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July/August, 2014 • Vol. 6, Issue 4
www.vet-advantage.com
Promoting Excellence
in Animal Health Sales
Tiger
by the Tail
Zack Mills has a passion
for veterinary medicine
Inside:
Patterson National
Sales Meeting
Success, Unplugged
The Senior Pet
Heartworm Diagnosis
» p.10
» p.23
» p.56
» p.64
It’s a soft chew.
Kills both fleas and ticks.
It’s prescription only.
Now a
pprov
to kill m ed
ore
ticks!
NexGardTM (afoxolaner) is the protection you
asked for, and patients will beg for.
NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill Black-Legged (deer) ticks,
Lone Star ticks and American Dog ticks. NexGard is available only with a veterinarian’s prescription,
and features anti-diversion technology monitored by Pinkerton® Consulting & Investigations.
NexGard and FRONTLINE VET LABS are trademarks
of Merial. ®PINKERTON is a registered trademark of
Pinkerton Service Corporation. ©2014 Merial Limited,
Duluth, GA. All rights reserved. NEX14TTRADEAD (06/14).
TM
IMPORTANT SAFETY INFORMATION: For use in dogs only. The most
common adverse reaction is vomiting. Other adverse reactions
reported are dry/flaky skin, diarrhea, lethargy, and anorexia. The
safe use of NexGard in pregnant, breeding, or lactating dogs has not
been evaluated. Use with caution in dogs with a history of seizures.
July/August 2014
www.vet-advantage.com
46
page
»»
Publisher’s letter: Chris Kelly
Is the Pet Owners Act Really Fair? pg6
»» Industry insights: Kirk Augustine
Your Summer/Fall
Forecast for Sales
pg8
»» d istribution
Patterson Veterinary
National Sales Meeting
Committed to Possibilities
pg10
pg14
»» Sa
les:
Big Words Lead
to Big Confusion Brian Sullivan
pg16
Sales Call Challenges Pat Malone
»» Sales: ATS
Voice Mail vs. Text Messaging
pg20
pg24
»» Finance: Fritz Wood, CPA, CFP
Who Does What?
»» r oad tales
»» Trends
pg32
FIV, Lyme disease up, but many signs of
improvement appear in Banfield State
of Pet Health 2014 Report, with its
focus on infectious diseases
The Persistent
Threat of Rabies
pg22
Success, Unplugged
pg34
Laura Thill
Summertime finds more pets outdoors,
making it a good opportunity for your
customers to remind pet owners to
stay current with their pets’ rabies vaccines.
Understanding Diabetes
»» p erspective: Adam Augustine
Get more accomplished with
a healthy dose of detachment
Help veterinary practices become the local
pet-care authority in their communities
Infectious Disease Trends are Mixed
Cut Through the Clutter
The steps toward solving two of the
biggest obstacles reps face with customers
Local Authority
Effective use of veterinary healthcare team talent pg28
»» Inside Sales: Dawn Singleton-Olson
Find and use the information that will
be most valuable to your customers
»» M
arketing: Pam Foster
pg38
Laura Thill
An understanding of diabetes – including
the symptoms and challenges it presents –
can help sales rep better service their
veterinary customers.
pg42
pg23
Veterinary Advantage magazine (ISSN 1948-0288) is published bi-monthly, PO Box 862151, Marietta , GA 30062. Copyright 2014 All rights reserved. Subscriptions: $49.00 per year for individuals;
issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address
changes to Veterinary Advantage, PO Box 862151, Marietta, GA 30062. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement
by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Marietta, GA and at additional mailing offices.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
3
July/August 2014
Editor
Mark Thill
[email protected]
www.vet-advantage.com
Managing Editor
Graham Garrison
[email protected]
Senior Editor
Laura Thill
[email protected]
Contributing Editor
Jennifer Ryan
[email protected]
Art Director
Brent Cashman
81
page
[email protected]
Vice President of Sales & Marketing
Rick Boggess
[email protected]
»» cover story: Tiger tails
Tiger by the Tail
Graham Garrison
Zack Mills has a passion for veterinary medicine
pg46
»» Trends
Preventive healthcare, an understanding of the unique
needs of older pets, and owners’ eagerness to care for their aging
animals have contributed to longer lives for companion animals pg56
Heartworm diagnosed by
75 percent of veterinarians
Preventives identified as key to stemming incidence
Managing Expectations
Practice managers discuss the future of veterinary medicine
pg64
pg66
pg70
»» Sa
les meeting
pg74
Jennifer Ryan
pg78
A passion followed
Karen McGarrah uses the skills – and passion – she learned
as a healthcare supply chain executive to help rescue horses
pg81
News
pg85
»» Product Announcementspg89
»» Editor’s note: Mark Thill
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
Sales & Marketing Coordinator
Paige Kelly
Circulation
Laura Gantert
[email protected]
Photography by Dan Carmody, Studio 7
Corporate Headquarters
3628 Blakeford Club Dr.
Marietta, GA 30062
866-388-8212 phone
866-615-9232 fax
2014 editorial board
»» C OMMUNITY
Senior pets demand our attention
[email protected]
[email protected]
»» E quine
Equine veterinarians are increasingly using stem-cell
therapy to help repair bone, ligament and tendon injuries
Vice President Industry Relations
Lorne Elder
President & Publisher
Chris Kelly
Anesthesia Equipment
Veterinarians are looking to provide safe anesthesia
at a reasonable cost. By understanding the needs
of their clinics, sales reps can help them do so.
Executive Vice President
of Business Development
Kirk A. Augustine
[email protected]
Words that Work
The best messages about preventive care
are simple and to-the-point, says Karyn Gavzer
[email protected]
[email protected]
»» pa
rtners for healthy pets
4
[email protected]
Account Executive
Doreen Carpenter
The Senior Pet
Cell by Cell Recovery
Senior Account Executive
Kim Long
pg98
Kim Allen, Henry Schein Animal Health
Spencer Breithaupt, M
WI Veterinary Supply
Scott Handler, DVM, Patterson Veterinary
Jeannie Jeffery, Henry Schein Animal Health
Jackie King, AVDA
Karen Miller, Midwest Veterinary Supply
Clay Cass, Merritt Veterinary Supplies
John Ryan, MWI Veterinary Supply
Michael Stone, Henry Schein Animal Health
Mark Ziller, Animal Health International
»» Publisher’s Letter
Is the Pet Owners Act Really Fair?
Most people believe our system of government is not serving
Chris Kelly
its constituents well. That includes people from both political parties and all walks of life. While
much of what goes on in Washington, D.C. is aggravating, the new Fairness to Pet Owners Act
(H.R. 4023) rates very high on the aggravation scale. Like its predecessor H.R. 1406, it would require a veterinarian to provide a client with a written prescription for pet medications, regardless
of whether it was requested by the client. The veterinarian would also be prohibited from charging
for the prescription or asking a client to sign a liability waiver related to writing the prescription.
It’s likely that even if H.R. 4023 is defeated, like its predecessor, it will continue to be brought
up time and again in Congress. That’s because, at least in my opinion, the big box stores, who are
anxious to increase their market share in pet prescriptions, have successfully lobbied and/or contributed to a Congressman who then goes to work on their behalf. The Congressman, in the spirit
of “fairness” then brings up a bill that moves money from the veterinary hospital to the retailers
supporting him, with the veterinarian required to work on behalf of the retailers.
I know this is standard protocol in D.C., but it is hitting close to home once
again, thus the aggravation. If this was truly an issue of limiting consumer choice
and flexibility, I would probably favor a bill of this nature. I don’t believe this is a
problem though. Consumers understand they have choices, and are reminded of
that every time they turn on the TV or shop in a big box retailer. In addition, most
states have laws protecting consumer choice when it comes to pet prescriptions.
The big question is how do we win this battle? There are many valid arguments
against this bill, from the burden placed on veterinarians to whether choice truly
is being limited, but the one I believe resonates most effectively has to do with
safety. Veterinarians are uniquely qualified to fill prescriptions because they can
offer guidance and education around the use of the products, which most human
retail pharmacies are not qualified to do. This helps ensure that pets are properly
treated, which is hard to argue against, regardless of your position.
On a related note, in an attempt to help veterinarians properly price these products, we have launched a new Price Index App which is now available in the Apple
App Store. It focuses on flea, tick, heartworm and NSAID products and pulls pricing
from a large number of retail sources. The information is presented as a pricing range, showing the high, low and median prices. It also includes a calculator to determine margin or margin
dollars, historical pricing, as well as retail tips. If hospitals are currently doing their own pricing
research, the Price Index will save them a significant amount of time and money. The cost is $25
and includes future upgrades. For more information please visit www.vet-advantage.com.
Veterinarians are
uniquely qualified
to fill prescriptions
because they can
offer guidance and
education around
the use of the
products, which
most human retail
pharmacies are not
qualified to do.
6
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
DECHRA
OPHTHALMIC
O I N T M E N T S
A R E
BA C K
Now your customers can treat canine and feline patients
with the trusted ophthalmic products, VETROPOLYCIN®
(bacitracin-neomycin-polymyxin) Veterinary Ophthalmic
Ointment and VETROPOLYCIN® HC (bacitracin-neomycinpolymyxin-hydrocortisone acetate 1%) Veterinary Ophthalmic
Ointment, that are FDA-CVM approved for use in dogs
and cats. The choice is clear. Contact your Dechra
Representative for
more information.
24 Hour Technical Support available
from trained Veterinary Professionals.
LIMITED
TIME
OFFER
|
866-933-2472
BUY 9, GET 3 FREE
Some restrictions apply.
As with all drugs, side effects may occur. In field studies, the most common
side effects reported were ocular itching, burning, or inflammation in animals
sensitive to the product. Prolonged use may result in the overgrowth of nonsusceptible organisms including fungi. VETROPOLYCIN ONLY— Do not use
as a pre-surgical ocular lubricant. VETROPOLYCIN HC ONLY— This product
is not for use in animals with corneal ulcers, fungal infections, or viral
infections. Patients should be monitored for signs of corticosteroid overdose.
The safe use of this product has not been evaluated in pregnant animals. Refer
to the prescribing information for VETROPOLYCIN and VETROPOLYCIN HC for
complete details or visit www.dechra-us.com.
Dechra Veterinary Products, 7015 College Blvd., Suite 525, Overland Park, Kansas 66211, 866-933-2472
»» Industry Insights
Your Summer/Fall Forecast for Sales
Summer can make selling a bit challenging. Doctors are on vacation, hospital managers are juggling duties and often short-staffed. Purchasers or buyers are not sure
what the upcoming days or months will bring. Certain geographies are reeling from drought or floods.
However, uncertainty is often the distributor rep’s best friend, because you could know more about
the practices’ purchasing needs than they do. You have a complete look at their historical purchases, and
field reps can frequently see (literally) the products that practices are not buying from your organization.
In a previous issue, I shared practice profile information, including the reality that average clinic
reorders hover around +/- $500. This is an indication of an unsophisticated supply chain or channel.
Distribution reps that seek to help their customers forecast and ensure key products remain on-hand
By Kirk Augustine
will be successful.
Consider how you might take action:
Consider this: The average hospital reacts to inventory
• Teach customers how to use your company’s history
outages (“0” quantity on hand) instead of acting to restock
tools in the web application.
based upon a minimum quantity on hand.
• Facilitate a discussion during a lunch meeting with your
A recent article in Supply Chain Digest underscores
key accounts to help them manage inventory as a team.
this. Although focused on issues in more traditional supply
• Utilize manufacturer promotions or offers to secure
chain management, the results also apply to our animal
customers level pricing for a time period (be sure to
health industry.
remind them to manage their margin calculations in
the practice management system).
Among the Leading Barriers to Improved Supply Chain
• Become the liaison to create an outside, inside, and clinic
Success* were:
buyer collaborative team to service key customers more
• Forecast accuracy and
• Lack of internal crosseffectively. (Too often, ISRs and OSRs are not aligned).
demand variability
functional collaboration
• Utilize purchase history to establish a forecast, reorder
• Lack of visibility across
points (ROP), and economic order quantities (EOQ).
• Cost volatility
the supply chain
The most collaborative reps that help customers optimize
• Lack of external crosstheir business opportunities are those who will be at work in our
• Supply chain complexity
functional collaboration
industry five years from now. It takes just a little extra effort, a bit
more strategic thinking, and solid pre-planning to realize the re* http://www.scdigest.com/ASSETS/NEWSVIEWS/
sults from working in this way; but the rewards are boundless.
11-06-30-1.php?cid=4689
Forecasting Steps with a Customer
1st – Remember, inventory should never stand still.
2nd – Acquire annual purchases by SKU in total units.
3rd – Assemble this listing in descending unit quantities.
4th – Work first with the SKUs where the annual quantity is >
144 units (12/month)
5th – Divide the annual quantity by 18. This establishes
a reorder point (ROP), which leaves three weeks of
inventory on hand pending buyer actions and time to
recognize a shortage, reorder, receive, and restock.
8
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
6th – Then suggest using the same formula (annual
quantity÷18) rounded to the nearest case quantity as
the economic order quantity (EOQ).
7th – Make sure you advocate your distributor company as
the primary supplier for these SKUs in the practice
management system.
8th – Make this collaboration a part of future calls and track
hospital progress by looking at the logical results indicated
by increasing dollars per order and lines per order.
•
•
•
•
•
•
W e a r e p e o p l e p r o t e c t i o n.®
Learn how eco-friendly practices minimize our
global impact at www.GlovethePlanet.com
»» Distribution
Patterson Veterinary
National Sales Meeting
Committed to Possibilities
Patterson Veterinary, a division of the
Patterson Companies, held its national sales meeting at the
Omni Fort Worth Hotel in Fort Worth, Texas on May 12-15. More
than 275 attendees from Patterson Veterinary and 100 of its
vendor partners were in attendance. The theme of the meeting was Committed to Possibilities and focused on the changes
Patterson is making as a company to differentiate itself in the
eyes of the customer, as well as celebrating the successes of
10
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
the past year. The meeting included breakout sessions, interactive forums where new ideas were shared, manufacturer presentations and presentations by well-known national speakers.
The meeting kicked off with a presentation by George
Henriques, president of Patterson Veterinary. “Our theme
for this year’s meeting, Committed to Possibilities, sets the
stage for envisioning, discussing and preparing for some of
the opportunities we plan to embrace in fiscal 2015,” said
Henriques. “We have many
factors in our favor, including
a 6 percent increase in pet
ownership and indications
that people are spending significantly more money on their
pets, making the independent
practitioner our bread and
butter.” Henriques also detailed the expansion of Patterson’s markets, key strategic
partnerships, and differentiators that continue to improve
Patterson’s competitive position in the marketplace.
Jeff Baker, Patterson Veterinary’s Vice President of
Sales, followed Henriques and
commented on Patterson’s
commitment to change. “As
a company, we have the right
strategy, the right team and
we’re going in the right direction,” said Baker. “In addition,
our commitment to change will
allow the company to remain
competitive by improving our IT
infrastructure and streamlining
“That’s just my [SUPRESSED IMMUNE SYSTEM.
ELEVATED HEART RATE. ABNORMAL RESPIRATORY
RATE. GI UPSET. HORMONE CHANGES.
] stress coming out.”
INAPPETANCE .
Start
Zylkene.
a new dialogue about behavior then start new
Because your patients aren’t just stressed out. They’re stressed within. Your clients don’t
realize behavior problems aren’t just stress-related, they’re health-related too. You’re the life line
for answers and new Zylkene is your first line:
• The only veterinary nutraceutical with alpha-casozepine, a safe and natural
ingredient derived from casein, a milk protein with calming properties
• Clinically proven for behavioral problem management without drowsiness or sedation
• Indicated for situational stress or chronic anxiety in dogs or cats
• Palatable, once-daily formulation in three sizes
Learn more at vetoquinolusa.com/zylkene or call 800-267-5707.
Relax, you’ve got
Zylkene is a registered trademark of Vétoquinol.
©2014 Vétoquinol
7/2014
®
»» Distribution
the way we do things.” Baker also urged Patterson team
members to personally commit to change, noting even small
changes can lead to big success. Baker concluded, saying,
“The reason we are a great company is because you make
up the company. You own it – it’s your business. Thank you
for all you do.”
Scott Anderson, Chairman and CEO of the Patterson
Companies, also addressed the group and discussed the
company’s vision to connect expertise to inspired ideas,
products and services to create a memorable difference
in the lives of their customers. “Patterson Companies is
making investments in IT that will give us the necessary
edge to be leaders in the industry,” he said. “These investments, combined with our specialized sales force, decentralized structure, full-service support and key strategic
partnerships, give us a competitive advantage.”
