Dr. Angie Krause (00:00)
Welcome back to Tails of Truth, where we tell the truth about veterinary medicine. I'm Dr. Angie, and this is my co-host and veterinary nurse extraordinaire, Jojo. And we are coming to you to talk about medical advice from chat GPT and why it's probably not the best.

JoJo (00:21)
interesting is that I wonder because we've gotten medical advice, we consumers from Google, so is chat GPT different?

Dr. Angie Krause (00:30)
It appears so, it appears so. I actually, so you and I both have been really sick. So JoJo and I might cough in this episode, we might have a sniffly nose. We have been sick for three weeks. Four weeks. I had to, that's right.

JoJo (00:43)
Four weeks? I know, I thought that's how you were gonna say we're

coming to you. I was like, so our voices aren't gonna sound the same. Both of us have, I have puffy eyes, I can kinda tell you have puffy eyes. No, I'm like, oh man, but we're doing it, cause it matters to us to be here.

Dr. Angie Krause (00:50)
No. I don't.

Well, and JoJo, I've missed you.

JoJo (01:04)
I was gonna say the same thing like hey It's so nice to see we have not even been like I've had no voice. It's been I Haven't been this sick. I Don't I don't even know I can't remember

Dr. Angie Krause (01:11)
No.

I mean, it's been catastrophic for both of us. I had influenza and then went on to develop a sinus infection, ended up in the ER and to the doctor a couple of times. Two antibiotic choices later. I think I am getting better, but it's like, I'm not, I'm not quite right.

JoJo (01:38)
I didn't test positive for anything, which is kind of my MO. I never light any tests up, so I don't know what that is, but now we're treating it as walking pneumonia and that I'm on my third antibiotic, which would be interesting episode too because the second antibiotic they gave me, I had hallucinations, nighttime like terrors, panic attacks, and then my bones hurt so

Dr. Angie Krause (01:42)
Yeah. Yeah. Yeah.

JoJo (02:03)
It cannot even describe how bad my bones hurt. And like, yeah, this is bad. There are CNS effects. And I'm like, are there animals that have side effects that they can't tell us about? Which is something I would look up on chat. GPT and chat and I have had quite the relationship. Actually, I've moved over to Claude. So Claude and I have quite the relationship and I have asked medical advice.

Dr. Angie Krause (02:14)
Right? Yeah.

Ha

And has it been good?

JoJo (02:31)
Well, how can I know? Well, I did tell it I was having hallucinations on this medication and how bad my bones hurt. And it was immediately like, that is a side effect of that medication, known side effect. So call your doctor and she's like, yeah, it is. It can cause those symptoms. And I'm like, great. Well, I don't want to do this. Although I did get to see my dead dog in one of my hallucinations and that was kind of lovely and not, because if I got too close to him, he like,

Dr. Angie Krause (02:36)
huh.

Yeah.

Did you really?

JoJo (03:00)
fluttered away so I had to step back and then he would come back and so was like interesting so I like I would keep hallucinations for that. Yeah anyhow that's kind of illness so maybe our episodes are going to be fever dreams who knows what's coming to come out today. Yeah.

Dr. Angie Krause (03:08)
for Bodhi.

⁓ my gosh, the fever dreams.

Well, I wonder if Claude hallucinates the same way chat GPT does. And I have a story. Sometimes I write articles for different publications and it was maybe a couple of years ago. I was asked to write an article about

feline pain and how we can handle it integratively. And so I was like, I wonder if chat GPT will write this for me, do an outline, get me sources. Cause you know, I do it the old fashioned way. I looked through the literature for hours, making sure I am up to date. What's the new thing? Because a lot of these are peer reviewed and the one I was doing was peer reviewed. I need,

you know, I need to cite my sources. And so I asked it, was like, will you give me these sources? And then will you write it? Because I just wanted to see like, I would not have submitted it written by chat GPT, but I wanted to see what it would do. And not only did it hallucinate facts, but then it hallucinated the articles that like, I was going to cite for those facts.

JoJo (04:31)
I just made them up.

Dr. Angie Krause (04:33)
just made them up like we've studied gabapentin in cats and here's this study about it. And I'm like, okay, so I go to PubMed, there's no study. There's no such study.

JoJo (04:45)
that's so bad.

Dr. Angie Krause (04:47)
Yeah, and so when people are like, I put this in chat GPT, I mean, sometimes it's right. And a lot of times it's not. So.

