pet insurance look sharp! get your facts straight tips to...

p 5

December 2016VOLUME 111, NUMBER 12

The no-guilt guide to not giving discounts

p 10Get your facts straightPET INSURANCE:

when clients adopt p4

WHAT TO EXPECT

p 6

Look sharp!Tips to buy a tonometer

A PIE CHART FOR YOUR HOLIDAYS

p 20

p 8

Canine noise aversion:

Th e sound and theworry

TM

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dvm360.com | Vetted | December 2016 | 1

TM

Content

Editor/News Channel Director | Kristi [email protected]

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Marketing

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Vetted (USPS 535170, ISSN print: 2469-3987 Online: 2469-3995) is published monthly by UBM Americas, Veterinary, 131 West First St., Duluth, MN 55802-2065. One year subscription rates: $60 in the United States and Possessions; $72 in Canada and Mexico; $97 in all other countries. Single issue orders: $18 in the United States and Possessions; $22 in Canada and Mexico; $24 in all other countries. Periodicals postage paid at Duluth, MN 55806 and additional mailing offi ces. POSTMASTER: Please send address changes to Vetted, P.O. Box 6087, Duluth, MN 55806-6087. Canadian GST Number: R-124213133RT001. Publications Mail Agreement Number: 40612608. Return undeliverable Canadian addresses to: IMEX Global Solutions, P.O. Box 25542, London, ON N6C 6B2, Canada. Printed in the U.S.A. © 2016 UBM. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording, or information storage and retrieval without permission in writing from the publisher. Authorization to photocopy items for internal/educational or personal use, or the internal/educational or personal use of specifi c clients is granted by UBM for libraries and other users regis-tered with the Copyright Clearance Center, 222 Rosewood Dr. Danvers, MA 01923, 978-750-8400 fax 978-646-8700 or visit http://www.copyright.com online. For uses beyond those listed above, please direct your written request to Permission Dept. fax 440-756-5255 or email: [email protected]. UBM Life Sciences provides certain customer contact data (such as customers’ names, addresses, phone numbers, and e-mail addresses) to third parties who wish to promote relevant products, services, and other opportunities which may be of interest to you. If you do not want UBM Life Sciences to make your contact information available to third parties for marketing purposes, simply call toll-free (866) 529-2922 between the hours of 7:30 a.m. and 5 p.m. CST and a customer service representative will assist you in removing your name from UBM Life Sciences’ lists. Outside the United States, please call (218) 740-6477. Vetted does not verify any claims or other information appearing in any of the advertisements contained in the publication, and cannot take responsibility for any losses or other damages incurred by readers in reliance on such content. Publisher assumes no responsibility for unsolicited manuscripts, photographs, art, and other material. Unsolicited mate-rial will not be returned. Address correspondence to Vetted, 8033 Flint, Lenexa, KS 66214; (913) 871-3800; e-mail [email protected]. To subscribe, call toll-free 888-527-7008.Outside the U.S. call 218-740-6477.

December 2016

20 A “pie” chart for your holidays

THE GUIDE

2 Failing to learn basic dentistry is demented

4 What to expect when your clients are adopting

8

Bone crusher: new dog breed discovered No discounts,

no regrets3

5

Read this before

you buy a tonometer

6


Th e sound and the

worry

10

Pet insurance: Fact and fi ction

2 / December 2016 / Vetted / dvm360.com

It’s demented not to learn basic dentistryDr. Dave Nicol calls it like he sees it.

THE PICKS

YATRA / SHUTTERSTOCK.COM

SHU

TTE

RST

OC

K.C

OM

/PO

PAR

T

(what we care about now)

Steven E. Jasinski, a doctoral student at the

University of Pennsylvania and acting curator

of paleontology and geology at the State

Museum of Pennsylvania, has identifi ed a new species

of fossil dog—Cynarctus wangi—according to a Penn

News article.

Named after the curator of the Natural History

Museum of Los Angeles County, Xiaoming Wang,

C. wangi was originally found under the Choptank

Formation in Maryland’s Calvert Cliff s region by an

amateur collector.

Jasinski and his study partner, East Tennessee

State University professor and East Tennessee State

University National History Museum at the Gray Fossil

Site curator Steven C. Wallace, say the coyote-sized

dogs likely lived on the eastern coast of North America

12 million years ago and behaved similar to hyenas.

C. wangi is the fi rst carnivore to be discovered in

the Choptank Formation and is an unusual fi nd for the

BoneA newly discovered hyena-like dog species sheds light on eastern North America’s prehistoric ecosystem.

The important disctinction here is incidence. What’s

the incidence rate

of dental disease

in cats and dogs?

