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February 2024
The Scoop, February 2024
AAHA Vice President Parva Bezrutczyk, DVM, shows how improvisational comedy techniques can be applied to the world of veterinary medicine. The AAHA Community answers the question: “How do you schedule and charge for sedated exams?” This month’s Scoop news articles include: Disease Discovered in Orphaned Kittens; NAVTA, NAVC Join Forces to Educate Pet Owners About Vet Techs; FDA Approves Oral Solution to Treat Cats’ Anxiety and Fear; Pet’s Quality of Life Drives Owner Decision-Making in Emergency Situations; and more!
View from the Board
Using Tools of Improv on the Front Lines of Vet Med
Despite all the training and credentials we receive in veterinary medicine, we often feel unprepared to effectively solve problems for and communicate with clients who are upset with a customer service experience. A big frustration we face is dealing with situations that do not follow a script or a protocol. It’s easy to become frustrated or overwhelmed when things don’t go the way we expected. A key to finding happiness in veterinary medicine is to develop skills necessary to adapt and respond to challenges with compassion and empathy for others, and for ourselves.
“Yes, and . . .” is a tool from improvisational comedy that can help us respond empathetically to a problem and work towards a mutually beneficial outcome. By making a connection and finding a realistic solution in a service interaction, we can often turn a negative situation into a positive one.
One such example is when a client shows up 15 minutes late for an appointment and still expects their pet to be seen. “I am here for Fluffy’s 9:00 a.m. appointment. We were stuck behind a train and rushed here as fast as we could. I need her to see Dr. Runs-On-Time for an ear infection today.”
A “Yes, and . . .” response sounds like this: “Thank you for coming in with Fluffy. I can understand how worried you must have been trying to make it to your appointment today to have her ear checked. We want to get this problem solved ASAP. Dr. Runs-On-Time’s next appointment opening is next Thursday. Dr. I-Gotchu-Covered has availability at 11:00 a.m. this morning, which ensures we will take care of Fluffy today. Would you like some water and snacks while you wait, or would you prefer to admit Fluffy to stay with us and return at 11:00 a.m. today to speak with the doctor?”
Making a compassionate connection by acknowledging the client’s predicament is the “Yes;” finding a mutually beneficial solution while honoring the boundaries of the schedule is the “and.” Using this combination helps us respond to unexpected situations with empathy and work towards a positive resolution.
Being adept at improvisational communication skills can create opportunities to feel empowered to strengthen relationships with clients and our team and to consistently produce more positive client service outcomes for those we serve.
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Parva Bezrutczyk, DVM, is a co-owner of Arizona Animal Wellness Center in Gilbert, Arizona, and the vice president of the AAHA Board of Directors.
Canine Infectious Respiratory Disease in Oregon
By late 2023, the Oregon Department of Agriculture (ODA) had received over 200 reports of atypical canine infectious respiratory disease from Oregon veterinarians. Veterinarians in other states report similar canine illnesses.
ODA is working with veterinarians and specialists at Oregon State University’s Carlson College of Veterinary Medicine (CCVM), the Oregon Veterinary Diagnostic Laboratory (OVDL), the USDA’s National Veterinary Services Laboratory (USDA-NVSL), and others to find the causative agent behind these cases. By late 2023, the cause remains unknown.
The cases reported to ODA appear as follows:
- Chronic mild to moderate tracheobronchitis minimally or unresponsive to antibiotics with a prolonged (6–8 weeks) duration.
- Chronic pneumonia, minimally or unresponsive to antibiotics.
- Acute pneumonia that becomes severe and often leads to poor outcomes in 24–36 hours.
Dog owners can help protect their pets from respiratory illnesses in general by:
- Consulting a veterinarian about infection prevention and mitigation, as well as respiratory vaccinations.
- Reducing contact with large numbers of unknown dogs and sick dogs (coughing, runny nose, runny eyes).
- Keeping sick dogs at home under veterinary care.
- Avoiding communal water bowls.
Using AI to Improve Clinical Care and Treatments
A state-of-the-art, artificial intelligence (AI)-enabled, digital imaging platform is being developed to collect, collate, and analyze patient data at the University of Florida (UF)’s College of Veterinary Medicine. With support from UF’s Strategic Funding Initiative, this innovative, first-of-its-kind veterinary learning health care system will create a path for the development of medical solutions to treat diseases like cancer. With the aid of molecular and genomic data sets, medical solutions can be customized to each patient.
“We need to do everything we can to eliminate barriers to cancer treatments, and creating an AI-enabled digital imaging platform will help us do that,” UF President Ben Sasse said. “This will be a transformative project that positions UF as a national leader in cancer treatments and medical innovation.”
With the second-highest small animal caseload among veterinary academic hospitals nationwide and more than 110,000 total cases, including large animals and field visits, the college offers a rich resource for data collection.
