Environmental Sustainability

Environmental sustainability is just one component of general sustainability of a product or practice. The American Public Health Association defines an environmentally sustainable food system as “one that provides healthy food to meet current food needs while maintaining healthy ecosystems that can also provide food for generations to come with minimal negative impact to the environment.”  

The specific factors measured when determining environmental sustainability include land and water use, waste production and management, and greenhouse gas emissions (including transportation). When thinking about animal-derived pet food protein, manufacturers and consumers concerned with sustainability should investigate a number of questions, including, but not limited to:

• How much land/water was used to grow crops to feed the production animals used in this food?
• How much land/water was used to raise these production animals directly?
• What percentage of the production animal was utilized in this food system?
• What type and volume of greenhouse gasses do these production animals release? 
• What is the energy cost of housing, processing and shipping these production animals?

Agriculture associated with animal consumption has a notoriously negative environmental impact when compared with other forms of agriculture. Livestock are estimated to be responsible for 14.5-18% of global greenhouse gas emissions. Some production animals are more environmentally expensive than others. Cattle comprise approximately 48.5% of livestock emissions, while poultry are more sustainable at 0.6%. Farmed fish, an increasingly popular source of protein in pet foods, have low greenhouse gas contributions but a significant negative environmental impact in the areas of water use, eutrophication and water acidification. 

It is important to realize, in the context of pet food, that much of this production is for human consumption. However, with more consumers feeding pets human-grade animal protein, companion animals are an important part of the food system sustainability discussion.

The Pet’s Role

We live on a planet with limited resources, and the ever-increasing human population already exceeds our ability to produce sufficient food. The United Nations State of Food Security and Nutrition in the World 2021 estimated between 720 and 811 million people globally suffered from hunger in 2020. The UN currently estimates the global human population is growing by around 80 million people each year and, if current agricultural and food systems remain in place, predicts food insecurity will increase to over 840 million people living with hunger by 2030. 

And while the effects of the COVID-19 pandemic were likely responsible for some degree of food unavailability, many of the issues leading to lack of food access are cited as escalating problems rooted in decades of unsustainable practices. 

As the human population grows, so does that of our companion animals. According to World Population Review, there are approximately 70 million dogs and 74 million cats being kept as pets in the United States in 2022. As of 2017, dogs and cats in the U.S. were estimated to be responsible for 25-30% of the environmental impact related to animal protein consumption. This impact is related both to the high number of pets and the shift in consumer preferences regarding pet food proteins. 

As more pet parents select foods with a high percentage of premium animal proteins previously reserved for humans, the carbon footprint of pet care increases. Protein sourcing has the highest environmental cost of any macronutrient, therefore it is critical to explore sustainable protein options for both humans and their animal family members. 

More Sustainable Protein Options

Fortunately, environmentally conscious consumers have options when looking for sustainability in pet food. One sustainable protein source has been used by pet food manufacturers for decades: meat byproducts. The Association of American Feed Control Officials (AAFCO), a non-profit regulatory organization for animal feed and pet food, defines byproducts as “secondary products produced in addition to the principal product.” 

Where animal protein is concerned, the principal product is the cut intended for human consumption and the byproduct is not intended for human consumption. Meat byproducts that are often used as a source of protein in pet food can include organs, blood, bone or any non-meat tissue suitable for use in animal feed.

While they may seem unappetizing, meat byproducts can offer a lot of digestible nutrition while reducing waste in a food system. Studies and organizations concerned with food sustainability have confirmed utilizing meat byproducts is an effective way to decrease competition with the human food supply and minimize environmental impact. AAFCO’s official stance on byproducts is, as long as labeling, nutrient content and safety regulations are met, they are a viable source of protein in pet food.

There are some protein pioneers in the field of pet food exploring non-traditional, environmentally friendly options. One potential protein is in a class of its own; “Insecta,” to be precise. Insects are part of the normal diet of many wild canids and felids, and some easily farmed species show promise as a component in pet food diets. 

Insect farming has a much smaller ecological footprint than traditional livestock farming, boasting few greenhouse gas emissions and low water and land use. Insects also do not require large amounts of resources to be spent raising them, converting feed to consumable protein much more efficiently than animals higher up the food chain. In fact, insects can utilize biomass considered “waste” at an incredible rate, meaning they can help clean up after other industries. 

Black Soldier Fly Larvae has preliminary approval from AAFCO as an ingredient for use in dog food. These larvae provide an average of 40-44% crude protein and are already extensively used for livestock feed worldwide. 

Crickets are also of growing interest to pet food manufacturers looking to reduce their environmental impact. With an amino acid profile comparable to those of egg, chicken, pork and beef, crickets have a high nutritional value. Pet food producers are also exploring insects as an alternative, novel protein for dogs with food sensitivities. 

Another potential protein source is located off the production line. Some pet foods are using invasive species as a primary protein. Silver Copi, formerly known as Asian Carp, have been wreaking havoc on the waterways of the United States. Their population has exploded since being introduced in the 1970s, and efforts to control it have been largely ineffective. They are rapidly growing, large fish with a high reproductive rate, traits that make them ideal for their role as intentionally farmed species in western Asia. Despite being edible, they are not generally consumed by humans in the United States. 

This abundant protein source is now the target of pet food manufacturers looking to help relieve the environment of a pest while providing a quality fish protein. Using invasive fish nearly eliminates the footprint of aquaculture and potentially reduces overfishing of native species. 

Identifying Sustainable Pet Food

There are a number of certifications that help a consumer identify a sustainable product. Two nonprofit organizations offering comprehensive sustainability accreditation are Pet Sustainability Coalition¹ and B Lab.² Both offer a list of companies that have met their sustainability standards.

