Client services for geriatric pets

Some veterinarians have been reluctant to discuss the prospect of the death of a pet because of a sense of discomfort and a lack of understanding about how to respond to the client's grief reaction. It is essential to take the time for this important communication and help clients deal with fears about the process, any feelings of guilt and helplessness, and judgments about the medical aspects of a case. Clients must be encouraged to express grief over the loss of a pet, particularly a geriatric pet that has lived with them many years and to which they are deeply bonded. Veterinarians need to counsel clients about obtaining additional pets or another pet. The phrase "replacement pet" must be stricken from the veterinarian's vocabulary. One does not "replace" a deceased spouse, mother, father, or child. It is possible to have another child or find another spouse, but it is not possible to replace a person. Neither can a pet be "replaced," because each pet is a unique living being. It is disrespectful to the memory of deceased pets to belittle their uniqueness by suggesting that they can be replaced. Instead, the veterinarian has the capability and responsibility to help pet owners maintain fond and happy memories of an irreplacable pet, while finding room in their hearts for another new pet to create happiness for the future. Once the grief is resolved, clients will be thankful for having had the privilege of sharing their life with an animal and experiencing the joy of the bond between two unique individuals.     

Effectively communicating with your clients

The successful ability to efficiently collect diet histories, convey appropriate health messages, and discuss client concerns about the safe feeding of pets requires excellent communication skills. In addition to understanding what the client wants for their pet, thorough nutritional interviewers gather information pertaining to animal factors, dietary factors, and feeding management factors. With the expansion of the Internet, increasing advances in medical care, and the health concerns associated with pet food recalls, small animal clients are looking to veterinarians for guidance and information on dietary recommendations in ever increasing numbers. Evaluating current information on changes in the pet food industry should be a periodic learning objective for all members of the veterinary health care team. Consistent, effective communication between veterinarians, their staff, and their clients can improve compliance, increase satisfaction levels, and improve patient outcomes.     

Homemade diets: attributes, pitfalls, and a call for action

At one time, it was estimated that the majority of dogs and cats in the United States received 90% or more of their nutrition from complete and balanced commercially prepared foods, and this estimate was reaffirmed in a 2004 survey. However, 4 years and several pet food and treat recalls later, fewer pet owners are feeding commercial pet food products exclusively and more are asking questions and looking for alternatives. As in any market-driven economy, there are many more alternative diets and food products available today from which pet owners may select. A difficult to measure but growing number of clients are feeding homemade diets that provide 100% of their pet's nutrition, while a larger number are feeding a combination of products, treats, and home prepared meals. Most practitioners can attest to this increase in their client's interest in homemade meals and to having insufficient knowledge to assist them. At a time when motivated clients are considering homemade for their pets as an alternative, veterinarians are less than adequately versed in canine and feline nutrition and dietary options. The article addresses the two most important health issues concerning pet owners and veterinarians about homemade diets: nutritional integrity and food safety.     

Cognitive dysfunction and the neurobiology of ageing in cats

With improvements in nutrition and veterinary medicine the life expectancy of pet cats is increasing. Accompanying this growing geriatric population there are increasing numbers of cats with signs of apparent senility. A recent study suggests that 28 per cent of pet cats aged 11 to 14 years develop at least one geriatric onset behavioural problem, and this increases to over 50 per cent for cats of 15 years of age or older. While behavioural changes may result from systemic illness, organic brain disease or true behavioural problems, the possibility of age-related cognitive dysfunction is often overlooked. Studies have revealed a number of changes in the brains of geriatric cats that showed signs of cognitive dysfunction, and potential causes include vascular insufficiency leading to hypoxia, increased free radical damage and the deposition of beta-amyloid plaques and/or the modification of other proteins. By recognising the importance of behavioural changes in old cats, investigating them fully for potentially treatable medical conditions, and instigating dietary and environmental modifications to meet their changing needs, we can make the lives of our geriatric cats much more comfortable and rewarding.     

Preliminary Results of Clinical Renal Allograft Transplantation in the Dog and Cat

Renal allograft transplantation was performed as treatment for terminal renal failure in six veterinary patients. Three patients failed to survive the postsurgical period, one patient died due to acute allograft rejection, one patient died subsequent to complications of previous parenteral hyperalimentation and infection, and one patient was euthanatized due to the inability of the clients to maintain the effort necessary to manage a transplant recipient. Further clinical studies are necessary to determine if renal transplantation with cyclosporine (cyclosporin A)/prednisolone immunosuppression has the potential to provide practical treatment of terminal renal disease in clinical veterinary medicine. Pharmacologic and immunologic monitoring of transplant recipients with individualized immunosuppression is imperative. Careful surveillance is necessary to identify and eliminate nosocomial sources of infection. Candidates for transplantation cannot be critically ill or malnourished prior to surgery, and pet owners must be prepared for the financial and time commitments associated with caring for a renal allograft recipient.     