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QUOTE OF THE MONTH
“Darkness cannot drive out darkness, only light can do that. Hate cannot drive out hate, only love can do that.”
—Martin Luther King, Jr.
Disease Discovered in Orphaned Kittens
Recently published research found that Tyzzer disease—which can affect the intestines and cause diarrhea—is more common than previously believed in orphaned kittens. Often associated with rodents, rabbits, and horses, Tyzzer disease is likely spread environmentally to orphaned kittens, since most of the kittens in the study were born to feral cats. The study was led by Eunju April Choi, DVM, PhD, DACVP, associate professor of clinical pathology, microbiology, and immunology at the University of California–Davis, and was published in the Journal of Veterinary Diagnostic Investigation.
For the study, researchers examined tissue samples from 37 deceased kittens seen at the UC Davis veterinary hospital from 2000–2021. Nineteen of the samples tested positive for the bacteria Clostridium piliforme, the causative organism for Tyzzer disease. Colitis was the major finding in 18 of the 19 kittens, suggesting a connection between a kitten’s diarrhea and the disease.
Clinicians will now investigate testing for Tyzzer disease and determine possible treatments for the often-fatal disease.
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More Than $1M Donation Raised to Care for Underserved Pets
Initiated by the Veterinary Emergency Group (VEG), the 2023 VEG Cares Share Day raised more than $1 million. Half the proceeds go into VEG Cares accounts at participating VEG locations. The other half is donated to charities chosen by VEG employees.
“Each year it is exciting to see hundreds of our VEGgies come together from all over the United States to make a huge impact on underserved pets and other causes they care deeply about,” says David Bessler, DVM, VEG’s founder and CEO.
VEG Cares is supported by donations to provide care to pets in need at all VEG hospitals. These include pets with owners in financial distress; animals displaced by natural disasters; police, service, and fire animals; and animals under the care of a shelter or rescue organization.
How do you schedule and charge for sedated exams?
Right now our sedated exams get scheduled as a drop-off on a doctor’s surgery day; however, this takes up a surgery spot, and we often lose income. Do we drastically increase the cost of these exams to compare to a surgery or is there a more efficient way that wouldn’t require a huge hike in the price? Thank you for your recommendations!
A:
We are a smaller clinic but book these sessions as double appointments.
A:
We gauge this by sedation needs. If it is full sedation, we will schedule it on the surgery side of our protocol but will often tackle other necessary needs like heartworm testing and vaccines to cut down multiple visits for the client.
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AAHA members, share your sedation scheduling protocol tips at community.aaha.org.
For help, email community@aaha.org.
FDA Approves Oral Solution to Treat Cats’ Anxiety and Fear
The US Food and Drug Administration (FDA) recently approved Bonqat (pregabalin oral solution) for alleviating acute anxiety and fear in cats associated with transportation and veterinary visits. Bonqat, a DEA Schedule Class V drug, is only available by prescription from a licensed veterinarian because of its potential for human abuse. Professional expertise is required to monitor the safe use of the product, including proper dosing and administration.
The drug is administered orally approximately 1.5 hours before the start of the transportation or veterinary visit. It can be given on two consecutive days.
Orion Corp., based in Espoo, Finland, conducted a field study in client-owned cats with a history of anxiety and/or fear when transported by car and during veterinary visits. A little over half of cats given Bonqat during the study had a good to excellent response compared to about one-third of cats given a placebo. In addition, 77% of cats given Bonqat showed improvement in levels of fear and anxiety, compared to 46% cats given a placebo.
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AAVMC Partners with Chewy Health to Launch New Veterinary Scholarship
The American Association of Veterinary Medical Colleges (AAVMC) recently announced that Chewy Health, the dedicated health care arm of Chewy, will be providing $300,000 in scholarships to underserved veterinary students. The Chewy Veterinary Leaders Program will reward 15 third-year students with a $20,000 scholarship paid directly to their educational institution via the AAVMC. The program looks to help increase representation within the veterinary profession by working with individuals from underserved groups and communities who might otherwise have limited access to these types of resources.
In addition to financial assistance, Chewy Health’s scholarship recipients will have access to monthly cohort conversations facilitated by Chewy partner MentorVet. This will provide them with support as they navigate the second half of their veterinary education. Postgraduation, participants will be sponsored to join MentorVet Leap, a six-month mentorship and professional development curriculum for early-career veterinarians. They can also join the Chewy Veterinary Leaders alumni network for ongoing networking opportunities.
Photo credit: Irina Samoylova/iStock via Getty Images Plus
Pet’s Quality of Life Drives Owner Decision-Making in Emergency Situations
Veterinarians conducted a study of 132 emergency room cases to better understand how pet owners make decisions when their dogs need emergency care due to nontraumatic hemoabdomen—bleeding in the abdomen without a known cause. The study’s results showed that the pet’s quality of life was the most important factor to owners when it came to deciding between surgery, palliative care, or euthanasia.