Additionally, there are certifications whose process includes monitoring of environmental impact. These include:

• USDA Organic
• Marine Stewardship Council (MSC) and Aquaculture Stewardship Council (ASC)
• Best Aquaculture Practices (BAP)
• Food Alliance
• USDA Process Verified Program
• Regenerative Organic Alliance
• Rainforest Alliance
• Savory Institute Ecological Outcome Verification

By working to make excellent pet nutrition more sustainable, we can help ensure animals and humans have a bright future to share together. +

References:

• Pet Sustainability Coalition. https://petsustainability.org/psc-accreditation/
• B Lab. https://www.bcorporation.net/en-us/find-a-b-corp

Resources:

• Bosch G., Swanson KS. (2020, Nov). Effect of using insects as feed on animals: pet dogs and cats. Journal of Insects as Food and Feed. 1-12. doi:10.3920/jiff2020.0084
• Ingredient Definitions Committee Report Midyear Meeting via Webinar. Accessed September 18, 2022. https://www.aafco.org/Portals/0/SiteContent/Meetings/Annual/2021/Committee-Reports/Ingredient_Definitions_Minutes_2021_Midyear.pdf
• Kępińska-Pacelik J, Biel W. Insects in Pet Food Industry—Hope or Threat? Animals. 2022;12(12):1515. doi:10.3390/ani12121515
• Okin GS. Environmental impacts of food consumption by dogs and cats. Crowther MS, ed. PLOS ONE. 2017;12(8):e0181301. doi:10.1371/journal.pone.0181301
• Pet Sustainability Coalition. (n.d.). An Introduction to the 4-Factor Framework for Sustainable Protein Evaluation in Petfood. Retrieved September 23, 2022, from www.petsustainability.org. 
• ‌Swanson KS, Carter RA, Yount TP, Aretz J, Buff PR. Nutritional Sustainability of Pet Foods. Advances in Nutrition. 2013;4(2):141-150. doi:10.3945/an.112.003335
• United Nations. (n.d.). Food. United Nations. Retrieved September 20, 2022, from https://www.un.org/en/global-issues/food 

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As we navigate these waters with our clients, it is very helpful to be able to answer their questions about which treatment is associated with the longest survival time. 

There are currently four treatment modalities: medical management with oral medications, dietary management with iodine restricted diet, surgical thyroidectomy and radioactive iodine treatment. Medical management using oral pharmaceuticals and dietary management are both reversible treatments that do not provide a permanent “cure” because signs will recur with discontinuation. Obviously, thyroidectomy and radioactive iodine are more permanent solutions since they involve removal/destruction of the thyroid gland(s).

Medical management with methimazole was preferred by 66% of the veterinarians, while 28% favored surgical thyroidectomy in a retrospective study in the UK.² We have many factors that influence which of the modalities is best for each individual patient, including the ability of the owner to medicate the patient long term. 

Other studies have looked at survival following radioactive iodine,³ but in clinical practice (especially those that do not have this modality readily available), it is good to know about survivability of cats treated with the most common choices; oral methimazole versus surgical treatment. 

A retrospective study published in Macedonian Veterinary Review in March compared these two treatments.⁴ They found that treatment with methimazole and with surgery produced comparable longevity with a median survival of almost two years in cats without comorbidities. We do know that because hyperthyroidism is a disease often found in geriatric cats, there is a greater risk that other diseases will be present. 

This study looked at these factors as well. Thankfully, no significant impact on survival was found in cats that have both thyroid disease and renal disease, or thyroid disease with a concurrent heart murmur. They did find that the age of the cat at the time of diagnosis decreased longevity regardless of treatment. 

Because the surgical intervention and medical management were found, in this study, to have no significant differences in survival time, veterinarians can feel confident in allowing the other factors (such as owner compliance and/or budget concerns) be their guide as they select individual treatment plans. It is important to note that although the cost of surgery is more of an investment on the front end, with a median survival of 23-25 months, one must consider the monthly cost of long-term medication. 

Each case is individual and the owner’s input must be sought. However, it is helpful to be able to explain that longevity may not be a factor in their choice. +

References:

1. Peterson. M. E., (2020, September). Hyperthyroidism in Cats: Considering the Impact of Treatment Modality on Quality of Life for Cats and Their Owners. Veterinary Clinics of North America: Small Animal Practice, Volume 50, Issue 5, Pages 1065-1084 https://doi.org/10.1016/j.cvsm.2020.06.004

2. Forrester, S., Towell, T., Shenoy, K. (2012). Nutritional management of feline hyperthyroidism. Conference Proceedings of the Veterinary Medical Association, 130th Annual Meeting, Iowa: p.87-91. https://www.avmi.net/information/hyperthyroid-hints/nutritional-management-of-feline-hyperthyroidism/

3. Slater, M., Geller, S., Rogers, K. (2008, June 28). Long-term health and predictors of survival for hyperthyroid cats treated with iodine 131. J Vet Intern Med. 15(1): 47-51. https://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2001.tb02298.x

4. Mata, F. and Bhuller, R. (2022, March 28). Hyperthyroidism in the Domestic Cat (Felis Catus): Informed Treatment Choice Based on Survival Analysis. Macedonian Veterinary Review, vol.45, no.1, pp.71-78. https://doi.org/10.2478/macvetrev-2022-0015

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Recent advancements in canine chemotherapy have turned what used to be a terminal cancer diagnosis into viable treatment paths for veterinarians and a glimmer of hope for pet owners. In the unfortunate instances when the chemotherapy takes more of a toll on the dog’s health than the cancer itself, and treatment has to be paused or stopped, other options are available to you. These treatment tips from experts in the world of veterinary oncology can help you combat adverse effects to keep your patients on their chemo regimens and hopefully bring them back to full health as soon as possible.

Chemotherapy Outlook

Adverse reactions to chemotherapy are common. Eighty percent of dogs undergoing treatment experience at least one side effect and 32% suffer from serious reactions. Specific symptoms usually depend on the drug being used and how aggressive the treatment is, along with the age and health of the dog. While most side effects are mild and require only monitoring or light treatment, some can be life threatening and result in hospitalization, and possibly an end to the cancer regimen. Not only is this devastating to the patient’s recovery outlook, but having to rescue the dog from a severe episode can be both financially and emotionally draining for your clients.

Your goal as the oncologist is to keep the dog on its chemo treatment until recovery with as little discomfort as possible. Chemotherapy-induced side effects can be a massive detriment to this goal, but there are treatments that allow you to manage these issues, improving the dog’s overall health and chance at beating cancer. Here are the three main areas where adverse effects of chemo can occur and advice on how to get ahead of disruptive symptoms.

Alopecia

Hair loss may be the least dangerous to a dog’s health of the three main chemo-induced health issues, but witnessing a pet’s hair thinning or coming out can be jarring to the pet’s owners. Alerting clients to the possibility that their dog may lose whiskers or even parts of their coat will ease the shock if alopecia becomes noticeable. Unlike other side effects, coat thinning is relatively breed-specific, hitting hardest in dogs with hair such as Poodles and Schnauzers. Vets should keep this in mind when talking about effects of chemo with clients and take extra care to bring up the topic to owners of dogs with this type of hair.

Treating hair loss brought on by chemo in dogs is fairly straightforward. Regardless of the severity of the thinning, the dog will likely need a haircut to even out its coat. If shedding or patching are bad enough to impact the aesthetic or cause discomfort for your clients, shaving may be the best option. Ultimately, the decision is up to the owner, but you can help by keeping an eye on the hair-loss progression and advising owners in the best interest of the dog.

