Information about our vet world on the Balkans
Regulatory Convergence Key to Improve Access to Veterinary Medicines say Global Veterinary Associations
Eleven global veterinary associations have signed a Position Statement calling for increased regulatory convergence and harmonization in order to ensure that veterinarians globally can access the medicines they need to treat their patients. The Statement, initiated by the World Small Animal Veterinary Association (WSAVA), is the latest step in its campaign to secure more equal access to vital veterinary medicines for companion animal veterinarians around the world.
Restricted access to veterinary medicines because of regulatory issues in regions of the world including Eastern Europe, Africa and Asia, is a long-standing problem and limits the efforts of many veterinarians to provide optimal care to their patients. Sometimes, even essential medicines, such as those required to properly manage pain, are difficult to access, causing immense and unnecessary suffering.
The WSAVA recently formed a Therapeutics Guidelines Group (TGG) to spearhead its work in this area and to campaign to ensure more open access to these medications. Its new Position Statement is designed to raise awareness of the problems around regulation and to call on governments and regulatory bodies to act. The Statement has been endorsed by:
- The World Veterinary Association
- The Federation of European Companion Animal Veterinary Associations
- The Commonwealth Veterinary Association
- The Federación Iberoamericana de Asociaciones Veterinarias de Animales de Compañía
- The Federation of Asian Small Animal Veterinary Associations
- The Federation of Veterinarians of Europe
- The Federation of Asian Veterinary Associations
- The Fédération des Associations Francophones Vétérinaires pour Animaux de Compagnie
- The Caribbean Veterinary Medical Association
It follows a 2018 Position Statement from the WSAVA outlining a range of factors which restrict global access to veterinary medicines and the significant impact on animal health and welfare this causes. This statement also received wide support from the veterinary sector, including those associations listed above.
In a survey of its members conducted by the WSAVA during 2016-2017, 75% of respondents confirmed that that problems in accessing veterinary medical products hampered their ability to meet the needs of their patients and 20% assessed the impact of this issue as resulting in a severe restriction on their ability to provide a high level of care. During its 2019 World Congress in Toronto, Canada, in July, the WSAVA’s Therapeutics Guidelines Group convened a summit meeting of global veterinary associations and stakeholders to discuss potential solutions. The new Position Statement was one of the outputs from this meeting.
Commenting, Dr Walt Ingwersen, WSAVA Past President, said: “Difficulty in accessing therapeutics to treat patients is a critical issue for companion animal veterinarians in many parts of the world. It causes huge frustration and means that many, if not most, companion animals globally do not receive optimum care. It’s a situation which requires urgent change and, working in partnership with our colleagues across the veterinary sector, we are focused on bringing this about.
“While a number of issues impact the supply of veterinary medicines, duplication of the regulatory medicines approval process in various regions of the world is one of the biggest and the focus of our Joint Position Statement on Regulatory Convergence. The WSAVA Therapeutics Guidelines Group has been working hard on the issue of access to and availability of veterinary medicines and will shortly be announcing the first of a set of practical tools to support veterinarians and their associations to lobby their own governments and regulatory bodies.
“To support them, we, as a global veterinary community, will continue to demand change at a global level and our Position Statements are proving effective in increasing understanding and prompting action.”
He added: “We thank our colleagues in other veterinary associations for standing with us and we will continue to collaborate closely to ensure that all veterinarians have access to the drugs they need to treat their patients.”
The WSAVA represents more than 200,000 veterinarians worldwide through its 113 member associations and works to enhance standards of clinical care for companion animals. Its core activities include the development of WSAVA Global Guidelines in key areas of veterinary practice and lobbying on important issues affecting companion animal care worldwide.
FECAVA announced Didier-Noël Carlotti Award Laureate: Assistant Professor Dr. Bogdan-Alexandru Vitalaru from Romania
The Didier-Noël Carlotti Award (DCA) is named after a veterinary surgeon who initiated, planned and inspired FECAVA and who served as its first President for four years. The Didier-Noël Carlotti Award is presented annually for ‘outstanding service in the fields of inter-professional communication and/or continuing education for companion animal veterinarians in Europe’.
In 2019, the DCA award will be received by Assistant Professor Dr. Bogdan-Alexandru Vitalaru from Romania.
