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A sick dog is lying on the carpet. Treatment of dogs at home

Talking About OA with Your Clients Doesn’t Have to be Painful

Mary Ann Vande Linde, DVM, Vande Linde & Associates, Brunswick, GeorgiaOsteoarthritis is the most common joint disease diagnosed in humans and pets. What does this mean to a veterinary team? It means that a high percentage of pets and their owners have some familiarity with the discomfort and pain of joint disease. I’m sure we have all had clients tell us they have noticed a change in their pet’s activity, but they usually pass it off as normal for his/her age or suggest their pet is just “slowing down.” This belief does not mean that they don’t care; they just do not understand that what they are seeing may be due to pain. There are some simple communication tools your team can utilize to add value and increase a client’s understanding and acceptance that osteoarthritis (OA) is not normal, and their pet has options.

One of my mentors once told me “never tell a client what you can show them.” A client may see their pet hiding or not playing, and they will need assistance determining if their pet is painful or fearful. Using the Fear Free Strategies of Considerate Approach (CA) and Gentle Control (GC) allows the pet to be comfortable enough to exhibit OA signs in the client’s presence. With CA, a relaxing atmosphere can be created where the pet can have room to move and be observed. Adding pheromones to help keep them calm and non-slip surfaces both on and off the exam room table enables them to safely explore. In addition, with GC, veterinarians can examine the pet where he or she prefers and is most comfortable. Make sure to plan ahead by having materials easily accessible, and have assistance available in the room so the veterinarian can keep a gentle reassuring hand on the pet. Later during the physical exam, the doctor can communicate how their assessment relates to what the client sees their pet experiencing.

To be efficient and consistent communicators, teams need tools that open clients’ minds to possibilities. The Zoetis Canine and Feline OA Screening Checklists can be a discussion starting point. These checklists have “cartoons” of cats and dogs doing common activities around the home that have been identified through research as top behaviors that can indicate OA pain.^1,2

This visual checklist allows the client to see their pet’s behavior changes through the animations. They can see how a healthy cat moves compared to a cat who has unhealthy changes from OA pain. With a checklist a client can tell the veterinarian what they see in comparison to the pictures, or they can review a video of what their pet is doing compared to the cartoon. By reviewing the checklist with a trained technician or veterinarian, the client can offer insight into how they view their pet’s mobility, behavior, and daily comfort. This checklist can be used prior to any exam with an email electric copy, or completed in the room by computer, phone, or as a printed hard copy. This could be a valuable addition to any biannual or annual checkup.

Age is not a disease. And we have tools, strategies and skills that make client discussion interactive, efficient and fun. Clients love to learn about their pets, they want a plan, and they want to feel confident they have made good decisions. Combining the tools of an interactive team checklist, Fear Free strategies of CA and GC and using open questions with active listening create productive discussions, save time, and produce healthier teams and pets. Go ahead talk about OA with these tools: it’s painless.

References

Enomoto, M. (2020). Development of a checklist for the detection of degenerative joint disease-associated pain in cats. Journal of Feline Medicine And Surgery
Wright, A. (2019). PVM1 Diagnosis and treatment rates of OA in dogs using a Health Risk Assessment (HRA) or Health Questionnaire for OA in general veterinary practice Value In Health, 22, S387
Adams, C., & Kurtz, S. (2017). Skills for communicating in veterinary medicine. Oxford: Otmoor Publishing.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Sponsored by our friends at Zoetis Petcare. NA-02335

Communicating the Value of Fear Free to Your Clients

Dr. Julie Reck, Owner, Veterinary Medical Center of Fort Mill, Fort Mill, South CarolinaMore than ever, pet owners have a strong bond with their pets. That means they are expecting their pet’s experience at the clinic to be enjoyable. Fear Free provides that excellent “customer” experience for both the pet and the pet owner. However, a client’s first Fear Free experience will likely be different from previous veterinary visits and could seem strange. It is important to ensure that each client fully understands that Fear Free considers both the medical and emotional well-being of their pet and realizes the significance of taking both aspects of the pet’s care into consideration.

Three Key Messages for Our Practice

We believe in the power of positive reinforcement. Patients will be treated kindly and receive lots of treats and verbal encouragement.
Fear Free is reinventing the definition of a successful veterinary visit. It is no longer acceptable to “just get it done.” We take into consideration where the patient is emotionally and proceed appropriately, which may mean that some things will not get done during a visit. For example, toenail clipping may have to be done another day if the patient elevates to moderate signs of fear, anxiety, and stress (Level 3 FAS).
Our hospital has a consistent approach to handling and treating our patients: Everyone is practicing Fear Free techniques with every patient.

