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JUNE / JULY 2020
A Practical Guide for Pet Health Professionals
CONTENTS 4
PetVet Advisory Board
5
Veterinarian Life Advice
6
Competitor or Collaborator
14
The Veterinary Trap (and How to Get Out)
HEAL US 10
16 All that Glitters Is Not Gold: The
Long-term Service Contract Dilema
20 Dr. Lisa Radosta: Behaviorist,
Perfectionist, Fashionista
24 Cracking the Shell on the Benefits
of Green Lipped Mussel
32 PetVet 10: Ten Things to Do
This Month
IN
ON THE COVER WWW. PET VETMAGAZINE .COM
VOL. 3 ED. 3 • JUNE / JULY 2020
HEAL US
A Veterinarian’s Role in COVID-19 and How to Keep Pet Owners Informed
COVER PHOTO OF DR. DAPHNE MOBLEY
PANDEMIC
28
IN
PERSPECTIVE A VETERINARIAN’S ROLE IN COVID-19
PetVetMag
@PetVet_Magazine
COVER PHOTO OF DR. DAPHNE MOBLEY PHOTO BY CAROLLPHOTOGRAPHY
Copyright June 2020. PetVet Magazine is published bimonthly by Barkleigh Productions, Inc, 970 West Trindle Road, Mechanicsburg PA 17055. Postmaster: Send change of address to Pet Vet Magazine c/o Barkleigh Productions, Inc., 970 West Trindle Road, Mechanicsburg PA 17055. No part of this publication may be reproduced without written permission of the publisher. Editorial offices: 970 West Trindle Road, Mechanicsburg PA 17055. (717) 691–3388 FAX (717) 691–3381 Email: info@barkleigh.com PETVET MAGAZINE
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ADVISORY BOARD
Meet our EDITORIAL ADVISORY BOARD!
PetVet’s advisory board is here to help ensure quality content to motivate & educate Veterinarians and their staff.
Jenifer Chatfield DVM, Dipl. ACZM, Dipl. ACVPM
Courtney A. Campbell DVM, DACVS-SA “My passions ultimately drove me towards becoming a veterinarian, but when I was growing up I briefly flirted with the idea of becoming a magician. As a veterinarian, the ability to save lives, keep animals healthy, and strengthen the human–animal bond makes me realize there’s nothing more magical than that.”
“People should be so lucky as to get to be a veterinarian. The broad-based education empowers us to be successful in multiple fields and affords us the opportunity to choose how we spend our professional time.”
Julie Legred CVT
Alberto Fernandez DVM, DACVECC
“I have had the privilege of working with a variety of animals in my career and my passion has allowed me to be involved in teaching veterinary students, interns, residents and other veterinarians. I continue to enjoy going to work every day to help critically ill dogs and cats, and love the client interactions as well. I am proud to be a part of this advisory board to help teach and spread my love for this profession to others in the veterinary community.”
"The human race will not be possible without the animal kingdom. It is our duty to take care of those that provide to us and to me it is an honor to do so."
Lisa Powell DVM, DACVECC
Jill López DVM, MBA “Do something every day to make an animal’s life better.”
“I have worked in many areas of veterinary medicine and veterinary technology over the last thirty five years, and it is amazing how far our profession has grown and paved the way for the betterment of animals' lives and happiness, as well as improving public health issues. It is an honor for me to be a part of this advisory board to offer additional education and opportunities to grow in our profession.”
STAFF Publisher Barkleigh Productions, Inc. President Todd Shelly Vice President Gwen Shelly
4
Chief Operations Officer Adam Lohr
Senior Graphic Designer Jenn Barraclough
Director of Marketing & Client Relations James Severs
Executive Editor Rebecca Shipman
Junior Designer Jenny Thomas
Administrative / Marketing Assistant Karin Grottola
Art Director Laura Pennington
Web Master Luke Dumberth
Marketing Coordinator Alyx Robertson
PETVET MAGAZINE
Social Media / PR Coordinator Evan Gummo
VETERINARIAN LIFE ADVICE
“as my father told
me ABOUT LIFE
APPLIES HERE
'Just leave it a little better than when you found it...' If we realize that our jobs are not about momentous, paradigm swings of a pendulum and take personal value in helping the smallest—whether relieving suffering or holding a hand during a tough decision or coaching a colleague—it all very much makes it ‘better than when you found it.’”
Christine M. Crick, CVT, RVT, LVT Regional Technical Coordinator for VCA PETVET MAGAZINE
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Beyond the Stethoscope
By Angela Demaree, DVM, MPH, CHPC
Veterinary medicine can be both competitive as well as collaborative, but can our competitors also be our greatest assets?