Scottish veterinarian and resident BS-detector Dr. Dave Nicol thinks it’s crazy that we have so many veterinary students standing around watching spinal surgery

instead of learning dentistry (because, you know, they’ll actually use those skills later on).

100%Young vets who plan on a future in general practice would be better served by spending their time learning about dentistry than other specialized topics. Don’t be demented.

Watch Dr. Dave Nicol in this interview with Dr. Sarah Wooten and get more tips at dvm360.com/demented.

crus

We’re not afraid to get our hands dirtyAnd neither is badass veterinarian-slash-amateur-paleontologist Dr. Patrick Salsbury, who named his amazing dinosaur fi nd after Harry Potter. Scan the code to read the whole story or head over to dvm360.com/dinosaur.

period. “Most fossils from this time period represent

marine animals, who become fossilized more easily

than animals on land,” Jasinksi says in the article.

“It is quite rare we fi nd fossils from land animals in

this region during this time, but each one provides

important information for what life was like then.”

Th e fossil dog belongs to the Borophaginae subfamily,

an extinct group of canids commonly referred to

as “bone-crushing” dogs due to their powerful

jaws. According to the article,

“Borophagine dogs were widespread

and diverse in North America from

around 30 million to about 10 million

years ago … C. wangi represents one

of the last surviving borophagines

and was likely outcompeted by

ancestors of some of the canines

living today: wolves, coyotes and

foxes.”

Th e researchers’ work has

been published in the Journal of

Paleontology.

THE PICKS

her

dvm360.com / Vetted / December 2016 / 3

>>> Steven E. Jasinski, courtesy of Penn News.

THE PICKS


Every new pet is a whole new world for your veterinary clients. Even long-time pet owners may need reminders about what happens when they welcome a brand new puppy or kitten into the family. Share these general aging milestones and remind owners that, of course, each dog and cat are different and individual as snowfl akes. Awww.

What to expect when your clients are adoptingAnswers to “When is my pup

aware of the world?” “When

will my puppy’s adult teeth

start coming in?” “When will

my kitten use the litter box?”—

and much more.

ANNETTE/SHUTTERSTOCK.COM

We come in handout form! Download these handouts

to share the milestones with your new puppy and

kitten owners. Scan the code or

visit dvm360.com/

milestones.

Whelp: A newborn puppy that lacks the ability to see, hear or regulate body temperature

Neonate, 0-13 days: The pup cannot see, hear, regulate body temperature or eliminate without stimulation and is totally dependent on its mom.

Transition period, 13-21 days: The pup’s eyes and ears gradually open, and it begins to hear and respond to taste and smell.

Awareness period, 21-23 days: The pup is able to use its senses of sight and hearing. Learning begins.

Canine socialization period, 3-7 weeks: The pup learns specifi c behaviors that make it a dog such as barking, chasing, biting and body posturing. The pup also begins to eliminate on its own at 3 to 4 weeks. (For which Mom is forever grateful.)

12

3

4

5

puppy milestones

LISKUS/SHUTTERSTOCK.COM/GETTY IMAGES dvm360.com / Vetted / December 2016 / 5

I don’t give discounts ...And I don’t feel bad about itAssociate veterinarian Hilal Dogan, BVSc, has a little self-reflection exercise for you.

Ask yourself:> Do you believe there is value in what you do?> Why do you feel guilty about charging clients

appropriately?> Do you truly believe you are stealing from people?… Or do you simply need to reassess your pricing

strategy and make sure it represents an accurate and fair value of your services?

For some veterinarians, discounting is an emotional issue. For some, the reasons we behave the way we do with money are deep-rooted in our subconscious; sometimes we can’t access those feelings until someone hits us on the head with it.

So this is us, hitting you on the head. Read more at dvm360.com/idontgivediscounts.

Feeling like you’re walking a tightrope?You’re not alone in veterinary practice if you’re struggling a bit (or a lot) with work-life balance, time management, burnout or other practice-related frustrations. Here’s your starting place.

Whether you’re a pooped-out practice owner, an anxious associate, a mad manager or a tired technician, we’ve got the resources to get you back on track to a more happy, more calm, more fulfilled career—all courtesy of this Biz Essentials from Veterinary Economics. Scroll through our long, detailed list and find what you need to find your version of balance. Because we <3 you. Check it all out here: dvm360.com/burnoutessentials.