Below are tips for successfully communicating the benefits of Fear Free to your clients.

Maximize Your Social Media Presence

Currently I have owners seeking out my clinic specifically for the Fear Free experience, but in the beginning this was not the case. It became obvious to me that the benefits of the Fear Free visit needed to be stated clearly in all my communications.

For the pet owner, the Fear Free journey begins before they get to the clinic. I want my clients to be educated consumers, so they “know before they go,” or, in other words, they know what to expect when they arrive at my clinic. My website and my clinic’s Facebook page fully communicate this to pet owners. We take a proactive approach to prepare the client for a positive experience. This includes stating our philosophy on what a good veterinary experience looks like for the pet and the pet owner using videos, testimonials, news feeds, or stories to keep pet owners informed and prepared for that great Fear Free experience.

The Customer Service Representative (CSR) Prepares the Client and Pet for the Visit

Our CSRs are the next line of communication. They are trained to answer any questions about Fear Free and are critical in making sure that the pet arrives safely and prepared for the visit.

Safety includes recommending that the pet is either in a carrier or harnessed/seat belted while in the car, and that they have a collar and leash if walked into the clinic or stay in the carrier until in the exam room. The carrier can provide the pet a sense of comfort.

Being “prepared” for the visit means making sure the pet arrives hungry and that we have their favorite treat ready for them when they arrive. A day or two before the visit, we send the owner a reminder email and/or text with these same instructions.

Continuing to Communicate During the Examination

The examination provides an opportunity to have a conversation with the pet owner, allowing them to feel more involved with the entire process. I will explain what I am doing, such as standing behind the patient instead of examining their head and face first. I will also describe the patient’s emotional status based on the patient’s body language and my physical findings. This prepares the owner for any diagnostic and/or treatment recommendations that I make, and they are more likely to be compliant with my plan.

Additionally, if the patient’s level of FAS does not allow the completion of the exam or planned procedures, such as nail clipping, the client will be more likely to understand because of the ongoing conversation about the patient’s behavior and emotional status.

It is also important that the pet owner understands their pet’s level of fear, anxiety, and stress will change, based on the situation. A dog who typically loves coming to the clinic may behave differently when coming in for examination and treatment of a painful ear infection. Where we may have never needed to sedate in the past, it is necessary now to ensure that the patient had the best possible experience because the dog’s pain has exacerbated his level of fear.

For patients with a history of severe veterinary visit FAS who we are seeing for the first time, we will inform the pet owner that the first visit will be a consultation. We take the patient’s history, perform a visual examination, but forgo the physical examination to keep the FAS level as low as possible. We may prescribe PVPs and/or schedule a series of “Happy Visits” where the patient arrives, receives treats, then leaves before we ever get to the hands-on physical exam.

What About the Client Who Fails to See the Benefits of Fear Free?

For clients who are more interested in “just getting it done,” I will inform them that the goal is to consider the long-term emotional wellbeing of their pet rather than the short-term approach of “just getting it done.” Some clients will understand and comply. For those who do not, we will agree to disagree and part ways.

It is important that the clinic owner and staff back this decision and uphold the values the Fear Free team has agreed upon. This is especially true if the pet owner is loud and unpleasant. Professional affirmation for the decision and support from colleagues can reinforce that one negative encounter with a client cannot undermine all the positive feedback and improved patient outcomes that comes with being Fear Free.

I have found that it is the small consistent changes that accumulate over time that get you to Fear Free. You might start with pheromones and see a subtle difference, then add in Considerate Approach and Gentle Restraint with liberal use of treats and see more of a change. As you continue to master the techniques and communicate the benefits of Fear Free, you will find that you and your staff are emotionally enriched, your clients have a renewed feeling of trust and bonding to you, and your clinic and your patients are actually happy to see you!

Sponsored by our friends at Zoetis Petcare. NA-02292

Reduce Bite Risk by Teaching Children Not to Approach Fearful Dogs

Linda LombardiChildren up to nine years old are at highest risk of being bitten by a dog. A new study confirms previous research that children are not very good at recognizing fear in dogs and reveals an additional issue: even when they do recognize fear, children are just as likely to approach a fearful dog as a happy one. This has important implications for how we educate children and parents to minimize the risk of bites.

The study used images and video clips of dogs showing behavior signals in three categories: frightened/aggressive, defensive/aggressive, and happy/playful. These were reviewed for accuracy by an experienced dog trainer with a bachelor of science degree in animal behavior. They were shown to children ages 4 to 5 and 6 to 7 years who were then asked questions to assess how well they identified the dog’s emotional state, how confident they were about their interpretation, and how likely they would be to approach the dog.