JoJo (04:53)
Mm-hmm.

Yeah, I

feel like Claude is a little bit more... How do I say it? Chat GPT seems very generalized and very... I don't know a nice word. Very basic. Let's just go with basic. Claude is a little bit more mature. Is that... Like, we'll actually tell you.

Dr. Angie Krause (05:10)
I mean, okay, okay. I mean, it sounds like a more mature name, Claude.

JoJo (05:22)
You're not on the right track at all. Whereas now where chat GPT is like, what a beautiful question, how thoughtful of you to ask this. Claude like, no. So I feel like that's a little bit more mature. But it's interesting because I only think of chat GPT right now. Well, not I think about it in my daily life. Right. But and I use it for everything or Claude one or the other. But

Dr. Angie Krause (05:24)
it'll hurt your feelings!

Yeah. Yeah.

JoJo (05:49)
I think about it more from an SEO standpoint because we're moving away from Google. So I'm thinking about it from a business standpoint all the time. So where is it gathering its information? It's gathering its information from anybody who said anything.

Dr. Angie Krause (05:58)
Right.

Right, well people are finding us on chat GPT. They're like, I have an itchy dog. Yeah, I have an itchy dog. Who should I go to? And chat GPT tells people like, come see Dr. Angie at Boulder Holistic Vet. Which is, I would, love to help them. I love a good itchy dog, but like I, yeah, it's such a strange, strange application. So when someone's typing in,

JoJo (06:09)
So if we could say anything, yeah.

Yeah.

Dr. Angie Krause (06:32)
my dog has these symptoms or my cat has these symptoms. What is it? People come into the exam room feeling like, well, chat GPT said this, so it must be right.

JoJo (06:42)
And they're saying

it out loud, whereas before Google, kind of people like I googled this, which now I'm understanding the difference when you Google something, you have to click on the site that you trust for the information. So it just gives you a searchable database. Whereas chat GPT is like, here's the answer and doesn't really tell you where it got the answer because I only plugged things into chat GPT was saying, you're not allowed to lie to me. I need you to cite and source anything.

Dr. Angie Krause (06:53)
Right. Right.

Yeah, and it's gonna hallucinate. Maybe, but maybe not. Some of the sources were not hallucinations, but at that point, I never used it again, like for anything medical or anything that I needed. so, I mean, but here's the other part of this. Like when we tell people not to Google their pet symptoms, that's so unrealistic.

JoJo (07:11)
So then I can check it and make sure it's accurate.

Dr. Angie Krause (07:35)
I mean, we Google our pet symptoms sometimes. guess I just feel like, you know, as much as I want to say, don't use chat GPT, what I really should say is please understand the limitations of chat GPT and still like trust your veterinarian or at least have a conversation with your veterinarian about it because it might be hallucinating. might, you know, at the end of the day,

JoJo (07:39)
100%. Yeah.

Dr. Angie Krause (08:02)
AI just can't replace practitioners. Yeah, it can't replace 20 years of clinical practice. it just, I can't do it.

JoJo (08:06)
Absolutely not.

No,

mean, you can't doubt, if it could, then every veterinarian would never have to lay hands on an animal while they're studying. You could just learn academically from a book.

Dr. Angie Krause (08:20)
Totally.

Yes, you could just, yeah.

JoJo (08:26)
So what your client brought in, was it accurate or was it not accurate?

Dr. Angie Krause (08:30)
No, a lot of times when people say, chat GPT said it could be this, and it pulls, it will pull in some like really random disease that we'll often in medicine call zebras or like something that's so rare. We're like that.

That's so unlikely. Like maybe you have a symptom or a condition and like 95 % of the time it's this medical diagnosis and like 1 % of the time it's something else. And so I'm finding that AI is kind of leading people down rabbit holes that are probably not productive.

JoJo (09:06)
And we've always

been pro like if you're up at 2 a.m. You're gonna Google So that's what we have to do dr. Angie is we just have to answer all the questions so when people go to chat CPT Because that's what it is. It's just it if you've answered the question somewhere on your website. That's what it's gonna pull

Dr. Angie Krause (09:11)
Yeah.

That, yeah, you're right. We just need to work harder to infuse the interwebs with better information to try to like win out. Yeah. Okay. Let's get on it.

JoJo (09:28)
Yeah.