He was selected for the Award by the DCA Committee and will receive it at the opening ceremony of the 25th FECAVA EuroCongress in St. Petersburg.
Assistant Professor Bogdan Alexandru Vitalaru graduated the Faculty of Veterinary Medicine of Bucharest in 2004, PhD since October 2009, and he has participated since then in numerous national and international conferences, both as a doctor and as a lecturer. Since January 2016 he became Assistant Professor at the Faculty of Veterinary Medicine of Bucharest.
Over the years he has written more than 100 scientific papers on topics related to oncologic surgery, dialysis, hemodialysis and emergencies. His 4 books about emergencies were sold in more than 2000 copies in Romania in the last 4 years. His last book it is completely dedicated to peritoneal dialysis in small animals and it has been released also in English in Italy, Bulgaria, Turkey, Greece, Croatia, Ukraine and Poland starting February 2018.
Since January 2014, in collaboration with BBraun Romania, within the Faculty of Veterinary Medicine, he opened the first Veterinary Hemodialysis Clinic in Romania and one of the few in Eastern Europe.
Starting 2013, he established the Romanian Association of Veterinary Nephrology, Hemodialivet, who’s Chairman he is.
In the last 10 years, Dr. Vitalaru has been a lecturer for Hills Romania and KTL in Romania and Europe regarding urology, nephrology and renal replacement therapies. He is also leading the Emergency Department of the Faculty of Veterinary Medicine of Bucharest since 2015.
Starting 2014, Dr. Vitalaru has initiated a program of workshops and seminars regarding renal patients all over Romania (București, Iași, Cluj, Timișoara, Brașov, Constanța), Bulgaria (Varna, Stara Zagora), Poland (Krakow, Warsaw), Croatia (Zagreb), Italy (Perugia, Pisa) and in Turkey (Istanbul, Ankara, Antalya). He was awarded with the Continuing medical education prize – AMVAC/RoSAVA, Sinaia 12-14 November 2015 and SPEAKER OF THE YEAR – Romanian College of Veterinarians, Bucharest, 17 December 2015. He is a member within the board of some of the most prestigious publications in Romania: Cat life, 2015, Romanian Journal of Veterinary Orthopedics and Imagistic, 2015, Romanian Journal of Veterinary Medicine & Pharmacology, 2016, Romanian Cardiology Review. In 2016, Dr. Vitalaru has received the Special Prize for the best veterinary initiative of the year in Romania – Innovation in Health.
Since November 2017 he is a board member of AMVAC (Small Animal Romanian Practitioners Association), FECAVA Director for Romania and since October 2017, Dr. Vitalaru is FECAVA Ambassador and ROVECCS Ambassador (Romanian EVECCS partener).
His passions are mountain hiking, fishing and nature and as a result of this, he has initiated in 2017 a Vet Camp in the Romanian mountains with vets all around Romania.
The World Small Animal Veterinary Association (WSAVA) and The Webinar Vet have joined forces to offer free access to Virtual Congress 2020 to WSAVA members from countries in which companion animal practice is still developing. Discounted registration will also be offered to all other WSAVA members.
The Webinar Vet’s Virtual Congress is the world’s largest online veterinary congress. The 2020 Congress will take place on February 1 and will include webinars from global experts on a comprehensive range of topics, including companion animal medicine and surgery, dermatology, emergency medicine and veterinary wellness.
WSAVA works to enhance the clinical care and welfare of companion animals globally, representing more than 200,000 veterinarians around the world through its 110 member associations. Its core activities include the creation of Global Guidelines that set standards for veterinary care in key areas of practice, including nutrition, pain management and welfare.
Set up by British veterinarian Anthony Chadwick BVSC Cert VD MRCVS to make continuous education (CE) easier, more accessible and affordable, The Webinar Vet is the largest online veterinary community in Europe and is rapidly extending into the North and South America, Asia and Africa.
Commenting, Dr Chadwick said: “The Webinar Vet aims to help veterinary healthcare team members to become more confident in their practice and to fit their learning into a busy life in the profession without having to take time out of work or to travel.
“Thanks to all the tickets sold to developed countries over the last five years, our 1-4-1 initiative, under which we donate a ticket to one veterinarian in a developing country for every ticket we sell, has already provided free access to Virtual Congress to more than 5,000 veterinarians from developing countries as part of our mission of making CE accessible to all. We hope that by partnering with the WSAVA we can increase this ten-fold and we are delighted to offer all of its members from developing countries free access to the vast array of learning on offer at the event.”
