCert(VetEd), FHEA, Senior Lecturer in Companion Animal Behavior and Welfare Science at the Royal Veterinary College and one of the study’s authors. “Even when owners correctly identified a condition, they did not necessarily appreciate how quickly veterinary intervention was required.”

In fact, in nearly a third of cases, owners judged a condition to be less urgent than the veterinarians who reviewed each scenario.

Michelle Farrow, BSc (Hons), MRes, RVN, Research Assistant and PhD Candidate at the RVC, and another of the study’s authors, pointed to how that gap shows up at home. “If a dog appears comfortable, continues eating or behaves relatively normally, owners may assume the condition can safely wait, even when veterinary intervention is time-critical,” she said.

The conditions that hide in plain sight

Clients were most accurate at naming conditions with obvious, visible signs, such as kennel cough, flea infestations, epilepsy and osteoarthritis. They struggled most with conditions that progress with few outward clues, including mast cell tumors, glaucoma, and gastrointestinal foreign bodies.

When presented with symptoms of otitis externa, clients often recognized it correctly, yet more than half judged it less urgent than the veterinarians did, the widest gap of any condition in the study. That is of particular concern, as otitis externa is painful, and is likely to worsen quickly the longer it goes untreated.

Heat stroke showed a similar pattern, generally recognized correctly but still underestimated when it came to urgency, despite its potential to kill within hours.

Glaucoma and corneal ulcers proved even harder for clients on both fronts. They were among the least accurately identified conditions in the study, and were also frequently rated less urgent than recommended, despite the risk that either can cause permanent blindness if left untreated.

“Another important factor may be the phenomenon of normalization,” Farrow said. She explained that owners tend to read new clinical signs through the lens of past experience. If they’ve previously seen symptoms like panting, squinting, or mild discomfort resolve on their own without serious consequences, those same signs can come to feel unremarkable the next time around, even when the underlying condition is more serious.

Farrow pointed out that high-profile campaigns like “Dogs Die in Hot Cars” have done a good job warning owners that heat stroke is fatal. But she noted those campaigns mostly focus on prevention, not on helping people recognize and respond to it once it’s already happening.

“Heat stroke is particularly interesting because many owners recognize overheating but may not appreciate how rapidly deterioration can occur or what actions should be taken once heat stroke is suspected,” she said.

Rethinking Dr. Google

“One of the most surprising findings was that internet searching was not associated with poorer performance,” Packer said. “Owners who reported using the internet as an information source were not worse at identifying conditions or assessing urgency than those who did not.”

Specifically, clients who used the internet to help answer the vignettes scored slightly higher on accuracy, not lower.

Farrow suggests that the internet has potential to be an asset rather than something simply to be tolerated. “Owners are increasingly using online resources as part of their decision-making process and online information can sometimes be beneficial,” she said. “In this way, internet searching becomes a complement to veterinary care rather than a substitute for it.”

One noteworthy distinction was the difference between searching the internet broadly vs. looking at specific sites or resources. Clients who used general online dog groups, such as breed or sport communities, were less accurate and more likely to underestimate urgency, while those who used condition specific health groups tended to judge urgency more appropriately. This could prove to be important information for veterinary teams seeking to guide clients to use the internet more effectively.

Which online communities help, and which don’t

Natasha Janke, PhD, Assistant Professor at Colorado State University and Director of the Veterinary Communication for Professional Excellence program feels the profession has often dismissed all online searching under one label.

“I think it’s been so frowned upon for so long, like, oh, Dr. Google.” She went on to explain that the internet has more to offer. “I think there can be so much benefit for pet owners, especially with the condition-specific groups, because not only might they be getting information that can help them, but they’re getting the support from other pet owners who have been through a similar experience,” she said.

Research published in the journal Veterinary Evidence in 2021 supports the value of keeping a conversation open between clients and their veterinarians about the way they are using the internet. As Janke put it, “One of their main outcomes of that study was showing that pet owners who felt that they could openly discuss what they were finding online had stronger relationships with their veterinarians.”