Bone Marrow Suppression

Since bone marrow is the body’s “factory” for new blood cells that grow at a similar speed to cancer, it is often targeted by chemo drugs that cannot distinguish cancerous from noncancerous rapidly growing cells. According to Michael K. Guy, DVM, MS, Ph.D., “Complete blood cell counts should be performed early and often after chemotherapy treatment has begun to monitor for myelosuppressive effects. A mild decline in both white and red blood cells is expected after beginning chemo and likely will not require treatment.”

In any case, Guy emphasizes that monitoring is the most important step to take in keeping blood cells at a healthy amount. It is recommended that veterinary oncologists include testing as a regular part of the treatment plan. Guy encourages vets to prescribe antibiotics as a boost to the immune system if white blood cell counts begin to dip. If red blood cell levels are looking low, the patient may require a blood transfusion to prevent more serious issues and potential hospitalization.

Digestive Issues

Gastrointestinal problems are the most common side effects to chemotherapy in dogs. These issues are caused by chemotherapy’s disruption to the balance of chloride ions and fluid in a dog’s intestines, causing discomfort and a variety of issues ranging from anorexia to vomiting and chemotherapy-induced diarrhea (CID).

As with blood cell counts, the most important step in managing digestive issues caused by chemotherapy is monitoring. Cooperation between vets and owners and open communication about patterns in appetite and stool are critical. If an owner mentions that their dog is experiencing a decrease in appetite, encourage them to pursue new options in making the dog’s food more appealing. VCA Animal Hospitals recommend heating food to body temperature in the microwave or enhancing the dog’s diet with low-sodium broth or home-cooked alternatives. Appetite stimulants are available to prescribe, and you should consider this option in cases where the problem persists. 

Since the animal is already weakened by cancer and chemotherapy treatment, anorexia can quickly turn dangerous and require hospitalization. In drastic situations, a dog may require a feeding tube or IV to avoid starvation.

Vomiting and CID are both common and important to stay on top of as both symptoms can lead to potentially deadly dehydration and halt the chemo regimen. There are effective anti-emetic (anti-vomiting) medications that are fast-acting and crucial for certain chemotherapy protocols. Vomiting can happen quickly after the chemotherapy dosing starts, but sometimes dogs need to be on anti-emetics even at the time of chemo treatment to be sure it can occur without the dog having a reaction. Keep track of a dog’s history of nausea and reactions to medication and decide if providing anti-nausea medication before chemo would be the best option. 

Unlike vomiting, which happens immediately, CID can occur hours or days following a chemo dose. Owners will need to monitor their pets and make sure that if the dog is exhibiting CID, the animal is drinking extra water to compensate. You can also prescribe a new plant-based medication with the active ingredient crofelemer that normalizes fluid influx in the GI tract. Both methods are great steps to diminish likelihood of a trip to the hospital for rehydration via IV. 

Improving a dog’s health after a cancer diagnosis is a constant battle for both you and the owner. Even the best possible treatment plan can cause adverse symptoms. However, having a solid plan that involves treating both the cancer and any potential side effects can save money, stress and, in many cases, a dog’s life. +

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The rewarding field of veterinary medicine has never been more in demand. As more people have pets and want to give them top care, the more veterinarians, nurses and technicians are needed. 

In an industry poised for continued growth,¹ attracting and retaining talent is essential. And part of that retention focus is to help people feel valued in the workplace. However, the North American Veterinary Community (NAVC) 2020 research found that 34% of veterinarian nurses and technicians were considering leaving the field within five years. 

“We saw that as a real problem for our community because the veterinarian nurses and technicians are the backbones of the veterinarian community,” Gene O’Neill, CEO of NAVC, shared.  

While a certain amount of attrition is expected in any field, the NAVC board chose to consider this as an opportunity to lean into its mission of facilitating opportunities for learning, growth and wellbeing within the veterinarian community, and create a multi-pronged initiative. 

The Veterinary Nurse/Technician Empowerment Initiative launched last fall with a Veterinary Nurse/Technician Summit. Other programs include webinars, hands-on workshops, a mentorship program and a consumer awareness campaign.  And it has certainly struck a chord with the veterinarian nurses and technicians…

According to Robin Pence, Vice President of Public Relations at NAVC, “Any and every veterinary nurse/technician I spoke with about our Initiative was thrilled, and one, in particular, broke down in tears when I shared our press release with her in January announcing the Initiative. Through tears, she said, ‘I’ve been waiting 35 years for this.’” 

As stated in the accompanying press release for its first webinar, which was hosted on April 13th of this year, “The NAVC is committed to supporting the entire veterinary healthcare team, and that includes helping to elevate the role of veterinary nurses and technicians so they can reach their full potential,” said O’Neill. “The webinar series, a key part of the NAVC’s broader veterinary nurse/technician empowerment initiative, is designed to give these critical team members the tools and resources to take care of and advocate for themselves.”

The consumer awareness campaign is another vital element of this initiative, where VCA serves as a partner with support from NAVTA. The goal of this division is to help build the confidence that pet owners have in those caring for their pets.

“Pet owners are nervous when pets are outside of their sight. But once they’ve developed any level of rapport with the doctor or staff, people are much more likely to calm down,” Dr. Jenifer Chatfield, DVM, DACZM, DACVPM says.

The staff veterinarian at 4J Conservation Center, Inc. in Dade City, Florida agreed and had this to share: “The recent NAVC survey² showed that people have no idea who’s handling their pet care. If they recognize the people looking out for the pet are skilled, trained, and care for their pets, it’s an opportunity.”

The opportunity is one of improved pet healthcare and advocacy for support staff. As pet owners recognize the skills of veterinary nurses and technicians, they feel more confident in their pet care. This confidence spills over to the staff, who then feel more appreciated. 

Pet owners are largely unaware of these support staff members’ training and skill level. The NAVC-commissioned survey² found that 73% of pet owners thought veterinary technicians and nurses mostly cleaned cages and fed pets. According to that survey, “Sixty-three percent of pet owners do not know that credentialed veterinary nurses and technicians are the animal healthcare equivalent of registered nurses.” Yet, the survey found 84% of pet owners would trust support staff as much as the veterinarian if they knew their training and skill level. 

Dr. Chatfield has recently started using different terminology, such as veterinary assistant instead of veterinary technician, during her pet-owner interactions. She says it’s a way to explain to pet owners the level of training and care veterinarian staff bring to the practice. 

“These people have more education and awareness than just how to handle a dog, and they can handle catheters, draw blood, and some can read advanced diagnostics,” Dr. Chatfield shares. 

Not only does such advocacy help educate the public about the skill level and care of veterinarian support staff, but it also helps them find more job satisfaction. 