THE PICKS

INFORMATION COURTESY OF ROBERT J. MUNGER, DVM, DACVO; IMAGES BY PORTIA STEWART

... more great info on products to measure IOP at dvm360.

com/IOPmonitor


Read this before you buy a tonometerEyeing a new veterinary tonometer? Here’s a quick buying guide before you spend.The tonometer is a critical instrument in basic eye exams, and it’s very important for any exam of the eye. Veterinary ophthalmologist Robert Munger, DVM, DACVO, offers this advice to help you make the best buying decision:

“As with any examination, the practitioner must understand and interpret the fi ndings in light of each clinical case. Examples include understanding how restraint, excitement, squinting and thickening of the cornea (among other things) can affect the values they obtain and the practitioner must interpret the values with respect to their evaluation of the patient,” says Dr. Munger. “In other words, the clinician needs to think! Medicine is not all rules and formulae. You have to interpret the values and apply what you know.”

A closer look at glaucomaIncreased intraocular pressure = glaucoma. This is what you've been taught, but new research shows that diagnosis is more involved than this one factor. And treatment varies based on the severity and type. We’ve gathered our best articles on managing this painful ophthalmic disease in your veterinary patients. Visit dvm360.com/

essentials for all of the information you need on glaucoma, including how to diagnose and treat associated conditions, team tools and updates.

Expect these features: Accurate

Easy to use for the animals you treat

Affordable and practical for regular use

Durable

What companies might try to sell you on:

Ergonomics“I personally think

advertising an instrument based on ergonomics is overdoing it a bit, since I

have not found any problems using a tonometer since the

Schiotz tonometer.”

Features that could use improvement:

Make it more intuitive to change for

different species

There are two main types of tonometers:

1. Rebound models2. Tono-Pen applanation/contact models

Both are accurate within their parameters of use “One may be more accurate than the other at very high or very low intraocular pressures, or IOPs, but it’s not all that important clinically.”

Quick tip: The rebound tonometer is ideal for small eyes and for animals shy about having the Tono-Pen models approach the eye.

Price is important, and most models are competitive in this aspect.

Consider this quick math:

Say you buy your tonometer for $3,000

And, conservatively,charge $15/test

You’ll pay off your equipment in 200 uses.

How quick will that happen? “Bearing in mind that the instruments can tell you if IOP is low, use on any red eye can help differentiate between conjunctivitis, uveitis and glaucoma.”

Optional Windows tablet for mobile display

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STICKLER / ZORANA MATIJASEVIC / SHUTTERSTOCK.COM

By Mindy Valcarcel, Editor, Medicine Channel Director

Boom! Crash! Bang! Th e loud carols,

noisy house guests and New Year’s

fi reworks might be part of the sea-

son, but the sound behind each may send

some of your canine patients shivering in

the corner or cowering under the couch.

At a special luncheon during the

CVC Virginia Beach sponsored by

Zoetis, Sara Bennett, DVM, MS,

DACVB, a veterinary behaviorist

in Evansville, Indiana, presented an

overview of this common but commonly

undiagnosed behavior issue in dogs.


Th e sound and the

worryNoise aversion is a fearful or anxious response to sounds within the environment. It’s what sends dogs cowering under the couch when fi reworks burst in the night sky or a car backfi res. The dog is distressed by the noise and wants to get away. Fireworks, thunder and gun shots are obvious triggers for dogs with noise aversion, but a wide variety of environmental sounds can also be disturbing to dogs—children shrieking, loud TV noises, doors slamming, loud engine noises and much more, says Dr. Bennett.

She says certain dog breeds are over-represented, such as herding dogs, while others such as hunting dogs are more likely to fi nd startling noises just part of the job.

The howl of the holidays

HEAR THAT?

Find calming products here: dvm360.com/

calmdown


Reference1. Sherman BL, Mills DS. Canine anxieties and phobias: an update on separation anxiety and noise aver-sions. Vet Clin North Am Small Anim Pract 2008;38:1081-1106.

Unearth the whole scary storyWhat can you do to catch this behavior in a dog? Just ask the owner! Dr. Bennett recommends asking all clients how the dog is at home. Specifi cally, what does the dog do when a loud noise occurs? Although the owner might be able to describe fear-related behavior, there might be a disconnect in recognizing that the dog is afraid.

Once this behavior condition is caught, what can you do? Several drugs, including benzodiazepines, antidepressants (e.g. selective serotonin reuptake inhibitors), alpha2 agonists, other serotoninergic medications, and supplements such as L-theanine, have been used to help calm pets or decrease their anxiety. In fact, a new medication has been formulated particularly for this form of anxiety.

Environmental management and behavior modifi cation should be considered standard accompaniments to drug therapy, of course. Making sure the pet is in a safe secure location where it is exposed to less of the frightening noise is an important fi rst step to make it through the immediate event. Dr. Bennett says you can also slowly expose affected dogs to a recorded version of the sound they are scared of, starting at a low volume level and gradually increasing the volume—implementing systematic desensitization and counter-conditioning. However, this will not work for every dog, and for things such as thunder, it needs to be done outside of storm season.

