Cover: Pet-Specific Care for the Veterinary Team by Lowell Ackerman

Pet‐Specific Care for the Veterinary Team

Pet‐Specific Care for the Veterinary Team

Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS
Global Consultant, Author, and Lecturer
Editor‐in‐Chief, Pet‐Specific Care







Logo: Wiley

On a personal note, I'd like to dedicate this book to my incredible family – to my wonderful wife, Susan, and to my phenomenal children – Nadia, Rebecca, and David.

On a professional note, I'd like to dedicate this edition to my colleagues who participated in this book – to the authors who gave generously of their time and talents to help produce this incredible resource for the veterinary healthcare team.

Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS

Contributors

Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS
Global Consultant, Author, and Lecturer
Editor‐in‐Chief, Pet‐Specific Care
www.lowellackerman.com

Peter Alberti, BSBA
CEO, Inulogica, Northborough, MA, USA
www.inulogica.com
peter@inulogica.com

Helen Ballantyne, PG Dip, BSc (Hons), RN, RVN
Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, UK
helen_ballantyne@yahoo.com

Marty Becker, DVM
Founder and CEO, Fear Free, LLC, Denver, CO, USA
www.fearfreepets.com

Jerold S. Bell, DVM
Adjunct Professor of Clinical Genetics, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
jerold.bell@tufts.edu

Gary Block, DVM, MS, DACVIM
Ocean State Veterinary Specialists, East Greenwich, RI, USA
GBYLC@AOL.com
www.OSVS.net

Nan Boss, DVM
Best Friends Veterinary Center, Grafton, WI, USA
drboss@bestfriendsvet.com

Jane Brunt, DVM
Cat Hospital At Towson(CHAT), Baltimore, MD, USA
jbrunt@catdoc.com
www.catdoc.com
CATalyst Council, Inc., Annapolis, MD, USA
www.catalystcouncil.org

Kara M. Burns, MS, MEd, LVT, VTS (Nutrition)
Independent Consultant, Author, and Lecturer, Lafayette, IN, USA
karamburns@gmail.com

Betsy Choder, JD, MS
VetCounsel, LLC, Crown Pointe Parkway, Atlanta, GA, USA
www.vetcounsel.net

Mary Craig, DVM, MBA, CHPV
Gentle Goodbye Veterinary Hospice and At‐home Euthanasia, Stamford, CT, USA
www.gentlegoodbye.org

Caitlin Dewilde, BS, DVM
Consultant, Author, and Lecturer, Founder and CEO, The Social DVM, LLC, Webster Groves, MO, USA
www.thesocialdvm.com
cdewilde@thesocialdvm.com

Michael R. Dicks, PhD
President of AE Consulting, Arvada, CO, USA
Chief Data Human for Erupt, LLC, Kodak, TN, USA
aecnslt@gmail.com

Amanda L. Donnelly, DVM, MBA
ALD Veterinary Consulting, LLC, Nashville, TN, USA
www.amandadonnellydvm.com
www.onecallatatime.com
adonnelly@aldvet.com

Patricia Dowling, DVM, MSc, DACVIM (LAIM), DACVCP
Professor, Veterinary Clinical Pharmacology
Western College of Veterinary Medicine, Saskatoon, Canada
trisha.dowling@usask.ca

Robin Downing, DVM, MS, DAAPM, DACVSMR, CVPP, CCRP
Fear Free Certified Professional, Speaker, Author, Clinical Bioethicist
Hospital Director, The Downing Center for Animal Pain Management, LLC, Windsor, CO, USA
www.downingcenter.com

Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Associate Professor, College of Veterinary Medicine, University of Arizona, Oro Valley, AZ, USA
renglar@arizona.edu

Mark E. Epstein, DVM, DABVP (Canine/Feline), CVPP
Medical Director, TotalBond Veterinary Hospitals, Gastonia, NC, USA
mark.epstein@totalbondvets.com

Maria Inês Ferreira, DVM, MTB
Veterinarian, journalist, and author, São Paulo, Brazil
mvmariaines.ferre@gmail.com
linkedin.com/in/maria‐inês‐f‐1914852b

Tamara Grubb, DVM, PhD, DACVAA
Washington State University, Pullman, WA, USA
tamaragrubb@wsu.edu

D. J. Haeussler, Jr., BS, MS, DVM, DACVO
The Animal Eye Institute, Cincinnati, OH, USA
www.animaleyeinstitute.com

Randy Hall
4th Gear Consulting, Huntersville, NC, USA
www.4thgearconsulting.com

Tara Harmon, APR
Personal Lines Marketing Director, Illinois & Wisconsin
The Cincinnati Insurance Companies, Fairfield, OH, USA
www.cinfin.com
tara_harmon@cinfin.com

Donna L. Harris, DVM, MBA, MS(Strategic Foresight)
Veterinary Special Services, College of Veterinary Medicine, Michigan State University
East Lansing, MI, USA
harrisko@msu.edu
vssmich@sbcglobal.net

