Expanding families: preparing for and introducing dogs and cats to infants, children, and new pets

Once clients make a decision to expand their family with children or pets, veterinarians can be instrumental in providing education and support to make the additions successful. Veterinarians should remind clients to make changes in the household well in advance of the new addition's arrival, to be patient, to make all introductions safe and controlled, and to reward good behavior. If problems arise, owners should be advised to separate those involved and get behavioral treatment as soon as possible. Through these simple steps, veterinarians can increase the likelihood that clients will be able to integrate new family members successfully.     

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.     

Communicating with special populations: children and older adults.

Veterinary professionals must meet the growing expectations of a diverse range of clients to sustain success in veterinary medicine. Few veterinarians, however, receive comprehensive skills training for communicating effectively with clients, particularly among special populations, such as children and older adults. An increasing number of veterinary professionals have recognized a need to master requisite skills for effectively interacting with pet-owning families. This article highlights the importance of the human-animal bond for children and older adults, addresses issues of pet loss, and provides suggestions for meeting the communication needs of both populations.     

Faculty expectations of veterinary students in clinical rotations

Expectations of veterinary students during clinical rotations should be developed with the goal of bettering the veterinary profession as a whole. This article outlines five areas of expectations for the veterinary professional: treating colleagues with respect, providing excellent care for patients and clients, developing and maintaining skill sets to support intellectual curiosity and continued professional development, and improving upon and using self-care and life-balance skills.     

Offering the best to patients: ethical issues associated with the provision of veterinary services

Veterinary surgeons have long been perceived as animal advocates and yet their income is usually dependent on a third party: the owner. Given the ever-increasing options now available to treat complex clinical conditions, it is important to consider which services should, rather than could, be offered to clients. Does the professional obligation to act as an animal advocate conflict or concord with the desire to operate a successful business? David Main discusses the ethical issues associated with the provision of professional services to clients and their animals.     

Australian veterinarians who work with horses: attitudes to work and career

OBJECTIVE: To describe the attitudes to their work and career of those Australian veterinarians who work with horses. METHOD: Questionnaires were mailed to 866 veterinarians who had been identified as working with horses, and 87% were completed and returned. Data were entered onto Excel spreadsheets, and analysed using the SAS System for Windows. RESULTS: The main attractions of veterinary work with horses were the horses themselves and the equine industries, but working outdoors and with rewarding clients, and the satisfaction of successful outcomes were attractions for many. The list of disadvantages was longer, and included unreasonable and disagreeable clients as well as those who provided inadequate facilities, could not control their horses or did not care for them. The physical demands and risks of injury, the amount of time required, low rates of return and difficulties in collecting payment, were other major disadvantages. Some mentioned concerns about litigation, unethical behaviour, and recruiting and retaining veterinarians competent with horses. For many in mixed practice, the difficulties in affording modern equipment, and of developing and maintaining their own competence with horses, was a real concern. More than three-quarters of the respondents reported that their careers had lived up to expectations and that they would become veterinarians again; 70% of equine veterinarians would become an equine veterinarian again. Almost all (93%) of the respondents were either very glad, or 'generally glad though with some misgivings' that they had done the veterinary course. Older veterinarians reported suffering less stress, and being more content with their career, than younger colleagues. CONCLUSIONS: The advantages of doing veterinary work with horses outweigh the disadvantages for most veterinarians, especially those well advanced in their careers.     

Diagnosis and management of patients presenting with behavior problems

Behavior problems are among the most common concerns for veterinary clients, and veterinarians need to be comfortable diagnosing and treating these conditions. Knowledge of animal behavior by veterinarians is critical for effective treatment of behavior problems, recognition and diagnosis of medical conditions for which behavior signs prevail, proper handling of veterinary patients, prevention of abandonment and euthanasia, preservation of the companion animal-human bond, and prevention of mental suffering. Successful patient management requires taking a thorough behavioral history, understanding the mechanisms underlying behavior changes, developing appropriate treatment interventions, and, in some cases, pharmacologic therapy.     

Nonverbal communication in veterinary practice.

Treating nonverbal communication with the thoughtfulness and observation with which we approach any other clinical problem can produce a set of skills that can be applied in every encounter. Skill development begins first with enhancing one's observations of nonverbal behavior and then diagnosing whether or not the client is feeling safe. Using one or more of the nonverbal skills when clients are feeling not-safe creates more satisfaction for the client and veterinarian and motivates clients to become full partners in their animal's care.     

Defining the attributes expected of graduating veterinary medical students, part 2: external evaluation and outcomes assessment

We have previously defined a set of 62 attributes-12 in the area of professional characteristics, 28 addressing knowledge and understanding, and 22 delineating skills-that veterinary students should be expected to have demonstrated by the time of their graduation (Walsh DA, Osburn BI, Christopher MM. Defining the attributes expected of graduating veterinary medical students. J Am Vet Med Assoc 219:1358-1365, 2001). We have used this set of attributes as the basis of an outcomes assessment completed by California practitioners to determine whether graduates from the University of California School of Veterinary Medicine are meeting these expectations. Based upon this assessment, these 62 defined attributes appear to reflect very well practicing veterinarians' views and expectations of DVM graduates. The survey results also indicate that, overall, the recent University of California graduates are meeting these set of expectations. Simultaneously, the outcomes assessment focused attention on several areas, including private practice management, work expectations for successful practice, and surgical capabilities. For each, California practitioners recommended that the definition of the expectation be expanded and that the level of achievement by graduates be improved. Defining a set of attributes expected of veterinary graduates is a key step in obtaining an effective outcomes assessment of a professional educational program.     