Stop the terror today!It’s easy for owners to think that their dogs can take these momentary shivers and shakes, but Dr. Bennett says noise aversion often becomes worse over time. This can result in severely suffering patients and compromised quality of life for the pet and the owner. By asking all dog owners if this is occurring at home and taking steps now to overcome this terrifying experience, you’ll be truly helping your patients live happier, healthier lives.

Why does Bella cower during the festivities?Dr. Bennett says dogs may develop this behavioral problem because of1:

> Lack of habituation—the dog encounters a novel, startling sound and fails to learn that it has no consequence or meaning, continuing to show fear instead.

> Stress-induced dishabituation—the dog experienced a stressful event and was therefore at a higher level of stress at the same moment of the environmental sound and was unable to cope with the noise as it previously had, resulting in a fear response.

> Sensitization—a noise bothers the dog more and more over time, causing it to be more sensitive to it rather than learning to ignore it.

> Social transmission—the dog learned to fear a noise from another dog in the household.



A study by the North American Pet Health Insurance Association uncovered some key fi ndings that may surprise you—and some you likely knew all along.

Pet insurance:Clients with pet insurance spend more on veterinary care.

FACT

FACTFICTION

Passive strategies

>> Place brochures in waiting area.>> Place brochures in puppy and kitten kits.>> Provide information on multiple companies.>> Answer questions when asked.

Active strategies

>> Use a designated pet insurance staff liaison.>> Provide policies for staff pets.>> Recommend one or two specifi c companies.>> Include link on website.>> Hand brochures to clients and encourage

them to explore pet insurance.>> Educate clients about pet insurance whether asked or not.

50%

Pet owners are

Stronger advocacy by veterinarians would signifi cantly increase use of pet insurance.

Th e main reason pet owners buy pet insurance is to min-imize risk of a major vet bill.

more likely to enroll in pet insurance

if their veterinarian recommends it. But most veterinarians are passive rather than active

about recommending pet insurance.

The fact is, pet owners buy pet health insurance more for emotional than economic reasons. They believe it ...

59%55% 49%

48%53%

42%

... Is helpful to them

Shows they love their pet

Shows they are a

responsible pet owner

Provides peace of

mind

Is a good investment

Helps avoid the need to

make painful choices about withholding

care

$251Non-enrolled dogs:

Amount spent onveterinary bills in past 12 months

$146Non-enrolled cats:


$324Enrolled dogs:


$264Enrolled cats:


+29% +81%

Source: 2016 Driving Growth of Pet Health Insurance Research Report, NAPHIA

&

Vetted / December 2016 / 11GETTY IMAGES

Fact

FICTION

FICTION

Most veterinarians oppose pet insurance and fear that it will lead to managed care.

Pet owners expect veterinarians to be experts in pet insurance. The 2016 Driving Growth of Pet Health Insurance

Research Report was conducted by John Volk of Brakke Consulting on behalf of the North American Pet Health Insurance Association (NAPHIA).

Pet owner study>> 626 pet owners in the U.S. and Canada>> Males and females ages 21-74 with an

annual income of $50,000+>> Have a cat or dog>> Have primary or shared responsibility for

making decisions for the care of their pet(s)>> Open to considering pet health insurance

Veterinarian study>> 505 veterinarians in the U.S. and Canada>> Full-time companion animal veterinarians, roughly

half practice owners and half associates>> Practice in a general companion animal

practice, feline or mobile/housecall practice>> Have at least some input in deciding which products

and services are recommended to clients

... “pet insurance companies will have too much infl uence

in the veterinary profession if it becomes commonplace.”

fi ction

11% 55%

10% 53%

48%

Makes no difference whether or not clients have pet insurance

Getting pet insurance shows that pet owners love their pets.

Getting pet insurance is what responsible pet owners do.

Pet insurance is a good investment.

Wish no clients had pet insurance

Wish all clients had pet insurance

In reality, veterinarians wish more clients had pet insurance.

41%

56%

3%

of Canadian

respondents

85%

5%

completely agree that …Only

Study details

The truth is, they want reinforcement of the concept more than cost or coverage details.

Veterinarians who agree

Enrolled pet owners who

agree

16%

Dr. MichaelSheffi eld comforting

Amelia. Courtesy Lakeview Animal Hospital.

It hurts to turn away a pet in needwhen owner fi nances are limited.

Don’t turn them away. Turn to us.

Professionally managed payment plans | No cost to practice Optional CreditAdvisor™ tool to assess risk | You control approvals

Pet savings accounts & Wellness plan billing

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YOU BECAME A VET TO HELP EVERY PET.


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MEDICAL EQUIPMENT

PRACTICES FOR SALE OR LEASE

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Arizona: Thriving SA w/RE. AZ1.

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Welcome backto the joy of theget-together.

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