“Practice owners and employees fail to recognize that job satisfaction isn’t just about having a job,” Dr. Chatfield continues. “It’s about providing an opportunity for growth. When you offer staff additional training opportunities, instantly, that person feels valued.” 

She says at the practice level, that can mean offering to pay the registration fee and lodging for the state conference. Then, at the next staff meeting, each attendee is asked to share one thing they learned at the conference. 

“When people feel like valued team members, they’re more likely to stay longer in their employment,” she adds.

Not only does the practice retain a valued team member, but reduced staff turnover means your patients are more likely to develop relationships with staff which makes for calmer and better-informed pet owners. It may even help them obtain better pet care since there is a relationship of trust and confidence where the pet owner may feel comfortable asking additional questions or offering background information. 

Of course, this NAVC initiative offers additional continuing education opportunities in the form of webinars and more that can easily fit into any veterinary professional’s schedule. 

Gene O’Neill says, “We want to help the veterinarians as much as possible. If the veterinarian nurses and techs feel like they have the opportunity for continuous learning and to fully utilize their skills, they perform at their highest levels, and that translates into job satisfaction.” 

You can find out more about the initiative and dates for upcoming events at: navc.com/veterinary-nurses-and-technicians-empowerment-initaitive/ +

References:

1. Global Veterinary Services Industry (2020 to 2027) Market Trends and Drivers. (22, Dec, 2020). Business Wire. https://www.businesswire.com/news/home/20201222005520/en/Global-Veterinary-Services-Industry-2020-to-2027—Market-Trends-and-Drivers—ResearchAndMarkets.com

2. Who’s Involved In The Care Of Your Pet? (29, Mar, 2022). NAVC. https://navc.com/whos-involved-in-the-care-of-your-pet/

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In a recent study published in Canine Medicine and Genetics,¹ an international team of researchers led by University of California, Davis, veterinary geneticist Danika Bannasch show that the majority of canine breeds are highly inbred, contributing to an increase in disease and healthcare costs throughout their lifespan.

“It’s amazing how inbreeding seems to matter to health,” Bannasch said. “While previous studies have shown that small dogs live longer than large dogs, no one had previously reported on morbidity, or the presence of disease. This study revealed that if dogs are of smaller size and not inbred, they are much healthier than larger dogs with high inbreeding.”

Inbreeding Affects Health

The average inbreeding based on genetic analysis across 227 breeds was close to 25%, or the equivalent of sharing the same genetic material with a full sibling. These are levels considered well above what would be safe for either humans or wild animal populations. In humans, high levels of inbreeding (3-6%) have been associated with increased prevalence of complex diseases as well as other conditions.

“Data from other species, combined with strong breed predispositions to complex diseases like cancer and autoimmune diseases, highlight the relevance of high inbreeding in dogs to their health,” said Bannasch, who also serves as the Maxine Adler Endowed Chair in Genetics at the UC Davis School of Veterinary Medicine.

The researchers partnered with Wisdom Health Genetics, a world leader in pet genetics, to obtain the largest sample size possible for analysis. Wisdom Health’s database is the largest dog DNA database in the world, helping researchers collect data from 49,378 dogs across 227 breeds—primarily from European sources.

Some Breeds More Inbred

So, what makes a dog breed more inbred than others? Bannasch explained that it’s often a combination of a small founding population followed by strong selection for particular traits in a breed—often based on looks rather than purpose. While she has always had an interest in the population structure of some of these breeds, she became particularly interested in the Danish-Swedish Farmdog several years ago. She fell in love with their compact size, disposition and intelligence, and ended up importing one from Sweden.

Bannasch discovered that Danish-Swedish Farmdogs have a low level of inbreeding based on their history of a relatively large founding population of 200, and being bred for function, rather than a strong artificial selection for looks. And according to the insurance health data on breeds collected from Agria Insurance Sweden and hosted online by the International Partnership for Dogs, the Farmdog is one of the healthiest breeds.

The study also revealed a significant difference in morbidity between brachycephalic (short skull and snout) and non-brachycephalic breeds. While that finding wasn’t unexpected, the researchers removed brachycephalic breeds from the final analysis on effects of inbreeding on health.

Preserving Genetic Diversity

In the end, Bannasch said she isn’t sure there is a way out of inbred breeds. People have recognized that creating matches based solely on pedigrees is misleading. The inbreeding calculators don’t go back far enough in a dog’s genetic line, and that method doesn’t improve overall high levels of population inbreeding.

There are other measures that can be taken to preserve the genetic diversity and health of a breed, she said. They include careful management of breeding populations to avoid additional loss of existing genetic diversity, through breeder education and monitoring of inbreeding levels enabled by direct genotyping technologies.

Outcrosses are being proposed or have already been carried out for some breeds and conditions as a measure to increase genetic diversity, but care must be taken to consider if these will effectively increase overall breed diversity and therefore reduce inbreeding, Bannasch said. In particular, in the few breeds with low inbreeding levels, every effort should be made to maintain the genetic diversity that is present. +

References:

1. The effect of inbreeding, body size and morphology on health in dog breeds. (2021, Dec, 1). BioMed Central. https://cgejournal.biomedcentral.com/articles/10.1186/s40575-021-00111-4

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An hour and several laboratory diagnostic tests later, it was clear: this little primate was severely anemic and in need of a blood transfusion. My only choice was to obtain a donation from an adult in our existing group of spider monkeys. Several hours later, I crossed my fingers and started her transfusion. Fifteen minutes into the procedure, she became a new monkey! I had to hold and entertain her for the remaining one and a half hours of the transfusion to keep her in one place. Subsequently, she grew into a strong adult and never looked back. 

Many veterinarians have witnessed the incredible power of transfusion medicine like I did with my little spider monkey patient. However, transfusion medicine is actually not new. The first known successful blood transfusion occurred in 1665 in England when Dr. Richard Lower transfused dogs with blood from other dogs in order to keep them alive¹—that’s right, animal research for the win! 

Following Dr. Lower’s success with dog-to-dog transfusions, Dr. Lower and Dr. Jean-Baptiste Denis in France recorded successful transfusions from lambs to humans. However, when Dr. Denis’s fourth transfusion patient died, his surviving wife accused the physician of murder. Although the doctor was cleared of the charge in court, the court also banned blood transfusions because of the rate of adverse reactions, and the rest of the world soon followed suit.² 

The 1800s saw continued efforts in refining transfusion medicine, including the first human-to-human blood transfusions to treat postpartum hemorrhage and hemophilia. In the late 1800s, U.S. physicians were using milk from cows, goats and humans instead of blood for transfusions. As one might imagine, transfusion reactions to milk were frequent and severe, so saline replaced milk as a “blood substitute.” 