David Haworth, DVM, PhD
President, Vidium Animal Health, Phoenix, AZ, USA
vidiumah.com

Brandon Hess, CVPM, CCFP
VetSupport Inc., Cincinnati, OH, USA
Brandon@vetsupport.com
www.vetsupport.com

Alicea Howell, LVT, VTS (Behavior), KPA, CTP
Owner, Barks and Rec Animal Training and Behavior, Traverse City, MI, USA
www.BarkRanger.net

Jessica Johnson, DVM
Main Street Veterinary Dental Clinic, Flower Mound, TX, USA

Anna Katogiritis, BSc, DVM
Independent SA and Wildlife Emergency Veterinarian and NGO Consultant
www.DoctorAnnaK.com
DoctorAnnaK@gmail.com
Social media:@DoctorAnnaK

Kim Kendall, BVSc, MANZCVS (Cat Medicine and Animal Behaviour)
Clinical cat veterinarian and behavioural consultant, Roseville, NSW, Australia
www.felinefriendlycare.com

Chand Khanna, DVM, PhD, DACVIM (Onc), DACVP (Hon)
Veterinary Oncologist and Chief Science Officer, Ethos Veterinary Health, Woburn, MA, USA
ckhanna@ethosvet.com

Patricia Khuly, VMD, MBA
Independent veterinary journalist and owner, Sunset Animal Clinic, Miami, FL, USA
khulyp@bellsouth.net

Jacqui Ley, BVSc (Hons), PhD, DECAWBM, FANZCVS (Veterinary Behaviour)
Registered Specialist in Veterinary Behaviour, Melbourne Veterinary Specialist Centre, Glen Waverley, Victoria, Australia
behaviour@melbvet.com.au

Heidi B. Lobprise, DVM, DAVDC
Main Street Veterinary Dental Clinic, Flower Mound, TX, USA
HeidiDent93@gmail.com

Mark J. Mcgaunn, CPA/PFS, CFP®
McGaunn & Schwadron, CPA’s, LLC, Medfield, MA, USA
www.mcgaunnschwadron.com

Brennen Mckenzie, MA, MSc, VMD
Adobe Animal Hospital, Los Altos, CA, USA
www.skeptvet.com

Emma Goodman Milne, BVSc, MRCVS
Independent Veterinary Surgeon
www.vetsagainstbrachycephalism.com

Jason C. Nicholas, BVETMED (Hons)
Independent Consultant, Author and Speaker, Co‐founder, Preventive Vet
www.DrJasonNicholas.com
www.linkedin.com/in/drjasonnicholas
DrJVet1@gmail.com

Anita M. Oberbauer, PhD
Professor and Associate Dean, Department of Animal Science, University of California, Davis, CA, USA
amoberbauer@ucdavis.edu

Kurt A. Oster, MS, SPHR, SHRM‐SCP
Bay State Veterinary Emergency and Specialty Services, Swansea, MA, USA
www.kurtoster.com

Joanna Pendergrass, DVM
Freelance Medical Writer
Founder and owner, JPen Communications, LLC, Sandy Springs, GA, USA
www.jpencmc.com
joanna@jpencmc.com

Saya Press, BVSc, MS, DACVECC
The Veterinary Specialty Hospital of San Diego, Sorrento Valley, San Diego, CA, USA
spress@ethosvet.com

I. Craig Prior, BVSc, CVJ
Independent Consultant, Lecturer, and Practitioner, College Grove, Brentwood, TN, USA
ausivet@gmail.com

Krystle L. Reagan, DVM, PhD, DACVIM (SAIM)
Assistant Professor, Department of Veterinary Medicine and Epidemiology, Small Animal Infectious Disease Fellow, School of Veterinary Medicine,University of California, Davis, CA, USA
kreagan@ucdavis.edu

Sarah Rumple
Veterinary Writer and Editor, Owner and Chief Creative Officer of Rumpus Writing and Editing LLC, Denver, CO, USA
rumpuswriting.com

Suzanne Russo, DVM, MS
Associate Dean of Clinical Education, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
osudvm92@gmail.com

Robert Sanchez
CEO, Digital Empathy, San Diego, CA, USA
digitalempathyvet.com

Kymberley C. McLeod, DVM
Conundrum Consulting, Toronto, Ontario, Canada
kymberley‐stewart@idexx.com

Samuel Stewart, DVM, DACVECC
Veterinary criticalist and commercialization scientist, Ethos Veterinary Health, Woburn, MA, USA
sstewart@ethosvet.com

Natalie Stilwell, DVM, MS, PhD
Southeastern Cooperative Wildlife Disease Study, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
nkstilwell@gmail.com

Jane Sykes, BVSc, PhD, DACVIM (SAIM)
Chief Veterinary Medical Officer and Professor, Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
jesykes@ucdavis.edu