The Awards Ceremony celebrated the accomplishments
of the past year, and also included a special tribute to Dale
Spann, Vice President of Marketing and Operations, who
is retiring after a 38-year career with Patterson Veterinary.
The tribute included pictures and comments of gratitude to
Spann by Patterson Team Members, as well as a moving
thank you from Spann, who thanked his colleagues for an
unforgettable journey. Also receiving special recognition as
the top branches of the year were the Southern Branch, the
North Central Branch and the Southwest North Branch.
“There are many great opportunities on the horizon,”
said Henriques in closing. “We are positioning ourselves for
growth and are giving you more tools to be more efficient
and effective. We have what it takes and we are committed
to the possibilities.”
Renowned Speakers
The meeting featured presentations by a number of wellknown speakers, including futurist Jim Carroll, musician
Mike Rayburn and Andy Roark, DVM, MS. Jim Carroll’s
presentation, Positioning Ourselves for the World of 21st
Century Veterinary Care, talked about the pace of change
and the need for innovation. “Everything is becoming
connected as things are speeding up,” said Carroll. He
added it’s no longer a world in which the big will beat the
small, but a world where the fast will beat the slow. “And
it’s not just the customers who are changing,” said Carroll.
“Future veterinarians are different too. The next generation thrives on change. They are tech savvy, collaborative,
entrepreneurial, wired, and change oriented.” He added
it is innovation which will allow companies to serve these
customers with the resources they want and need.
Mike Rayburn, a talented musician who combines
his music with an entertaining and inspiring presentation, asked the audience to ask themselves, “what if?”
and urged them to move outside of their current comfort
12
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
zones. “Look at perceived problems as an opportunity, and
use your creativity to turn a problem into a solution,” said
Rayburn. He also stressed the importance of setting goals,
writing them down and committing to them. “After you do
this, events that seem like coincidences begin to happen.”
Dr. Andy Roark’s presentation, Leading Those Who Don’t
Want to be Led, was filled with his trademark humor and
keen insights into the veterinary profession. “Veterinarians
aren’t business people, and they need someone to lead
them,” said Roark. “You can be that person.” He recommended four activities that he believed would lead a sales
rep to be successful in building partnerships with customers. First, embrace change. “We aren’t going to continue
growing and moving toward the future doing what we did
yesterday,” said Roark. Second, invest in the long term
and always have the best interests of the practice at heart.
Third, speak the language and use messages that resonate
with your audience. Last, never give up. “If you help educate
and enlighten customers, they will take ownership.”
EASOTIC®
Otic Suspension
(hydrocortisone aceponate, miconazole nitrate,
gentamicin sulfate) Anti-inflammatory, antifungal,
and antibacterial
For Otic Use in Dogs Only
CAUTION
Federal law restricts this drug to use by
or on the order of a licensed veterinarian.
BRIEF SUMMARY: Please consult package
insert for complete product information.
INDICATIONS
EASOTIC® Suspension is indicated for
the treatment of otitis externa in dogs
associated with susceptible strains of yeast
(Malassezia pachydermatis) and bacteria
(Staphylococcus pseudintermedius).
CONTRAINDICATIONS
Do not use in dogs with known tympanic
membrane perforation.
EASOTIC® Suspension is contraindicated in
dogs with known or suspected hypersensitivity
to corticosteroids, imidazole antifungals, or
aminoglycoside antibiotics.
WARNINGS
Human Warnings: Not for use in humans.
Keep this and all drugs out of reach of children.
Humans with known or suspected hypersensitivity to hydrocortisone, aminoglycoside
antibiotics, or azole antifungals should not
handle this product.
Animal Warnings: As a class, aminoglycoside
antibiotics are associated with ototoxicity,
vestibular dysfunction and renal toxicity.
The use of EASOTIC® Suspension in a dog
with a damaged tympanic membrane can
result in damage to the structures of the ear
associated with hearing and balance or in
transmission of the infection to the middle
or inner ear. Immediately discontinue use
of EASOTIC® Suspension if hearing loss or signs
of vestibular dysfunction are observed during
treatment (see ADVERSE REACTIONS).
PRECAUTIONS
Do not administer orally.
Concurrent administration of potentially
ototoxic drugs should be avoided.
Use with caution in dogs with impaired hepatic
or renal function (see ANIMAL SAFETY).
Long-term use of topical otic corticosteroids
has been associated with adrenocortical
suppression and iatrogenic hyperadrenocorticism in dogs (see ANIMAL SAFETY).
The safe use of EASOTIC® Suspension in dogs
used for breeding purposes, during pregnancy,
or in lactating bitches, has not been evaluated.
ADVERSE REACTIONS
In a field study conducted in the United States,
there were no adverse reactions reported in
145 dogs administered EASOTIC® Suspension.
In foreign market experience, reports of hearing
loss and application site erythema have been
received. In most reported cases, the hearing
loss and erythema were transient and resolved
with discontinuation of EASOTIC® Suspension.
To report suspected adverse drug events,
or for technical assistance contact Virbac
at 800-338-3659.
ANIMAL SAFETY
Aural administration of EASOTIC® Suspension
to 12 week old Beagle dogs at 1, 3, and 5 times
the recommended dose (1mL/ear/day) for
15 days (three times the treatment length) was
associated with alterations of the hypothalamicpituitary-adrenal axis as evidenced by the
ACTH stimulation results. Other findings
considered to be related to treatment include
the development of aural hyperemia; the
presence of renal tubular crystals and possibly
renal tubular basophilia and atrophy; elevated
liver weights; the development of otitis
externa and media; and elevations in alanine
aminotransferase, alkaline phosphatase, total
protein, albumin, and cholesterol levels.
STORAGE INFORMATION: Store at
temperatures between 20º C-25º C (68º F-77º F),
with excursions permitted between 15º C-30º C
(59º F-86º F).
HOW SUPPLIED: EASOTIC® Suspension is
supplied in a polyethylene canister, with a soft
applicator canula.
Distributed by:
Virbac AH, Inc., Fort Worth, TX 76137 USA
NADA 141-330, Approved by FDA.
© 2013 Virbac Corporation
All Rights Reserved. Rev 8/2011
12
34
5 DAYS
OF EASY
A unique, new-generation steroid
makes otitis externa simpler to treat.
The hydrocortisone aceponate in EASOTIC® (hydrocortisone aceponate,
miconazole nitrate, gentamicin sulfate) Otic Suspension for Dogs enables a
quick, 5-day treatment regimen with low risk of systemic side effects.1
Combine that with an innovative applicator and proven antimicrobial and
antifungal agents, and you get a one-of-a-kind treatment for otitis externa.
1 pump • 5 days • No sweat
Talk to veterinarians about this simple, effective treatment today.
Visit www.virbacvet.com to learn more.
Indications: EASOTIC Otic Suspension for Dogs is indicated for the treatment of otitis externa
in dogs associated with susceptible strains of yeast (Malassezia pachydermatis) and bacteria
(Staphylococcus pseudintermedius).
Important safety information: EASOTIC Otic Suspension for Dogs is contraindicated in
dogs with known or suspected hypersensitivity to corticosteroids, imidazole antifungals,
or aminoglycoside antibiotics. Do not use in dogs with known tympanic membrane
perforation. The safe use of EASOTIC Otic Suspension for Dogs in dogs used for breeding
purposes, during pregnancy, or in lactating bitches has not been evaluated. See brief
summary for additional product information.
Reference: 1. Guaguere E, Bensignor E, Carlotti DN, et al. Clinical practice guidelines on the best use
of topical glucocorticoids in canine dermatology. Prat Med Chir Anim Comp. 2011;46:S1–S20.
© 2014 Virbac Corporation. All Rights Reserved.
EASOTIC is a registered trademark of Virbac S.A. 3/14 14340
»» Inside Sales
By Dawn Singleton-Olson
Cut Through the Clutter
Find and use the information that will be most valuable to your customers
“Life is really simple, but we insist on making it
complicated.” Confucius may have spoken those words more than 2,000 years
ago, but they have never been truer than they are today. We have become a culture
of information overload. Technology allows us to receive more than five times as
much information every day as we did 20 years ago. Globally, consumers will own
more than 6 billion mobile phones by the end of this year; about 2 billion of those
will be smartphones. Since 1980, a typical credit card contract has jumped from a
page and a half to 31 pages long!
A big part of our job in animal health sales is to stay informed about hundreds of new and current products, promotions and specials and pass that
14
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
information on to our clients. How
do we cut through all the clutter and
reach customers who are bombarded with as much, or more, information as we are on a daily basis?
Empathize,
distill and clarify
In their book “Simple – Conquering
the Crisis of Complexity” authors Alan
Siegel and Irene Etzkorn advocate a
three-part formula for simplifying almost anything. They stress the need
to empathize, distill, and then clarify
to save your customers time, build
their trust, and be a valued asset to
their business.
I once worked for a company who
– as numerous customers expressed
– made it very hard for them to do
business with us. A lengthy, complicated credit application caused
many prospects to give up before
there was even a chance to turn
them into customers. Online ordering
was a chore with a poorly-designed
website and frustrating item search.
Even small orders shipped from several warehouses created stacks of
packing slips and multiple invoices
to be paid.
Imagine if creating a positive customer experience had been at the
forefront when each of those processes was put into place.
Ideally, everything a company creates that touches a customer – from
its products or services, to its website, correspondence or
invoices – should reflect a commitment to considering the
customer’s point of view. Simplicity means shortening the
distance between you and your customer. Empathizing involves understanding your customer’s needs and taking the
time and effort to customize and simplify the information you
give them.
When you make a sales call – on the phone or in person – are you just repeating facts and figures about a new
product or promotion, or are you taking the time to understand and focus on the benefits for that specific customer?
One of the best ways to improve any customer experience
is to focus on the essence of what people want or need in a
particular situation.
Distilling information
When you understand your client’s
needs, you can help them make informed decisions by cutting out the
clutter. An article in this issue of VetAdvantage discusses senior pets and
the key issues and products for geriatric animals. Joint health is one obvious
concern for older animals, and there
are dozens of joint treatments and
supplements available. It would be impossible and inefficient
to carry them all. Too many options can be overwhelming,
so “distilling” all that product information and providing solutions that consider their needs will help your clients determine
the best product mix to provide for their customers and help
save them time and money.
What message are you sending to your customers? Too
much information is a prime source of complexity, not clarity. When they are inundated with information, people are
apt to lose sight of what’s important and just stop paying
attention. Some sales managers tend to emphasize quantity
over quality and require their sales teams to make ‘X’ number of sales calls in a given day or week, in order to achieve
a specific call volume.
Calling simply for the sake of calling to hit a goal erodes
your credibility and wastes your customer’s time, so make
every contact count. Whether you’re communicating by
phone or in writing, take time to organize and prioritize
before you dial a number or send an email.
Keeping track of numerous manufacturer promotions
or rebates can be time-consuming and confusing, so you
can be a huge asset to your customers by providing them
with this information. Preparing a clear, concise spreadsheet
showing their purchase history, total dollars to date and how
much more they may need to spend – along with the end
date of the promotion and when you’ll check in before it
wraps up – sets you apart from your competitors as a true
partner to your customers.
Marketing departments are notorious for designing
product brochures with dark colors and fine print that
don’t fax well. If faxes are a preferred communication for
your clients, provide them with an easy-to-read detailer,
Simplicity means shortening
the distance between you
and your customer
emphasizing the features you know will be important to
them. Bullet points, large type size, bold fonts for emphasis
and plenty of white space will ensure that your fax will be
read. And don’t forget to include your contact information!
A couple of hundred years after Confucius made his
comments about how complicated we make our lives,
another famous philosopher developed a classic model
for simple communication that has stood the test of time.
Aristotle’s theory of persuasion combining logos (logic
and common sense in all of your messaging), pathos
(empathizing with and relating to your customers) and
ethos (maintaining integrity and honesty in all your client
interactions) is still a solid model in this era of information overload. Remember this 2,000-year old advice: Keep
things simple, and your value to your customers will continue to grow.
Dawn Singleton-Olson has over 25 years of experience in the animal health industry, including distributor sales, manufacturing, practice
management, and as a zoo supervisor. She is a volunteer, fundraiser and board trustee for several humane organizations and the Omaha
(NE) Police Mounted Patrol.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
15
»» Sales
Big Words Lead
to Big Confusion
If your sales presentation sounds like it came from a
corporate brochure, change it! Language on the sales “street” is often different than
the language created for brochures and marketing materials. Those are created to
help you in your conversations with customers – not to be the conversation itself.
Customer interactions
By Brian Sullivan
Sales Coach and Business Consultant
Brian Sullivan, CSP is the author of the
book, 20 Days to the TOP – How the
PRECISE Selling Formula Will Make You
Your Company’s Top Sales Performer in
20 Days or Less. Follow him on twitter
@preciseselling. Daily tips that will keep
you focused on getting to the top!
Be yourself. Act like you are talking to
a friend. Don’t recite your presentation
from the PowerPoint that’s behind you
or just spew out your company mission statement. Your job on the outside is to translate the message created on the inside. In fact, you exist in
sales because you are good at taking
an often complex message and getting to bottom-line benefits.
Here are some examples of “overspeaking” I recently heard uttered to
customers from the mouths of misguided salespeople:
Your job on
the outside
is to translate
the message
created on
the inside
16
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
• “Our product increases efficiencies.”
(What on earth does that mean?)
• Better translation: “I can
save you an hour each day.”
• “You will maximize your workflow
utilization” (Hey Buddy, try utilizing
the English language next time)
• Better translation: “You can get
more done without adding more
employees.”
• “Other clients have seen significant
outcome enhancement.” (The outcome of that statement is that the
customer wants you out the door)
• Better translation: “I have
three clients just like you that
saved 15 percent in expenses,
increased profit by 10 percent
and reduced their insurance
rates by 17 percent.”
So this week, while delivering your
sales presentation, keep it real. Think
about what you would need to hear
as a prospect to get you excited by
focusing on the plainspoken benefits.
You will arrive at those benefits by
answering this question at least three
times. HDTHMP-How Does That Help
My Prospect?
When you can no longer answer
that question, you will have arrived at
the real reason the prospect needs your
product or service. And by delivering your
value in its simplest form, your prospect
will come to the simple conclusion that
they cannot live without you.
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»» Sponsored by IDEXX: Building Your Lab Business
Improving education, efficiency and care:
High-tech disease screening wows clients
Pet-side disease screening has often
been a mystery to clients. They usually see their pets taken
away to the lab area and then returned to the exam room for
a final conversation about next steps.
What’s been missing is the WOW FACTOR: the ability to
show test results in a compelling way during the conversation,
opening the door to improved client education and better care.
This all changed when IDEXX introduced a new screening tool in early 2014: the SNAP Pro™ Mobile Device. It’s
revolutionizing the way practices
use the SNAP® tests they’ve relied
on for years.
With its high-tech display of
screening results, the SNAP Pro device gives practices a new way to
impress clients in the exam room –
with meaningful answers that really
hit home.
Dr. Adam Hechko, owner of
North Royalton Animal Hospital in
Ohio, explained. “Before, we’d run
SNAP® tests and tell clients the results. They wouldn’t see the test or
the process. But we discovered that
our clients love technology – they become more engaged
when they see the SNAP Pro results. Our clients really get
into it, often saying, ‘Wow, this is cool!’
And, because the SNAP Pro is portable, it’s easier to discuss prevention with every client. During the appointment, if
we’re negative, we’re celebrating and reinforcing the good
care while bringing up steps to keep the pet negative. If it’s
positive, we’re talking about why it’s positive and what to
do about it.”
Plus, the SNAP Pro is more efficient. All we do is fill in
the blood for any SNAP test, and our SNAP Pro does the rest.
My team can move on to the next thing while I relay the
importance of each result to my client!”
How to discuss the many benefits of
SNAP Pro testing with your customers
When visiting a practice, ask about the approach their team
follows for pet-side disease screening and discussing prevention with clients.
• Check-off (qualify): Establish your direction by asking,
“Doctor, are your clients truly engaged when you talk
about disease screening and prevention with them?”
• Confidence: If YES, confirm and support benefits. If NO,
assert the benefits with confidence.
“I’m sure you can deepen the prevention conversation with a hightech tool that wows your clients.”
• Invitation to neutral: “Let’s look
at the ways the SNAP Pro Mobile
Device gives you more opportunities to impress clients, get their
attention and have an impactful
conversation about care… while
also saving steps for your team.”