I
've been thinking about this question a lot lately as I watch the continued consolidation of veterinary hospitals, the rhetoric within the profession, the quickly changing technological environment—we are, after all, in the midst of the Fourth Industrial Revolution—and the skyrocketing student debt. If that wasn't enough, data is bombarding us, stating that veterinary hospitals are inefficient businesses. The last statement would be my greatest fear and what would keep me up at night if I was still an associate in practice and labeled as "inefficient." To employees, that statement immediately translates into "management will be 6
squeezing us for everything we've got as if we aren't overworked and underpaid enough." So how do we reconcile the inefficiencies, the competition and the high debt loads as a profession? Collaboration is one possible answer to this question. I challenge each of us to ask the following questions and seek to collaborate whenever we feel that we might be reacting from a place of fear rather than joy. How can we work fewer hours and make more money? What if we could leverage technology to work fewer hours and not be sucked into the technological ether? What if our greatest fears were our most significant strengths? PETVET MAGAZINE
What if the world was conspiring for us rather than against us? This concept and practice boils down to the fixed mindset versus the growth mindset. If we choose to believe that the opportunities in this world are finite or fixed, then, if a competitor opens down the street, we will, of course, be negatively impacted. If, on the other hand, we believe that opportunities are infinite and we have a growth mindset, then we may view competition as a means to create more awareness of the services we also offer—which may positively impact our business. Free marketing can only help! The best part about this concept is that we get to choose which
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What if we decided to view our competitors as our friends and neighbors? How would that feel? Weird, right? But wouldn’t it also build a sense of community; of belonging, and maybe even friendship? mindset we will have each day—and our minds are powerful. We've all heard about and have probably experienced a phenomenon known as “frequency illusion”1. It's the fancy term for a trick our brain plays on us. For example, when we are shopping for a new car, and decide we want the new Ford Focus in blue, the next thing we know, we see blue Ford vehicles on every road and every corner, or so it seems. Well, actually, they were there all along, we just weren't looking for them. The same thing holds true when we are looking for opportunities; they seem to be magically lurking around every corner. But the truth is, they were there all along, we just weren't cueing our brains to seek out positive solutions. What if we decided to view our competitors as our friends and neighbors? How would that feel? Weird, right? But wouldn't it also build a sense of community; of belonging, and maybe even friendship? We got into this profession to serve our communities, to serve pets, to serve pet owners—or maybe all three. If we honestly had a service-focused mindset, would you care that your favorite client with three kids, four dogs and two cats went down the street to a wellness clinic that was open on your day off ? Or would we be grateful that our favorite client was able to get heartworm prevention for their pets on short notice while juggling three kids, four dogs and two cats, and you got to enjoy your day off ? Throughout my career, I've met leaders and mentors who had both views of the world; those who think the sky is falling because of how rapidly our profession is changing and being disrupted through consolidation, technology and entrepreneurship, and those who embrace and lead change through innovation and
entrepreneurship. The sky is not falling; however, the world is changing—and fast. The people and businesses who will not only survive, but thrive, are those who are embracing technology, innovating and being customer-focused. A customer-centric business may go all out by trying to put themselves in their clients' shoes—adding incredible value, often at a high cost and chipping away at profits—but at the same time, also creating loyal, repeat clients and customers. So how do we put this theory into action? I recently tested this theory for myself. I noticed someone on social media with a very similar message to my own; not the same training, but we were essentially both engaged in related businesses. She was following me on multiple channels and liking my content, all while promoting her own, very similar business. I had choices; I could get upset and immediately block her from all of my accounts, because, how dare she snoop on me! Or I could reach out, say hello, and see what opportunities there might be to collaborate. So, I reached out, said hello, and invited her to connect because it looked like we were doing something similar. After all, a rising tide lifts all boats, right? We might just find that we are most successful and happy when we are working together and looking for opportunities. We might even create a more robust community than we would otherwise have by toiling away on our projects alone. My colleague agreed. We are exploring opportunities to collaborate in our businesses, and I might have even made a new friend that, otherwise, I would never have had the opportunity to meet.
1. The News Wheel. (2019, April 16). Why Do You See Your Car Everywhere After Buying It? Retrieved February 6, 2020, from https://thenewswheel.com/why-do-you-see-your-car-everywhere-after-buying-it/
Dr. Angela Demaree is the CEO and Principal Consultant for PAWS Consulting, a public health and political consulting firm. Angela recently retired as a Major in the United States Army Reserves, is a Certified High Performance CoachTM and the host of Beyond the Stethoscope, the podcast for veterinarians and busy professionals who want actionable, implementable solutions surrounding work-life balance, accomplishing your goals and living your dreams. She spends her free time with her horse, Tommy and teaching her Quaker Parrot the Purdue Fight Song. You can connect with Angela on Twitter and LinkedIn @DemareeDVM. 8
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CLIENT SERVICES
By Daphne Mobley, DVM
Pets have a tremendous impact on people’s lives. One way that pets affect clients’ lives is by providing unconditional love.
I
t is essential to retain veterinary clients in this increasingly competitive veterinary market in order for veterinary clinics to sustain profitability. This can be accomplished in a number of ways; veterinary clinics can offer additional services or products for pets, provide excellent customer service, and/or effectively communicate to their clients. When communication is specifically evaluated, veterinarians typically discuss methods that clients can utilize to maximize the health
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of their pets. However, have veterinarians considered communicating the benefits of having pets? Clients can actually feel that love when they return home to an exciting greeting or cuddle up close to their pets and receive loving gazes. This establishes a solid, loving bond between people and their pets. Pets also help people feel as though they have purposes for their lives and experience fulfillment. I observed this phenomenon when I interviewed
PETVET MAGAZINE
Veterinarians, as well as clients, may not know that having pets also decreases loneliness and enhances wellbeing due to the secretion of oxytocin.