The turn of the century brought about the recognition of different human blood groups and efforts to cross-match prior to transfusion in order to avoid adverse reactions. Once anticoagulation compounds and refrigeration were integrated into the storage and handling of blood, early blood depots were utilized to save lives during WWI. And, in 1932, the first blood bank was established in Leningrad hospital. World War II saw the emergence of albumin transfusions (rather than whole blood) to treat shock in victims of the attack on Pearl Harbor. 

In the 1950s, the plastic bag for blood collection and the development of a refrigerated centrifuge allowed for more precise blood component therapy. And, as recently as the 1980s, the era of transfusion medicine began and doctors could be trained specifically in blood transfusion for patient care. From there, the growth of blood component therapy continued to soar. 

In one of the latest developments to allow for even greater shelf-life and use in austere settings, the FDA issued an emergency use authorization to allow the U.S. military to use freeze-dried plasma to treat hemorrhage in combat settings in 2018.

While veterinary medicine may not yet have reached the point of transfusion medicine as specialty or administering freeze-dried blood components, transfusion with blood products has seen some incredible changes in the last 50 years. For most practitioners, the blood donor dog living in the clinic is long gone and has been replaced with either a list of client-owned dogs available for presentation and blood collection when necessary, or use of a commercial veterinary blood bank. 

Typically, client-owned donors are provided free or discounted preventive care and blood-borne disease screening with a nominal payment for each donation, but programs vary significantly among clinics. What seems far more interesting is the emergence and rapid growth in commercial veterinary blood banks.

The Association of Veterinary Hematology and Transfusion Medicine currently lists 12 veterinary-specific blood banks in operation with one of those being exclusively feline.³ While the exclusively-feline blood bank harvests blood from cats owned by shelters prior to their purchase by new owners, other facilities use either client-owned pets or have on-site colonies and kennels from which to harvest blood. Many, if not all, facilities with on-site donors have a program by where the animals may find a home in the community following their retirement from donating blood. 

Some states, like California, control animal blood banks with significant regulations such as requiring licensing fees and recently allowing for transition to “community animal blood banks” utilizing “volunteer” donors from the community, etc.⁴ However, most states do not address animal blood banks, making it prudent for practitioners to do their own research in selecting a bank to work with. 

Most commercial veterinary blood banks not only provide blood components, but also offer support to practitioners in the form of ancillary supplies for transfusions and guidance on appropriate administration, as well as other clinical advice. For the general practitioner who performs transfusions less commonly than their emergency and urgent care colleagues, technical support from those better versed in transfusion medicine can be critically important to clinical success. Indeed, proper selection of pre-transfusion diagnostics, clinical indications for component therapy versus whole blood administration and adverse event mitigation are all key to a successful clinical resolution. 

Veterinary transfusion medicine has become incredibly advanced in the last 20-30 years and, in this clinician’s opinion, practitioners should consider moving beyond the “donor in the back of the clinic” paradigm and engage the services of a professional veterinary blood bank. 

Now, if veterinary blood banks could just accommodate spider monkey-specific components… +

References:

1. Highlights of Transfusion Medicine History. Aabb. https://www.aabb.org/news-resources/resources/transfusion-medicine/highlights-of-transfusion-medicine-history

2. The Strange, Grisly History of the First Blood Transfusion. Encyclopedia Britannica. https://www.britannica.com/story/the-strange-grisly-history-of-the-first-blood-transfusion

3. Veterinary Blood Banks. AVHTM. https://www.avhtm.org/resourceslinks

4. AB-1282 Veterinary Medicine: Blood Banks for Animals. (2021, Oct, 11). California Legislative Information. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1282

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Opioid Abuse In Veterinary Medicine

The Food and Drug Administration (FDA) clearly states that prescription opioids can potentially cause serious risks for those who abuse them. Some of the pain-reducing medications that have contributed to the opioid epidemic include hydrocodone, fentanyl and tramadol.  Those who visit their veterinarian may receive medications like buprenorphine for their pets, which is an opioid approved for cats. Veterinarians prescribing opioids to animals may be taken advantage of by pet owners with opioid use disorder.

Federal Regulations

The American Veterinary Medical Association (AVMA) has regulations regarding controlled substances that veterinary clinics in eighteen states must follow. The states that participate in prescription drug monitoring programs include:

• ​Alaska
• Arkansas
• California
• Connecticut
• Colorado
• Indiana
• Maine
• Michigan
• Nebraska
• New Hampshire
• New York
• North Carolina
• North Dakota
• Oklahoma
• South Carolina
• Tennessee
• Washington
• West Virginia

However, some veterinary practices follow more than just federal regulations. Some veterinarians look at the animal patient’s previous medical history to determine if the pet owner may be participating in drug abuse. 

Stolen Pain Medications

The Drug Enforcement Administration (DEA) must be notified if prescription medications are stolen from a veterinary clinic, including theft by staff members. Veterinarians who prescribe opioids for pain management may have a safety plan in effect due to opioid incidents that can occur—a person addicted to opioids may go to drastic lengths to obtain the drug.

Safety Concerns For Pets

There have been instances where pet owners will purposefully hurt their animal in order to get pain medication from their local veterinarian. As AVMA notes, a woman in Kentucky confessed to cutting her dog with razor blades in order to get prescription painkillers to use for herself.

In addition, pet owners who are addicted to opioids may neglect their animal in the following ways:

• Forgetting to give their pet food and water.
• Forgetting to take the pet outdoors. 
• Intentionally harming the pet.
• Leaving the pet outdoors for too long without water.
• Accidentally leaving their pet in a hot car.

A Veterinarian’s Role 

Veterinarians play an important role in monitoring opioid use. These professionals may take notice of any signs of animal abuse or neglect and may be one of the first to discover that a person is abusing the prescribed medications. 

Veterinary practices that prescribe medications likely do not use commercial pharmacies. Because of this, it’s important for veterinarians to do the following:

• Stock and manage the opioid inventory, always keeping medications behind locks.
• Put accountability measures in place, such as double-checking the inventory count.
• Require employees to take training courses to learn more about opioid policies and procedures.
• Have a safety plan in place for when potential opioid abusers insist their animal needs medication.

Veterinarians can also watch out for common signs of potential opioid abuse in pet owners, which may include:

• Inquiring about specific opioid medications by name.
• A new client bringing in a pet with suspicious injuries (raising the alarm that the owner harmed their pet to obtain opioids). 
• Asking for refills because the medications were lost or stolen.
• Continuing to request an opioid prescription for their pet.

Veterinarians are urged to contact their local police department if they encounter threatening customers or need assistance.