• Seek alignment/
understanding as the
dialogue continues: “Can you
help me understand …
• “How do you currently discuss pet-side screening
results and prevention with clients?”
• “When you run SNAP tests, do you still have the team
run them in the lab area and then give you the results?
• “What if a portable, high-tech solution could save time
and help you deliver your prevention message in a
more compelling way, getting more clients to comply?”
With its high-tech
display of screening
results, the SNAP
Pro device gives
practices a new way
to impress clients in
the exam room – with
meaningful answers
that really hit home.
When you show your customers the many advantages of
using SNAP Pro in their practices, you’ll be making a difference in the practice workflow… but even more important
– you can improve disease prevention compliance and the
overall health of patients.
To learn more, visit idexx.com/smallanimal/inhouse/snap/snap-pro-instrument.html
18
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
SNAP test results
just got a whole new look
®
With the new SNAP Pro™ Mobile Device, your customers
can streamline SNAP® protocols and automatically capture
SNAP test invoice charges to improve practice revenue.
See scratch card in this issue for a SNAP Pro™ Mobile Device
offer for your best customer.
© 2014 IDEXX Laboratories, Inc. All rights reserved. • 104722-00
All ®/ TM marks are owned by IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries.
The IDEXX Privacy Policy is available at idexx.com.
»» Sales
Sales Call Challenges
The steps toward solving two of the biggest obstacles reps face with customers
I recently attended a conference with a diverse
group of distributor reps. During an informal session after dinner the subject of
sales call challenges was raised and discussed. I thought it might be helpful to
share our thoughts on a couple of those issues that seemed to present the greatest
challenge to the group.
“How do I get past
the gatekeeper?”
By Patrick T. Malone
Patrick T Malone is a Leadership Expert
and Senior Partner at The PAR Group, an
international training and development
firm based in Atlanta, Ga. He is the coauthor of the business book Cracking the
Code to Leadership and may be reached
at [email protected]
The mindset that a gatekeeper is
someone to “get past” is the root of
some of the problem here. I believe
there are various levels of decisionmakers within a practice, and each
deserves the same level of respect
that would be accorded to the owner.
Gatekeepers decide whether or
not to grant access. These are generally the staff at the front desk.
My sense is most reps talk
about what they believe is
important to the decisionmaker without really knowing
for sure that it is important.
20
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
An influencer cannot decide “yes,”
but they can suggest “no.” Even worse,
they can sabotage the implementation
in order to prove their suggested “no”
was the appropriate response. These
can be practice managers, technicians
and/or associate veterinarians.
The owner is usually the ultimate
decision-maker.
The experienced successful reps
in the group talked about finding out
what was important to the individual
decision-makers and then mentioning
that benefit in order to gain a positive
decision. But that is not so easy. After
all, what is important to the front desk
personnel is likely different than what
is important to the practice manager or
the tech or the associate vet. All of that
is likely different than what is important to the owner.
The answer involves some work to
determine the values of all the decisionmakers involved in making your sales
call a success. The question remains: Is
it worth the time and effort it takes to
obtain all this information? The distributor reps that know what each decisionmaker values are those who are the
primary suppliers to those practices.
So if you want to be primary, stop
trying to “get past” the gatekeeper
and start ask more questions to determine what every
decision-maker values.
“How do I differentiate
myself and my company from
others calling on the practice?”
My sense is most reps talk about what they believe is important
to the decision-maker without really knowing for sure that it is
important. Not every practice owner wants to grow their business. Some may what to maximize its sale value. Others may
want to lighten their workload or maximize their bottom line.
Once again the experienced successful reps talked about
building their territories to become the primary supplier by
understanding the specific values of every decision maker.
When they were on the outside looking in, the first question
they asked was, “What do you like about your current distributor?” The answers to that question begin to paint that
practice’s value picture.
The next question was “Is there anything you would
like to have, that you are not getting out of your current
relationship?” The answer adds targets of opportunity to
the value portrait.
The final question “Are there any points of contention in your
current relationship that you would like to change?” The answer
here will describe the current pain points, and that is important
because change only occurs when the pain of doing nothing
exceeds the perceived pain associated with the change.
The answers to all three questions provide the successful distributor rep with the information necessary to
construct a strategy to build a long and loyal relationship
with her/his clients.
Start by addressing the pain points and finding out what the
potential consequences are if those areas of contention are not
fixed. Once the consequences reach the point of being intolerable, your solutions will seem like a snap. If there are no pain
points, select the targets of opportunity to provide something
they would like to have. In either case you will have an entry to
prove you and your firm can provide everything they like and
more. Over time you will have more and more of the business.
Certainly these two challenges only scratch the surface
of the various challenges a distributor sales rep faces on
a daily basis. So if you have a specific challenge you are
struggling with, send us the information. We’ll select the
most popular challenges for inclusion in future columns.
THINK
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www.vet-advantage.com • Veterinary advantage
vetadvantage_MAG_insert_July_Sept.indd 1
«« July/August
2014
21
6/27/14 2:59 PM
»» Sales
Voice Mail vs. Text Messaging
Over the last few years I’ve been told
voice mail is outdated and text messaging is the way to go. Both
are tools to maintain contact with your customers, and both
have advantages and disadvantages for sales professionals.
Regarding texting, one business owner put it this way: “I’d rather
get almost any other type of message than voice mail.” Does this
individual represent to norm? The short answer is – it depends.
Most of what I’m reading claims people who are tech
savvy may not even listen to voice mail and recommend
sending a text message to follow up if the call goes unanswered. For some people checking voice mail is more of a
nuisance than a convenience, and voice mails go unchecked
unless it’s a call from an unknown number.
What this means to me is you have taken the time to assess your customer and understand their preferred method
for communications not requiring a conversation.
Research shows 8-in-10 Americans now own cellphones
and three quarters (and growing) of them are using text messaging. Additionally, some research indicates as many as onethird of adults prefer to receive a text to talking on the phone.
The same research shows a business contact is more
likely to be an SMS power user if aged 18-29 (87.7 messages per month) or have an income of less than $30,000
(58.7 messages per month).
Why do people prefer texting?
• Text messages force the person to be brief; they
need to carefully consider the message due to
character constraints.
• A text message can be read faster than listening to a
voice mail.
Additionally, the research suggests the more important the
message, the more important it is to follow up with some kind
of explanation of the missed call. For example, if an answer is
needed immediately, sending a short text explaining the nature
of the call is warranted. Don’t assume the person receiving the
call is going to call you. Texting, “Call me back” is already implied
(the missed call) but this text doesn’t provide any information and
doesn’t invite immediate action from the business contact.
If texting a business contact, stick to text messaging
whenever the message is short and would be better communicated in text rather than a conversation. For example,
calling to say, “I am on my way” or confirming an appointment is not worth a conversation or a voice mail.
So when should you leave a voice mail?
• If your message is long and would require more than
one text to explain. E.g., the order is incomplete or
the product is out of stock.
• If you have several questions to ask or you need
clarification on an action.
• Also, never assume the number you are calling is a
cellphone. If there is a single phone number on the
business card assume it may be an office phone.
• Also, if you’ve left a voice mail and you know the person rarely checks voice mail you may want to leave a
text saying you’ve left a voice mail message.
For more information on training in this area or other sales training curriculum, visit: www.ats-solutions.net
or contact Mike Biggins at [email protected]
Are you new to the Animal Health industry?
Are you new to the Animal Health industry? Are you looking for a way to “accelerate”
your new employees along the learning curve for the Animal Health Industry?
Then you are a candidate for the next session of “Introduction to the Animal Health Industry”
Open enrollment courses are offered at ATS’s Kansas City
Training Facility.
• September 23-24, 2014
22
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
To enroll contact: ATS animal health training solutions
ATTN: Leah Byers
12200 NW Ambassador Drive, Suite 601
Kansas City, MO 64163
Phone: 816-569-3154
Perspective ««
By Adam Augustine
Success, Unplugged
Get more accomplished with a healthy dose of detachment
I recently read a personal management article in a
popular business magazine in which a life coach extolled the virtues of occasionally
“losing it” for the purpose of stress management. His advice: Stop in a parking lot,
roll up the windows, and scream bloody murder while pounding away at your steering wheel. He claimed it would make you feel better. A strong dose of heroine would
also make you feel better, but that doesn’t make either of those things a good idea.
We know from nearly a century of research that venting, also known as catharsis, has detrimental cognitive, emotional and physiological effects. So, ignore the
life coach’s ill advice and do something that will actually help you manage your
hormone levels, emotions, and felt stress … unplug.
Research from my laboratory (Augustine & Hemenover 2008, 2013; Augustine
& Larsen, 2014) has consistently shown that distraction is one of the easiest and
most effective means of emotion regulation across all levels of self-regulation
ability. Even if you are horrible at
managing intrusive stress and emotions, anyone can jump on a treadmill
or pick up a good book.
Unplugging doesn’t mean that an
annual trip to the lake will recharge
you for another year of mistreating
your body and mind. It is something
that must occur multiple times a
day. The first step to a proactive
distraction program is simple. Turn
off the phone.
The vibrating call to action that follows you around has the effect of never
letting you disengage from work, or the personal upkeep notifications from social
media and email that quickly feel like work. Set aside two or three hours in the
evening where you refuse the disruption; let the nightstand take the rattling. If you
must, turn the infernal contraption off. During that time, attend to anything but
action items, spreadsheets, and obligations: a conversation with your spouse, the
latest episode of Game of Thrones, or, for a double dose of physical and cognitive
health, a heavy set of weights or a yoga mat.
“But how will I succeed if I am not
at the beck-and-call of my superiors?”
A relaxed mind is also an agile mind
– a million pin-pricks can kill, just as
a hundred thoughts can disable. Benjamin Franklin often remarked that
his best ideas were born in a bathtub,
and for good reason. Research has
consistently demonstrated that innovation comes easier when we are not
directly focused on the task at hand.
When the noise is quieted by a healthy
dose of enjoyment and distraction, you
Unplugging doesn’t
mean that an
annual trip to the
lake will recharge
you for another year
of mistreating your
body and mind.
will quickly find that ideas spring from
nowhere and focus is easier to attain
when it is required.
So, at least once a day, throw the
Apple in the garbage. I would imagine that for most of you, it has already
spoiled anyway. Your mind, just like
your body, cannot heal without rest.
Adam Augustine, Ph.D., is a statistician and psychologist with over 20 scientific publications. He works as a consultant in the veterinary
supply industry, and as a manager of marketing, customer, and big data analytic projects in the hunting and shooting sports industry.
He may be contacted at [email protected]
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
23
»» Marketing
Local Authority
Help veterinary practices become the local pet-care authority in their communities
If you’re looking for new ways to serve as a value
consultant to your customers, here’s an idea: Help veterinary practices become the
local pet-care authority in their communities.
By Pam Foster
Pam Foster is Managing Editor,
Community Content & Media for the NAVC
(North American Veterinary Community)
and the Marketing Faculty Advisor on
its CE website VetFolio.com. Pam is
a Certified SEO Copywriter and the
co-author of Wildly Profitable Marketing
for the Pet Industry. She specializes in
helping practices and other veterinary
organizations thrive through strategic
marketing content, online and offline.
In every community, local pet parents need advice. They need to know
what to do about flea prevention,
crate training a puppy, introducing an
adopted cat to the family, choosing
the right pet food, how to trim nails
(and how often), what to do about
their dogs’ thunderstorm fears and
much, much more.
Sure, dog and cat owners can
read generic websites to find answers, but research shows that pet
July/August 2014
Marketing Test No.
4: “Who is the local
authority for pet care?”
Your customers are constantly thinking about the latest marketing “mustdo’s.” But one of the easiest and most
effective marketing approaches is
overlooked. Public relations – and
reaching out to local media – can be
incredibly powerful. It can establish
your customer as the “local authority”
the area’s pet owners trust for care.
Local TV, print and online
news editors are eager to find
community authorities on a
wide range of pet subjects.
owners trust their local veterinarians
more than any other source for reliable pet-care information.
Not only that, but the local media
is always looking for human-interest
stories – including animal-related stories – to bring in viewers and valued
advertising dollars. Local TV, print
and online news editors are eager to
find community authorities on a wide
range of pet subjects.
Find out how veterinary practices can make a huge local splash
24
as the local pet-care authority (and
then show them how to do it with our
cheat sheet).
»» Veterinary adVantage • www.vet-advantage.com
The problem is, most practices don’t
include PR in their marketing efforts.
As you prepare for practice calls,
ask the following question during your
visit. This cheat sheet can help you explain why you’re asking the question,
and how the answers can help the
practice. Consider this cheat sheet to
be a tool for enhancing the value you
offer your customers, and even their
loyalty to you. It’s a win for everyone.
In the next issue, we’ll cover Marketing
Test No. 5: The “Email Savvy” practice.
Does Your Veterinary Practice Pass
the Local Authority Test?
Use this quick, easy test to see if you’re doing all you can to be the local resource for pet-related questions and
important pet care tips.
our practice website
Y
includes LOCAL articles
and/or blog posts.
If your website includes pethealth content, well done!
However, make sure your
content is LOCAL. Here’s what I
mean. When pet owners search
in Google to find “pet nutrition
advice in [your town],” Google
won’t show your pet nutrition
article unless you put your
town or region name in it, such
as, “Pet Nutrition Tips for Pets
in [Your Town].” This image
happens to have the city in the
hospital name. If that’s not the case for you, add the
city name to your article title. Also add an invitation
or incentive to schedule a screening. This approach
works well with all kinds of pet-care topics.
ou’re building relationships
Y
with local news media.
Which local-interest topics can you help the media
cover when it comes to pets? For instance, if you’re
in a region of the United States where hurricanes
are an annual concern, send out a one-page press
release to local media: “Preparing to Bring Your Pet
Along During a Hurricane Evacuation in [Your Town].”
The media may present your tips on TV, in the local
newspaper and on their websites, and perhaps even
interview you.
ou’re building strong
Y
alliances in your community.
As you know, local referrals are very strong sources
of new business for your practice, and we don’t
mean just among your clients. Think of all the local businesses that could be referral sources: dog
trainers, rescue shelters, pet bakeries, Chamber of
Commerce members, etc. Are you connecting with all
these opportunities so they refer your practice?
As you offer your community more pet-health information, your practice will gain momentum as the local
go-to expert on anything related to pets, bringing more
revenue your way.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
25
»» Sponsored by Merck: Sourced by Merck Animal Health
A leap forward in
flea and tick protection
Easier dosing, long-lasting efficacy helps solve the challenge of compliance
Even the most willing owners may
forget to diligently administer their pet’s monthly flea and
tick control programs, notes Joel Sailor, D.V.M., owner of the
Town & Country Veterinary Clinic in Starke, Fla.
Fleas and ticks just won’t cut pets a break – fleas will
reinfest a dog the moment a protection gap occurs after
a monthly treatment is missed or is inconsistently applied.
“It’s not so much a willingness to comply, but it’s remembering,” Dr. Sailor says. “We have clients with the best intentions, but we’re all human. If it’s a topical product, maybe
the owner missed an application because they wanted to
wait until after visitors left. Pills are the same way.”
One mistake can lead to a home reinfested with fleas
or potentially lead to a preventable tick-borne disease like
Lyme disease.
1 chew = 12 weeks of protection1*
BRAVECTO™ (fluralaner), approved by FDA in May, is the
first oral chew to deliver up to 12 weeks of flea and tick
protection in a single dose.1*
“Easier dosing helps solve the challenge of compliance,”
says Kathleen Heaney, D.V.M., director of technical services for
the companion animal business unit at Merck Animal Health.
“The great thing about BRAVECTO is that it helps reduce
gaps in protection that can be seen with monthly products,”
Dr. Heaney says. “It delivers robust protection, even at the
end of the 12 week treatment period to give pet owners not
just fast, but long-lasting and consistent flea protection.”1
When Dr. Sailor began participating in a BRAVECTO field
trial prior to the launch of the product, he was excited about
offering his clients a product with long-lasting efficacy against both fleas and ticks.1 He also found
it started killing rapidly. BRAVECTO kills fleas within
two hours1 and killed 100 percent of fleas within 12
hours of administration.2
“I think we still hold the record for the dog with the
most fleas – 2,000,” Dr. Sailor says. “That population
went down to basically nothing, and we were impressed
with the speed of kill and how long the product lasted.”
Plus, BRAVECTO offers an opportunity to offer a prescription
product only through his veterinary clinic. It gives him the chance
to discuss flea and tick management within the practice.