pet parents in Central Park in New York City. I questioned them about the significance of their pets in their lives. One young man had a dog that he was walking and his eyes welled up with tears as he told me about his experience with his female dog. Years ago, his doctor informed him that he was HIV positive. He was so depressed that he remained in his bed all the time. One day a friend came to visit him with that dog and said, “Now you absolutely have to get out of the bed to walk this dog at least twice a day!” His love for his dog grew stronger over time and he realized that he wanted to get healthy so that he could be present for his dog. This ultimately placed him on a path back to wellness and happiness. Veterinarians, as well as clients, may not know that having pets also decreases loneliness and enhances wellbeing due to the
www.rememberapet.org
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secretion of oxytocin. This is often evident when therapy pets visit nursing homes. I can recall numerous instances when I took my dog to a nearby nursing home where my mother resided. I visited my mother pretty much every day and knew how much the residents delighted in seeing my dog Molly (they did not care about me, I was simply the means to get her there). I would walk Molly around the facility and they would scream out, “Molly! Come here Molly!” Some would respond that her visit was the highlight of their day and others would ask when she would be returning so that they could give her a portion of their meals. There are plenty of studies about the benefits that service dogs provide. Some service dogs are companions of war veterans with Post-Traumatic Stress Disorder, or a child like Iyal, who was born with Fetal Alcohol Syndrome Disorder. In
both of these instances, the service dog’s presence resulted in fewer outbursts, the ability to sleep through the night and increased calmness. In Iyal’s case he slept through the night and did not experience night terrors the initial night that his service dog, Chaucer, stayed with him. He also began to use words with multiple syllables and articulate his opinions after Chaucer was with him for just two weeks. Social interactions and activities increase due to the presence of a pet in the home. This is not specific to dogs. There are social groups, such as Meetup, that have activities for people with snakes and rats, too. In addition, clients may find that they experience increased self-esteem when they have pets, just as Owen did. He is a boy who resides in England and has Schwartz-Jampel Syndrome which results in joint contractures, myotonia, a short stature and other clinical signs as well as symptoms. This caused Owen to be very self-conscious and he disliked going out in public. His parents rescued an Anatolian Shepherd for Owen. When the dog was a puppy, he lost a hind limb when he was cruelly left on a railroad track and run over by a train. One unexpected result of this union was Owen’s increased self-confidence. He began to look up at people to tell them about his gigantic companion after they inquired about him. Furthermore, there are a number of beneficial medical effects for people who have pets. One major, positive impact is the effect on their cardiovascular systems. Pet owners can have decreased heart rates, blood
pressures, cholesterol, triglycerides and increase their longevity if they become heart attack victims. Other medical benefits of pet parenting include a reduction in stress and cortisol levels. Various study results have demonstrated this when pets were in the vicinity of college students prior to taking examinations and employees who were allowed to have pets in their work environments. Pain studies also noted pain reduction in hospitalized patients and people with fibromyalgia when pets were present. In addition, a positive pet effect was observed in allergy studies. One study found that if infants were exposed to pet allergens, it decreased the probability that they would develop asthma by the time they became seven years old. Furred and unfurred pets not only provide companionship, but they also bestow so many health benefits to humans. A healthy pet can lead to a healthy client. If veterinarians provide this information to their clients, it can strengthen their bond with them so that they and their pets can be a part of their veterinary practices for many years to come.
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Dr. Daphne Mobley is committed to making the world a happier, healthier place for people and their pets. She is a veterinarian who accomplishes this through her company Daphne Mobley, LLC. which provides motivational speaking and coaching services. Dr. Mobley frequently speaks about the tremendous impact that animals have on our lives and she also coaches veterinarians, as well as other professionals. Dr. Mobley is a graduate of the University of Florida College of Veterinary Medicine and Cornell University.
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LIFESTYLE
THE VETERINARY
TRAP
(AND HOW TO GET OUT) By Kathryn Primm, DVM, CVPM
V
eterinarians are a different lot. We are driven, yet empathetic. We feel things deeply and we tend to be motivated by things other than finances—but we all have to pay our bills. With the significant investment we have made in our education, we feel obligated to be “productive”. This obligation drives us to do things like work long hours—or when not working, spend long hours worrying over patient outcomes or relationships with team members. It gives us feelings of guilt if we take our focus off of work, or we work and then feel guilty that we are not the perfect spouse or parent. Productivity is a word that dehumanizes us. It is a word that applies to automation, not humans. According to etymonline.com, the word productive comes from an economic term for “rate of output per unit”. Some of us receive pay based on
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productivity, and even if we don’t, we hold ourselves—even outside of work—to a high standard of productivity. We are not machines. This is the veterinary trap. So how do we get out?
1. You are only human after all. Recognize that you feel like you are in a productivity trap and that it is a very human trait. As human beings, we are programmed to want to create order out of chaos and to set goals for ourselves that lead us to a better life. Productivity alone is not a bad thing. It is only bad when one feels that they needs to be productive for the sake of being productive does she become dehumanized. No one is saying that you should stop trying to be the best you can be.
2. Set clear boundaries. This means when you are working you focus on
work and on patients, but when you are off, you must be off. Schedule yourself some time outside of work when you get no emails, no texts and no social media. Or maybe just schedule a limited time for these things so that you can relax but are not completely unplugged. Many of you feel like social media and venting to friends (and strangers) is therapeutic, but studies have shown that it can be destructive to your wellbeing.
3. Set reminders. If you have anxiety about forgetting a task (or a patient), set a reminder in your phone to alert you about the task at an appropriate time, when you will be able to focus on it. We have technology, use it. Once your brain knows that you will not forget the item when the time comes, it is easier for you to focus on the things at hand, even if that thing is yoga with your dog or cooking a meal. 4. Pull up a seat at the bar. We don’t mean the actual bar (unless you enjoy it). Recognize that your life is like a threelegged stool, and if one leg is broken, the stool will not stand. The three legs represent your work, your home, and your health. Make sure that if you are leaning onto one of the three legs too much that it does not break, because then you will be on the floor. Finish your charting. (Doesn’t that feel great?) Organize your closet. (Now there is feng shui!) Rearrange your
furniture. (So much better!) Make a smoothie with healthy ingredients. (See, you are taking care of you!)
5. Give up. No, we don’t mean give up as in quit! We mean give up your time to help others. Multiple studies have shown that generosity makes us feel good. Generosity restores the humanity that the concept of productivity takes from us, and you will not have to look very far to find someone that can use your gifts. Read to children or even shelter pets. Volunteer at a cat café. Make meals for senior citizens. Think about ways you can shore up your three-legged stool. Don’t forget that your family, friends and pets can be a part of all three legs, so they need to be a part of any escape plan. Kathryn Primm, DVM, CVPM is the owner and founder of Applebrook Animal Hospital in Ooltewah, Tennessee. She sees patients, manages a busy small animal practice, and enjoys writing for and speaking to veterinary professionals and pet lovers. She has written and contributed content to many outlets, including magazines like Woman’s Day, Prevention and Health as well as veterinary-focused press.