Warning Signs Of Opioid Abuse

While these medications are used to control pain, they are also heavily abused. Knowing the warning signs of opioid misuse can prevent opioid overdose and curb this ongoing public health crisis. 

In addition to signs of animal mistreatment or frequent visits to the veterinarian, an opioid abuser may:

• Be forgetful and not follow through with plans.
• Steal items or money from friends or relatives.
• Have poor hygiene.
• Develop financial difficulties.
• Have frequent flu-like symptoms.

If you or a loved one struggles with opioid abuse, call our helpline at 1-800-526-5053 to learn about our substance abuse treatment options. +

The post Pet Owners and Opioid Abuse: A Deadly Combination appeared first on PetVet Magazine.

Wait, what?! No mention of rabies prevention?! 

Justification would seem obvious as rabies is a significant human health concern and canine rabies has been eradicated in the US for decades following effective policies legally compelling vaccination and eliminating stray populations. However, digging just a bit deeper into the issue provides some startling and disturbing facts surrounding rabies, animal movement and resulting animal welfare. Let’s start with canine rabies…

In 2007, the CDC officially declared the US free of canine rabies.² The announcement represents the culmination of years of hard work and is the result of a multifactorial approach to a serious public health threat. Rabies remains nearly 100% fatal in most, if not all, species susceptible to infection. In fact, at least 60,000 people die from rabies annually and most are children infected with canine rabies from a dog bite.³ 

A key characteristic of rabies is that the virus exists as different strains or types that are named according to their maintenance host in which the virus is adapted to survive and as an indicator of transmission. For example, raccoon rabies is specifically used to refer to a strain that is maintained in raccoon populations, thus, raccoons may survive for extended periods following infection and successfully transmit the virus to others to maintain the virus in their population. 

Rabies is most frequently transmitted via a bite as the virus is shed efficiently in saliva of infected hosts. The virus then remains in the local bite site for several days before traveling through the nervous system to the brain and then into the salivary glands. Rabies has two distinct clinical syndromes: paralytic (or dumb) and furious. However, both are nearly 100% fatal once symptoms appear. 

The most effective “treatment” for rabies in any species is prophylaxis prior to the onset of clinical symptoms. If vaccinated prior to exposure, patients require less post-exposure prophylaxis and externally administered immunoglobulin is not indicated. 

Each year, ~55,000 people are treated for rabies exposure in the US with cost ranging from $10,000 to $100 million per person, depending on exposure, wound care, intervention timing, etc.⁴ Total public health expenditures on rabies prevention and control in the US tops out at an eye-popping $245-510 million annually. A recently imported rabid rescue dog cost the federal government a whopping $215,000-$509,000 to investigate.⁵ Currently, the companion animal vaccine is perhaps the cheapest vaccine available and, once again, confirms that prevention is much, much cheaper than a cure. 

Rabies is surely a concerning disease, but how often are companion animals or other species actually traveling internationally and being imported into the US? 

According to a recent report by the USDA, more than one million dogs are imported into the US each year.⁶ This includes those declared as personal pets by the owners and those imported for distribution and resale through all outlets (shelters, rescues, breeders, etc.). The majority of these are assumed to be personal pets; however, assumptions are less than ideal when discussing disease vectors. 

Importation permits for dogs are fairly simple and variables are based on country of origin. Generally, a simple health certificate is all that is required. In fact, with changes in the last few years to the CDC requirements, 75% of all imported dogs are exempt from any rabies certificate requirements. Contrast these facts with the significantly more complex process of importing almost any other species into the US, as most require multiple serological tests, immunizations and permanent ID placement, and are visually inspected by officials upon entry into the US, with some species further requiring significant quarantine at great expense (and risk) to the importer. 

Beyond these minimal requirements for dogs to move around internationally, what about the welfare implications—not only for the dogs in transit but for the dogs already in the US?

Roughly 1.5 million animals are killed at US shelters every year which is more than the estimated total dog imports from the USDA’s 2018 report.⁷ It is simplistic to believe all dog imports are by traditional pet stores or even breeders. Importing dogs to “rescue” them is a rapidly growing industry with apparently mortal consequences for local resident pups. For example, one such organization states that they have imported 600 dogs from China over the last two years for the purpose of rehoming them in the US.⁸ The organization states that the cost to bring each dog to the US is $2,500-$3,500. That’s per dog! While all personnel involved are said to be volunteers so that all funding is consumed by operations, that’s a lot of money for each dog. This organization is based in a county with a population of ~100,000 and the county animal shelter has dogs available for purchase (adoption) for a mere $85 and estimates $460 spent per animal.^9-11 If the rescue organization shifted focus to animals within their home community, an additional 3,300 American dogs could be saved. Additionally, China is currently categorized as a “high risk” country for rabies by the CDC¹² and considered an incubator for influenza. Surely avoiding euthanasia is the pinnacle of improved animal welfare?! 

While the CDC claims the temporary change in importation policy is a response to the number of dogs denied entry that have poor outcomes awaiting shipment home, one may wonder if the dramatic increase in the number of imported dogs testing positive for rabies after arriving in the US and the number of people involved in likely exposures to the nearly 100% fatal virus is also a contributing factor? 

As a veterinarian routinely administering rabies vaccinations in practice, this approach would make perfect sense. For a pathogen with a near 100% mortality rate in dogs and humans (and many other species), caution seems minimally prudent. This policy might also inspire all shelter pets in the US to rejoice! 

A commonsense presumption would be that if rescue organizations and shelters are actively seeking to import stray dogs for resale (adoption), then all shelters in the US must be empty or, at the very least, have euthanasia rates nearing zero? Must we look abroad for homeless pets? What a champagne problem! 

Importing cattle from foot and mouth disease (FMD)-endemic countries is far more difficult than importing dogs from canine rabies-endemic countries—and FMD is not lethal to humans. FMD is considered a foreign animal disease not currently present in the US. Canine rabies is considered not currently present in the US. Should importation policies not be applied equally across species in order to maintain these hard-fought (and expensive), disease-free designations? 

The change in policy is not only perplexing in and of itself, but the early warning of the implementation is equally disconcerting as it allowed for circumvention of the targeted outcome. Following the CDC’s announcement of the future effective date of the ban, overseas rescues use the announced implementation date to ramp up efforts to ship as many “rescue dogs” into the US as possible ahead of the ban, thereby circumventing the effort to prevent rabies control efforts.¹³ 

Overall, this recent temporary CDC policy shift has illuminated the large number of organizations expending incredible resources to import stray dogs from abroad while American strays are euthanized daily. Shouldn’t available resources be focused on avoiding euthanasia of as many dogs as possible in the US before looking for additional dogs abroad? Especially if those imported dogs are potential disease vectors for diseases currently absent from the US?