Study Method

Children rated the dogs’ emotions on a chart using cartoon images and a five-point scale. They also rated on a five-point scale questions about how they would act toward the dog, including “Would you pat this dog?” “Would you cuddle this dog?” and “Would you sit next to this dog?”

The children were relatively good at recognizing angry dogs but less able to recognize frightened ones: only 56 percent of 4- to 5-year-olds and 76 percent of 6- to 7-year-olds accurately recognized frightened dogs.

Knowledge Doesn’t Mean Safety

However, the ability to recognize a frightened dog did not mean that a child would behave safely by avoiding that dog. Children were unlikely to approach an angry dog, but 81 percent of children answered that they would approach dogs they recognized as frightened. Statistical analysis also found no difference in the likelihood that children would approach a frightened dog compared to a happy one.

Children’s intuition about how to behave around an angry dog seems good, so why the difference with fearful ones? Coauthor Sarah E. Rose of Staffordshire University says, “It is possible that young children may think that it is okay to approach a frightened dog as when they themselves feel frightened, physical comfort can be reassuring. They fail to recognize that the dog’s feelings and reactions in this situation may be different to their own.”

The study also looked for effects of age and whether children lived with a dog or not but did not find consistent differences. “Children do show some improvements in correctly recognizing the emotion with age, and there is also some evidence that those growing up in a house with a dog may be a little better at recognizing the emotions,” she says. “But these findings are not consistent for all emotions.”

Lisa Radosta, DVM, DACVB, says, “This study shows at least one reason–there may be others–that children are the most common bite victims. They are not adept at recognizing frightened dogs, and even when they are able to recognize them, they don’t know how to interact with those dogs.”

Practical Prevention

This has implications for parents, behaviorists, and the design of dog-bite prevention programs. Dr. Radosta says parents need to educate themselves and their children. “The best practical advice is to prepare the dog for the child before the child is born and educate little ones with pictures that they can comprehend as soon as they are born,” she says. “We read with kids from day one, why not read picture books about dogs and cats?”

Adults also need to be aware of both their dog’s signals and the risk that a child may approach a fearful dog. “Adults don’t recognize fearful behavior and they do not understand that any animal can bite if the circumstances are stressful enough. As a result, chances are taken that should not be taken,” she says. “Make sure to practice proactive supervision all the time.”

The authors note that while there is evidence for at least short-term benefits for dog-bite prevention education programs, this mostly evaluates children’s ability to recognize risky situations and their performance on tests of knowledge, rather than their ability to recognize dog signals and how they behave in response. The results of this study suggest that programs should explicitly teach children both how to recognize behavior and that fearful behavior means that a dog wants to be left alone, rather than wanting the hug that they themselves would find comforting.

“Children seem to have a relatively good understanding that they should not approach an angry dog, but this is lacking for frightened dogs,” says Rose. “We recommend that children should be explicitly taught not to approach frightened dogs.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Linda Lombardi writes about the animals who share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.

Taking Fear Out of the Veterinary Visit for Pets and Owners

Taking Fear Out of the Veterinary Visit for Pets and Owners

If we want to do what is best for the pet when they are in for a preventive care visit (run diagnostics) and what is best when they are sick and injured (early presentation, diagnostics before therapy) then we need to see the patient! In this webinar, Dr. Peter Brown discusses how creating a Fear Free environment will help you communicate with your clients.

Dr. Brown also covers:

* Home tips and tricks on preparing clients for what to expect and decreasing the fear of the unknown
* Tools and process changes that will improve in-hospital client communications
* Simple and easy ways to integrate technology into the client journey, enhancing their experience

Six Client Tips for Puppy Socialization

Six Client Tips for Puppy Socialization

Veterinarians often recommend that new puppy owners actively socialize their puppy during the sensitive socialization period. Well-intentioned pet parents may take that general guidance and inadvertently create, not prevent, problems. In this webinar, Jacqueline Neilson, DVM, DACVB, demonstrates how sharing six socialization principles will allow veterinary staff to help owners make wise choices for socialization that promote the pups’ emotional and physical wellbeing.

Groomer Client and Colleague Communication

Course Overview

As a Fear Free groomer, you now understand the benefits of grooming this way. But what about explaining it to your clients or your colleagues? If you sometimes meet resistance or questions and would like some quick and handy “sticky scripts” to use for both your peers and your clients, this module is for you!