The owner of the pet with cancer

Cancer is an emotionally charged disease. During treatment, it is not uncommon for pet owners to engage veterinarians in frank discussions and emotional confrontations based on their fears and anxieties about cancer. Pet loss counseling skills are invaluable when dealing with clients after the death of their companion animal. Incorporating pet loss counseling into a veterinary practice is pragmatic as well as compassionate because clients who feel that they have received good emotional care in addition to medical care return to the veterinarian with new pets and recommend the practice to others.     

Geriatric heart diseases in dogs.

A discussion of the diagnosis and therapy of heart disease in an aged pet does not differ significantly from that in a pet of any age. Mitral regurgitation constitutes by far the most important geriatric heart disease, and the selection of drugs to treat heart disease of aging pets is based on identification of specific pathologic features (eg, atrial fibrillation, left atrial enlargement) for which each aspect of treatment (eg, diuretics, angiotensin-converting enzyme inhibitors, spironolactone) is specific.     

Calculations of energy requirements of dogs, cats and small psittacine birds

How much and on what should I feed my dog, cat or budgerigar? This must be a common question veterinarians are asked by their clients and possibly the most difficult question to answer because of the number of options available. When advising on the most appropriate daily feeding regimen for a companion animal, one must not only consider the animal's requirement for energy and other key nutrients at a particular bodyweight or age but also provide a food that is readily consumed by the pet. Feeding plays an important role in the relationship between the pet and its owner. The occasion provides the greatest pleasure for the owner when the pet has not only eaten the food supplied but also indicated, via its behaviour pattern, that the occasion was pleasurable. These factors, together with the animal's own individual preferences, will determine whether a particular food, even if nutritionally balanced, is eaten or not.     

Home monitoring of the diabetic pet

Home monitoring of the diabetic pet is a challenging proposition for many pet owners. Diabetes, unlike many other diseases, requires that the client, not the veterinarian, treat the disease. It is crucial that veterinarians reinforce and educate clients that successful treatment of diabetes mellitus will depend solely on the client's actions throughout the course of the treatment. This article provides guidelines on educating clients in the home monitoring process. This commonsense approach covers elements of in-home monitoring, including general appearance, clinical signs, behavior changes, feeding schedules, and medication administration. Additionally, thorough explanation is provided for clients who wish to take a more active role in obtaining and monitoring blood and urine chemistry values. This information is provided to assist the veterinary technician and veterinarian in educating clients of their responsibility in treating this disease.     

Use of complementary veterinary medicine in the geriatric horse.

The use of complementary and alternative veterinary medicine continues to grow within the veterinary community. As more clients seek out complementary and alternative medicine for their own health care, they begin to seek out these forms of therapy for their animals. For the equine practitioner, this includes those clients with geriatric animals. It is hoped that this article provides some insight into what conditions may be helped with CVM (complementary veterinary medicine) and when an equine practitioner may want to consider CVM as a form of therapy for the geriatric horse.     

Intestinal parasites of dogs and cats in Australia: The veterinarian’s perspective and pet owner awareness

During a recent national study of intestinal parasites in dogs and cats in Australia, questionnaires were submitted to veterinarians and pet owners to evaluate from a veterinary and public health standpoint the veterinarians’ perception, awareness and knowledge of gastrointestinal parasites in their locality. The study included sourcing information with regard to commonly recommended deworming protocols. The awareness of pet owners regarding parasitic zoonoses and the degree of education provided to them by veterinarians was also determined.Very few veterinarians routinely discussed the zoonotic potential of pet parasites with clients but most recommended regular prophylactic administration of anthelmintics throughout a pet’s life. Some pet owners were unaware of the existence of zoonoses. It is possible that an overreliance on anthelmintics may have led to a certain complacency about the need to educate pet owners about the risks of zoonoses. Veterinarians are important educators in the community and it is important to evaluate their performance if improvements are to be made.     

Potbellied pig husbandry and nutrition.

Vietnamese potbellied pigs, when appropriately cared for, make excellent pets for some people. However, their proper housing, care, and training is more challenging to the average person than that required for most traditional pets, such as dogs and cats. Failure to feed and house the pet pig appropriately results in the most common health and behavior problems. The obese, intractable pet pig gives little pleasure to a pet owner and appears to lead a very poor-quality life, frequently leading to the pet pig being given away or worse. Preventing health and behavior problems is easy if pet owners are armed with correct information early, either before or immediately after their acquisition of a pet pig. A veterinarian prepared to share this information can save the lives of many pigs as well as keep clients happy and coming back.     

Obtaining a pet: realistic expectations

Millions of dog-human relationships fail each year-some from simple and preventable mismatches. False or unrealistic expectations of a dog's behavior are a common reason for failed human-animal bonds. Veterinarians can reduce the incidence of false expectations and thereby increase the likelihood of successful adoptions by offering preadoption counseling to help clients sort through the many factors involved in the process of successful pet selection, by preparing clients to take on the important tasks of puppy socialization and the management of the home learning environment, and by educating new owners about the needs and behavior of dogs.     

