3 Remember the 3 Rs. For every patient and every disease process there should be one of these: a Reminder entered for the next exam, vaccination or blood test; a Recheck appointment scheduled; or a Recall to contact the client again.
4 The client education, call‐back and follow‐up should be done in a kind, gentle, and professional manner by well‐trained employees.
Include STT with senior wellness panels for dogs.
Include blood pressure measurement for every senior feline exam.
Offer preanesthetic ECG screening for every patient, not just blood testing.
Monitor blood pressure every six months for dogs on phenylpropanolamine.
Offer ECG screening annually for every large‐breed dog with genetic risk for cardiomyopathy, including boxers and Doberman pinschers. VPCs often precede heart failure in dogs of these breeds when cardiomyopathy is developing.
Offer NT‐ProBNP screening for giant breeds, which don't usually develop VPCs with their cardiomyopathy.
We have hundreds of opportunities every week to teach our clients about what is available to them, why it's important for their pets, and how we can deliver it.
What we choose to recommend or educate our clients about at a given visit is a combination of what the pet owner wants from us and what we need to discuss, based on our risk assessment for the pet. We have to prioritize, and we also need to be brief.
We need a plan or program for every type of routine visit, in order to maximize our opportunities.
The pet owner has the right to make the decisions for their pet's care. It's our job to give clients the information they need to make responsible choices.
The opportunity to deliver pet‐specific care comes at a cost. You cannot necessarily deliver high‐quality care while remaining a low‐cost provider.
Abbreviations
DNADeoxyribonucleic acidECGElectrocardiogramNT‐proBNPN‐terminal pro B‐type natriuretic peptideVPCVentricular premature contraction
Reference
1 1 Institute of Medicine Committee on Health Literacy, Board on Neuroscience and Behavioral Health, and Institute of Medicine of the National Academies (2004). Health Literacy: A Prescription to End Confusion. Washington, DC: National Academies Press.
Recommended Reading
1 Baldwin, K., Bartges, J., Buffington, T. et al. (2010). AAHA nutritional assessment guidelines for dogs and cats (Canine & Feline). Journal of the American Animal Hospital Association 46: 285–296.
1.5 Feline-Friendly Care
Jane Brunt, DVM
Cat Hospital At Towson (CHAT), Baltimore, MD, USA
1.5.1 Summary
Cats are the most unique and ubiquitous household pet. As a species, they are obligate carnivores and normally exhibit behaviors related to being both predators and prey, hunters and hunted. As such, cats are frequently lumped together as if they are all the same when, just like people, they are individuals with different experiences, different responses to external stimuli, and therefore different needs. A variety of so‐called personalities are frequently described, including the widely used “scaredy‐cat” descriptor. Pet‐specific care is a practice philosophy involving transformation from the current reactive model to a proactive version of care. This must start with understanding normal behavior for cats as a species and recognizing individual expressions of behavior. This is the foundation for being both feline friendly and pet specific.
1.5.2 Terms Defined
Body Language (Feline): Communicating nonverbally through movements or position. When properly reading a cat's body language, veterinary team members and cat parents can recognize how cats feel. Body posture and facial expression, including ear set and whisker positions, provide significant information on a cat's level of arousal, distress, and pain. This is a key feature of being feline friendly because an astute observer of cats' body language can alter their interaction with the cat accordingly in advance of any necessary physical contact.
Environment Enrichment (Feline): Availability of resources for a cat to exhibit normal behavior where it lives, including physical, nutritional, elimination, social, and behavioral resources. Examples include providing adequate space and locations for eating and drinking, resting and sleeping, playing and perching, hiding and personal space, and elimination. Thoughtful, open‐ended client queries can explore the number and location of food and water stations, toys, perches and resting areas, and litter box number, location, and substrate(s).
Ethos: The distinguishing character, sentiment, moral nature, or guiding beliefs of a person, group, or institution. An ethical appeal using credibility and character.
Handling (Feline): The term and mindset which should replace the concept and the word “restraint” in all veterinary practices. Scruffing has been shown to be detrimental in handling cats due to the stress and distress it can cause.
Heightened Arousal (Feline): Arousal is a state of heightened activity in mind and body that makes individuals more alert. It manifests along a spectrum from low to high. An individual can be slightly aroused or extremely highly aroused. Arousal is the result of stimulation related to a change in places, people, and patterns with which a cat is familiar and is an outcome of stress, anxiety, fear, or a combination of all three. Fear aggression is a common sequela in cats, and it is important to avoid labeling it as mean and understand the cat is scared, which allows us to act with empathy.
Medicalization: The process by which conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new evidence or hypotheses about conditions; by changing social attitudes or economic considerations; or by the development of new medications or treatments. Medicalization is also a term used to describe the percentage of animals receiving veterinary care over a 12‐month period.
1.5.3 The Data is for the Dogs
Companion cats outnumber dogs in the US, Canada, and many other nations, yet comprise only 25–40% of patients in typical companion animal veterinary