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Best Practices
ALL THAT GLITTERS IS NOT GOLD The Long-Term SERVICE contract DILEMMA
I
By Wilson McManus II, DVM CVPM & Kris Smith, CVPM
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magine this…after many, many years of practice, you’ve sold your busy three-doctor animal hospital, FourLegged Friends Veterinary Hospital, to an associate who had been with you for several years. Meanwhile, you and your spouse retire to the sunny coast of Florida. One day, you go to the mailbox and find an ominous-looking letter sent by an out-of-state law firm. Its contents inform you that the firm represents the outside laboratory company your practice used for many years. It also advises you that since Four-Legged Friends Veterinary Hospital has not been using their client’s services for the last several months, you are in breach of the contract. Not only that, but there are three years remaining on your contract with their client. Since you agreed to the contract and signed it personally, the lab is expecting $60,000 in compensation from you for its loss of business. The letter states the money will go toward repayment of the loan you were given by the lab when you signed the contract. Wait, what? You thought the $60,000 was a signing bonus. The company wants to be paid within 30 days or it will proceed with collection
It slowly sinks in, and you realize for the first time you will likely have to pay the lab for the loss of business and the reimbursement of the prepaid discounts it gave you in the form of an incentive (loan). by filing legal action against you for breach of contract. You don’t own the practice anymore, so what’s the problem? When you signed the contract with the laboratory and received the loan, your first thought was, “What a great opportunity.” Right away, you put the money to work to improve the practice instead of buying a new fishing boat—as perhaps a less disciplined veterinary practice owner might do. Your head begins to spin as you try to piece together what this letter has to do with you. After all, you no longer own the practice. You immediately call your former practice to speak to the new owner, Dr. Smith. He confirms that, yes, he just signed a new contract with a competing lab—with a huge upfront cash incentive (i.e., a loan). Not only that, but the clinic would be using this service exclusively for the next five years. Dr. Smith says he understands your predicament, but reminds you there was never an agreement to continue or assume the contract with the lab service company you had been using when he purchased the practice from you. He also tells you that as an associate in another practice, he had received poor service from the lab previously used and vowed to never use that particular lab again, if and when he owned a practice. You are dumfounded. You finally sit down and read the copy of the contract
you had signed, which personally guarantees the use of the lab service exclusively for three more years at a certain volume of lab business per month. It slowly sinks in, and you realize for the first time you will likely have to pay the lab for the loss of business and the reimbursement of the prepaid discounts it gave you in the form of an incentive (loan). You quickly realize you should have
paid better attention to the details of the contract—especially as you had been anticipating your retirement and the sale of your practice to an associate for several years. You also realize the glitter of getting cash up front to make the improvements to the practice came with a high price, and now you, as the signatory to the contract, are going to have to pay the lab company back.
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It is often best to have your attorney review any contract before you sign it—especially if its term is longer than a year, has an automatic renewal clause, requires a specific volume of business by you and/or has prepayment penalty clauses. A fleeting thought crosses your mind—maybe buying a fishing boat with the lab contract money may not have been all that bad of an idea. At least you would still have something you own to show for it. Though this fictitious example centers on a lab service agreement, there are many other long-term contracts or leases that can complicate your life and the sale of your practice. Besides lab companies, garbage pickup/dumpster services, medical waste services, phone or internet service contracts, credit card processing agreements and equipment leases all can
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have similar contracts that want to tie up your business for X number of years. They may resort to many forms of upfront inducements, deals or special discounts over the term of the contract to keep you locked down. This is much like mobile phone companies used to do when you receive a deep discount to sign a multi-year contract with the purchase of a new phone. The agreement guarantees them your ongoing business and restricts your ability to shop other service providers without first paying a “hostage fee” to switch to another carrier. Practitioners are usually so busy they
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may fail to thoroughly read contracts to fully understand their long-term ramifications. It is often best to have your attorney review any contract before you sign it—especially if its term is longer than a year, has an automatic renewal clause, requires a specific volume of business by you and/or has prepayment penalty clauses. Remember that everything is negotiable; you can delete clauses you find unfavorable up until the point you decide to sign the contract. Although, in our example, the discovery of the service contract did not occur until after the sale transaction had
taken place, it is often the case that these issues come up during the due diligence phase of the practice sale and can be negotiated to mutually agreeable terms between the buyer, the seller and the service provider. Therefore, it is extremely important for both parties to be aware early in the selling process of any service contracts or leases that could affect their exit from the practice. Though long-term service agreements can often provide much-needed capital in the form of a loan, new equipment or various services at discounted prices, they are legally binding contracts. If your practice does not or cannot perform to meet a contract’s terms—either with your volume of business or for the full term—you may want to consider other options such as joining a buying group or cooperative that has already negotiated the best deals and pricing for members. This can help you avoid having to sign a long-term service contract, especially where you are personally guaranteeing the outcome. Whenever someone wants you to sign a multi-year contact with automatic renewal clauses for additional multi-year periods of time, remember: all that glitters is not gold.
BOARDING KENNELS:
THE DESIGN PROCESS
Dog spaces, cat spaces and even human spaces. Everything you need and insights on things you may NOT have considered. Features color photos, helpful diagrams, blueprints, glossary and more!
Wilson McManus II, DVM, CVPM, is a practicing veterinarian, practice management consultant, speaker, and veterinary practice broker with Simmons & Associates, MidSouth, located in Huntsville, Alabama. Kris Smith, CVPM is a certified veterinary practice manager with more than 20 years’ experience and a veterinary practice valuation analyst with Simmons & Associates, MidSouth, located in Huntsville, Alabama.