Yes.

and ask the

right questions. Like what questions are people, well how do you even, what's gonna be the term for that? Because it's not Googling.

What are they? What is it gonna be called? We should come up with a term right now. Yeah. You're not like chatting, you're...

Dr. Angie Krause (09:50)
Like, what's the verb? It's not AI-ing.

JoJo (09:56)
What are you doing? I don't know when you're engaging chat in the middle of the night. Well, that's the thing too. It's conversational. So it does feel a little bit more like it's real.

Dr. Angie Krause (10:02)
Yeah.

Should we ask, should I get on chat GPT right now and should we ask it a question? Okay, okay, hold on, let me log in. By the way, I still have our account. Let me log into it. I wish I probably should stop paying for it if you're using Claude Or do you sometimes use it, do you want it?

JoJo (10:13)
Yeah, let's ask it a question.

Yeah, well, yeah, I I use both

but I don't ever use your account No, well because I'm back in school and so I'll talk about that while you're googling So it's interesting to be back in school because I do use Claude a lot to help me organize my thoughts or I have to do presentations or All of the types of things and I actually learned quite a bit using AI

Dr. Angie Krause (10:33)
you don't? Okay.

Okay.

JoJo (10:54)
it will pull in information that I maybe didn't like it'll pull in a peer review study that I maybe didn't ever find because it was 20 years old but so interesting so I find it really interesting but I have an instructor this term who has severe AI policies that three different emails fully you know laid out about you better you have to cite AI now what you used it for on every single post

and which AI platform you use, and then you have to save like 10 iterations of your work so that she can see that you're not just pulling stuff in. And so I have to have like 10 save separate documents to show, because then they check your pace at which you're typing.

Dr. Angie Krause (11:38)
Yes, I saw that. Yes, for school.

JoJo (11:40)
Yeah, they do all

kinds of things. it's interesting to know how to use it appropriately and not appropriately. But it's a useful tool.

Dr. Angie Krause (11:52)
Yeah. Okay.

I've logged in. Something I see a lot of in practice. I'm going to say, I have a 12 year old cat that is not eating and has lost three pounds. This is a common presentation. Yes. Let's do it. Okay.

JoJo (12:12)
I should put this same one into Claude.

Okay, hold on, I gotta pull him up. I wish he had a girl's name.

Dr. Angie Krause (12:23)
What

do I know? Claudia, that's how we start calling her.

JoJo (12:29)
I have a 12 year old. You have to tell me what your prompt was.

Dr. Angie Krause (12:33)
Okay,

I have a 12 year old cat that is not eating and has lost three pounds. What should I say? What could it be? What do I?

JoJo (12:43)
I would probably say, what's happening?

Dr. Angie Krause (12:46)
What is happening here? Okay, I don't use AI too much. I'm really glad you asked. This is one of those situations.

JoJo (12:51)
Of course, chat is really

glad you asked Mr. Friendly.

Dr. Angie Krause (12:57)
Yeah, where your instincts are right to be concerned. A 12 year old cat who isn't eating and has lost three pounds is not something to watch and wait on. Well, I agree with that. Thanks, Dr. Chat. That's significant, especially in a cat. What this most likely means. In senior cats, the combination almost always points to an underlying medical issue, not just picky eating. The most common.

JoJo (13:18)
Okay, I thought it was gonna say almost always

and I thought I was gonna give you a diagnosis like whoa, okay

Dr. Angie Krause (13:23)
Yeah.

The most common causes I see clinically. I see clinically? no, you don't see anything. Chronic kidney disease. See, that's not my number one. I mean, it is on the list. Often causes weight loss, decreased appetite and nausea. May also see increased thirst, urination, and it gives like, it's pulling in graphics from

JoJo (13:30)
interesting.

Dr. Angie Krause (13:48)
I'm guessing social. And then number two, hyperthyroidism. That's right. Also, pulling in cats that are look emaciated and have hyperthyroidism. Three, cancer, especially GI lymphoma. I mean, that is on the list. Four, dental pain.

Cats often want to eat but walk away, can lose weight quickly, extremely underdiagnosed. I'm gonna disagree with this. mean, cats do have dental pain. It just rarely makes them stop eating. Five, liver disease, including hepatic lipidosis. Not eating causes liver problems that can quickly develop, can become life threatening. Yeah, so it missed one of the most important ones.

which is inflammatory bowel disease. So.

JoJo (14:39)
I have it. Claude has IBD.