Created based on feedback from Fear Free Certified Groomers and written exclusively for them, this one-hour module will equip you with short phrases to make explaining different aspects of Fear Free simpler for you.

This module is COMPLIMENTARY to all professionals that are already signed up for the certification program.

Client and Colleague Communication is divided into four lessons:

Lesson 1: Defining Fear Free Grooming
Lesson 2: Communicating with Colleagues
Lesson 3: Addressing Common Challenges
Lesson 4: Turning Clients into Teammates

Weathering the Storm: Disaster Preparedness for Pet Professionals and Pet Owners

Weathering the Storm: Disaster Preparedness for Pet Professionals and Pet Owners

If a disaster hit your community tomorrow, would you and your business be prepared? How about the animals that live in your home or community? It is never too late to begin planning for a disaster or business disruption. In this webinar, representatives from State Farm talk about disaster preparedness, having a business continuity plan, and what insurance does and doesn’t cover. Whether you are a pet professional or a pet parent, this webinar can help you prepare for and recover from the unexpected.

How to Raise a Gentle PUP: 3 Tips to Share with Every Puppy Parent

How to Raise a Gentle PUP: 3 Tips to Share with Every Puppy Parent

“PUP” isn’t just short for “puppy.” It stands for three core puppy-raising principles: Praise, Unflappable, and Prevention.

In this webinar, Jacqueline Neilson, DVM, DACVB, covers how to:

Provide puppy parents consistent and concise behavioral guidance during veterinary visits to assist them in raising a gentle, behaviorally healthy dog.
Make sure every puppy parent knows at least three core PUP raising principles: Praise, Unflappable, and Prevention.
Make PUP part of the dialogue for every puppy parent at every visit.

5 Ways to Have the Worm Conversation with Your Clients

When clients come to your clinic and discuss the parasites that worry them most, they often start with ticks and fleas because they’re visible — they can see the threat. As a veterinary professional, however, you know there are other dangerous parasites they can’t see, including more than just heartworm. You also know that recommending broad-spectrum parasite protection isn’t a sales tactic; it’s good medicine. So how do you start the conversation about the importance of protecting dogs against other types of parasites in a way that pet owners will understand, appreciate, and ultimately listen to?Here are five conversation starters to help your clients understand the risks and why intestinal parasites can pose a bigger problem than they may think.

1. Parasites disrupt the pet owner-pet bond.

No pet owner wants to see the dreaded “rice” on their dog’s rear, or learn their dog has been shedding eggs from intestinal parasites and contaminating their yard. Intestinal parasites aren’t just stressful for pet owners, but for pets, too. An indoor dog could suddenly be relegated to the outdoors or confined to a single room – all while a frantic pet owner tries to reach their veterinarian after hours. Dogs are intelligent creatures, but that doesn’t mean they will understand why their owner is suddenly distant, worried or disgusted. The bottom line: Parasitic infections can undermine efforts to create a warm, inviting, Fear Free home for a pet.

2. Intestinal parasite prevalence rates are rising.

The average number of heartworm-positive dogs per clinic increased by 21.7 percent in a 2017 survey conducted by the American Heartworm Society.¹ While pet owners may recognize the importance of protecting against heartworm, they might not realize the threats posed by intestinal parasites as well. Along with the increasing threat of heartworm, prevalence rates of intestinal parasites are also on the rise. In shelter dogs:

Canine hookworm (Ancylostoma caninum) prevalence rates increased from 19.2 percent average prevalence nationwide in 1996 to 29.8 percent in 2014^2,3
Canine whipworm (Trichuris vulpis) prevalence rates increased from 14.3 percent average prevalence nationwide in 1996 to 18.7 percent in 2014^2,3

3. Pets are out and about (and exposed) more than ever.

Dog parks are prime areas for the spread of parasites like hookworm, whipworm and roundworm. In a pilot study conducted across the Dallas-Fort Worth area, 80 percent of sampled dog parks had at least one dog test positive for intestinal parasites.⁴ If a client frequents dog parks or other areas with lots of dogs, they should know that it increases their dog’s risk of picking up a parasitic infection.