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PETVET PROFILE
DR. LISA RADOSTA
Behaviorist, Perfectionist & Fashionista By Steve Dale, CABC
W
e’ve all heard of type A personalities, but veterinary behaviorist Dr. Lisa Radosta is in her own category— Type AAA. She is passionate about what she does and has more energy than a Border Collie; arguably, she’s simply a perfectionist. In addition to her long list of credits, Radosta runs her specialty behavior practice in West Palm Beach, FL. She’s been published numerous times in peer-reviewed journals, and authored chapters in various textbooks including Handbook of Behavior Problems of the Dog and Cat and Blackwell’s Five Minute Veterinary Consult. Radosta is also a contributing author of Decoding Your Cat, a book authored by various members of the American College of Veterinary Behaviorists, expected to be released this year. With her passion being behavior, she understands the value of positive reinforcement. She concedes, “I’m tough on
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myself and everyone around me. But I try to lead with empathy and kindness.” Radosta is totally honest with her clients, but she says she learned a long time ago that pets don’t benefit if she’s snarky or judgmental. “I try to meet clients where they are, not where I think they should be,” she says. Having said that, she doesn’t hesitate to quietly and with all her heart tell clients the truth as she sees it: “I wouldn’t want to lead your pet’s life, would you?” And she explains to the client the emotions that individual pet is likely feeling. She concludes that clients who seek out a behavior specialist may be more likely to listen to and accept her instructions. “They are in my office in the first place because they want to help their animal,” she adds. Radosta’s personality is powerful but packed into a small package of just around five feet, and always looking and acting
She was recently the keynote speaker at the Professional Pet Guild Dog Training Conference, and spoke on aggression in dogs.
professional. She’s even known by other speakers for her fashion sense, including her highest of high heels as she speaks to veterinary professionals at meetings around the world. She also speaks to dog training professionals. She was recently the keynote speaker at the Professional Pet Guild Dog Training Conference, and spoke on aggression in dogs. She says one trainer told her, “After your talk, I went to Google Scholar; I
used to hate science and now I am excited about it. “ Radosta and I were chatting by phone, but I bet she popped out of her seat as she added, “For me, that’s the best compliment ever. I stick to the science—it’s my religion! Behavioral medicine is first and foremost medicine. And it’s all based on science.” She’s implemented her goal to reach pets and their caretakers directly, where they live, via her new
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DR. LISA RADOSTA’S
Top 4 Messages for
VETERINARY PROFESSIONALS 1. “Veterinarians should ask about behavior every visit.” 2. “Behavioral medicine should be practical; it’s not hard. You can learn to manage behavior cases, like aggressive dogs, just as you’ve learned to manage diabetic dogs.” 3. “Behavior responses are neurochemical and physiologic; the animal most often isn’t able to control the choices being made when they are fearful and stressed.” 4. “Emotional suffering is as painful as any other kind of suffering. Suffering isn’t acceptable—we can help these animals.”
website, www.dognerds.thinkific.com . “There’s an increasing awareness of emotional health, and that our animals—family members—may be suffering,” she says. “This is especially true for millennials and Gen Xers. Qualified help [for behavior problems] may not be readily available in all parts of the country. Even if you find a qualified trainer or behavior consultant, receiving additional support in the convenience of your home is of value.” Naturally, she hopes veterinary professionals become familiar with this new resource. She’s also on the Fear Free Executive Council. “I remember when and where I was on the road driving when Dr. Marty Becker phoned me about Fear Free,” she says. “When he explained what Fear Free is about, I said, ‘Hell yes, I’m in.’ I sensed his plan would turn everything around. Now, Fear Free is catching on around the world. We were losing the war before Fear Free, and now we’re winning,” Radosta graduated from the University of Florida College of Veterinary Medicine in 2000. “I knew I didn’t want to go into primary care, and was thinking about neurology, but I stink at surgery. Then thought about dermatology, but decided on behavior.” She completed a residency in Behavioral Medicine at the University of Pennsylvania and, as soon as she could, moved back to her native land of Southeast Florida. “I believe I am best adapted for the culture and intensity of Southeast Florida,” she says. “I’m the one
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Radosta’s 11-year-old daughter, Isabella, says mom is a ‘helicopter mom’, calling her ‘The World’s Greatest Smother’. Radosta laughs and replies, “I own it; it’s my badge of honor.”
swerving in and out of traffic, just knowing my way here and feeling comfortable.” Despite her relentless passion, Radosta has managed to find a work-life balance—at least one that works for her. Radosta’s 11-year-old daughter, Isabella, says mom is a ‘helicopter mom’, calling her ‘The World’s Greatest Smother’. Radosta laughs and replies, “I own it; it’s my badge of honor.” Her husband, Scott, sells and supports medical devices for people.
They all share their home with Chewie, a black cat, and a Labrador Retriever named Maverick (AKA Mavelicious). Radosta’s secret drug, she says, is running. She’s run three or four marathons, and recreationally runs regularly. Still, she says, “I’m in the middle of the pack as a runner, and I’m good with that. As a veterinary behaviorist, I would never settle—I am always striving to be at the top of my game; the best I can possibly give. I love what I do.”
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BUSINESS TRENDS
Cracking the Shell on THE BENEFITS OF
GREEN LIPPED MUSSEL By Rachel Hylton, BVetMed, MRCVS Green Lipped Mussel has become increasingly popular as a natural support for managing osteoarthritis (OA) in dogs in the United States and around the world. But what it is, how it works, its clinical studies and more are somewhat still relatively unknown in the veterinarian community.
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nown as the New Zealand mussel, Green Lipped Mussel (GLM), Perna canaliculus, is endemic to the coastal waters of New Zealand, and for hundreds of years has been a source of food to the indigenous Polynesian people of New Zealand known as the Maori. Interest in the health benefits of GLM actually started when researchers saw a much lower incident rate of joint and mobility issues in the Maori, who lived in the coastal regions, compared to their neighbors living inland. So, what was the main difference between these two groups? Their diet. Once understood, researchers focused their attention on understanding the benefits of GLM as it related to joint health. Green Lipped Mussel contains a unique combination of omega-3 fatty acids and other bioactive lipids, vitamins, minerals, anti-oxidants and glycosaminoglycans, which includes Chondroitin sulphate1. With dogs with OA, double-blind, place-
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While historically GLM products have had limited U.S. appeal, these types of products now entering the U.S with higher levels of clinical proof are showing greater adoption in the U.S. veterinary market.