“We can increase or renew interest in flea control in those
clients that are getting it at the grocery store or other over-thecounter outlets,” Dr. Sailor says. “Plus, there are an awful lot of
clients that aren’t doing preventive care at all. Innovation brings
interest. People want to know when there’s something new and
cool available. It’s going to be one of those products that will
draw clients to it.”
*BRAVECTO kills fleas, prevents flea infestations, and kills ticks (black-legged tick, American dog tick, and brown dog tick) for 12 weeks.
BRAVECTO also kills lone star ticks for 8 weeks.
IMPORTANT SAFETY INFORMATION: The most common adverse reactions recorded in clinical trials were vomiting, decreased appetite, diarrhea, lethargy, polydipsia,
and flatulence. Bravecto has not been shown to be effective for 12-weeks’ duration in puppies less than 6 months of age. Bravecto is not effective against lone star
ticks beyond 8 weeks after dosing.
Please see the BRAVECTO advertisement for full prescribing information.
1
Bravecto [prescribing information]. Summit, NJ: Merck Animal Health; 2014. 2 Freedom of Information Summary, NADA 141-426. Approved May 15, 2014.
BRAVECTOTM is a trademark of Merck Animal Health, Summit N.J., USA
26
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
INTRODUCING…
FLEA AND TICK MANAGEMENT
JUST TOOK A GREAT LEAP FORWARD—
12-WEEK PROTECTION,* ONE ORAL CHEW1
This is now.
That was then.
*
Order BRAVECTO today—contact your Merck Animal Health sales representative or distributor partner.
*Bravecto kills fleas, prevents flea infestations, and kills ticks (black-legged tick, American dog tick, and brown dog
tick) for 12 weeks. Bravecto also kills lone star ticks for 8 weeks.
IMPORTANT SAFETY INFORMATION: The most common adverse reactions recorded in clinical trials were vomiting, decreased appetite,
diarrhea, lethargy, polydipsia, and flatulence. Bravecto has not been shown to be effective for 12-weeks’ duration in puppies less than
6 months of age. Bravecto is not effective against lone star ticks beyond 8 weeks after dosing.
Please see Brief Summary on following page.
Reference: 1. Bravecto [prescribing information]. Summit, NJ: Merck Animal Health; 2014.
Available by veterinary prescription only.
Copyright © 2014 Intervet Inc., a subsidiary of Merck & Co., Inc. All rights reserved.
Intervet Inc. d/b/a/ Merck Animal Health, Summit, NJ 07901.
US/BRV/0514/0026
www.BravectoVets.com
»» Finance
Who Does What?
Effective use of veterinary healthcare team talent
In too many clinics today, compensation for all members of the veterinary healthcare team is inadequate. Why, on average, do dentists
enjoy personal incomes more than double their veterinary counterparts? Why are
starting salaries for optometrists nearly twice that for veterinarians? Why do dental hygienists make more than many veterinarians? The good news is that most
clinics can address and resolve these problems. There are great opportunities to
improve veterinary practice productivity.
How is revenue or income produced in a veterinary clinic? (Note:
By Fritz Wood, CPA, CFP
For purposes of this discussion, revenue and income are synonymous with
other commonly used terms such as
“gross” or “gross income”). Revenue is generated when pet owners give up something of value – typically money – in order to receive something of perceived equal
or greater value – in this case, veterinary services and products.
The greatest opportunity for veterinary income or productivity is to grow
revenue – or the top line. There is typically far less opportunity to enhance
practice health through cost cutting. Rare is the practice that cost cuts its
way to prosperity. Unusual is the veterinary practice where expenses are
wildly out of control. Because growing the top line – or gross income – is
the key to higher hospital productivity and income, let’s dissect hospital
revenue further.
Two types of gross income
I broadly classify gross income into two categories: (1.) Active income, and (2.)
Passive income.
Active income is income that can only be generated with the doctor’s direct,
full-time involvement.
Examples of veterinary services that require the doctor’s direct, full-time
involvement include:
• Examining the pet • Diagnosing
• Prescribing and initiating treatment
• Surgical procedures
• Certain client consultation activities
Passive income is income that can be produced without the doctor’s direct,
full-time involvement. Passive income is critically important to overall practice
profitability and productivity.
28
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
Examples of veterinary hospital services
that generate passive income include:
• Routine dental cleanings
• Radiographic procedures
• Lab work (fecal tests, heartworm
tests, urine tests, CBC’s, and
biochemical profiles)
• Nail trims
• Ear cleaning
• Anal sac expression
• Suture removal
• Bandage changes
• Anesthesia induction
• Boarding
• Grooming
• Pet adoption programs
• Behavioral programs
• Weight management programs
• Etc.
It’s important to note that although
the doctor may have some involvement in the delivery of these services,
the veterinarian need not be involved
on a direct, full-time basis. The doctor
might be in an exam room or the surgical suite (generating active income)
while these services are delivered.
For example, assume the doctor orders a radiograph. Team members are
capable of taking radiographs – which
constitutes the bulk of the time and effort involved in that procedure. The veterinarian could then read and interpret the radiographs. Both processes are vital to an accurate diagnosis
– that is, good images to read and competent interpretation of
those images. In this scenario, each party is assuming an appropriate role. Team members are performing tasks for which
they have adequate training and experience (taking the radiograph), while the doctor is performing tasks for which he or she
is rightly trained (ordering and interpreting the radiograph).
Examples of veterinary products that generate passive
income include:
• Heartworm prevention products
• Flea and tick control and prevention products
• Nutritional products
• Refilling other prescriptions
• Shampoos and other skin and coat products
• Other pet supplies
Look around your clinics and you’ll see myriad veterinary
services and products that produce passive income.
Is passive income important?
Passive income is critically important to the success of a
practice. Why? Because in a veterinary practice, the veterinarian’s time is the constraining factor – or the most limited,
finite, and scarce resource. A doctor has only 24 hours each
day to generate active income. As a result, there exists a
“cap,” or physical limitation in terms of how much active
income a veterinarian can generate. As other professionals
have found, that cap may be quite low. Therefore, dramatic
increases in hospital income are a function of how well the
practice is positioned to generate passive income.
The principle of having people undertake tasks or activities for which they are adequately trained and experienced
is called delegation. Delegation is required in order to generate passive income. That is, if a doctor is unable or unwilling to delegate to others, only active income can be produced. A veterinarian can and should delegate to members
of the veterinary healthcare team everything not specifically
required of the doctor. Then, veterinarians can begin to command the level of income they deserve and competitively
compensate other members of the healthcare team.
Recall your last visit to the dentist for routine care. How
much time did you spend with the hygienist? How much time
did you spend with the dentist? Most likely, the great majority
of your time was spent with the hygienist. The hygienist probably examined your mouth, cleaned your teeth, applied fluoride,
and perhaps took radiographs. Next, the dentist examined your
mouth and read the radiographs. Again, each member of the
dental healthcare team assumed an appropriate role – each
doing what he or she was specifically trained to do.
Similarly, recall your last visit to the optometrist for routine eye
care. Which tasks or activities were delivered by the optician or
optical assistant? Which were reserved for the optometrist?
The economic or financial consequences of delegation are
staggering. Imagine how many more patients a dentist or optometrist can see each day by appropriately delegating to team
members. If the dentist performed tasks typically assumed by the
hygienist, could he or she see
even half as many patients? If
the optometrist “fitted” each
set of eyeglasses and performed all the eye tests, could
he or she see even half as
many patients? In both cases,
the answer is “no.” These professionals have found that by
effectively delegating to members of their healthcare team,
they can focus on the more
complex – and the more remunerative – tasks and activities.
Although veterinary medicine, dentistry, and optometry
have been specifically mentioned, the principle of delegation is relevant to all professional service businesses.
What tasks or activities in your customers’ practices
are currently performed by a veterinarian, which could be
delegated to members of the veterinary healthcare team?
Encourage your customers to “brainstorm” lists of things
that could (should) be performed by non-veterinary personnel. Veterinarians are often surprised by the confidence,
competence, and talent of their support staff. Also, team
members usually enjoy the opportunity to use their skills
and abilities to contribute to pet health and well-being.
Effective use of veterinary healthcare team talent cannot be
overemphasized. In general, veterinary income and income of
veterinary healthcare team members is woefully inadequate.
Dramatic increases in hospital income are a function of how
well the practice is positioned to generate passive income.
Encourage
your customers
to “brainstorm”
lists of things
that could
(should) be
performed by
non-veterinary
personnel.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
29
CAPSTAR
®
(nitenpyram)
IS THE TRUSTED CHOICE
FOR IN-CLINIC USE
1
CAPSTAR (nitenpyram) can be the cornerstone of maintaining a healthy clinic environment and making sure
patients that come in flea-free leave that way. In addition, establishing a flea-free facility admissions protocol
can generate up to $12,000 a year in new revenue.*
CAPSTAR is the #1 on-site
flea product for both dogs
and cats among clinics that
stock CAPSTAR.
1
Almost 40 % of clinics that stock CAPSTAR treat all dogs and cats entering the clinic for surgery or boarding.1
S PE E D O F F L E A K I L L
Starts working within 30 minutes.
Greater than 90 % effectiveness against adult fleas within 4 hours for dogs and within 6 hours for cats.
SAFET Y
Safe for daily use.
Safe for puppies and kittens 4 weeks of age and older, weighing 2 lbs. or more.
Safe for use in breeding or pregnant dogs and cats. (Refer to label.)
Can be used in conjunction with other flea products, parasiticides and medications. (Refer to label.)
CONVENIENCE
Oral formulation.
Can be given with or without food.
VA LU E
Available in bulk packages for in-clinic administration.
Priced to provide high-margin revenue stream for high-volume, in-clinic usage.
Provides great value-added service clients appreciate when boarding or grooming pets.
*Individual clinic results may vary.
Data on file. Novartis Animal Health US, Inc. – NAH.JE.001
1
CAPSTAR (nitenpyram)
CLINICS GENERATE
REVENUE WITH
A FLEA-FREE
FACILITY PROTOCOL
®
It’s not uncommon for a pet entering a clinic to have fleas.
How much could your clinic generate by implementing a
flea-free protocol?
A conservative estimate of increased profit for a clinic that sees
2,000 dogs and 1,200 cats a year is more than $12,000.
H ER E ’S H O W IT W O R KS:
3,200
2,000 dogs and 1,200 cats per year
x $3.10
Average cost of a CAPSTAR tablet
= $9,920.00
Cost per year to clinic
3,200
x $7.00
2,000 dogs and 1,200 cats per year
Average daily flea-free facility fee
(1 CAPSTAR tablet every 24 hours)
= $22,400.00
$22,400.00
–
$9,920.00
Annual clinic revenue generated from protocol
Clinic revenue
Clinic cost
$12,480.00 CLINIC PROFIT
THE PROTOCOL FOR A FLEA-FREE CLINIC
STEP 1
Administer CAPSTAR upon admission of all patients staying more than a couple of hours
(dogs and cats coming for boarding, surgery, grooming, and/or an annual wellness exam).
STEP 2
Administer CAPSTAR upon discharge for all patients staying more than 24 hours.
STEP 3
Incorporate a flea-free fee into your standard clinic fee or itemize as “routine flea-free clinic maintenance.”
© 2014 Novartis Animal Health US, Inc. CAPSTAR is a registered trademark of Novartis AG. US/CAP/14/0845
ROAD TALES
»»Role models?
Parents are just as likely to engage in driving distractions, such as cell-phone use, as drivers from the general
population, according to a recent University of Michigan
study published in Academics Pediatrics. The study finds
that 90 percent of parent drivers said they have engaged
in at least one of the 10 distractions examined in the study
while their child was a passenger and the vehicle was
moving, according to lead author Michelle L. Macy, M.D.,
M.S., an emergency medicine physician at the University
of Michigan’s C.S. Mott Children’s Hospital. The study, conducted in two Michigan emergency departments, shows
• Get the used parts from the repairs. If the garage will
not give them to you, send a written request and keep
a copy.
• Have the car checked by an expert. While it’s
possible to get a free estimate from a repair shop,
drivers may be better off paying an expert to evaluate the need for repairs.
• Negotiate. Armed with evidence, drivers may be able
to call and ask the first repair shop to redo the work,
or discuss a refund. If the repair shop agrees to redo
its work, insist on a written agreement detailing what
they’ll do and how long it will take. Talk to the mechanic who’ll actually work on the
car to be sure you both understand
what needs to be done. Giving
the repair shop a chance to make
amends is usually easier to negotiate than getting a refund.
• Write a demand letter. If still not
satisfied, drivers should write a
formal demand letter that is short,
polite and written with the expectation that a judge will read it.
• Consider filing in court. If necessary, drivers can file papers at a
small claims or other appropriate
court, depending on their jurisdiction and the amount in
dispute. These will typically be filed with the court clerk’s
office in the county where the garage is located. If the
state or locality has a motor vehicle repair law that the
repair shop did not follow, drivers should consider asserting a claim or defense based on the violation.
• Prepare for court. Research the situation by reading car
manuals, talking to an objective mechanic, etc., in order
to be able to explain to a judge why the original repairs
were substandard.
• Appear in court. If appearing in court, it’s necessary
to be organized, with documented, written warranties,
photographs and used parts if they help make the case.
Bring any witnesses to court, or if that’s not possible,
ask the witness to write a letter explaining what he or
she heard.
While it’s
possible to get
a free estimate
from a repair
shop, drivers may be better off
paying an expert to evaluate
the need for repairs.
that about two-thirds of respondents (570 parents of
1-to-12-year-old children who arrived in the emergency
departments of the two hospitals) say they have talked
on cellular phones while driving their child, and one-third
say they have texted while driving their child. Each year,
more than 130,000 children younger than 13 are treated
in U.S. emergency departments after motor-vehicle collision-related injuries, according to Macy, who says she is
also concerned about whether parents are modeling the
right behaviors in front of children who will eventually
learn to drive.
»»Get it fixed
ARAG ®, a legal insurance company, recommends the
following for drivers who believe their car was not
properly repaired:
32
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
»» Trends
Infectious Disease Trends are Mixed
FIV, Lyme disease up, but many signs of improvement appear in Banfield State of Pet
Health 2014 Report, with its focus on infectious diseases
Feline immunodeficiency virus (FIV)
infection has risen 48 percent since 2009, while the proportion of dogs infected with the bacterium that causes Lyme
disease has risen 21 percent, according to Banfield Pet Hospital® in its State of Pet Health™ 2014 Report.
The report, compiled by Banfield’s internal research team,
Banfield Applied Research and Knowledge (BARK), analyzed
data collected in 2013 from nearly 2.3 million dogs and
470,000 cats cared for in Banfield’s more than 850 hospitals
in 43 states. This year’s report focuses on infectious diseases,
that is, diseases caused by organisms, such as bacteria,
commonly transmitted during mating, through bite
wounds associated with cat fights or from an infected
mother to her kittens. FIV infection leads to permanent
and progressive infection in affected cats, eventually attacking the immune system and increasing the cat’s risk
for other serious infections. However, not all cats who
become infected with FIV will become ill, and with care
taken to avoid other infections along with frequent veterinary visits, many infected cats can go on to lead long
lives. FIV infection is typically diagnosed by a veterinarian using a blood test.
“We don’t really understand what’s behind
[the rise in FIV],” says Sandi Lefebvre, DVM,
PhD, an epidemiologist and senior research
manager at Banfield Pet Hospital. “Unfortunately, although a vaccine is available, its ability to
prevent FIV infection in the average house cat is
not fully understood. The best way of preventing infection is by keeping the cat indoors and
making sure other cats in the household aren’t
infected.” Cats who do go outdoors should be
tested every year, she adds.
Lyme disease
viruses, fungi and parasites. Many of these diseases can be
avoided by good preventive care, according to the company.
FIV
The report shows that in 2013, approximately one of every
300 cats seen in Banfield hospitals was found to be infected
with feline immunodeficiency virus, with the highest prevalence identified in Oklahoma, Iowa and Arkansas. Banfield’s
research shows male cats are three times as likely to be
infected as female cats.
Like HIV, FIV is a slow-acting virus spread through
intimate contact with infected individuals. The virus is
34
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
In 2013, approximately one in every 130 dogs
visiting Banfield hospitals was infected with the
bacterium (Borrelia burgdorferi) that causes Lyme disease.
It is spread through the bite of an infected deer tick. Since
2009 there has been a 21 percent increase in the prevalence of infection among dogs, corresponding to an increase
in tick infestation over the same period.
The report reinforced that the Northeastern states are a
hot spot for Lyme disease. The highest prevalence of infection is in New Hampshire, where one in every 15 dogs seen
was infected, followed by Massachusetts and Rhode Island.