Lori Massin Teller, DVM, BS (Vet Sci), DABVP (Canine/Feline Practice)
Clinical Associate Professor, Telehealth, Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
http://vetmed.tamu.edu

Cindy Trice, DVM
Founder/CEO, Relief Rover, Bradenton, FL, USA
reliefrover.com

Ernie Ward, DVM, CVFT (Certified Veterinary Food Therapist)
Founder, Association for Pet Obesity Prevention, Ocean Isle Beach, NC, USA
PetObesityPrevention.org
DrErnieWard.com

Linda Wasche, MBA, MA
LW Marketworks, Inc., Sylvan Lake, MI, USA
Lindaw@LWmarketworks.com
www.LWmarketworks.com

Peter Weinstein, DVM, MBA
PAW Consulting, Irvine, CA, USA
PeterWeinsteinDVMMBA@gmail.com

Preface

This book was designed to provide a valuable resource for all things related to pet‐specific care, from prevention, to early detection, to evidence‐based treatment, guidelines, and facilitated compliance. It is an appropriate source of information to foster consensus building and a team approach to delivering excellent healthcare to animals.

The concept of pet‐specific care is relatively new in veterinary medicine (while the equivalent “personalized medicine” is now considered de rigueur in human medicine) and involves selecting appropriate services for pet and owner, based on both subjective and objective criteria, including breed predisposition, age, level of care requested by owner, risk assessment, appropriate guidelines, financial considerations, and many more aspects. While much of veterinary medicine has been reactive in the past, waiting for pets to develop problems before veterinary teams got involved, pet‐specific care is more proactive, focuses on keeping pets healthy, and considers approaches that span a lifetime rather than from one veterinary visit to the next. It also involves managing pets in a truly team‐based fashion, so throughout the book emphasis is given to the roles of team members in delivering excellent healthcare, communication, and client service. In addition to specific topics covered within the book, there is also a rich collection of appendices that provide additional resources, abbreviations, glossary, and breed tables of heritable conditions organized by canine and feline breeds, conditions, and breed attributes.

Whether you want to know how to provide genetic testing and counseling in practice, find out more about guidelines and standards of care, or the meaning of the term “incremental care” as it applies to healthcare options for clients who couldn't otherwise afford services, you'll find it within the pages of this book.

The intention is to provide as much information as is available that pertains to pet‐specific care for both dogs and cats, and that can be somewhat challenging because there tend to be more resources in the veterinary literature on dogs than cats. That does not detract from the importance of cats and their owners, but recognizes that at this time there are more guidelines, genetic tests, and conditions recognized with a breed predisposition in dogs versus cats. Still, every effort has been made to include as many feline resources as possible, including topics primarily or exclusively dedicated to cats. This isn't just a nod to practices dedicated to cats. In many countries, the majority of pets are cats, and yet cats often represent a much smaller percentage of office appointments and often significantly less hospital revenue. Thus, improving pet‐specific care for cats and their owners also represents a major opportunity for veterinary practices. Most of the content of this book applies equally to cats as to dogs, and there are additional cat‐specific topics in the book as well. It is a sincere hope that there will be even more feline resources available in future editions as the profession develops more of such content because everyone (practices, pet owners, and cats themselves) will benefit from such developments.

The veterinary marketplace has changed dramatically from only a few decades ago. Pets are considered as family members, more so than at any time in the past, and it is imperative to recognize the human–animal bond in all of our efforts. Specialization within the profession has become more commonplace and the creation of specialty and referral hospitals has been robust on a global basis. Partially as a result of this, we also have more published guidelines for veterinary care than were available previously and many are referenced within the pages of this book. Corporate practices are also coming into their own, as are retail‐anchored practices, and we are also witnessing the role this plays in delivering a more market‐driven approach to healthcare. It is also important to recognize the evolution of the veterinary healthcare team and the critical role each healthcare team member provides in the delivery of excellent healthcare, and consistent healthcare.

Yes, things are changing, and change is often difficult to assimilate, especially within the veterinary profession. Veterinary practice often stood as an anachronism, an attempt to hold back the escalation in healthcare costs as

The profession is indeed changing, and clients have changed, and the services available for pets have changed, but primary care veterinary practices are still very much as they have been in the past, and face many challenges ahead. It is the goal of this book to provide veterinary practices and teams with the information necessary to compete effectively in the marketplace and to deliver exceptional pet‐specific healthcare in a truly team‐based fashion.

Compiling all this information in one volume was an immense task, and I am eternally grateful to my gifted colleagues who contributed to this incredible resource. It wasn't that long ago that the delivery of healthcare was entirely veterinarian focused, and pet‐specific care was a self‐taught discipline based on personal experience, and often by trial and error. That has changed, and I am very proud to be involved in a project, along with the many authors of this book, that helps deliver this much‐needed resource for veterinary healthcare teams.

Lowell Ackerman, DVM, DACVD, MBA, MPA, CVA, MRCVS