In other words, if the US is battling overpopulation, why are additional dogs being imported by the millions each year? I encourage all veterinarians to make an effort to remain aware of these activities in the pet industry as well as encourage clients to purchase dogs that have empty passports. +

References

1. Notice of Temporary Suspension of Dogs Entering the United States. (2021, June, 14). CDC. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk-dog-ban-frn.html 
2. US Declared Canine-Rabies Free. (2007, Sept, 7). CDC. https://www.cdc.gov/media/pressrel/2007/r070907.htm
3. Rabies. OIE. https://www.oie.int/en/disease/rabies/
4. Cost of Rabies Prevention. (2019, June, 11). CDC. https://www.cdc.gov/rabies/location/usa/cost.html
5. Dog Adopted By Chesco Family Had Dangerous Variant Of Rabies. (2021, June, 21). Patch. https://patch.com/pennsylvania/philadelphia/rabid-dog-azerbaijan-adopted-chester-county-family-cdc
6. Report on the Importation of Live Dogs into the United States. (2019, June, 25). AKC GR. https://cqrcengage.com/akc/file/ZSOYKBw3C5F/USDA_DogImportReport6_25_2019.pdf
7. Pet Statistics. (2015-2018). ASPCA. https://www.aspca.org/helping-people-pets/shelter-intake-and-surrender/pet-statistics
8. China Rescue Dogs. https://chinarescuedogs.org/about/# 
9. Moore County, NC Sheriff’s Office. https://www.moorecountync.gov/sheriff/animal-services 
10. Public Animal Shelter Report. (2017). North Carolina Department of Agriculture & Consumer Services. http://www.ncagr.gov/vet/aws/Fix/documents/2017PublicShelterReport.pdf 
11. Moore County, North Carolina Census. (2019, July, 1). United States Census Bureau. https://www.census.gov/quickfacts/fact/table/moorecountynorthcarolina/PST045219
12. High-Risk Countries for Dog Rabies. (2021, July, 14). CDC. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk.html
13. US Suspends Dog Importation From 100-Plus Countries. (2021, July, 28). AMVA. https://www.avma.org/javma-news/2021-08-15/us-suspends-dog-importation-100-plus-countries 

The post Exploring the Dog Importation Ban (And the Reintroduction of Rabies) appeared first on PetVet Magazine.

When I began working as a Medical Director at the VCA West Los Angeles Animal Hospital in 1996, I saw dogs coming in almost every day with diseases for which options were limited and had not changed in 30 years. One of those diseases was lymphoma. After delivering the heartbreaking diagnosis, I only had two options for owners: One, we could walk downstairs to the oncologist who would offer them standard-of-care therapy using a chemotherapy protocol called CHOP. And, while this protocol is associated with the longest survival times, it is rarely curative. In addition, for many clients, there are concerns regarding cost and the potential for side effects. The only other option I had was to prescribe steroids as palliative care, providing the owners with a limited amount of time to cope with the fact that they were going to lose their pet. 

I felt that there had to be a way to create another alternative for lymphoma treatment, as well as several other unmet pharmaceutical needs in the veterinary community. Lucky for me, a young but experienced entrepreneur named Dylan Balsz felt the same way. And after he sent me a cold email message through LinkedIn asking if I knew anything about dog diabetes, we met to discuss how we could find and develop drugs more rapidly and for less money. Looking back, I’m sure glad I didn’t ignore that message—and I’m sure the 700,000 dogs diagnosed with lymphoma each year are too. 

Anivive Lifesciences was started in 2015 with the idea that we could get veterinary therapies to market faster and cheaper by leveraging the tremendous amounts of data that exist surrounding medications being developed for diseases in man. This is where our Chief Technology Officer, Cody Arbuckle, PhD, came in. He was able to create a software that sifted through the 30,000 drugs that various researchers had in development for numerous diseases. This allowed us to discover and develop LAVERDIA™-CA1 (verdinexor), the first and only oral tablet to treat lymphoma in dogs. 

LAVERDIA-CA1 is special for several reasons. Given the main obstacles to any cancer treatment are cost, convenience and concerns over side effects, we wanted to develop a therapy that could increase access to care for more lymphoma patients. 

LAVERDIA-CA1 is the first veterinary SINE inhibitor on the market, and its mechanism of action results in lymphoma cells being targeted while normal cells are spared. This results in the drug’s demonstrated efficacy and safety in studies involving pet dogs with lymphoma. In addition, treatment does not decrease the pet’s quality of life which is very comforting for pet owners and veterinarians when prescribing a therapy for a fatal disease.

Treatment is also convenient as tablets are easy for owners to administer from the comfort of their own home without having to put their dogs through unnecessary and inconvenient trips to the veterinarian.  

Getting this first approval was huge for Anivive. It provided internal (our Anivive team) and external (veterinary professionals and pet owners) validation of our strategy. It also allowed us to now focus on our pipeline of other therapeutics. One of the exciting products in that pipeline, that likely will result in our second approval, is an anti-fungal vaccine to prevent Valley Fever. 

Valley Fever is an infection caused by inhaling Coccidioides fungal spores found most commonly in the soil of the Western and Southwestern United States. Symptoms in humans resemble those of the flu, but dogs are more likely to develop severe disseminated forms of the disease. 

Because of climate change, Valley Fever, which was originally isolated to Arizona, is now in the Southwest and Northwest and, by the end of the century, will be everywhere west of the Mississippi, all the way up to the Canadian border. This is why it is becoming more and more crucial to find a preventative. 

There is also the potential to use this same technology to develop other fungal vaccines for diseases such as histoplasmosis and blastomycosis which occur in the more eastern parts of the United States. 

We also get calls almost every day from pet owners and veterinarians asking about our investigational treatment (GC 376) to treat the feline coronavirus FIP. This would have a huge impact on cats, cat owners and the veterinary profession as, world-wide, there are no treatments for this disease, and it is 100% fatal. It could also potentially lead to a path for human use, which, as coronaviruses continues to evolve, would be nothing short of groundbreaking. 

Throughout my years as a veterinary professional, I have strived to provide the animals I treat with the best quality of care. Anivive has allowed me to take this one step further by bringing new, trailblazing solutions to the veterinary industry. We are determined to solve the unmet needs of the animal health community and LAVERDIA-CA1 is just the start of something greater. +

To learn more about how Anivive is working to address unmet needs for pets, visit anivive.com. 

The post Developing the Veterinary Drugs I Wish I Had Years Ago appeared first on PetVet Magazine.

Gentle reminder: Normal wasn’t great (so let’s NOT go back there!)