By contrast, only one in 1,000 dogs or less was infected in
the Pacific Northwest. Furthermore, the infection was twice
as common in large breed dogs as in toy/small breed dogs.
“We think the increase in Lyme disease is caused by an
increase in the tick population and white-tailed deer population,” says Lefebvre. “As more humans encroach in the
deers’ natural environment, the chance of a deer going into
an urban area, where pets hang out, is greater.”
Though the Northeast has the highest incidence of Lyme
disease, any dog that goes outside – anywhere in the country –
is at risk, she adds. But Lyme disease is easily preventable. “A
dog cannot catch Lyme disease if ticks don’t bite it, and it’s so
easy to prevent them from doing so with flea/tick preventives.”
Other infectious diseases
The prevalence of upper respiratory infection in cats has
increased by 18 percent in the past five years – from eight
cases for every 100 cats in 2009, to almost 10 cases per
100 in 2013, according to the 2014 Banfield report. “This is
really disappointing, because there are vaccines to help prevent these illnesses among cats,” says Lefebvre. The data
would suggest that after the kitten series of vaccinations,
cat owners are failing to keep up to date as their pets age.
Banfield also has data on diseases such as canine influenza, leptospirosis, canine distemper and toxoplasmosis, for
which the prevalence of infection on a national scale has not
been quantified. Such diseases are either rare or emerging and
therefore still fairly uncommon, or they cause signs of illness
that are not specific to any one disease and/or for which testing
for them is not routinely performed, according to the company.
For example, canine influenza is so new that dogs do
not have the antibodies to fight the infection naturally. The
disease is caused by a fairly new strain of the influenza virus
that affects the respiratory system and is typically spread
through the air, or through interaction with an infected dog
or contaminated objects.
Leptospirosis is an example of a disease that dogs are
not routinely tested for, but that continues to be a serious
health threat to dogs and people alike, according to Banfield. The disease, caused by infection of the internal organs,
can be contracted through exposure to urine from infected
animals such as dogs, livestock and wildlife. Though it exists all over the world, leptospirosis is commonly found in
tropical climates, where the risk is even higher after a hurricane, flood or heavy rain.
Backyard dangers
Banfield Pet Hospital’s State of Pet Health™ 2014
Report suggests that the threat of infectious disease
is often closer to home than pet owners realize.
Seemingly innocent and regular activities for pets
– such as drinking out of or swimming in a pond,
sharing a toy or chasing wildlife – may result in
serious illness if a pet is not properly vaccinated and
protected with anti-parasite medications. For example, dogs can contract leptospirosis by drinking,
swimming or wading in contaminated water, or by
sniffing or licking contaminated urine. Similarly, cats
can come into contact with the parasite that causes
toxoplasmosis by eating raw meat from infected
animals, such as mice, or by eating items contaminated with the feces of infected cats.
A veterinarian can provide additional information
for pet owners to protect their pets against the spread
of disease, as well as recommend vaccines that
may be best for the individual pet based on the pet’s
lifestyle and geographic location, the company says.
Encouraging notes
Despite the statistics on the rising incidence of FIV infection
and Lyme disease, the 2014 report offers cause for encouragement, says Lefebvre. The incidence of several diseases
decreased or stayed roughly the same last year, she says. Examples include kennel cough, parvovirus and Giardia in dogs;
and feline leukemia virus and ear mite infestation in cats.
“Pet owners are doing some things right,” she says. But
they can do more. Simply keeping an eye on their pet, ensuring he or she doesn’t eat feces or fight with other pets, and
making sure they get their vaccines and anti-parasitic treatments, can stave off many infectious diseases, she points out.
“We want to ensure that pet owners [follow preventive measures], not only for their own pets, but to protect
other pets from becoming infected,” she says. “So get
your pets vaccinated, and clean up after them when they
go outside.”
Editor’s note: To see the entire State of Pet Health™ 2014 Report, visit www.stateofpethealth.com.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
35
»» Trends
Breed Icon*
Banfield sees
1 cat per every
5 dogs
Breed Overview
Dogs and cats can be prone to certain diseases based on their breed. For dogs, breed size
can also put them at an increased risk for certain diseases. As such, breed and breed size have
become important in veterinary medicine to understand the diseases or conditions to which
a dog may be predisposed.
Cat – average weight: 10 lbs
Common Breeds
51%
of dogs seen
at Banfield
Domestic Shorthair
Domestic Medium Hair
Domestic Longhair
27%
Chihuahua
Scottish Terrier
Shih Tzu
Yorkshire Terrier
of dogs seen
at Banfield
Common Diagnoses
Dental tartar
Patellar luxation
(kneecap pops out of place)
Retained baby teeth
Common Names
Bella
Max
Coco
Buddy
Medium – weight: 20-50 lbs
Common Breeds
Beagle
Boxer
Cocker Spaniel
Schnauzer
21%
Common Names
Kitty
Bella
Tiger
Toy/Small – weight: <20 lbs
Common Breeds
of dogs seen
at Banfield
Common Diagnoses
Feline respiratory virus
Kidney disease
Tapeworms
Common Diagnoses
Common Names
Conjunctivitis (eye infection) Bella
Cystitis (bladder inflammation) Max
Underbite
Buddy
Daisy
Large – weight: 50-90 lbs
Common Breeds
German Shepherd
Golden Retriever
Labrador Retriever
Rottweiler
Common Diagnoses
Common Names
Gastroenteritis (GI upset)
Bella
Otitis externa (ear infection) Max
Overweight
Buddy
Bailey
Giant – weight: >90 lbs
Common Breeds
2%
of dogs seen
at Banfield
Great Dane
Great Pyrenees
Mastiff
St. Bernard
Common Diagnoses
Arthritis
Lameness
Skin tumor
Common Names
Bella
Zeus
Duke
Max
* The percentages for dogs add up to 101% (not 100%) due to rounding
6
36
July/August 2014
Chart Credit: Banfield Pet Hospital’s State of Pet Health 2014 Report.
»» Veterinary adVantage • www.vet-advantage.com
Jorgensen Laboratories, Inc.
A family owned business, owned by veterinarians
for veterinarians, since 1965
PawFlex Bandages are a true innovation in
wound care. PawFlex super stretch material
flexes in all joint degrees
and angles plus moves
gently and smoothly with
your patient. In sizes for
the tiniest of patients to
the giant breeds.
- Non-adhesive means
absolutely
NO FUR
pulling or skin ripping.
This makes the bandage comfortable and easy
to change.
- Non-slip application assures minimal
slippage....even on
the most active dogs.
- Non-adherent wound pad - each bandage
has a non-adherent absorbant pad integrated
into the bandage itself as a primary bandage
layer.
- Can be adjusted or re-adjusted. Can check
on wound healing and still keep the same bandage....just lift and release.
ECO - friendly
biodegradable burial pods
Be a part of the new standard in pet aftercare
services.
Provides a better end of life experience.
All Paw Pods® can be
personalized at home.
Personalize
at home.
Sympathy
Card
- For use with either cremation ashes or whole
body burial.
- Made from 100% bamboo and rice husk
»» Trends
By Laura Thill
The Persistent Threat of Rabies
Summertime finds more pets outdoors, making it a good opportunity for your
customers to remind pet owners to stay current with their pets’ rabies vaccines.
Although awareness of rabies continues to grow,
the threat still exists. Veterinarians have done a nice job of containing
rabies with regard to domestic pets, says Robert Menardi, DVM, director,
veterinary technical services, Merial. Nevertheless, “we’ll never get rid
of the wildlife reservoirs,” he says. “And, complacency cannot be accepted, because there are still thousands of wildlife cases documented.
Any time animals are more likely to be exposed to wildlife, there is a
greater risk of rabies.”
38
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
Veterinarians are very thorough
when it comes to communicating to
clients the importance of vaccinating pets against rabies, he continues. “Many veterinarians continue to
use the rabies vaccine appointment
as a means of getting clients in the
front door.”
What is the role of the distributor
sales rep? “Sales reps don’t need to
remind their veterinarian customers about the importance of rabies
vaccines,” says Menardi. “The most
important thing they can do is to
know the products they carry and understand how they stand apart from
other products.”
“In any discussion [with the customer], it comes down to managing
relative risks,” he continues. “The
disease is prevalent across the country in the wildlife population, and it’s
100 percent fatal to pets. So, there’s
no question that veterinarians need
the vaccine on hand. The question
may be as to the type of vaccine they
need. For instance, we have learned
that modified live vaccines can cause
a rabies-like illness in vaccinated animals, so they are no longer allowed.
So, killed vaccines have since served
us well. And, in the last 15 years, the
first recombinant vaccine was introduced to address the risk of injectionsite inflammation in cats.”
Vaccination is important not only
clinically, but from a regulatory standpoint
Covidien Animal Health
Clinically proven products; from Spay to Z.
Absorbable suture
FDA approved, human hospital accepted
• Over 100 years of suture manufacturing expertise
• Unique materials made for improved outcomes
• Higher strength1, with easy handling
Competitive price with brand quality
• From manufacturer straight to distribution, no middle-man
• Higher margin products
• Direct account support from the manufacturer
Maxon™ Monofilament Synthetic Absorbable
• 67% stronger out of the package than competition1
Biosyn™ Monofilament Synthetic Absorbable
• Stronger through the critical wound healing time1
Polysorb ™ Braided Synthetic Absorbable
• Significantly stronger knot security than competition2
1
2
Learn the benefits, feel the difference, see the savings.
www.covidien.com/animalhealth
Data on file, Covidien Ltd.
Faulkner, et al, University of Virginia School of Medicine, Biomechanical Performance of a Braided Absorbable Suture, 1996.
“In any discussion [with the customer], it comes
down to managing relative risks. The disease
is prevalent across the country in the wildlife
population, and it’s 100 percent fatal to pets.
So, there’s no question that veterinarians
need the vaccine on hand. The question may
be as to the type of vaccine they need.”
– Robert Menardi, DVM, director, veterinary technical services, Merial
as well, notes Menardi. “The rabies vaccine is the only vaccine regulated by state,
county and municipal laws, although it varies by location,” he says. Sales reps can
check with local public health officials and state veterinary medical associations to
be clear, he adds.
If anything, rabies vaccines have done such a good job of helping to diminish
the disease, some pet owners might mistakenly believe the disease has disappeared. “The rabies vaccine is one of the biggest vaccine success stories,” says
Menardi. “In the last century, we have been able to reduce rabies in animals and
people to the point where many have forgotten it exists.” Fortunately, though, it’s
always on veterinarians’ radars, he adds.
Have the
discussion
When discussing rabies vaccines
with their veterinarian customers,
sales reps can remind them to:
• Communicate information about
current state and local requirements for rabies vaccination
compliance in writing with clients.
• Educate clients on the risk –
and consequences – unvaccinated pets face when exposed
to rabies.
• Clarify the importance of
keeping pets current with
their rabies vaccination. When
a dog or cat is even one day
overdue for its rabies vaccine,
it is considered unvaccinated.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
39
»» Trends
Rabies: Testing and diagnosis
When it comes to rabies in the United States, raccoons and skunks are the most highly reported rabid
wildlife species, followed by foxes and coyotes. Small
animals, such as squirrels, rats, mice, hamsters,
guinea pigs, gerbils, chipmunks, rabbits and hares,
are rarely discovered to be infected with rabies, according to the CDC.
Generally, there are two types of rabies exposures:
bite and non-bite. A bite refers to the penetration of
the skin by teeth. A non-bite includes the contamination of open wounds, abrasions, mucous membranes
or scratches. Rabies is only transmitted through saliva
and brain/nervous system tissue.
Rabies is transmitted when the virus is introduced into a bite wound, open cuts in the skin or
onto mucous membranes, such as the mouth or
eyes. When the virus is introduced by a bite into
a dog, cat or ferret, it travels within the animal’s
nerves from the site of the bite to the brain. During this time – the incubation period, which may
last between three weeks to two or three months in
dogs and two to six weeks in cats – the animal does
not appear ill. Because the rabies virus has not yet
reached the animal’s saliva, it will not pass along the
virus if it bites another animal or human. However,
studies have shown that rabies can be excreted in
an infected animal’s saliva for up to 10 days before
the illness is apparent, according to the CDC.
Once the virus reaches the animal’s brain and
multiplies, it causes inflammation of the brain before
moving from the brain to the salivary glands and
saliva. Infected animals generally show signs of illness once the virus has multiplied in its brain (usually
between three and five days). In dogs, the early signs
of rabies include a change in the dog’s tone of bark,
chewing at the bite site, fever, loss of appetite or
small changes in the animal’s behavior. These signs
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July/August 2014
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may last for two or three days, followed by aggressive behavior that lasts for two to four days. During
this time, rabid dogs may viciously attack a moving
object, person or animal, show strange food (and/or
non-food) cravings, constantly growl and bark, behave
erratically, disoriented or restless, or have seizures or
lack muscle coordination. In the last two to four days
of illness, the rabid dog may appear to be choking,
have difficulty swallowing, leading to drooling and
foaming of saliva, or have paralysis of the jaw. Paralysis spreads to other parts of the body and the animal
enters a coma and dies.
With cats, the first stage of illness involves anxiety
and sometimes a fever. They likely will lick the site of the
bite. After a couple of days, cats often become restless
and vicious. They become disoriented, have seizures
and develop paralysis, which generally affects the throat
and facial area. They have trouble swallowing, become
increasingly weak and die of respiratory failure.
There are several methods used to test euthanized animals for rabies, according to the CDC. These include:
• A histologic exam.
• Immunochemistry.
• Electron microscopy.
• Amplification methods.
• Direct fluorescent antibody (dFA).
The CDC considers the direct fluorescent antibody
test, which has been used in the United States for
about 50 years, to be highly sensitive and specific
and, as such, the gold standard diagnostic method
for rabies. Animals infected with the rabies virus have
rabies virus proteins – or antigens – present in their
tissues. Unlike many viruses, which are present in
the blood, rabies is present in nervous tissue, making
brain tissue the ideal place to test.
MISSING
SOMETHING?
. More complete.*
For ferrets†
HEARTWORMS
MICROFILARIA
Dogs only
FLEAS
ROUNDWORMS
HOOKWORMS
WHIPWORMS
Dogs only
SARCOPTIC MANGE
Dogs only
EAR MITES
Cats only
FLEAS
HEARTWORMS
See the difference at bayerdvm.com/multi
*Based on label indications: spectrum of species, parasites (dog) and life stages (dog and cat).
†
Advantage Multi® for Cats (imidacloprid + moxidectin) (0.4 mL) is indicated for ferrets that weigh at least 2 lbs.
CAUTION: Federal (U.S.A.) law restricts Advantage Multi® for Dogs (imidacloprid + moxidectin) to use by or on the order of a licensed veterinarian. WARNING: DO NOT
ADMINISTER THIS PRODUCT ORALLY. For the first 30 minutes after application ensure that dogs cannot lick the product from application sites on themselves or other
treated animals. Children should not come in contact with the application sites for two (2) hours after application. (See Contraindications, Warnings, Human Warnings,
and Adverse Reactions, for more information.) CONTRAINDICATIONS: Do not use this product on cats.
CAUTION: Federal (U.S.A.) law restricts Advantage Multi® for Cats to use by or on the order of a licensed veterinarian. WARNINGS: Do not use on sick or debilitated cats
or ferrets. Do not use on underweight cats. (see ADVERSE REACTIONS). Do not use on cats less than 9 weeks of age or less than 2 lbs body weight. Do not use on ferrets
less than 2 lbs body weight. PRECAUTIONS: Avoid oral ingestion. HUMAN WARNINGS: Children should not come in contact with the application site for 30 minutes
after application.
©2014 Bayer HealthCare LLC, Animal Health Division, Shawnee Mission, Kansas 66201
Bayer, the Bayer Cross and Advantage Multi are registered trademarks of Bayer.
AM14535
»» Trends
By Laura Thill
Understanding
Diabetes
An understanding of diabetes
– including the symptoms and
challenges it presents – can
help sales rep better service
their veterinary customers.
As pets age, they face
several health issues, including diabetes. They
typically show symptoms at around 7 years and up,
according to Peter Hanson, DVM, PhD, director of research &
development and medical affairs, Abbott Animal Health. Particularly as older pets become increasingly sedate and often overweight, they are at higher risk of developing the disease. Distributor
sales reps can play an important role in ensuring their veterinary customers are supplied with solutions for diagnosing and treating their diabetic patients, as well as tools for educating their clients.