Dr. Angie Krause (14:41)
⁓

okay, tell me what Claude said.

JoJo (14:44)
Okay, claw is so much more mature.

Dr. Angie Krause (14:47)
Claudia.

JoJo (14:48)
Claudia

Those are concerning signs, and I want to give you a helpful answer But I also want to be upfront a 12 year old cat who has lost three pounds and stopped eating needs to see a vet so mature put that in bold Weight loss of that magnitude in a senior cat is significant and warrants diagnostics and not just monitoring So I love that because most people want to sit in the monitoring space

Here's what's commonly behind these symptoms in older cats, most likely culprits in a senior cat, hyperthyroidism. It goes on to explain what each one is. Chronic kidney disease, diabetes, dental disease, cancer, IBD, liver disease, heart disease. And then it goes in to say, why are the three pound loss matters?

Dr. Angie Krause (15:13)
Mm-hmm.

JoJo (15:35)
In cats, even one to two pounds of weight loss is considered significant because they're small animals. This is 20 to 30 % of their body weight. And then I think every time I hear that, it's very jarring because sometimes people are like, oh, they only lost this much. I'm like, yeah, that's a significant amount of their overall percentage. And then it goes into what to expect at the vet.

Yeah, so it tells them a good workup is likely going to include blood work, including a CBC in chemistry, a urinalysis, thyroid levels, and possible imaging. Many of the conditions above are very manageable when they're caught and treated. So if you're interested, it knows me now, if you're interested in an integrative or holistic approach, because I obviously have done a lot of work around that, because I didn't ask it that conventional diagnostics are still worth pursuing.

Dr. Angie Krause (16:26)
my gosh, Claudia.

JoJo (16:27)
But don't wait on the visit.

Senior cats, any kind of appetite loss for more than a day or two can lead to fatty liver disease, which becomes its own emergency. Yeah, so I think it's just more mature.

Dr. Angie Krause (16:36)
X.

Okay. Has this episode turned into don't use chat GP, chat GPT use Claudia.

JoJo (16:46)
I don't know and if you're going to use it because we are the world is like this is going to be part of everybody's daily

Dr. Angie Krause (16:50)
Okay.

Yes.

JoJo (16:54)
I don't Google anymore. That's interesting. So I, we need a term.

Dr. Angie Krause (16:58)
I still Google. Okay, because I feel guilty that I'm like using water or something like that. Is it not?

JoJo (17:04)
Apparently it's not as, it's not as

yeah, I don't know.

I think it is definitely, but so is Googling, so is everything that we do. I just stopped using my pleases and thank yous, like I'm very direct.

Dr. Angie Krause (17:14)
Okay, so it's not, okay. Okay, well maybe.

JoJo (17:21)
You're going to use your AIs and you're going to Google, but they are not the end all, all.

Dr. Angie Krause (17:28)
No, they're not. Know that they have some, there are some big oversights.

JoJo (17:34)
Mm-hmm.

Dr. Angie Krause (17:34)
Well, if you do Google use chat, GPT or Claude and you get something concerning and you want to talk about it, you can meet with me. You can book a time on my calendar, go to boulder holistic vet.com and go to, what does it say? Schedule now, book a consultation.

JoJo (17:53)
It says book a consultation. It's a special

colored button on the right hand side of the website. And it'll give you all the information about consultations. This is a great reason for a consultation. If you've Googled or AI'd something that you want to pick apart, that scared you in the middle of the night.

Dr. Angie Krause (17:58)
You can.

Yeah. Yeah.

Yes, you can book with me. We can't meet in the middle of the night, but you can book in the middle of the night. Yep. And so we'll get your, pets records. We'll meet on zoom. It'll be recorded. We'll make a plan. We can talk about all your AI search results and, then we'll, make a plan just for you and anything else we should say before we sign off.

JoJo (18:15)
Yeah, you can book in the middle of the night.

Well, I want

to know what people are using. Are you using chat or Claude or Google? And what questions are you asking? So maybe we can answer those questions so that AI chats find them.

Dr. Angie Krause (18:34)
Okay.

Yes, let's do it. Tell us what you're doing. Leave us a review. Yes. Yes. Okay. And don't forget to hit the subscribe button wherever you're listening. Okay, see you next time. Bye.

JoJo (18:46)
Yeah, helps us, inform us about what we need to do.

Do it. Have a great day.