bo-controlled studies saw that this combination of nutrients demonstrated: • Reduced joint pain2 • Reduced joint swelling2 • Reduced total arthritis score (combined assessment of mobility, degree of joint pain, swelling, crepitus, and reduction in range of movement)3 • Increased activity (as measured by accelerometers)4 The health benefits of GLM continue to be reported as more than 150 publications over the last 40 years have reported on GLM. During this time, a number of well-designed, double-blind, placebo-controlled studies have been conducted in dogs and cats (Bierer & Bui 2002; Bui & Bierer 2003; Hielm-Bjorkman et al, 2009). In 2018, a broader review of the literature relating to GLM research was published (Eason et al, 2018). Omega-3 fatty acids continue to be highlighted as a natural anti-inflammatory action through extensive research. In fact, in vitro studies propose fatty acids from GLM affect the metabolism of Arachidonic Acid by both cyclo-oxygenase and lipoxygenase pathways5, while other lipids, such as pro-resolving lipid mediators, bioactive peptides and F-acids, may also play a role in the beneficial effects that have been demonstrated and may act via different pathways. Current research is exploring additional modes of action for the omega-3 fatty acids and the role of non-lipid bioactive compounds from GLM. For Dogs with OA, veterinarians should recommend supplements containing GLM. In the UK, the number
one veterinarian recommended joint supplement is a clinically-proven GLM containing product which has now passed the traditional glucosamine and chondroitin supplements that are widely given to dogs. While historically GLM products have had limited U.S. appeal, these types of products now entering the U.S with higher levels of clinical proof are showing greater adoption in the U.S. veterinary market. For dogs using clinically-proven GLM supplements, both veterinarians and pet owners are seeing general improvement in mobility—range of motion, ability to rise from rest and possible increases in the distance that dogs can walk. The timeframe for improvement is approximately 4-6 weeks, which is crucial as it allows for incorporation of
the GLM omega-3 fatty acids into joint tissues, with associated reductions in discomfort and increased mobility. During this time, pet owners may observe their dogs are now more easily able to jump on the couch, chase a ball, interact with other dogs and climb stairs again. It’s important to note the difference between GLM products and those only made with glucosamine and chondroitin, which are the most common supplements used. For several decades, the use of glucosamine and chondroitin in isolation has been the subject of controversy. The evidence base is equivocal, and many of the studies used to justify products using principally glucosamine and chondroitin are bench-top studies—with little or no evidence for effect in real life situations. That is compared with the growing body of evidence supporting and understanding the role of omega-3 fatty acids in joint health, and specifically GLM, in both in vitro and in vivo studies. There is now a strong body of evidence for both GLM in isolation1,2,3, and also in combination with glucosamine and chondroitin, demonstrating an effect in dogs with OA, including an objective improvement in mobility in dogs in placebo-controlled studies4. But not all GLM extracts are created
equal, and extract quality can vary significantly. This is why it’s imperative for manufacturers of GLM products to follow principals to create the highest efficacy of GLM products.
Sourcing GLM is only grown in the coastal waters of New Zealand. The location of the bays and position of the lines within the bays can significantly impact the quality of the mussels by effecting the levels of omega-3 fatty acids. GLM manufacturers need to select reputable farmers, working in specific bays, and the best-performing areas within these bays, to ensure they source the highest-quality mussels.
Harvesting The actual time when mussels are harvested significantly affects their quality. Manufacturers need to research
and understand the best time to harvest in each individual bay. The local environment, including tidal nutrient flow, geographic location, the genus of spat (juvenile mussel) used and the time of year influences the optimal time of harvesting for maximum quality.
Manufacturing GLM is usually freeze dried for extraction over a 24-48-hour process involving high heat, which can actually damage GLM’s quality. This form of processing with poor quality mussels results in a less effective product. Smart manufacturers are now using a very rapid vacuum-drying process, reducing the mussels to powder in mere seconds, and importantly, protecting the essential omega-3 fatty acids and other important properties. The result is high-quality powder with
1. Hielm-Björkman A, Tulamo RM, Salonen H, Raekallio M. Evaluating Complementary Therapies for Canine Osteoarthritis Part I: Green-lipped Mussel (Perna canaliculus). Evid Based Complement Alternat Med. 2009;6(3):365– 373. doi:10.1093/ecam/nem136 2. Bierer TL, Bui LM. Improvement of Arthritic Signs in Dogs Fed Green-Lipped Mussel (Perna canaliculus). The Journal of Nutrition. 2002;132(6):1634S–1636S. doi.org/10.1093/jn/132.6.1634S
Analyzing Today, the best manufacturers test literally every single batch of GLM powder, checking the levels of more than 40 different fatty acids in order to measure bioactivity and to look at oxidative stability. This constant monitoring ensures high-quality GLM powder consistently. In summary, GLM supplements are effective for supporting dogs with OA and joint issues. Veterinarians, who currently aren’t using GLM products, should explore using clinically-proven GLM products as part of a multi-modal strategy. Our canine patients will benefit as the science continues to advance and new treatment options and choices continue to be developed.
3. Bui LM, Bierer TL. Influence of green lipped mussels (Perna canaliculus) in alleviating signs of arthritis in dogs. Vet.Ther. 2003;4(4):397-407 4. Pead MJ, et al. A novel nutraceutical versus placebo in dogs with degenerative joint disease: a randomised double blind placebo controlled clinical trial. Data on file, Royal Veterinary College, London. 2018;1-19. 5. Eason CT, Adam SL, Puddick J, et al. Greenshell™ Mussels: A Review of Veterinary Trials and Future Research Directions. Vet Sci. 27 Mar 2018;5(2). doi:10.3390/vetsci5020036
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significantly higher levels of omega-3s compared to most GLM powders.
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Rachel Hylton is a Veterinary Technical Manager at Lintbells, which recently launched YuMove Advance 360, a clinically proven hip and joint dog supplement, into the U.S. recently; and makers of YuMove (yumove. com), the clinically proven, #1 veterinary hip & joint supplement for dogs in the UK. She graduated from the Royal Veterinary College, and spent 20+ years in general practice mostly working with small animals in an independent practice. As part of the Lintbells’ Research and Development team, she’s involved in the ongoing process of making high-quality and high-performance supplements.