WSAVA President Dr Shane Ryan said: “Increasing access to veterinary CE is the most effective way to advance the skills and knowledge of veterinarians around the world. Online CE can be an affordable and convenient option for our colleagues in those countries where traditional CE access is limited. We anticipate that many of our members will take up the offer of free or discounted access to Virtual Congress 2020 and so take advantage of the great learning on offer.”
Notching up record delegate and exhibitor numbers for 2019, this year’s VET Festival, received an overwhelmingly positive response from delegates for the calibre of speakers and entertainment. The event took place at Loseley Park, Guildford on 7-8 June.
With wellness a strong focus for VET Festival, the Wellness lecture tent was packed for Lara Heimann, an American who has achieved global recognition for her unique vinyasa yoga style and regularly leads international retreats and workshops. Many delegates took their wellness into their own hands by visiting the Wellness Hub for a massage and yoga session while the Family Hub was busy throughout the two days.
Continuing the wellness theme but also embracing eco concerns, event sponsor MWI Animal Health offered delegates the opportunity to use their own energy by cycling on an exercise bike to create a fruit smoothie. On the Friday night, delegates, many in 80s costumes, partied into the night with live music from MadHen.
Clinical speakers received with particular enthusiasm included Dr Ronaldo da Costa, Professor of Neurology and Neurosurgery at Ohio State University, USA, and Laurie Edge Hughes, a veterinary physiotherapist from Canada.
Professor Noel Fitzpatrick said: “It is a real joy to see the VET Festival growing and growing, not just in physical size, but from the immense goodwill that radiates from it. The weather didn’t get in the way of the wellness and there was nothing rainy about the atmosphere at VET Festival – in fact I think that the rain brought us closer together.
“I set out to build a community of compassion for our profession and I genuinely felt that there was a tangible sense of togetherness. There were loads of great conversations with each other and with the exhibitors. The educational content really was world class and the tents were packed. I hoped that VET Festival would be a breath of fresh air, where having an education event outdoors – combined with a focus on wellness of body and mind for all of us – could help vet professionals to be the very best that they could be – and so serve our patients better.
“Everyone there was part of something innovative and refreshing I felt – the delegates, the exhibitors, the team who have worked year-round to create the event, and the fantastic speakers. I’m very grateful to all of them and I sincerely hope that this feeling remains strong for each and every one all year round. The resonant theme this year was ‘kindness’ – to ourselves, to each other, to the families of animals and the animals we are lucky enough to take care of. Nobody is a nobody at VET Festival, and never will be. In that field, we’re all equal, no matter what we do in the vet profession – we all matter – we all want the same thing, which is wellness for each other and the animals we serve – and importantly, we’re all in it together for the greater good, rain or shine.”
Nicole Cooper, Managing Director, Events Division, Fitz All Media, said: “We are all delighted by the support of the industry and welcomed over 1,900 delegates, a 12% increase and 60 exhibitors – a 28% increase on 2018. VET Festival continues to grow because its unique format, half top-flight congress, half festival, offers a laid back and fun environment in which delegates can learn, catch up with friends and have fun. We’re delighted with the response to this year’s event and are already planning to make next year’s event even better.”
Experts from around the world will discuss the implications of research undertaken by the WSAVA’s Professional Wellness Group (PWG) into veterinary wellness in a panel session during WSAVA World Congress. The discussion, called ‘Shaping the Future: Wellness in the Veterinary Profession’, will take place on 17 July, following a presentation of the preliminary results of a study of more than 4,000 veterinary professionals globally. They will be presented by PWG Committee Co-Chair Dr Nienke Endenburg, a human psychologist, who works at the veterinary school at the University of Utrecht, Netherlands.