Now, don’t get me wrong, I totally understand wanting the enhanced level of chaos, stress and frustration to decrease; I even understand the desire for it to be the way it was. After all, the mind will always find comfort in familiarity…even if that familiarity includes stress and frustration.  

What the mind doesn’t like is uncertainty, and right now the whole world has that in spades. Because of that, in this moment, the veterinary industry has an unprecedented opportunity to fundamentally change the culture and future of the practice of veterinary medicine; changes that will improve patient care, client service and, most importantly, work-life balance and personal wellbeing for ourselves and our teams.

The one thing that is certain? Change is happening. 

Not that long ago, the idea of hosting entire veterinary CE conferences online was deemed impossible and utilizing a drop-off system as a primary business structure for full-service veterinary practice was considered ludicrous. Within the last year, both became necessary. Today, these continue to be the norm. Tomorrow, they can continue to exist…if we want them to.

The truth is, YOU get to decide how you want to practice veterinary medicine. I think somewhere along the way we forgot that part—we adopted a collective belief that we had to offer all things, to all people, at all times. We created business structures that didn’t simultaneously support, at a human level, the people who worked there. We disregarded what we individually wanted and needed. We have decades of statistics and experiences that show us the tragic results.

Resisting change—even change we want—is normal. The resistance is anchored in the fear over the backlash of our client base and, thus, perceived potential loss of revenue. But, right now, with the entire world in flux, it’s the perfect time to act. People are expecting changes and we’ve gotten used to things changing in all areas of our lives since the arrival of COVID-19. It’s not going to get easier than this in regard to the human component.

To help you get started dreaming and brainstorming about what’s possible, I’ve got three out-of-the-box ideas to consider:

1. Self-hosted mass preventive care events

Many hospitals are experiencing a backlog of preventive care appointments and simultaneously booking weeks out for these services. There is opportunity to serve these clients in dedicated preventive care service events (e.g., running a vaccine/HW/Fecal clinic in your parking lot). This will not only help clear the backlog in your preventive care case load, but also frees up appointments for true medical cases. The clients will appreciate the efficiency, too!

Tip: Communication is key! Clients must be well informed that these are preventive care only visits. Any medical conditions found during the physical exam will require a separate appointment. And, by the way, we should be doing this anyway.

2.  Minimize cross-training and increase the use of staff members in dedicated, key roles

There are two areas where having consistent, dedicated staff members will greatly increase hospital efficiency, client satisfaction and patient care: Consent Coordinator and Surgery Team.

Consent Coordinator

This role is for the person on your team who is the very best at speaking to clients about treatment plans and money. They understand every line item on a treatment plan and the purpose behind them. They also have a good understanding of how a treatment plan can be adjusted if the client declines the initial doctor recommendations. They are familiar with the payment options your organization offers and can facilitate payments over the phone. They are also comfortable talking about money and do not take client reactions personally.

Curb-side has highlighted the real need for efficiency and confidence in discussing treatment plans and pricing. Many doctors and staff are spending way too much time back and forth on the phone sorting these things out…and many pass off these conversations to avoid them. The result? Time inefficiencies, confusion, and lack of standardization in recommendations and gaining consent.

By creating the dedicated role of Consent Coordinator, your organization will not only benefit from a streamlined process regarding treatment plans, consent and payment, but your medical staff can get back to focusing on treating patients which will decrease appointment time and increase client satisfaction

Surgery Team

This role consists of two to three (+) people whose sole job is to facilitate patient surgery. This includes pre-op labs, prep, anesthesia, surgical assistance/monitoring, post-op and discharge. The benefit? Improved patient care, decreased anesthesia accidents and increased efficiency, which will likely increase the number of surgical cases that can be scheduled per day. 

The key here is dedicated staff. These people should not be pulled away to restrain for another appointment, refill a prescription or take an unrelated phone call. They must be allowed to focus on the surgery rotation to keep it moving smoothly. This will allow them to enhance their skills, develop a rhythm and establish trust with the veterinarian. 

As a result, veterinarian workflow becomes much more efficient. When supported by a trusted surgery team, the veterinarian can do their initial physical exam, sign off on the anesthesia plan and then continue with other duties (writing records, refill authorizations, necessary phone calls, etc.) until it’s time to perform the surgery. Once complete, they can leave post-op to their trusted team while they once again focus on other duties. 

By creating a dedicated Surgery Team, not only will patient care and client service improve, your team members will actually enjoy their jobs much more because they are able to utilize the knowledge and skills they were trained for. And, don’t forget, the increased efficiency and pattern of workflow is good for everybody.

3. Appropriate delegation 

There are two main areas where improving delegation of responsibility will have a massive impact on daily work flow, patient care and morale: Call Backs and Client Education.

Call Backs

Only about 10% of client calls need to be returned by the doctor (no matter what the client says). The remaining 90% can be returned by a veterinary technician or assistant under the doctor’s guidance. Instituting this system has many benefits: 

A) It reinforces the concept of the veterinary healthcare team to the client and, given time to adjust, clients will accept (and even request) talking to a trusted technician or assistant as an extension of their primary veterinarian;

B) It keeps the doctor focused on doing the things only they can do (diagnose, prescribe and surgery); 

C) It improves overall efficiency and workflow because doctors are not stuck on the phone in non-critical conversations. 

Client Education

There are a variety of topics we regularly educate clients on…vaccine protocols, diet, exercise, spay/neuter, parasites and prevention, dental health, urinary health, diabetes, thyroid disease, ear infections, atopy and so on. And one of the greatest frustrations for the veterinary team is when they educate a client and then at a later date it becomes clear that the client didn’t understand. Many of us conclude they didn’t listen, but I’d argue that’s not the case.

When we throw a bunch of information at a client, particularly when it involves a new diagnosis for their pet, it is overwhelming. On a good day, people only retain about 20% of what is told to them—under stress, it’s less—and add to that the differences in learning styles (not everyone is an auditory learner!)

The solution? Visual backup! It has never been easier to create educational PDFs to print out and send with the client. They can take a little time to create on the front end, but once complete, the same document can then be used over and over. They can also be emailed. 

In addition to PDFs, educational videos are also super easy to create and inexpensive platforms exist to host them. You can include a link (or even a QR code) on a handout or in your discharge instructions or receipt prompting the client to review the additional information. 

The benefit? The client has an opportunity to learn and integrate the information you’ve provided between appointments so the next time they come in or call, they come with useful questions instead of total confusion and the need to start again at square one. This not only makes client interactions more efficient, it also improves patient care and service. +

The post The Silver Lining of COVID-19 for Veterinary Medicine appeared first on PetVet Magazine.