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Industry News
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A Veterinarian’s Role in COVID-19 and How to Keep Pet Owners Informed By Courtney A. Campbell, DVM, DACVS-SA
O
n December 31st, 2019, a pneumonia of unknown cause was reported to the World Health Organization Office in China. In a few short months, the world was united in the fight against a viral pandemic caused by SARS coronavirus 2—or the novel coronavirus. The outbreak has now reached every continent (except Antarctica), sickened millions, tragically taken hundreds of thousands of lives, wreaked havoc on broad swaths of the economy and, not surprisingly, infected some animals. Veterinary medical professionals have always played an integral role in public health. Whether it is through veterinary medical research, advocating for parasite prevention or reporting cases of possible zoonosis, the veterinary profession has been an invaluable asset in the protection of animal and human health. Whether clients implicitly or explicitly understand our role in protecting pet and human health, they rely on us for sage advice and sound medical guidance—especially in the midst of a pandemic. There has been a deluge of news regarding the human toll exacted by the novel coronavirus. That news has largely drowned out COVID-specific information related to animal health. In the cacophony of COVID-related information, clients naturally turn towards those whom they trust to sort out fact from fiction. As their veterinarian, 28
you play a vital role in keeping them informed.
We Don’t Know What We Don’t Know Transparency is paramount in times of crisis. Not only is it okay to admit you don't know a certain factoid about this virus, but doing so strengthens the relationship you have with your clients. The relationships that you have with your established clients and the connections you are building with your newer clients will be rooted in honesty, truth and evidence. The virus is not only novel in its scientific discovery, but also insofar as new information is being discovered daily. It’s reassuring to clients to know that their veterinary medical team’s understanding of the virus is evolving according to the most updated information. A natural syllogism for many pet owners is, if their veterinarian is knowledgeable about the most contemporary issues (i.e., COVID-19 infection in pets) then there’s a good chance that their veterinarian will be well versed in other matters related to their pet’s health. The confidence and trust that they build in you during this crisis may impact your relationship with them in the future. Whether you’re educating clients on the importance of parasite prevention, or having a delicate discussion about surgical complications, the confidence that undergirds those conversations is built,
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in part, on the reputation that you establish with them during times of crisis.
Can Some Pets (And Other Species) Be Infected With the Novel Coronavirus? Almost all discussions regarding animals and the novel coronavirus have to be couched with the caveat “as of now” or, “as of this date”, because our understanding regarding the COVID pathogenesis in pets and other species is constantly evolving. News is changing rapidly, but as of the time of this writing, it does appear that the virus can affect a few species of animals including some pets. Those that followed the timeline of confirmed cases of COVID-19 in animals, initially read reports from Hong Kong which documented two dogs testing PCR positive after exposure to COVID-19 positive owners. One 17-year-old Pomeranian tested positive for COVID-19 on PCR and serology, and later died. Although the death is not believed to be due to the novel coronavirus.1-4 Since then, a cat in Belgium, a cat in Hong Kong, tigers and lions at the Bronx zoo, mink in the Netherlands, a cat in the United States and a Pug in the United States have all tested positive for the virus.1-5 (Although Winston the Pug is the first confirmed/documented case of a dog infected in the US, there is a possibility that he is not the first infected dog.) There is a question of whether Winston’s clinical signs were truly attributable to the novel coronavirus. It appears that SARS-CoV-2 can cause COVID-19-like disease in cats but, as of now, it appears to be subclinical in dogs. Currently, there is no evidence that domestic animals—or any animal within the United States—can serve as a source for human infection with SARS-CoV-2. A variety of other species have also shown susceptibility in experimental settings, including ferrets, Syrian hamsters and Rhesus macaques.1-4 The virus appears to replicate poorly in dogs and does not readily infect pigs, chickens or ducks.1-4 Experimentally, the virus did infect and replicate well in cats and ferrets. Cats were also able to transmit the virus to other cats.1-4
Many clients understand the implications of zoonosis (animal-to-human transmission of disease); however, reverse transmission (human-to-pet) is a novel concept for some. Helping clients understand these news stories and the implications they have for their pets at home may help keep their mind at ease.
How Can I Protect My Pet? To be sure, COVID-19 is a disease almost entirely exclusive to humans. However, because pets are such an integral part of our families, there will undoubtedly be more cases of pets exhibiting COVID-like illness and subsequently testing positive for the disease. The news of each new COVID-infected pet will likely fade from the front pages and gradually lose its grip on the twenty-four-hour news cycle. Fortunately, the emphasis from clients has been, and continues to be, how to protect pets from the virus. The CDC has issued guidelines on how to protect pets from this virus which can be summarized with these main tenants: • Socially distancing for you and your family includes the species-diverse members of your family as well. Keep all pets inside with you (if possible) and if and when they need to go outside, it is important to limit contact with strangers or any other animals. • If you’re infected or you have a strong suspicion that you have been exposed to someone who is sick, it is prudent to limit contact with your animals (and people, of course). If possible, recruit another family member living in the same household who is not sick to care for the animal. • Sheltering in place and quarantining includes your pets too. If you’re infected, keep your pet with you in the same household. Clients may be dismayed at the shifting and seemingly contradictory recommendations. However, it’s important for clients to understand that pet health advisories will be sculpted and refined based on the newest information. For now, scientists are continuing to work hard to understand the animal and human health implications for PETVET MAGAZINE
COVID-positive pets.