When AI joins the conversation

The data behind this study were collected before generative AI tools became part of daily life, but the same question—where people get their information and how reliable it is— applies just as much to AI as it does to online groups. Janke pointed to this as a growing concern.

“Misinformation is a huge one because we don’t know always where AI is pulling its sources from,” she said, noting that AI summaries can present unverified content as established fact. At a recent veterinary conference, she watched a search on dog vaccination return an AI summary built partly on anonymous Reddit posts. “You don’t know anything about [the sources], and it’s in your AI summary as information that you might believe to be true and accurate,” she said.

For Janke, that risk presents an argument for practices to be more visible online. “It’s also valuable to understand where people are getting their information from so that those areas could be potentially targeted by veterinary practices,” she said. That starts with building out clear, well-sourced content on a practice’s own website, since strong owned content tends to rank better and gives clients somewhere reliable to land. But because AI tools often pull from wherever the conversation is already happening, it may also be worth practices having an accurate presence on the platforms feeding those searches, including Reddit, Facebook, Instagram and TikTok, rather than leaving that space entirely to anonymous posters.

Building better bridges between practice and client

One of the study’s findings that might be of most interest to veterinary practices is how the relationship between the practice and client affects the way clients understand the urgency of a medical condition. “We found that owners who routinely sought information from their veterinary practice were more likely to assess urgency appropriately,” Packer said.

Asked how a practice might encourage that kind of contact without overwhelming its team, Janke said the answer is not to ask more of the current system, but to adapt it. “Something I’d be interested in exploring more is the use of [tele-]triage services because I think that can become very overwhelming for a practice [with] the way practices are currently set up,” she said. “Maybe the model needs to shift.”

She pointed to Canada, where many practices already offer after hours phone-based triage, questioning why that support stops once the clinic reopens. She suggested that practices might incorporate those services, even during clinic hours, so the team is not overwhelmed with answering phone calls.

She also drew on her own experience after recently moving to the United States from Canada and registering her son with a new pediatrician, where she was given a phone number for a 24-hour nurse triage line, available whether the office was open or not. Reflecting on what a similar model could offer veterinary clients, she said, “Imagine if there was that service available 24/7 to call and help you decide, is this urgent? Do I need to go to an emergency clinic?”

Where a dedicated triage line is not yet realistic, Janke pointed to consistency among whomever answers the phone as the more immediate priority. “Something that I saw and is reflected in the human medical literature that can be really helpful to improve relational coordination, is cross-training,” she said. Training receptionists alongside technicians helps a practice agree on what counts as urgent.

Closing the urgency gap

Farrow stressed the most obvious and, possibly, essential recommendation that could come from the study. “One of the clearest implications of our findings is that education should focus not only on recognizing disease but also on understanding urgency,” she said.

Seeing the benefits of having a client base who is better equipped to recognize the seriousness of symptoms in their dog, Packer said, “Many welfare outcomes are determined before a dog ever reaches a veterinary clinic. Supporting owners to recognize problems, assess urgency appropriately, and access reliable information may therefore be one of the most effective ways to improve canine welfare at a population level.”

What this study adds to the conversation is a more precise picture of the challenges clients face in their decision-making.

In most cases, the issue is not that the client has failed to notice that something is wrong with a dog. The challenge lies with the judgements that determine how quickly this needs attention, and what happens if it waits. That is a welfare issue, because the time between a symptom appearing and a dog reaching a clinic is time a veterinary team has no control over.

Closing that gap is unlikely to come from a single fix. It is more likely to come from the kind of work this study points toward.

Clearer client education that goes beyond naming conditions to explaining urgency, consistent communication within practice teams so that whoever answers the phone gives the same advice, and a client relationship solid enough that people feel comfortable reaching out before a problem has become an emergency. A devoted triage service, the kind Janke described, could be part of that solution too, giving clients a reliable place to call before deciding whether a problem can wait.

None of that requires correcting clients for getting it wrong. It does mean meeting them earlier, with better information, easier access to guidance, and a standing invitation to call before a treatable problem becomes an emergency.

Photo credit: Olena Miroshnichenko/iStock via Getty Images Plus

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