Recognizing increased concern as to the impact on veterinary professionals of their demanding working environment, the PWG set out to assess professional wellness and the key factors which affect it globally when it launched its online survey in September 2018. Dr Endenburg will present the findings before inviting panelists to respond and discuss their perspectives on the issue. The panel members are:
- Dr Marie Holowaychuk, a Canadian board-certified small animal emergency and critical care specialist and advocate for veterinary team wellbeing
- Dr Jen Brandt, the American Veterinary Medical Association’s Director of Member Wellness and Diversity Initiatives
- Dr Derick Chibeu, Co-chair of the PWG and Honorary Secretary of the Kenya Small and Companion Animal Veterinary Association
- Dr Vicki Lim, who works in New Zealand and is the founder the Riptide Project, an international veterinary wellbeing initiative
- Mr Elwin van Oldenborgh, President-Elect of the International Veterinary Students’ Association.
Commenting, Dr Endenburg said: “Veterinarians care for our animal companions but the question is, who is caring for them? As a global community we wanted to gain a clear understanding of the challenges to their well-being faced by our members around the world and to find out both what they have in common and where their experience differs.
“The results of our research provide a unique global view of this important issue and we look forward to discussing these with our expert colleagues and exploring practical solutions that respect the regional, economic and cultural differences of our membership. It will be an important first step towards bringing about positive change and enhancing the wellbeing of veterinarians globally.”
The WSAVA works to enhance the clinical care and welfare of companion animals globally, representing more than 200,000 veterinarians around the world through its 110 member associations. Its core activities include the creation of Global Guidelines which set standards for veterinary care in key areas of practice, including nutrition, pain management and welfare.
WSAVA World Congress takes place in Toronto from 16-19 July. The Professional Wellness presentation and expert panel discussion takes place at 11.40 am on 17 July.
Vet Business Academy, an amazing association, open to give us the knowledge and help us to make our life better
We are really happy that more and more veterinarians are aware of the needing, to improve our knowledge in a field that is really far of our medical way of thinking, because if we are aware or not, we are managers of our own business. So, we should be open and to start learning how to improve this field.
And we are lucky because we have the sources and the people who can teach us.
One of these opportunities is Vet Business Academy, an amazing association, open to give us the knowledge and help us to make our life better.
VET BUSINESS ACADEMY
- What is our desire?
- Create a vet business community and provide access to business education.
- Provide knowledge and increase vets’ competencies in areas like:
- People management, Communication, Marketing-merchandising, Financial knowledge.
- Improve vet the efficiency of vet clinics by providing better services to clients and improving internal processes.
- Training and workshops to improve vet competencies in business areas.
- Vet consultancy in the business field.
Why us and why now?
- Practical experience in vet clinic management
- Experience in vet industry , local and international.
- Experience in fields like: marketing, communication, planning, business administration and people management.
- Good relationship with KOLs, Universities and local authorities.
- Knowledge of vet legislation and experience in the prediction of future vet business trends.
- Coaching, Leadership, Critical thinking.
- Become more than a Vet clinic
- Provide a consultative relationship model
- Build effective TEAM
- Become preferred Vet Clinic for Vets & Pet-Owner’s
- Differentiate in a crowded market
In 2018 the association has organized plenty of events in Romania.
- Workshops : Communication , People Management, Merchandising , Financial intelligence
- Class – “Mastering Public Speaking”
- Management presentations on AMVAC Congress –Dr.Lowell Ackerman
- Provide the management string in different vet events
If we realize or not, we are part of the economically world, we sale service and together with our love to the animals and our professional, we are responsible about our employers, for their financial comfort and work environment. So, it is time to start learning to be good in this as well
- Hi Luba,
I have followed your journal for a long time, and I sincerely enjoy your success. Hope there are more people like you, radiant and dedicated to your profession.
Your question, “What would make your work easier and what do you need to work with pleasure?” I would answer so …
Our profession is wonderful, our patients too, but we also work with people. For this reason, my answer is exactly the same … people. In my opinion, working atmosphere, our colleagues, our attitude towards each other is very important. Our work is tense and responsible and our day would be lighter if there are more smiles, jokes and teas, mutual help and respect among colleagues.
I will be glad if I can contribute at least a little bit, in order to be more creative, fruitful and happy at my workplace.
- Regarding this issue I think we should look from 2 points of view. From my opinion going to work has always been a pleasure in the last 10 years because passion was my motivation but with the passing of time I understood it is the most important to work in an environment that makes you feel at home because all of us spend more time at work than at home with our families. So the work team need to be united and lead by a leader that work side by side with his employees and motivates each of the members by having a nice attitude and giving money reward when needed.On another hand this job would be perfect if the people’s culture regarding the PET industry will grow somehow in a way more responsible, to give more respect to the medical team, to stop treating us like garbage, to stop asking Dr.Google and to be more aware of what means raising a dog or a cat but that will only happen in another world.