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.     

Perceptions of Livestock Owners of Private Veterinary Practice in Ghana

Using the participatory appraisal approach, a study was designed to assess the perceptions of livestock owners on private delivery of veterinary services in two districts in the major livestock-producing area in Ghana. A significant proportion (74%, n = 180) were willing to patronize locally established veterinary practices. However, the respondents emphasized that the fees charged had to be reasonable and affordable. Factors identified as likely to discourage the use of the private provider included the inability of the provider to speak the local language; non-availability of credit facilities for services rendered by the provider; unreliability of personnel; poor interpersonal skills; lack of technical know-how; inability of the provider to make house calls or farm visits; and poor personal and work ethics. These findings provide information for prospective private veterinarians on the expectations of their clients and could be used in the preparation of veterinarians for private practice.     

End-of-life communication in veterinary medicine: delivering bad news and euthanasia decision making.

Given the expectations of clients and the resultant impact of end-of-life conversations on pet owners and the veterinary team, compassionate end-of-life communication is considered to be an ethical obligation, a core clinical skill, and integral to the success of a veterinary team. End-of-life communication is related to significant clinical outcomes, including enduring veterinarian-client-patient relationships and veterinarian and client satisfaction. Effective techniques for end-of-life communication can be taught and are a series of learned skills. The purpose of this article is to present best practices for delivering bad news and euthanasia decision-making discussions. In this article, the SPIKES six-step model (setting, perception, invitation, knowledge, empathize, and summarize) currently employed in medical curricula is utilized to structure end-of-life conversations in veterinary medicine.     

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.     

Gender differences and the definition of success: male and female veterinary students' career and work performance expectations

This article addresses the challenges that gender performance expectations create within the veterinary profession. An investigation of veterinary students' perceptions of the essential characteristics that define successful veterinarians and veterinary students, and the gender differences within these definitions, is described. Because previous research supports the premise that the standards required for success differ for males and females, it is likely that male and female veterinary students possess different career expectations and definitions of career success. The ramifications of these differences are explored, and proposed strategies to address this issue, in the form of student support services, are discussed.     

Surviving as a solo practitioner

Despite the trend toward larger and larger group practices, they are not for everyone. The solo practitioner needs to accept that he or she cannot be all things to all people. It is necessary to define the services one wants to provide and then seek those clients whose needs match those services. This article reviews the principles behind the author's successful solo practice.     

Perspectives and advances in in-clinic laboratory diagnostic capabilities: hematology and clinical chemistry.

The typical technologies used in veterinary hematology and biochemical analyzers are reviewed, along with associated advantages and disadvantages. Guidelines for implementing a successful in-clinic laboratory are provided, including criteria for system evaluation and expectations for comparative performance evaluations. The more common problems and limitations associated with in-clinic laboratory diagnostics and how to best prevent them are also discussed.     

Owner perceptions of radiotherapy treatment for veterinary patients with cancer

Veterinary clients may have trepidation about treating their pet with radiotherapy because of concerns about radiation side effects or repeated anaesthetics. The purpose of this study is to assess whether owners' attitudes towards veterinary radiotherapy, including concerns over side effects, change during the course of treatment, and whether radiotherapy was perceived to affect pets' quality of life (QOL). A prospective cohort study of clients from 2012 to 2015 was performed. Pets received palliative or definitive radiotherapy for various tumours. Clients completed questionnaires before, during and after radiotherapy. Questions assessed owner preconceptions before treatment, including side effect expectations, actual side effects experienced and overall satisfaction with the process. In addition, at each time point, the owners assessed their pet's QOL using a simple numerical scale. Forty‐nine patients were included. After completing treatment, owners were significantly less concerned about potential side effects of radiotherapy (P < 0.001), side effects associated with repeat anaesthetics (P < 0.001), and about radiotherapy in general (P < 0.001). QOL did not show a significant change at any point during or after treatment. Following treatment, 94% reported that the experience was better than expected and 100% supported the use of radiotherapy in pets. This is the first prospective study evaluating client attitudes and satisfaction before and after radiotherapy treatment in pets. The results indicate that radiotherapy is well tolerated, and the anxiety associated with radiotherapy is significantly alleviated after experiencing the process. These results will help veterinarians allay client concerns, and will hopefully lead to an increase in clients pursuing radiotherapy in pets.     

Normal behavior and the clinical implications of abnormal behavior in guinea pigs.

Cavies are becoming more popular as pets because they are relatively easy to care for and provide never-ending love and entertainment with their curious but gentle nature. As with other species, the best way to learn about guinea pig behavior is to own guinea pigs. Understanding normal behavior provides the practitioner with the ability to more easily recognize pathology and abnormal behavior. This allows the veterinarian to provide necessary supportive care and pain management more quickly while performing diagnostics and determining the need for therapeutics. Understanding the behavior of cavies allows the clinician to better educate guinea pig-owning clients and to better and more quickly serve the needs of their guinea pig patients.     

Disease outbreak investigation in food animal practice.

In addition to excellent observation skills and a good understanding of production medicine, veterinarians require the tools of epidemiology for the successful investigation of disease outbreaks. Food supply veterinary practitioners are often called upon to investigate various types of disease outbreaks. In this article, the authors outline the primary questions a practitioner should address and summarize a systematic approach to determining the causes of an outbreak and minimizing further losses. The investigation of disease outbreaks provides an opportunity for the herd veterinarian to show clients the advantages of a herd health program and the value of a good record-keeping system.