42
July/August 2014
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Humans share
a lot of things
with their pets.
NOW AT A
REDUCED
PRICE
Blood glucose meters shouldn’t be one of them.
Portable blood glucose meters designed for blood glucose monitoring in humans
are not validated for veterinary use on pets.
AlphaTRAK is specifically calibrated and validated for dogs and cats for accurate readings.
Now with a reduced price, accuracy is affordable for your practice and
your patients. With a recommended Starter Kit price of just $70 to pet
owners, there is no better time than now to upgrade to AlphaTRAK.
© 2014 Abbott Laboratories. AlphaTRAK is a trademark of Abbott Group of companies in various jurisdictions. AT2-2058
For more information call
866-257-8807 or visit
www.AlphaTRAKmeter.com
»» Trends
About the disease
Veterinarians generally agree that obesity is a leading factor
in the increase of diabetes in dogs and cats, according to
Hanson. (Tremayne J., Education Key in Diabetes Maintenance, Vet Practice News, Nov 2009 (RPRT-010)) However,
pet owners are not always aware that their pet is obese, he
says. “In a recent study, 47 percent of veterinarians felt that
their canine patients were obese, while only 17 percent of
dog owners agreed,” he says. (Bound G., When Man’s Best
Friend Is Obese, WSJ, Feb 2011)
There are two types of diabetes: type 1 and type 2. Type
1 diabetes occurs from a shortage of insulin, while type 2
diabetes results from impaired insulin production or an incorrect response to the insulin. “Dogs most often get type 1
there is a greater likelihood that changes in diet can reverse
the insulin resistance, and cats enter remission if diagnosed
early and aggressive intervention is started,” he adds.
Common signs of diabetes include:
• Excessive drinking.
• Excessive urination.
• Increased appetite.
“Often, there is weight loss, even with the increased
appetite,” says Hanson. “If the disease has been present
for a while, cataracts of the eyes may occur in dogs. In
cats, diabetic neuropathy may present. In either species,
diabetic ketoacidosis can be a life-threatening complication of untreated diabetes.”
“Human meters underestimate blood glucose in
dogs and cats because glucose is distributed
differently in the blood and blood cells between
species.” Accurate blood glucose monitoring
– along with proper diet and insulin therapy –
permit veterinarians to control their patients’
diabetes and reduce secondary complications,
usually at a minimal cost to the pet owner.
Screening
and monitoring
Screening and early detection of diabetes can help veterinarians prevent
the disease from progressing to a
severe state. Uncontrolled diabetes
may result in cataracts, severe metabolic disorders, such as ketoacidosis, depression, inappetance, coma
and sometimes death. And, as the
disease progresses, it can be more
costly to treat.
– Peter Hanson, DVM, PhD, director of research &
The most common screening
development and medical affairs, Abbott Animal Health
test is for blood glucose. “Cats may
have elevated blood glucose if they
are stressed,” says Hanson. “With dogs and cats, a single
diabetes,” says Hanson. “In dogs, obesity may lead to longhigh blood glucose result may be followed with a repeat
term pancreatitis, which in turn impairs islet cells and leads
test after the animal has fasted. Persistent hyperglyceto diabetes.
mia with levels >200 mg/dL in dogs and >250 mg/dL
“Cats most often get type 2 diabetes,” he continues.
in cats is consistent with diabetes. Persistent glucose in
“Particularly in cats, obesity can lead to insulin resistance
the urine is typically a confirmatory diagnostic for susand an overproduction of insulin. Prolonged overproducpected diabetes. Additionally, fructosamine can be run
tion of insulin causes increased demand on the islet cells
to evaluate the average blood glucose readings over the
in the pancreas that produce insulin. Over time, this leads
past few weeks.
to damaged cells or cell death, which may result in a
“Ideally diabetic dogs and cats should be monitored
shortage of insulin.”
daily, one to three times per day, to allow proper adjustOnce a dog is diabetic, it typically requires insulin for life.
ment of insulin doses,” he says. “People with diabetes
However, proper weight and diet can reduce the insulin recheck their blood glucose levels throughout the day to
quired and improve glucose control, says Hanson. “In cats,
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“It is important [for sales reps] to find
out if there is a diabetes champion in
the practice who understands
the benefit of home
monitoring and other
management practices.”
– Peter Hanson, DVM, PhD
ensure they are maintaining proper glucose levels through
diet and insulin therapy. Pets are the same. Their blood
glucose levels rise and fall through the day based on diet,
activity, insulin dose, and other factors. To ensure the right
dose of insulin is being given requires regular monitoring
of blood glucose.
“Handheld blood glucose monitors that require only
a drop of blood have made home monitoring easy,” Hanson continues. It is important to use a meter that is calibrated for use in dogs and cats, he says. “Human meters
underestimate blood glucose in dogs and cats because
glucose is distributed differently in the blood and blood
cells between species.” Accurate blood glucose monitoring – along with proper diet and insulin therapy – permit
veterinarians to control their patients’ diabetes and reduce
secondary complications, usually at a minimal cost to the
pet owner, he adds.
Working with customers
Distributor sales reps looking to initiate a discussion about
diabetes with their customers might do so by asking several
probing questions, such as the following:
• “Doctor, how many patients do you see who are at
risk for diabetes?”
• “How do you screen these patients?”
• “How do you address diabetes with your clients and
educate them on the signs of the disease?”
• “Does your staff utilize a designated technician who
can initiate diabetes discussions with owners of
recently diagnosed pets?”
• “How do you manage a diabetic patient in
the hospital?”
• “What is your approach to glucose curves
and interpretation?”
• “Do you discuss home monitoring as an option with
your clients?”
While many veterinarians and their clients appreciate the
convenience of home monitoring, some veterinarians may
initially be uncomfortable with their clients’ role in regulating their pet’s blood glucose levels, says Hanson. However, a
number of texts and protocols now exist to guide this, he says.
“There may be concern that the client is not capable of getting a blood sample for home monitoring,” he says. And, some
clients might be tempted to make decisions about adjusting
insulin dose without first consulting with their veterinarian.
“It is important [for sales reps] to find out if there is a
diabetes champion in the practice who understands the
benefit of home monitoring and other management practices,” he says. “This champion can instruct the client on
diet, exercise and easy techniques to get a blood sample
for home monitoring. Proper training is [also] key for the
owner to understand the need to share blood glucose
levels with the practice before adjusting insulin levels.”
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
45
46
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
Tiger
Tail
by the
Zack Mills has
a passion for
veterinary medicine
By Graham Garrison
It was an itch that he just couldn’t
leave alone. Despite a very successful run on the business
side of the veterinary industry, including head of sales for
Merial, Zack Mills still had his eye on where he first began
– practicing veterinary medicine. “I always wanted to go
back,” says Mills, DVM, owner of Duluth, Ga.-based Tiger
Tails Animal Hospital. “I never planned to stay in industry
full time. I was planning on staying about 5-10 years, but
different opportunities kept coming up.”
There and back again
Mills began his career as a veterinarian in 1984. He started
at a practice in Charleston, S.C., with the understanding that
in five years he would buy out the owner. Within five months
though, they ended up negotiating a deal, and Mills was the
owner of a practice. Within ten years he had built the business up to two practices and four veterinarians.
During this time, Mills got involved doing clinic trials
for Rhone Merieux. The industry itself was something that
intrigued Mills. “I enjoyed sales,” he says. “I was a born
salesman. I actually worked my way through veterinary
school as a salesman – purchasing an ice cream truck and
selling ice cream novelties.”
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
47
Tiger Tails
Eventually, Mills decided to sell his practice and make
the leap into industry. He was hired by Hills Pet Nutrition.
He worked there as a territory manager, and then moved to
Rhone Merieux as a senior manager of technical services,
vaccine product manager and then director of veterinary
services for Rhone Merieux. When the merger between
Rhone Merieux and Merial happened, Mills considered going back into veterinary practice. However, he was convinced to stay on board, and transitioned into global marketing. Tom Zerzan, VP North America, soon came aboard at
Merial Limited. He became Mills’ mentor and moved him to
head veterinary medical affairs. The last six and a half years
worked and what didn’t work for other practices. I could
learn from others and apply my own ideas.”
His involvement with the American Animal Hospital Association, as well as the Partners for Healthy Pets programs,
gave him an up-close look at the challenges and problems
veterinary hospitals were having.
There were also the relationships he’d already built
with distribution. Mills says the distributor reps he worked
with made a huge difference in helping get Tiger Tails off
the ground. “Jim Cleary at MWI introduced me to the people at IDEXX,” Mills says. “He told me ‘we have grown our
business working together; now I want to help you grow
Mills was at Merial, he was in what he called his “dream
job” in the industry – head of sales. “I loved it and it was fun
for me. I was responsible for not only the Merial sales force,
but the relationship with the distributors.”
Still, there was always the pull toward his first passion
– veterinary medicine. “I loved industry, but also loved and
missed practice,” he says. “My wife Susan and I knew if we
didn’t get back in now, I’d never do it. Practicing veterinary
medicine is something I can do for the next 30 years.”
your business.’” The distributor reps introduced Mills to the
people, products and equipment he would need to make
a successful launch. Patterson Veterinary had a draftsmen
visit the proposed site Mills was considering to purchase
and lay out a rough draft of floor plans. Mills was able to
use that in his business plan he took to the bank. “If I hadn’t
had that opportunity with Patterson I’d have to do it myself,”
Mills says. “That helped me start getting things approved.”
His distributor reps were instrumental in getting the
business up and running, and both of his reps were there
supporting his open house. Today they are regular visitors
at the office, coming in every week to two weeks to discuss
products, training and promotions with Mills and his team.
“They are partners,” Mills says. “They know my
numbers and I trust them. That’s the kind of relationship
you should be able to have. They should know where
Lessons that carry over
The lessons learned from his time in the industry proved
critical in developing his business plan. “I had the opportunity to see hundreds of practices while I was head of sales
and talk to a tremendous number of vets and see different ways of things being done,” he says. “I could see what
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July/August 2014
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everything is, and continually come with new ideas.
They see more practices than I see now, so they can
help me keep up with what’s new.”
Foundations
Mills says it is easier in the long run to invest in creating
the practice you want at the beginning, so he set out to do
just that with the building specs, equipment they chose, and
certifications they strove to meet.
When choosing which equipment to invest in, Mills
says he was sold on the idea of systems integration “and
it has proven to work beautifully,” he says. “We were also
right and we had all our protocols together, he says. “By
forcing ourselves to do that, it allowed us to get all protocols in place to make sure we were doing everything right.
By getting it right early, it ensured we were doing what we
needed to be doing from the beginning. If you get into good
habits, good habits will stay. If you get into bad habits, it’s
very hard to change.”
While the average client may not know what AAHA accreditation meant, if clients asked, Mills could tell them it
meant they were doing things the right way. This also carried
over into their decision to become a Cat-Friendly practice.
The name, the people
Mills wanted a story behind the name of their practice, and
he had a good one in Tiger Tails. He attended Clemson University and was the school’s mascot at one point, “which in
addition to being a great experience, it opened a few doors
for me along the way.”
fortunate to work a great deal on the purchase of our
building so we could invest more into the build-out and
equipment. We wanted a state-of-the-art practice, so we
invested in cutting edge technology.”
For the facilities, “look and feel” were important too.
Consumers appreciate a friendly, efficient and clean
‘shopping’ experience, Mills says. “When we built the
practice we wanted it to have the look and feel of a spa,
yet evoke a playful, fun feeling. We’ve also embraced
technology and state-of-the-art equipment. We like to be
cutting edge in treatments and therapies we offer. Yet
the basic premise of best quality medicine and customer
care remains unchanged.”
Mills set a target goal to become AAHA accredited within six months. Tiger Tails actually accomplished it in four
months. “I wanted to make sure we were doing everything
CALL TO SCHEDULE YOUR IN-CLINIC DEMONSTRATION
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
49
Tiger Tails
The Tiger Tails
staff meets on a
regular basis to
discuss how they
function and the
right, consistent
messaging to
have in place for
things such as
flea/tick season,
vaccinations, etc.
Just as important as the building was
the team. Mills says that during the interview process, it was important to find
people that liked people, not just pets.
“Anybody can say ‘I love animals.’
That’s great, but that’s not a reason
I will hire you,” says Mills. “I want
someone who loves animals, but
loves working with people, because
it’s a team. You’ve got to have ‘giveand-take’ on a team, and enjoy working with clients. It’s the clients who
bring in the animals – the animals
don’t come in by themselves. You can
be the greatest vet in the world, but if
you don’t have a great happy team to support you and communicate to the client you aren’t going to be successful.”
The Tiger Tails staff meets on a regular basis to discuss
how they function and the right, consistent messaging to
have in place for things such as flea/tick season, vaccinations, etc. He says they also rely heavily on manufacturer
reps to come in and train staff on the talking points.
Retail
Tiger Tails doesn’t shy away from being competitive in the
retail space. You can see their retail strategy the moment
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July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
you walk into the practice – a neat,
clean shelving system with products the Tiger Tails recommended
to clients. Mills says Tiger Tails offers a 12-pack for heartworm preventatives, in either oral or combo
applications, because that’s what
they need. He also limits the number of products he keeps in inventory to keep his costs in line. “We
work hard to educate clients on our
retail products and are proactive in
recommending them,” he says. “We
coach our team on having a consistent message about the products
so customers hear the same message whether they are
speaking with the doctor, a tech or a customer service
team member, and it pays off. Our compliance on 12
months of heartworm prevention is 70 percent. Living in
the South, there’s no reason a pet shouldn’t be on heartworm prevention, as well as flea and tick control.”
With pricing, Mills says people look to see how competitive a veterinary practice is based upon things like heartworm preventives and flea/tick. “If you’re charging $140 for
a 12-month supply of HEARTGARD, and they look online and
can get a 12-month supply for $100, they’ll look at it and
.
D
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G
N
A
?
o
H
o
t
,
C
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I
E
A
S
V
N
r
A
u
o
H
y
e
g
S
n
E
a
h
c
M
TI Is it time to
THEN.
NOW.
®PREVICOX is a registered trademark of Merial.
©2014 Merial Limited, Duluth, GA.
All rights reserved. PVX13PB2014TRADEAD (02/14).
Important Safety Information: As a class, cyclooxygenase inhibitory NSAIDs may be
associated with gastrointestinal, kidney or liver side effects. These are usually mild, but
may be serious. Pet owners should discontinue therapy and contact their veterinarian
immediately if side effects occur. Evaluation for pre-existing conditions and regular
monitoring are recommended for pets on any medication, including PREVICOX® (firocoxib).
Welcome to the now.
Tiger Tails
say – ‘If he’s overcharging me for this, what else is he
overcharging me for?’ I tell clients that my prices are
about what you’d see online. I’m not going to match the
price you get online, because it’s not fair to my other
customers. But I price my products at a fair markup and
there are a number of benefits they enjoy buying directly
from their veterinarian.”
Veterinary medicine is Mills’ first love, but with his
success and experience on the business side, his switch
back into practicing has become a proving ground of
sorts. “One of the reasons I wanted to do this was to prove
to practitioners that you can still be very successful being a veterinarian,” Mills says. He’d heard the concerns:
There are too many vets, too much debt, veterinarians
can’t compete with Wal-Mart or retail chains, etc. “I want
to prove that yes you can, and be very successful at it.”
Social media
The best way to promote a practice is still through word
of mouth, says Zack Mills, DVM, owner of Tiger Tails Animal Hospital. Social media has just become a high-tech
way to do it.
Tiger Tails uses a mixture of social media, community events and traditional advertising to build client
awareness. “We continue to do those things and whole
heartedly embrace social media. However, our clients
recommending our practice to their colleagues, family
and friends is our most effective form of advertising.”
The message is certainly resonating. Tiger Tails has
almost 1,000 Likes on Facebook within 18 months of
opening. “We don’t put a lot of medical information in
there,” says Mills. Rather than in-depth medical content,
Tiger Tails uses Facebook for things such as posting
pictures of lost animals that people bring in to their clinic.
“Almost every single time, the post is responded to
and in a couple hours the owner is coming to pick up
their pet,” Mills says. “Someone on Facebook saw the
pet and realized it belonged to somebody else or they
shared it with their network of friends.”
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July/August 2014
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Leslie Scarpa, Tigers Tail’s social media and event
coordinator, says their Facebook page gets a lot of traffic from clients on vacation who want to see pictures
of their dog that is being boarded. “The boarding and
day care team is so good at putting pictures up,”
says Scarpa. “Sometimes we’ll get a private message
‘please put a video up of our pet’ because a little boy
is missing his dog.” Tiger Tails has a Shutterfly page,
referenced on the boarding invoices, so clients know to
go there for lots of pictures.