In conclusion I think passion and hard work are the success key in this field.
- I would do it more easily if I didn’t waste my energy on unnecessary things, if I had the understanding and appreciation of my colleagues, encouraging of my mentor, if we stop complaining for things that are difficult to solve or things that don’t work and see all like challenges, replace with the appreciation of things that work, complain but with a good optimist conclusion, make a effort to have good mood and positive energy maybe we can inspire all the team
- The team is most important and the attitude to owners!
- THE TEAM!
- The team is very important! And a boss who trusts you.
So, veterinarians from The Balkans are searching a team, good envoirment for work. Noone spoke about payment, schedule and so on.
I would like to ask every single vet to think with heart and see what we all can do, to work in a good envoirment, to trust more our colleagues and just to be kind. I would like to ask all the leaders to think how they can improve the good envoirment in their own clinic, how to create a TEAM , not just couple of vets in one place. As a vets, we would not see our colleagues as a competition, we should see them as a help and support. We are the first once who should respect our job between us and then to expect this from the owners
I work with them from 3 years and a half. I am one of them. Being very close to them, help me to see how amazing we are. In the region, economically depresses area with many political and administrative complications, working with clients, who don’t have the possibility to pay high level of medicine, we can see them…. Working hard with so much passion and willing to do their best. They have the hugest willing to grow and improve their knowledge, all the time to involve something new in their practice, if spite of, for them is the newest thing and they cant see this new practice in the university, they did not learn this when they were young students.
All of them coming from universities in very low level of education, and when they jump in the practice, all of them are in shock, feeling that they don’t know anything. And all the efforts to learn and be good vet start again, like you have never done before. I will skip the financial part of the efforts before and after the graduation. Because me, as a vet from the Balkans, I even don’t want to calculate how much money I invested in my education and how much money I make per year… .
How much hours per day all of them are working and when they go home, may be start reading and so on. They put 1000 more efforts even to convince the owner to do that examination, compare with vets who practice in countries with better economically environment.
In spite of all these things, I met vets in high professional level, with so much passion and soul full of enthusiasm, doing their best for their patients. I write all these things, because I really appreciate all our efforts and I am so grateful to all the vets from The Balkans, because they give me from their enthusiasm and this is the best feeling ever. This feeling fulfill your heart and you are the happiest person ever. Yes, I have the same difficulties everyday but that feeling is priceless!
Wish all the vets from The Balkans to love themselves more, to appreciate their efforts and job more, to be aware how special they are! Thank you for being part of you!
American physical therapist and Master Yoga teacher Lara Heimann will join veterinary experts from around the world on the speaker panel of VET Festival 2019. The two-day event, now in its fifth year, aims to combine inspiring, world-class CPD for the whole practice team with an outdoor ‘festival’ atmosphere.
Since its inception, the wellbeing of veterinary professionals has been a strong focus of VET Festival and for, 2019, the inclusion of Lara Heimann in the Wellness and Practice Development lecture, takes this to a new level. She is globally recognised for the unique vinyasa yoga style she has developed and regularly leads international retreats and workshops.
Speakers in the comprehensive clinical programme include Dr Antonio Pozzi, Head of the Clinic for Small Animal Surgery at the University of Zurich, Switzerland; Dr Susan Little, co-owner of two feline specialty practices in Ottawa, Canada, and past president of the American Association of Feline Practitioners and Dr Ronaldo da Costa, Professor in Neurology and Neurosurgery at Ohio State University, USA. Other speakers include:
- Veterinary cardiologist Professor John E Rush. A Diplomate of both the American Colleges of Veterinary Internal Medicine and Emergency and Critical Care, Dr Rush has been a professor for 25 years at the Cummings Veterinary Medicine Centre at Tufts University in Massachusetts
- Behaviourist Dr Sarah Heath. A founding Diplomate of the European College of Animal Welfare and Behavioural Medicine
- Soft-tissue surgeon Professor Christopher Adin. Professor Adin is Chair of the University of Florida’s Department of Small Animal Clinical Sciences and Associate Professor of Soft Tissue
Veterinary nurses are welcome to attend any of the lectures, in addition to those in the dedicated nursing stream. An exhibition of the latest products and services for all veterinary professionals takes place in a dedicated arena.