4. Shelter dogs may increase parasite prevalence in your area.

Did you know nearly two thirds of animal shelters and rescue organizations do not test, treat or provide heartworm prevention before transporting dogs? From 2014 to 2017 shelters imported 114,000 dogs to Colorado, and during that same time period Colorado saw a 67.5 percent increase in heartworm prevalence. Even if you practice in an area with historically low parasite prevalence, shelter dog relocation may contribute to a higher local risk of parasitic disease for your clients.⁵

5. Owners and their families are at risk, too.

Pet owners often don’t realize that zoonotic disease transmission is a real threat to their families, especially young children.⁶ If clients question the necessity of intestinal parasite protection, explain that roundworm eggs can remain in an environment for years⁶ — leaving pets and human family members at risk long after the problem was thought to be “over.” Even walking around barefoot in their own yard could be a risk, because infective hookworm larvae can penetrate human skin to spread zoonotic disease.⁷

Regardless of the many Fear Free reasons to protect against intestinal parasites, educating pet owners on the risks of these “hidden” parasites can be a challenge. Using the conversation starters above can help support a recommendation for heartworm prevention that also protects against hookworm, roundworm, whipworm, and tapeworm, as well as potentially increasing compliance. After all, a client who understands the value of intestinal parasite protection for their pet is that much more likely to administer it.

References

1. American Heartworm Society. AHS survey finds increase in heartworm cases. Available at: https://d3ft8sckhnqim2.cloudfront.net/images/bulletin/AHS-1705-May-17-Summer-Bulletin.pdf?1535050388. Accessed June 20, 2019.
2. Blagburn BL, Lindsay DS, Vaughan JL et al. Prevalence of canine parasites based on fecal flotation. Comp Cont Educ Pract. 1996;18(5):483-509.
3. Blagburn BL, Butler JM, Mount J, et al. Prevalence of internal parasites in shelter dogs based on centrifugal fecal flotation [abstract]. In Proceedings AAVP 59th Annual Meeting. Denver; 2014. 26-29 July 2014.
4. Elanco Animal Health. Data on file.
5. Drake J, Parrish RS. Dog importation and changes in heartworm prevalence in Colorado 2013-2017. Parasite Vector. 2019;12:207.
6. Companion Animal Parasite Council. Ascarid. Available at: https://www.capcvet.org/guidelines/ascarid/. Accessed May 16, 2018.
7. Companion Animal Parasite Council. Trichuris vulpis. Available at: https://www.capcvet.org/guidelines/trichuris-vulpis/. Accessed May 16, 2018.
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.This post is brought to you by our sponsor, Elanco, the makers of Credelio^® (lotilaner) and
Interceptor^® Plus (milbemycin oxime/praziquantel).INDICATIONS FOR CREDELIO

Credelio kills adult fleas, treats flea infestations (Ctenocephalides felis) and treats and controls tick infestations [Amblyomma americanum (lone star tick), Dermacentor variabilis (American dog tick), Ixodes scapularis (black-legged tick) and Rhipicephalus sanguineus (brown dog tick)] for one month in dogs and puppies 8 weeks or older and 4.4 pounds or more.

IMPORTANT SAFETY INFORMATION FOR CREDELIO

The safe use of Credelio in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures. The most frequently reported adverse reactions are weight loss, elevated blood urea nitrogen, increased urination, and diarrhea. Please see full Credelio product information for complete safety information or contact your veterinarian.

INDICATIONS FOR INTERCEPTOR PLUS

Interceptor Plus prevents heartworm disease (D. immitis) and treats and controls adult hookworm (A. caninum), roundworm (T. canis, T. leonina), whipworm (T. vulpis) and tapeworm infections (T. pisiformis, E. multilocularis, E. granulosus and D. caninum) in dogs and puppies 6 weeks or older and 2 pounds or greater.

IMPORTANT SAFETY INFORMATION FOR INTERCEPTOR PLUS

Treatment with fewer than 6 monthly doses after the last exposure to mosquitoes may not provide complete heartworm prevention. Prior to administration of Interceptor Plus (milbemycin oxime/praziquantel), dogs should be tested for existing heartworm infections. The safety of Interceptor Plus has not been evaluated in dogs used for breeding or in lactating females. The following adverse reactions have been reported in dogs after administration of milbemycin oxime or praziquantel: vomiting, diarrhea, depression/lethargy, ataxia, anorexia, convulsions, weakness, and salivation. Please see full Interceptor Plus product information for complete safety information or contact your veterinarian

Credelio, Interceptor, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates.
© 2019 Elanco. PM-US-19-1483

Motion Sickness: Helping the Client/Pet Bond

Motion Sickness: Helping the Client/Pet Bond

There is nothing fun about having a client arrive at your clinic with a dog who just vomited all over himself. Many times motion-sick dogs are stuck in homes and are never taken anywhere fun because their owners don’t want to deal with the mess. Clients end up dreading putting their dog in the car, and as a result there’s a disconnect between the owner and dog. In this webinar, Amy N. Newfield, CVT, VTS (ECC), reviews why motion sickness occurs and how to help the client/pet bond get stronger.

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