Predictors of owner response to companion animal death in 177 clients from 14 practices in Ontario

OBJECTIVE: To identify predictors of grief and client desires and needs as they relate to pet death. DESIGN: Cross-sectional mail survey. SAMPLE POPULATION: 177 clients, from 14 randomly selected veterinary practices, whose cat or dog died between 6 and 43 days prior to returning the completed questionnaire. PROCEDURE: Veterinary practices were contacted weekly to obtain the names of clients whose pets had died until approximately 200 clients were identified. Clients were contacted by telephone, and a questionnaire designed to measure grief associated with pet death was mailed to those willing to participate within 1 to 14 days of their pet's death. The questionnaire measured potential correlates and modifiers of grief and included three outcome measures: social/emotional and physical consequences, thought processes, and despair. Demographic data were also collected. RESULTS: Approximately 30% of participants experienced severe grief. The most prominent risk factors for grief included level of attachment, euthanasia, societal attitudes toward pet death, and professional support from the veterinary team. CONCLUSIONS AND CLINICAL RELEVANCE: Bivariate and multivariate analyses highlighted the impact owners' attitudes about euthanasia and professional intervention by the veterinary team had on reactions to pet death. Owners' perceptions of societal attitudes, also a predictor of grief, indicate that grief for pets is different than grief associated with other losses.     

Healthy pets, healthy people.

Zoonoses, diseases that can be transmitted from animals to humans, can pose serious health risks to immunocompromised people. Although pets can carry zoonoses, owning and caring for animals can benefit human health. Information exists about preventing transmission of zoonoses, but not all physicians and veterinarians provide adequate and accurate information to immunocompromised pet owners. This disease prevention/health promotion project provides physicians and veterinarians with information, created specifically to share with patients and clients, about the health risks and benefits of pet ownership. Further, "Healthy Pets, Healthy People" encourages communication between veterinarians, physicians, clients, and patients and can serve as a model program for a nation-wide effort to aid health professionals in making recommendations about pet ownership for immunocompromised people.     

Evaluation and use of pet foods: general considerations in using pet foods for adult maintenance

Questions regarding pet animal nutrition are probably among the most frequent queries encountered by companion animal veterinarians. Given the plethora of pet food products available and the amount of advertising used to promote them, it is not surprising that pet owners have concerns as to what they should feed their pets. This "practical" review of pet foods and feeding is designed to assist veterinarians in making nutritional recommendations to their clients, with respect to feeding normal adult pets at maintenance.     

Alternative diets

As pet owners become more conscious of their own diets and the impact it has on their health, they naturally become more interested in what their animal companions are eating and how that might be affecting their pet's health. Many are exploring alternatives to standard commercial pet foods, and some are asking their veterinarians for advice. Small-animal nutrition is an ever-changing field. What veterinarians were taught 10 years ago may no longer be sound advice. This article explores some of the reasoning behind the development of both conventional commercial pet foods and the alternative foods and diets. It questions some of the conventional dogma as well as some of the trendy assumptions in the current marketplace. The intent is to provide the veterinarian with some balanced information on which to base nutritional advice to clients, and to begin forming new opinions or at least asking new questions. Guidelines on formulating a homemade diet for dogs are included.     

Anesthetic considerations for the geriatric patient

The geriatric patient presents an anesthetic challenge due to the physiologic alterations that occur during aging. The geriatric patient usually has an increased number of disease processes and does not possess the functional organ reserve capabilities compared to a younger patient. The geriatric patient seems more susceptible to the cardiopulmonary depressant effects of the preanesthetic and anesthetic agents in common use and, due to decreased hepatic function and other factors, may have a delayed recovery from these drugs. The preanesthetic and anesthetic drugs chosen for a geriatric patient will depend on that particular patient's physiologic status, the procedure to be done, and the experience of the veterinarian. Adequate fluid and monitoring support should always be provided for the geriatric patient.     

Owner response to companion animal death: development of a theory and practical implications.

This study used an inductive research method known as grounded theory to develop a theory to describe owner response to the death of a pet. Participants were identified from 8 veterinary clinics in Wellington Country, Ontario. Eighty percent (8 of 10) of the practices approached agreed to participate and there was a 77% (44 of 57) participation rate by clients. Nondirective interviews were conducted with participants approximately 10 days following the death of their pet, and at 3, 6, and 12 mo thereafter. The theory developed suggests that people's reactions are best described as a social and psychological search for meaning. Factors that contributed to the search for meaning included societal values and norms, the cultural milieu of pet death, and the cultural milieu of veterinary medicine. Other factors, such as the participant's personal beliefs, life stage, critical life events, and animal attributes, either alleviated or aggravated the experience. The outcome for participants grieving the death of a pet was a self-governing approach to coping with the death. Practical implications and suggestions for veterinarians are presented.