Commenting, Nicole Cooper, event director, said: “VET Festival is unique in bringing together cutting-edge, inspirational learning, fun and the great outdoors. CPD from our world-leading speakers is delivered in a high quality and contemporary setting but, once work is done, we encourage delegates to relax and enjoy free admission for them, their friends and family to the VETFest™ Live Party Night.”
She continued: “With the wellness and wellbeing of members of our profession increasingly in the spotlight, we’re delighted to welcome Lara Heimann for 2019 and hope that she will help our delegates to develop practical solutions to living healthier and more balanced lives.
Supported by MWI Animal Health, VET Festival is a family-friendly event, offering a unique Family Hub, in which parents can listen to lectures while their children play safely without disturbing other delegates.
“Balancing work and family life can often be a juggling act,” Alan White Group Commercial Director at MWI Animal Health, said “particularly in the veterinary profession where time is in short supply. This can sometimes compromise the work-life balance of vets, nurses and other team members. At VET Festival, the ‘Family Hub’ means that there is no compromise and that both our attendees and their families can get the best out of their time with us – and ultimately, at MWI Animal Health, that’s what we are all about – supporting vets, veterinary practices and the veterinary profession, so that they can do what they do best – providing care for the nation’s animals.”
Tickets can be purchased here: https://www.vetfestival.co.uk/delegate-info/ticket-information
Veterinary companies retailing or promoting companion animal products, primary care veterinary practices or referral practices interested in exhibitor or sponsorship opportunities are asked to contact Kara Hiscox at KHiscox@fitzallmedia.com
Notes to Editors
For more information about VET Festival, please visit: www.vetfestival.co.uk.
Author: Dr. Lowell Ackerman is a veterinary consultant, lecturer and author. He is editor-in-chief for “Five-Minute Veterinary Practice Management Consult,” and he lectures globally on medicine and management topics.
[© Lowell Ackerman 2019. No part of this material may be reproduced or copied in any manner without express written consent of author. Some of this material has been abstracted from Five-Minute Veterinary Practice Management Consult, 3rd Edition]
For veterinary medicine to provide real value to pet owners and real financial success for veterinarians, there is a need to focus on being proactive, appreciating risk factors, closing compliance gaps and managing through evidence-based guidelines. This is the essence of personalized medicine and an opportunity that veterinarians should embrace.
I define pet-specific care as veterinary care tailored to individual pets based on their risk of disease and their likely response to intervention. It could also be regarded as the right care, for the right pet, at the right time. This is a common sentiment in medicine, and it is known by a variety of other names, including lifelong care, client-centric care, personalized medicine, precision medicine and genomic medicine. At its core, pet-specific care focuses on prevention, early detection and evidence-based management using a pet’s individual risk factors and circumstances to determine the best course of action.
All veterinarians intend to practice the highest quality of veterinary medicine possible, but this is not always the case. For example:
- Animals continue to contract infectious diseases even when highly effective vaccines exist.
- Animals get parasites despite the widespread acceptance that all pets should have year-round parasite control.
- Diagnoses are often not made until a pet has overt clinical signs of an illness.
- Genetic predispositions are not always considered for each pet in a proactive manner.
- Even well-understood chronic diseases like atopic dermatitis and osteoarthritis are sometimes treated with on-again, off-again regimens despite the lifelong timeline.
Imagine the difference to the health of patients and to the bottom line if we ensured that preventive care was provided to all pets in the practice, that we embraced an early-detection model for disease surveillance based on risk rather than waiting for pets to get sick, and that we tailored treatment to patients on the basis of consistent guidelines rather than by relying on individual expertise to dictate how patients are managed.
Most veterinary practices are aware of the importance of prevention, but inconsistencies between doctors in the same practice, a failure to address compliance gaps, and not standardizing hospital-wide recommendations mean too many pets are not receiving optimal care. Practices lose the compensation that would be associated with such care.
Currently, many pet owners only appreciate the need to see a veterinarian for vaccination, routine care or serious illness. This failure to grasp the true value of pet-specific care can adversely affect the health of pets and the financial health of veterinary practices.