Tiger Tails has also developed an app, which
already has more than 1,100 downloads. “That’s well
over a third of our client base,” says Scarpa. The app is
popular for setting appointments for boarding and day
care. Customers have the ability to purchase product
through the app and request hospital appointments and
prescription refills.
Tiger Tails also has a YouTube page and is active on
Twitter. The key to making social media work for your
practice is having team members who embrace it and
update it consistently, says Scarpa.
RILEXINE®
(cephalexin) Chewable Tablets for Dogs
Antimicrobial for Oral Use in Dogs only
CAUTION: Federal (USA) law restricts this drug to use by or on the
order of a licensed veterinarian.
BRIEF SUMMARY: Please consult package insert for complete
product information.
INDICATION: For the treatment of secondary superficial bacterial
pyoderma in dogs caused by susceptible strains of Staphylococcus
pseudintermedius.
CONTRAINDICATIONS: RILEXINE Chewable Tablets are
contraindicated in dogs with a known allergy to cephalexin or to the
ß-lactam (any of the penicillins or cephalosporins) group of antibiotics.
WARNINGS: For use in dogs only. Not for use in humans. Keep this
drug out of the reach of children. Antimicrobials, including penicillins
and cephalosporins, can cause allergic reactions in sensitized
individuals. Sensitized individuals handling such antimicrobials,
including cephalexin, should avoid contact of the product with the
skin and mucous membranes in order to minimize the risk of allergic
reactions.
PRECAUTIONS: Prescribing antibacterial drugs in the absence
of a proven or strongly suspected bacterial infection is unlikely to
provide benefit to treated animals and may increase the risk of the
development of drug-resistant animal pathogens.
The safe use of RILEXINE Chewable Tablets in dogs intended for
breeding and in pregnant or lactating bitches has not been evaluated.
Positive direct Coombs’ test results and false positive reactions
for glucose in the urine have been reported during treatment with
some cephalosporin antimicrobials. Cephalosporin antimicrobials
may also cause falsely elevated urine protein determinations. Some
antimicrobials, including cephalosporins, can cause lowered albumin
values due to interference with certain testing methods.
Occasionally, cephalosporins have been associated with myelotoxicity,
thereby creating a toxic neutropenia1. Other hematological reactions
observed with cephalosporin therapy include neutropenia, anemia,
hypoprothrombinemia, thrombocytopenia, prolonged prothrombin
time (PT) and partial thromboplastin time (PTT), platelet dysfunction,
and transient increases in serum aminotransferases2.
ADVERSE REACTIONS: The most common adverse reactions in dogs
include diarrhea, vomiting, anorexia and lethargy. To report suspected
adverse reactions call Virbac at 1-800-338-3659.
ANIMAL SAFETY: RILEXINE Chewable Tablets were administered orally
three times a day to 12-week-old healthy Beagles at 0 mg/kg (placebo),
22 mg/kg (1X), 66 mg/kg (3X), and 110 mg/kg (5X) for 12 weeks, and at
22 mg/kg twice a day for 12 weeks. The most common clinical findings
included epiphora, salivation, vomiting and diarrhea among all the dose
groups. Three dogs had decreased activity (1 in each from the 22 mg/kg
twice a day, 22 mg/kg three times a day, and the 66 mg/kg three times a
day groups). These observations were mild and sporadic.
There were increases in alanine aminotransferase (ALT) in the
110 mg/kg three times a day group and in the 22 mg/kg twice a day
group that increased in a dose-dependent pattern. There was an
increase in sorbitol dehydrogenase (SDH) in the 110 mg/kg three times
a day group compared to the controls. These changes were minimal
and the values remained within expected historical control ranges.
There were several decreases in total protein (in the 110 mg/kg three
times a day group) and/or globulin (in the 22, 66, and 110 mg/kg three
times a day groups) compared to the controls. These changes resulted
in occasional increases in albumin/globulin ratios. Although a drug
effect cannot be ruled-out, these changes were not clinically relevant.
A mild prolongation in prothrombin time (PT) was observed in the 22
mg/kg three times a day group. This was not considered clinically
relevant due to the small change that remained within the reference
ranges.
One dog in the 110 mg/kg three times a day group had moderate
amounts of bilirubinuria at the Week 8 and Week 12 samplings. No
clinical significance was noted.
Cephalexin was not present in any Day 1 samples prior to dosing or in
any control animals. After dosing, cephalexin was well absorbed into
systemic circulation of the treated dogs. Within gender and dosage
level, Week 8 mean trough concentrations were generally higher than
the Week 4 and 12 mean trough concentrations (between a 0.9 and
3.6-fold difference). The geometric mean plasma cephalexin trough
concentration following three times daily administration of the 110
mg/kg dose was 11.2 µg/mL compared to 2.6 µg/mL and 8.7 µg/
mL following 22 mg/kg and 66 mg/kg, respectively at Week 12.
Geometric mean plasma cephalexin trough concentrations following
administration of 22 mg/kg twice daily were 0.7, 1.3, and 1.0 µg/mL at
Weeks 4, 8, and 12, respectively.
STORAGE INFORMATION: Store at 20°C-25°C (68°F-77°F), with
excursions permitted between 15°C-30°C (59°F-86°F).
HOW SUPPLIED: RILEXINE (cephalexin) Chewable Tablets are
supplied in 75 mg, 150 mg, 300 mg, and 600 mg tablets packaged in
bottles of 100 and 500 tablets or boxes of 28 blister-packs, 7 tablets
per blister pack.
NADA 141-326, Approved by FDA.
Distributed by: Virbac Animal Health, Inc. Fort Worth, TX 76137 USA
Revision date: 08/2011
References: 1. Birchard SJ and Sherding RG. Saunders Manual
of Small Animal Practice, 2nd edition. W.B. Saunders Co. 2000:
p. 166. 2. Adams HR. Veterinary Pharmacology and Therapeutics, 8th
edition, 2001, p. 825.
© 2014 Virbac Corporation. All Rights Reserved.
RILEXINE is a registered trademark of Virbac S.A. in the United States
and Canada.
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BITTER HUMAN PILL
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of RILEXINE (cephalexin)
Chewable Tablets for Dogs
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The first and only veterinary approved cephalexin makes treating
pyoderma feel more like giving a treat.
Human generic cephalexin may be your clients’ first-line choice for secondary superficial
bacterial pyoderma, but it’s a bitter pill to swallow for their canine patients. RILEXINE
Chewable Tablets for Dogs is the first and only FDA-approved cephalexin specifically
designed for the veterinary market. This unique alternative combines proven palatability with
the efficacy veterinarians have come to expect at a value similar to other veterinary-labeled
antibiotics. Plus, it comes in 3 convenient tablet sizes that can be easily scored for more
precise dosing. When your clients prescribe RILEXINE Chewable Tablets for Dogs, they
generate additional revenue for their clinic and create more sales opportunities for you.
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Visit www.virbacvet.com to learn more.
Indication: For the treatment of secondary superficial bacterial pyoderma in dogs caused by
susceptible strains of Staphylococcus pseudintermedius.
Important Safety Information: RILEXINE Chewable Tablets for Dogs are not for use in dogs
with a history of allergic reactions to penicillins or cephalosporins. Sensitized individuals should
avoid contact of the product with the skin and mucous membranes. The most common adverse
reactions in dogs include diarrhea, vomiting, anorexia, and lethargy. The safety of RILEXINE
Chewable Tablets for Dogs in breeding, pregnant, and lactating bitches has not been evaluated.
www.virbacvet.com
© 2014 Virbac Corporation. All Rights Reserved.
RILEXINE is a registered trademark of Virbac S.A. in the United States and Canada. 2/14 14336
Tiger Tails
Summer Camp
Tomorrow’s veterinarians and pet owners can start their
education for proper pet care today. Tiger Tails Animal
Hospital emphasizes this in a week-long summer camp
for kids. The camp runs each day from 9 a.m. to 1 p.m.
During the office lunch hours, the campers come through
the practice and meet and talk with the assistants, veterinary technicians and veterinarians while viewing some
really cool stuff in the hospital, says Leslie Scarpa, Tiger
Tails’ social media and event coordinator.
“We also have presenters coming in,” says Scarpa.
“For example, on Monday we have Pawsitive Practice,
blood (in this case vitamin water), and marbles in the
bladder area to simulate bladder stones. On another
day, the local K9 unit will have a presence. The SPCA
will also stop by to discuss the difference between a
no-kill shelter and shelter.
“We’re also going to do something on the importance
of spaying and neutering your pets,” says Scarpa. On
Monday, the kids will have the opportunity to color a pair
of cat drawings to coincide with a chart created to show
the kids how fast a cat population can grow without
spaying or neutering. Each day, according to the chart,
more cats will be dropped off, and the
campers will have to color each one. “So
it will be a great visual to drive home how
fast the population can grow.”
After the camp ends, the students
will bring in their pets on a Saturday,
and get a chance to show their parents
what they’ve learned by helping to
perform a physical exam. Mills says last
year’s Vet Camp and Saturday checkup
were such a hit, most of the families
became clients.
Mills says the camp is a great
opportunity to develop an interest in
veterinary medicine, and if nothing
else, an appreciation for taking care of
– Zack Mills
one’s pet. “This whole program is giving
back to the profession,” Mills says. “You
start educating kids, they get excited about veterinary
medicine, and you might get more kids into veterinary
medicine. More importantly too, even the ones who don’t
get into veterinary medicine now know the importance of
pet wellness. They can talk to their parents about it, and
help ensure it happens.”
During the first year, Tiger Tails had 16 campers. It
had a full house of 25 for this year’s camp, which ran the
first week of June.
“You start educating kids, they
get excited about veterinary
medicine, and you might get
more kids into veterinary
medicine. More importantly too,
even the ones who don’t get into
veterinary medicine now know
the importance of pet wellness.”
which is a dog training company, and they will talk to the
kids about bite prevention. Because the kids will be in
the hospital setting with animals, we want them to know
how to approach them.”
They also bring in outside visitors. Merial visits and
discusses the importance of heartworm preventives
and preventive medicine overall. Merial is also providing stethoscopes for the kids to use on a toy dog that
has been outfitted with a beating heart, a tube to draw
54
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
Keep your
Patients
Warm
™
3M Bair Hugger therapy forced-air warming
™
™
Quiet and easy to use
• Warming blankets available in a variety of designs and sizes
• Provides safe, effective warming for your patients
•
Now available to 3M veterinary distributors. Find out
more by contacting your local sales representative, or
visit us at www.3M.com/animalcare.
3M, BAIR HUGGER and the BAIR HUGGER logo are trademarks of 3M Company,
used under license in Canada. © 2014 3M. All rights reserved. 603720A 5/14
»» Trends
The Senior Pet
Preventive healthcare, an understanding of the unique needs
of older pets, and owners’ eagerness to care for their aging
animals have contributed to longer lives for companion animals
Pets – like people – are
living longer. And with the heightened
awareness of the needs of senior
pets comes a heightened awareness
of products and equipment geared to
this subset of the pet population.
“Over the past 11 or 12 years
since I graduated from Cornell University, I am seeing a trend toward longer life expectancies,” says Christopher Byers, DVM, DACVECC, DACVIM
(SAIM), Midwest Veterinary Specialty
Hospital, Omaha, Neb, and chair of
the Marketing and Communications
Committee of the American College
of Veterinary Internal Medicine. “Cats
today are expected to live near their
20s and often into their 20s, and miniature and toy breeds are expected to
live to their mid- to high teens.”
Says Kate Crumley, DVM, owner
of Heartwood Animal Hospital in
Youngsville, N.C., and president of the
American Animal Hospital Association, “Pets certainly are living longer
than they did 20 years ago, when
I came out of school. It depends on
breed and species, but gaining years
on the pet’s life is pretty common. It’s
expected these days.”
Starts with TLC, but
doesn’t end there
The reasons are many.
“A lot of it is TLC – from owners as
well as veterinarians,” says Crumley.
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That’s a reflection of the human-animal bond. “Animals are
living closer to us, so we can see when they don’t feel right.
And people care intensely about making the quality of their
pets’ lives better. We do what we can to help our pets feel
better and make them part of our lives.
“There’s a lot of good, new nutrition information out
there, and a lot of focus on nutrition,” she adds. “Also, the
general population of pet owners is aging a bit, so people
are sensitive to what’s ailing their pet. ‘What I am experiencing, are my pets experiencing that as well?’”
Says Byers, “In the United States, we have an extremely
dedicated base of what we call pet parents. They will go
above and beyond what commonly happens in other parts
of the world. Simply stated, the pet-owning American public is very proactive with animal health.” True, during hard
economic times, such as the recent
recession, priorities are rearranged,
and pet care may suffer. “But now
that we seemingly are on the upswing, with reports that the private
sector has made modest improvements in economic growth, pet parents have more disposable income,
for lack of a better term, for veterinary healthcare.”
But economics is just one factor
influencing pet longevity, says Byers.
“The level of education for
our primary care colleagues who are on the forefront
of preventive healthcare medicine is phenomenal,” he
says. “They are a very dedicated group of clinicians
who are trying to monitor and head off medical problems at their infancy, before they become major medical issues. Geriatric programs and protocols to perform
disease screenings at all ages, including the geriatric
years, have gone a long way in helping us identify disease and start treatment earlier.”
Veterinary specialty medicine plays a big role too. “It is
something that pet parents are honestly starting to expect
nowadays, and it is blooming,” he says. Pet owners have
come to expect assistance from what Byers calls the “triad
of care” – that is, a team comprising the pet parent, the
primary care veterinarian and the veterinary specialist – to
help them keep their pets healthier longer.
While primary care veterinarians assume responsibility
for screening and providing preventive care, the specialist
provides advanced care when needed, he says. Specialists, including surgeons, oncologists, cardiologists, critical care specialists, eye specialists, etc., are exposed to
data on many different disease processes, many of them
unique to the geriatric pet population. “Working and partnering with primary care doctors for those patients who
are really sick, a specialist can pull off the shelf the latest
drug therapies or new procedures that aren’t commonly
available,” he points out.
Unique health needs
Successful primary care practices have developed preventive healthcare programs targeted to their geriatric patients.
“Geriatric programs and protocols
to perform disease screenings
at all ages, including the geriatric
years, have gone a long way in
helping us identify disease and
start treatment earlier.”
– Dr. Christopher Byers
“When I worked as a technician in the mid-90s, if an old
dog or cat came into the office with his or her family, honestly, they were often treated just like any other patient –
with care and compassion, yes, but they weren’t considered
a special patient population with unique healthcare needs,”
says Byers. “Today, we recognize that geriatric patients do
have unique health needs, and the sooner we identify them,
the better they will likely be in both the short and long term.”
Many primary care hospitals have developed protocols
for geriatric care and have trained their nursing staffs and
client services teams to educate pet owners and promote
this specific aspect of preventive healthcare, he says. As a
result, practices are educating pet owners about their senior
pets’ oral health, osteoarthritis and heart disease.
“In the name of trying to keep these older pets as comfortable as possible, we talk about various supplements and
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
57
»» Trends
dietary modifications, and simple athome exercises that geriatric pets
can do at home with their families,”
he says. “It not only improves the
pet’s health, but it strengthens the
bond between family and pet.”
Veterinarians and their staffs are
trained to look for different things
among their senior pet patients, he
continues. Excess thyroid hormone
production – hyperthyroidism – is
an example. “Screening for hyperthyroidism in young kittens may be
a waste of resources; but failing to
do so in the geriatric feline population is a mistake,” he says. “Similarly, failing to monitor older pets
for chronic kidney disease or blood
Key Points
• Many veterinary practices
have developed protocols
for geriatric care and trained
staff to promote this specific
aspect of preventive care
• “Signalment,” taking into consideration a pet’s age, breed
and gender before initiating
treatment can be a key to
improving care for senior pets.
• Pet owners can pre-empt
some problems with proper
nutrition for their senior pet.
process progressed near to the end
stage, or to a point where a specialist
is needed.”
Arthritis and
mobility issues
The influx of senior pets is changing care protocols. Prior to bringing
their older pet in to Twin Cities Animal
Rehabilitation and Sports Medicine
Clinic, Burnsville, Minn., for example,
clients are asked to fill out a mobility
questionnaire, explains Julia Tomlinson, BVSc, MS, PhD, DACVS, CCRP,
CVSMT, DACVSMR. That’s because
arthritis and mobility issues are common among senior pets. “Older pets
are sedentary and prone to obesity –
“Today, we recognize that geriatric patients do
have unique health needs, and the sooner we
identify them, the better they will likely be in
both the short and long term.”