Are You Still Open? As the pandemic continues to upend normal life for so many across the globe, many clients understand that pets continue to need medical services. Debates about whether veterinary practices should be considered an essential service, news of veterinary hospitals shutting down abroad, and gubernatorial requests for veterinarians to donate Personal Protective Equipment and other supplies to human hospitals left many pet owners unsure if or what services their veterinary team may be providing. Moreover, many clients were calling to ask if veterinary hospitals were still open. That question can be answered with a straightforward “Yes, we are open. Our office hours are….” but that answer may miss an excellent opportunity to connect more deeply with your clients. Put the pandemic in perspective by discussing briefly what impact this crisis has had on your hospital, the workflow, new protective protocols and perhaps veterinary medicine writ large. Explain to your clients that the designation of an ‘essential service’ was left up to state and local governments; and fortunately, many states declared veterinary medicine an essential service or exempted them from their shelter-in-place orders. In response to this crisis, sweeping new COVID-specific protocols are being ushered in and clients may find it difficult to adapt quickly to the new regulations. Seize the moment to discuss in granular detail what ‘curbside drop-off ’ actually means at your hospital. Not allowing pet owners inside the hospital, having veterinary team members greet clients wearing personal protective equipment and their pet being examined away from them, all culminating to a doctor discussing medical recommendations telephonically, can be difficult for your clients to handle without preparation. Creating a ‘script’ or factsheet for your team to reference is helpful to ensure that the important minutia is not missed. The COVID-specific information you provide to your clients is not only germane for this moment, but there are 29
also broader implications within those conversations. Concern over client safety, the safety of their pets, the safety of your staff and your nimble response to changing situations are all potential positive client takeaways and contribute to the overall client experience. Excellent patient care, compassion for the clients and your staff, and being a trusted resource for information makes your relationship with the community more inveterate.
How Can I Help? Sometimes tragedy brings out the best in people. For World Veterinary Day this year, I celebrated the day by posting a short video thanking all those on the frontlines in the veterinary medical community including veterinarians, nurses and all the paraprofessionals in the pet health industry. Following that post, there was an unexpected outpouring of love and affection from pet owners and animals enthusiasts expressing gratitude for the service we provide. In addition to the overwhelming appreciativeness, there were several people that asked a simple question: How can I help my veterinary hospital in these unprecedented times? That question sincerely caught me off-guard. The question was unexpected mainly because it’s rare for anyone to ask how they can help us. Most of our lives and our careers are spent helping others and we are happy to do it. Although the legislative definition of a ‘healthcare worker’ lies with government officials, clients understand that providing their pets with urgent and essential care puts veterinary health professionals on the frontlines of exposure, similar to other dedicated professionals like human healthcare workers, grocery store team members, first responders, pharmacists and pharmacy technicians, among others. Of course, there are tangible ways that clients can help; however, one of the most powerful acts they can perform is an act of kindness. The message that I tried to communicate in that World Veterinary Day celebration video was simple: Be Kind. Being kind includes being flexible to a change in hours and protocols of the veterinary hospital. Being kind also comes with an understanding that many veterinary team members carry a high level of anxiety and moral fatigue which can lead to burnout. When clients ask how they can help your efforts, expressing to them that being treated with respect and kindness, and offering a simple thank you or smile can go a long way.
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References 1. Centers for Disease Control and Prevention. Coronavirus disease (COVID-19). Frequently asked questions. COVID-19 and animals. https://www.cdc.gov/coronavirus/2019-ncov/ faq.html#COVID19animals. Accessed April 1, 2020. 2. Centers for Disease Control and Prevention. Interim guidance for public health professionals managing people with COVID-19 in home care and isolation who have pets or other animals. https:// www.cdc.gov/coronavirus/2019-ncov/ php/interim-guidance-managing-people-inhome-care-and-isolation-who-have-pets.html. Accessed April 1, 2020. 3. World Organisation for Animal Health (OIE). Questions and answers on the 2019 coronavirus disease (COVID-19). https://www.oie.int/scientific-expertise/ specific-information-and-recommendations/ questions-and-answers-on-2019novelcoronavirus. Accessed April 1, 2020. 4. World Small Animal Veterinary Association. The New Coronavirus and Companion Animals - Advice for WSAVA Members. Advisory document: updated as of March 16, 2020. https:// wsava.org/wp-content/uploads/2020/03/ COVID-19_WSAVA-AdvisoryDocument-Mar-19-2020.pdf. Accessed March 31, 2020. 5. https://www.wral.com/coronavirus/ pug-with-coronavirus-first-dog/19074499/ Dr. Courtney A. Campbell is a board certified veterinary surgeon who specializes in orthopedic, soft tissue, and minimally invasive surgery. He currently practices at VetSurg in Ventura, California. He is also a host, author, and producer. Dr. Campbell is The Chief Creative Officer and host for VetCandy Watch, host of the popular podcasts, Anything Pawsible and The Dr. Courtney Show. He is also a former co-host of Pet Talk on Nat Geo Wild, a recurring veterinary correspondent and pet health expert on The Rachael Ray Show, CBS The Doctors, Home and Family, KTLA and other daytime talk shows.
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Start your summer off right with this delicious
citrus refresher: blend 6 cubes of grapefruit, 6 orange slices, a tablespoon of lemon juice and a tablespoon of lime juice. Pour in 4 ounces of orange juice and ½ of a frozen ripened banana. Blend until smooth and enjoy!
3 JUNE IS
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Send out an email or mailing to your clients with tips on how to be prepared to care for their pets in the case of a disaster such as a hurricane, tornado, flood or other natural disaster.
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GARDEN!
New research has found that allotment gardening promotes positive body image and an acceptance of bodily imperfections—and you’ll have fresh herbs readily available!
behavior guru Dr. Debra Horwitz lent her know-how to behaviorbits.com to provide free pet behavior counseling to pet owners. Check out the site and share with your clients.
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PLANT AN HERB
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this month
See how many you can do!
7
6 did you know july 19th is national
make sure you’re current on
covid-19 findings in pets —you’ll likely have concerned clients and will want to give them the most current info. Visit www.avma.org for up-to-date info.
8 FOR A HEALTHY
ice cream day? Surprise your staff with an afternoon ice cream party (don’t forget the toppings!)
HEART AND BRAIN
OLIVE OIL
is a great ingredient to add to your diet. The next time you reach for a cooking oil, choose olive oil.
9 The last week in is national nal atio NJuly
FEED A RESCUE
bores a kid more 10 Nothing than being stuck inside. Next time, be prepared with a Melissa and Doug tabletop easel. These easels are made of sturdy wood and help encourage creative play! Available on Amazon or at other retailers.
PET WEEK! Set up a collection bin in your lobby to encourage clients to donate pet food for a local animal rescue or shelter.
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