The area with the most need for improvement is early detection. Veterinary health care teams are very good at working up patients with clinical problems (such as polyuria/polydipsia), confirming a diagnosis and instituting treatment. However, a goal of pet-specific care is to identify problems when they are subclinical and the pet still appears well and when the most options are often available for management or prevention.
So, for example, our human physician counterparts would not be as satisfied with diagnosing diabetes mellitus in a patient; the preferred goal would be to identify the pre-diabetic patient and then manage the condition so that it might never evolve into clinical diabetes. For us to achieve the same level of care, we need to embrace early detection and not wait for animals to be clinically ill before we start routine screenings and intervention.
A comprehensive history, physical examination and appropriate periodic diagnostic screenings are the key components of early detection. Diagnostic screenings might include genotypic testing (e.g., DNA) and phenotypic testing (e.g., laboratory findings or imaging) for heritable or otherwise predictable medical issues.
Early detection is easiest if we first take the time to appreciate risk. Some animals are going to be at higher risk for specific conditions than others, based on genetics, family history, breed predisposition, lifestyle, exposure and other factors. Doesn’t it make sense to screen pets at risk for a variety of conditions proactively rather than waiting until the conditions become problematic?
The earliest screening is typically genotypic testing, which can be done as early as 1 day of age but for practical purposes is usually done at around 12 weeks (and after pet health insurance is in full effect, for pet owners who desire this form of risk management). With recent advances it is now possible to cost-effectively screen for dozens of genetic diseases with a single panel. Such panels include things like von Willebrand disease, progressive retinal atrophy, cardiomyopathy, degenerative myelopathy, MDR1 and cystinuria. A variety of laboratories, such as Orivet, Canine Health Check, Embark and Mars, provide comprehensive panels. However, the goal of such testing is not necessarily to identify problems, but to provide most pet owners with peace of mind that there are not underlying monogenic diseases that need to be addressed. This is the purpose of neonatal screening in human hospitals – to identify the rare individual with genetic errors, but to provide comfort to the majority of parents that worrisome disorders were not found in such screenings.
Genotypic testing is new and exciting, but it won’t uncover all risks, so phenotypic testing is needed for many conditions, including diabetes mellitus and orthopedic disorders, based on a pet’s individual risk factors. While genotypic testing can be done early in life since DNA does not change as a pet ages, phenotypic testing, such as blood work, urinalysis and radiographic studies, is usually performed at ages and intervals that vary with the breed and condition being detected.
Diagnostic screenings can provide baseline values and facilitate long-term monitoring to establish trends that might help to identify subclinical disease. Without early detection and management, many of these conditions can lead to a significant decrease in a pet’s quality of life.
Shared Standards of Care
The final aspect of pet-specific care is evidence-based management. Hospitals should endeavor to codify best practices that are common to all veterinarians in a practice and based on the most current guidelines available. These standards need to be periodically reviewed and updated as new evidence becomes available.
Clients want veterinarians to provide health guidelines in accordance with their pets’ actual needs, so adopting and implementing guidelines, protocols and evidence-based care pathways allows the veterinary practice team to satisfy this desire while simultaneously better meeting practice revenue objectives. A suitable starting point is to consider thorough assessments or questionnaires to determine which risk factors might influence the decision-making process, using the information to establish prevention protocols and early-detection opportunities, and then monitoring pets throughout their lives, modifying action plans as needed.
Early therapeutic intervention has been shown to offer the best chance of successful long-term management of many conditions. Clearly distinguishing between curing a medical condition and long-term control is important when discussing the benefits of intervention and disease management with pet owners.
The Bottom Line
It doesn’t take much imagination to see that personalized medicine allows for the delivery of better medicine. With improved prevention, early detection and evidence-based treatment and monitoring, as well as closing compliance gaps, there are many more opportunities for revenue generation just by providing better medicine. In fact, the American Animal Hospital Association has suggested a significant increase in revenue is possible over the life of a pet just by providing the level of care that most veterinarians already acknowledge is needed.
When will you incorporate pet-specific care into your practice?
Author: Dr. Lowell Ackerman is a veterinary consultant, lecturer and author. He is editor-in-chief for “Five-Minute Veterinary Practice Management Consult,” and he lectures globally on medicine and management topics.