The study, published in the Journal of the American Veterinary Medical Association, was led by first author Jenna Menard, DVM, who, at the time, was a veterinary student working in the Cornell University Hospital for Animals (CUHA), where the cases occurred. Menard partnered with professors Skylar Sylvester, DVM, and Daniel Lopez, DVM, DACVS.
The results were unexpected. “We thought that . . . finances and potential for a cancer diagnosis would be the most important factors,” Sylvester said. “But we found that quality of life was the primary driver of decision-making.”
Photo credit: Maria Levkina/iStock via Getty Images Plus
Animal Hospital Employee Union Ratifies First Contract
All Creatures Animal Hospital (ACAH), a small animal and exotic practice in Bremerton, Washington, is now the second US animal hospital where the employees have unionized. Their union, the ACAH Alliance, recently ratified its first contract with their corporate owner after a two-year negotiation.
Liz Hughston, RVT, VTS, (SAIM) (ECC), president of the National Veterinary Professionals Union, was involved in the contract negotiation and commented on how difficult it can be to unionize.
“All of the work has to be done internally,” she said. There have to be a lot of grassroots efforts and conversations with coworkers.
Through the negotiation of their union contract, employees were able to obtain additional paid time-off benefits based on seniority. They also successfully negotiated for better temperature control inside the aging building, air purifiers to improve air quality from frequent wildfires, and safety upgrades such as security cameras outside the building.
Another win was the institution of an abusive client policy, which saves front desk workers from having to enforce good client behavior and ensures management steps in to enact behavior expectations that protect the staff.
NAVTA, NAVC Join Forces to Educate Pet Owners About Vet Techs
“Trust Your Vet Tech” is a campaign to raise pet owner awareness of and support for the critical roles that credentialed veterinary technicians play in veterinary practices. The National Association of Veterinary Technicians in America (NAVTA) is collaborating with The North American Veterinary Community (NAVC) and VCA Animal Hospitals (VCA) to deliver campaign materials to veterinary practices worldwide.
NAVTA President Jamie Rauscher, LVT, noted, “The goal is to inform pet owners of the education, skills, and responsibilities of veterinary technicians so that they can feel comfortable discussing their pets’ health care with us.”
NAVC CEO Gene O’Neill added: “While credentialed veterinary nurses and technicians are the veterinary equivalent of registered nurses in human medicine in terms of education and skills, an NAVC survey of pet owners nationwide found that most pet owners are unaware of the wide range of care credentialed veterinary nurses and technicians provide. Through this campaign, we intend to change perceptions among pet owners.”
The campaign includes a “Toolkit for Change,” which includes downloadable materials that are customizable, allowing users to include their practice name and contact information. The toolkit is available at navc.com/trust-me-im-a-vet-tech.
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Minimally Invasive Surgery Helps 12-Year-Old Husky Mix
When Kaija, a 12-year-old shepherd husky mix, developed a tumor in her chest, her owner, Jim McLaren, looked online for alternatives to invasive surgery, Cornell University College of Veterinary Medicine (CVM) reports. McLaren found an article on minimally invasive surgery to remove tumors in the chest cavity. The author was Nicole Buote, DVM, DACVS, an associate professor at the Cornell University CVM and the only veterinarian at Cornell with a certified specialty in small animal minimally invasive surgery from the American College of Veterinary Surgeons.
McLaren contacted Buote who ultimately performed a two-hour minimally invasive surgery on Kaija at Cornell University Hospital for Animals (CUHA) to remove the tumor. Both the procedure and the recovery are quicker than the more invasive median sternotomy.
After three days at CUHA and three weeks of limited exercise, Kaija was back to her normal routine.
Study Aims to Revolutionize Osteosarcoma Treatment for Large Dogs
A new study, funded by the Morris Animal Foundation, is evaluating the effectiveness of a novel drug combination tailored to giant breed dogs diagnosed with osteosarcoma. This research aims to offer an alternative for dogs ineligible for limb amputation and to potentially reduce the need for surgical amputation altogether.
The study is a collaboration between ELIAS Animal Health and the University of Missouri. The investigators are assessing the safety and efficacy of a combination of two powerful immunotherapies: checkpoint inhibition and adoptive T cell therapy. ELIAS Animal Health developed this immunotherapy approach to stimulate a dog’s immune system to kill cancerous osteosarcoma cells.
Osteosarcoma disproportionately affects the long bones of large- and giant breed dogs. Surgical amputation followed by chemotherapy is effective for some dogs, but not all. This study endeavors to bridge that gap with expanded treatment options and renewed hope for dogs.
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