– Dr. Christopher Byers
pressure abnormalities is a mistake.” But 10 or 15 years
ago, these were things that were not routinely done.
“Today, I could go to any of my referring doctors and
ask them what they do for geriatric healthcare, and at some
level, they have a protocol and a recommended plan. Not
every parent will be able to heed those recommendations,
or they may elect not to, but at least a surveillance program
is in place.
“As a profession, we have recognized that individual
patient populations – whether you’re talking about geriatrics or pediatrics – have unique health concerns. If we take
that geriatric population and focus a majority of our efforts
on trying to identify issues before they become major, the
pet’s health and quality of life will remain high – much longer than if we let it get to a point where a specific disease
58
July/August 2014
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and obesity can exacerbate the problem,” she says. In addition, muscles in the older pet can waste away, a phenomenon that, in human beings, is called “frailty syndrome.” In
people as in pets, it leads to further problems with mobility,
she says.
Though general practitioners can – and do – equip their
practices with modalities geared to the older pet, such as
laser, they can offer their clients and senior pets a great
service by educating them on therapeutic exercises for the
home, says Tomlinson. “There are simple things to do with
the frail pet at home,” she says. For example, the owner
can gently bend his or her pet’s legs to loosen up the joints.
“Things like that have a big effect” on the pet.
At the annual or semi-annual wellness exam, the
veterinarian should include some quick mobility testing,
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such as watching the pet get up. They should prepare questions such as,
“Can your pet still stand up during eating their whole meal?”
It should come as little surprise to veterinarians or cat owners that cats exhibit
symptoms differently than dogs, continues Tomlinson. “Cats are masters at hiding
pain,” she says. “They can go a lot longer and hide a lot more issues that are only
recognized later on.”
Signalment
Kate Crumley believes that “signalment” – that is, taking into consideration a
pet’s age, breed and gender before initiating treatment – can be key to improving care for the senior pet. “That’s one of the first things they teach you in
veterinary school.
“If it’s a puppy, you look for puppy problems. If it’s a senior pet, there are many
more possible problems, and you have to ask the client many more history questions.” Feeling the lymph nodes, looking for lumps elsewhere in the body, listening
a little longer to the heart and lungs, asking questions about stiffness – it’s all part
of the senior pet wellness visit, says Crumley. Blood work is more comprehensive
as well. “We’re looking for thyroid issues, electrolyte problems – risk factors that
get greater as the pet gets older.
“The biggest thing for me is to watch for potential kidney disease. It used to
be, we picked it up only after they were in failure. But now, we can identify the
warning signs and postpone [its onset].”
“The general
population of
pet owners
is aging a bit,
so people are
sensitive to
what’s ailing
their pet.
‘What I am
experiencing,
are my pets
experiencing
that as well?’”
www.vet-advantage.com • Veterinary advantage
– Dr. Kate Crumley
«« July/August
2014
59
»» Trends
Healthy aging
Healthy aging for pets involves many components, but
one of the most critical is weight control, says Julia
Tomlinson, BVSc, MS, PhD, DACVS, CCRP, CVSMT,
DACVSMR, Twin Cities Animal Rehabilitation and Sports
Medicine Clinic, Burnsville, Minn., who speaks about
healthy aging to professional groups. The older pet
typically gets less exercise than his or her younger
counterparts, and hence needs fewer calories. Furthermore, contrary to what many believe, older pets, with
their aging muscles, need more – not less – protein than
when they were younger.
Outfitting the practice
Proper nutrition is another important aspect of
healthy aging, says Tomlinson. “We try to pre-empt problems [with activities and products] that support joints and
keep muscles strong.” Glucosamine chondroitin and fish
oil are two examples.
Simple mobility aids – such as harnesses that the pet
can wear all day – can help older pets get around, even up
and down stairs. “Some owners whose pets have trouble
getting up stairs choose to keep them downstairs all the
time. But giving them that little bit of aid – a harness – allows
their pet to be more mobile, which helps muscle mass.”
“If it’s a puppy, you
look for puppy
problems. If it’s a
senior pet, there
are many more
possible problems,
and you have
to ask the client
many more
history questions.”
with arthritis, and you have a
pet who wants to get up and go,
Accommodating older pets means outfitbut whose back end won’t. The
ting the veterinary practice accordingly.
muscles weaken. So you have the
Because of its patients’ special
combination of bones, muscles and
needs, Twin Cities Animal Rehanerves all getting older and weaker.
bilitation and Sports Medicine Clinic
“And these guys look embarfeatures high-traction flooring and
rassed,” she says, speaking of
soft padded treatment mats, and
some of her older canine patients
uses oils and psychoacoustically
whose feet have slipped out from
designed music to calm and relax
under them. (“The kitties tend to
pets during treatments and exams.
hunker down and look at you and
Its staff offers a wide range of thernot move, rather than embarrass
apeutic modalities, including hydrothemselves,” she adds.) Owners
therapy, laser and ultrasound theracan do the older pets a favor by
py, manual therapies, acupuncture,
fixing them up with a bottoms-up
electrical stimulation and more.
– Dr. Kate Crumley
leash, that is, one that offers supThough these treatments are availport to the rear legs, she says.
able for patients of all ages, they are
Hygiene is important too, particularly when older
particularly critical for the older pet, who may not be able
pets are involved, says Crumley. They may be incontito tolerate pain medications as well as their younger counnent, which challenges the hospital staff to keep surterparts, says Tomlinson.
roundings clean. “Sometimes it’s fecal incontinence,
“We have a lot more mats, to provide traction,” says
which can be very embarrassing for the dog.” Safety
Crumley. Older, arthritic pets aren’t as mobile as their
is another concern for older pets. “We need to make
younger counterparts. Their joints hurt, and they may
sure we isolate the young, rambunctious, wild ‘chilneed something to help them stand up. “The other
dren’ from the seniors, so they don’t get knocked over
thing is, their nervous system ages; they’re not nearly
or annoyed.”
as agile and nimble on their feet. You put that together
60
July/August 2014
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U-40 insu
lin
syringes
available
for diabe
te
mellitus s
in
both do
gs
and cats
Practices may have to augment
their inventory with new equipment
and/or supplies to accommodate procedures for the senior pet.
“When I came out of school, it
was pretty rare to see blood pressure measurements taken; now it
is very common,” says Crumley. In
fact, it’s something for which the
American Animal Hospital Association has standards. Furthermore,
surgery is an option for older pets,
something that wasn’t always true
in years past. But it’s an option that
some owners delay as long as possible. A former pet might have had
a bad experience with anesthesia
years ago, or maybe a friend or
neighbor shared an anesthesiarelated horror story.
Such fears are ungrounded today. “I have a couple dozen different anesthesia protocols,” which
can be tailored to the individual pet, her age, and her medical condition, says
Crumley. “So, just because the pet has heart disease or kidney disease doesn’t
mean she has to spend the rest of her life with a toothache.” Some teeth can
get so bad, the pet’s jaw breaks. That could be because the owner is unaware
of how much pain his or her pet is in, or because they want to avoid anesthesia
and surgery.
Surgery isn’t the only option for the older pet in pain or discomfort.
Therapeutic laser, chiropractic care, acupuncture, massage and stem cell
therapy are all options accessible to the general practitioner. Simply taking the time to talk to the owner about their pet’s nutrition and weight can
help, though such discussions must be handled delicately.
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«« July/August
2014
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»» Trends
Older Pet Care Considerations
Area of concern
Description
Increased veterinary care
Geriatric pets should have semi-annual veterinary visits instead of annual visits so
signs of illness or other problems can be detected early and treated. Senior pet
exams are similar to those for younger pets, but are more in depth, and may include
dental care, possible bloodwork, and specific checks for physical signs of diseases
that are more likely in older pets.
Diet and nutrition
Geriatric pets often need foods that are more readily digested, and have different
calorie levels and ingredients, and anti-aging nutrients.
Weight control
Weight gain in geriatric dogs increases the risk of health problems, whereas weight
loss is a bigger concern for geriatric cats.
Parasite control
Older pets’ immune systems are not as healthy as those of younger animals; as a
result, they can’t fight off diseases or heal as fast as younger pets.
Maintaining mobility
As with older people, keeping older pets mobile through appropriate exercise helps
keep them healthier and more mobile.
Vaccination
Your pet’s vaccination needs may change with age. Talk to your veterinarian about a
vaccination program for your geriatric pet.
Mental health
Pets can show signs of senility. Stimulating them through interactions can help
keep them mentally active. If any changes in your pet’s behavior are noticed, please
consult your veterinarian.
Environmental
considerations
Older pets may need changes in their lifestyle, such as sleeping areas to avoid stairs,
more time indoors, etc. Disabled pets have special needs which can be discussed
with your veterinarian.
Reproductive diseases
Non-neutered/non-spayed geriatric pets are at higher risk of mammary, testicular,
and prostate cancers.
Source: American Veterinary Medical Association, https://www.avma.org/public/petcare/pages/caring-for-an-older-pet-FAQs.aspx
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Arthritis pain questionnaire:
Does your pet have signs of arthritis?
Editor’s note: Clients of Twin Cities Animal Rehabilitation and Sports Medicine Clinic, Burnsville, Minn., are asked to print off
the following questionnaire from the website and bring it to the clinic at the consultation, so the doctor can better understand the
pet’s needs and disabilities. Thanks to Julia Tomlinson BVSc, MS, PhD, DACVS, CCRP, CVSMT, for allowing Veterinary Advantage to
reprint the questionnaire.
In general, how do you rate your pet’s health?
___Excellent.
___Very good.
___Good.
___Fair.
___Poor.
Has your pet ever seen a veterinarian because of joint pain,
stiffness or limping?
___Yes. Details________________________
___No.
Living with pain can lead to changes in behavior. This can be hard to
read in a pet. On average, would you say your pet is (choose one):
___Completely uninterested in their surroundings,
sleeps all the time.
___Will show interest, but no longer comes to greet you.
___Mostly interested in life and food, but reluctant to play.
___Plays only when encouraged, and not for long.
___Has had no change in personality.
Does your pet have pain, swelling, warmth or stiffness in one
or more legs?
___Yes, in one joint.
___Yes, in a few joints.
___Yes, in many joints.
___No.
Has your pet had a joint or bone injury or a surgery?
___Yes. (Describe) ____________________
___No.
___Unsure (e.g., adopted).
Did your pet’s signs begin slowly or suddenly?
___Slowly, over the course of months.
___Suddenly, within days or a few weeks.
In the morning, are the affected areas stiff for more than half
an hour?
___Yes.
___No.
___There’s no morning stiffness.
On any given day, how long does the joint stiffness usually last?
___Less than 30 minutes.
___30 minutes to 1 hour.
___More than 1 hour.
Has the joint pain suddenly gotten worse within the past few
weeks or days?
___Yes.
___No.
Which of the following methods do you use to manage the
pain, swelling or stiffness? (Check all that apply.)
___Physical activity/exercise.
___Nutritional supplements (fish oils, vitamins).
___Weight management.
___Physical therapy/chiropractic/massage
___Cold or hot treatment.
___Prescription medication.
___Over-the-counter joint supplements.
___Other (please specify): _________________
___None of the above.
Which over-the-counter medication and/or joint supplements
do you currently use? (Check all that apply.)
___Aspirin.
___Glucosamine human medication
(brand)________________
___Veterinary joint supplement (brand)_______________
___Herbal supplement (brand) ____________________
___Other ______________________
___None of the above
Does your pet have any of the following conditions?
(Check all that apply.)
___Kidney disease.
___Liver disease.
___Lung disease.
___Cardiovascular disease.
___Skin disease.
___Active infection.
___Bladder problems.
___Other.
___None of the above.
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63
»» Trends
Heartworm diagnosed by
75 percent of veterinarians
Preventives identified as key to stemming incidence
Three out of four veterinarians in the
Trends and factors
United States diagnosed patients with heartworm in 2013,
and heartworm-positive pets were reported in every state
in the country, according to the latest Heartworm Incidence
Survey conducted by the American Heartworm Society. And
while weather conditions favorable to mosquito proliferation
and transport of infected dogs were viewed as contributing
factors, client compliance in giving heartworm preventives
was identified as key in reducing incidence.
Veterinarians from the Gulf and Mississippi Delta states reported the highest incidence rates of heartworm disease in
dogs in the country, but relatively high rates were also noted
in areas less well known for heartworm risk. These included
the Upper Midwest (especially Michigan, Illinois, Indiana and
Ohio), and the western states of Arizona and California.
Sixty percent of veterinarians said that the incidence of
heartworm disease in their practice areas had held steady since
the last AHS survey was conducted three years ago. A roughly
equal proportion of veterinarians said that incidence was up (19
percent) and down (21 percent) in their practice areas.
One-third of veterinarians stated that heartworm is either a significant disease problem (18 percent) or one of
the most serious diseases affecting their patients (15 percent). Just over half reported they see heartworm cases
“occasionally,” while only 13 percent said they never see
heartworm-positive patients.
Top ten states
The top ten states in average rate of heartwormpositive cases/clinic in 2013 were:
1. Alabama.
2. Louisiana.
3. Mississippi.
4. Texas.
5. Arkansas.
6. South Carolina.
7. North Carolina.
8-9. Tennessee and
Georgia (tie).
10. Florida.
The AHS survey has been conducted every three years
since 2001 in order to track trends in heartworm incidence and
inform the veterinary profession and public about the need for
heartworm prevention. The latest survey, which was fielded in
March 2014, represented 2013 testing data from 3.5 million
patients from more than 4,300 veterinary clinics and shelters.
“Our survey determined that heartworm disease continues to be widespread in many parts of the country,” said AHS
president Stephen Jones, DVM, in a statement. “The silver
lining to this unwelcome news is that a simple solution is in
the hands of veterinarians and pet owners: getting more pet
owners to give their pets heartworm preventives year-round.”
The Society recommends heartworm prevention 12 months
a year and heartworm testing once a year. Seventy-two
percent of veterinarians surveyed said they follow the AHS
guidelines for prevention, testing and treatment.
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Veterinarians who witnessed an upward or downward trend
in heartworm disease reported on multiple factors related
to those trends:
• Poor compliance by clients, defined as not administering preventives year-round or skipping doses, was the
most common factor (61 percent) cited by veterinarians who witnessed an upward trend. An influx of
infected rescue dogs to local areas was also noted by
approximately 40 percent of veterinarians in this group.
• Heartworm preventive lack of efficacy was not considered
a major factor. Among the 19 percent of veterinarians who
reported that heartworm incidence was up, less than
6 percent of these cited lack of efficiency as a factor.
• Among veterinarians who noted a downward trend in
heartworm incidence, the leading reason given was
more pet owners administering preventives (74 percent),
followed by improved compliance (63 percent).
EVERY DOG,
EVERYWHERE,
deserves affordable
heartworm protection.
IVERHART MAX® (ivermectin/pyrantel pamoate/praziquantel)
Chewable Tablets help your clients keep more dogs protected.
Share the benefits of IVERHART MAX Chewable Tablets with your clients.
• Proven active ingredients used by veterinarians for years
• A more cost-effective option than comparable heartworm preventives
that do not control tapeworms1
• Four convenient tablet sizes including an option for toy breeds
• A satisfaction guarantee that veterinarians and their clients can be confident in
TALK TO VETERINARIANS about IVERHART MAX
Chewable Tablets and help protect more dogs today.
All dogs should be tested for heartworm infection before starting a preventive program with IVERHART MAX
Chewable Tablets. Use with caution in sick, debilitated, or underweight animals and dogs weighing less than
10 lbs. For oral use in dogs only. The safe use of this drug has not been evaluated in pregnant or lactating
bitches. Self-limiting adverse reactions including lethargy, limpness, salivation, shaking, diarrhea, decreased
appetite, licking lips, and belching were reported between 20 minutes and 72 hours following treatment.
91 of this publication. For full product
See brief summary of safety and effectiveness on page XX
insert, call 800-338-3659 or go to virbacvet.com.
Reference: 1. Brakke Consulting, Inc. Market Research Survey, December 2013.
© 2014 Virbac Corporation. All Rights Reserved. IVERHART MAX is a registered trademark of Virbac Corporation in the US. 7/14 14846
»» Trends
Managing Expectations
Practice managers discuss the future of veterinary medicine
What are newly certified veterinary practice managers thinking about their
future and that of veterinary medicine? Veterinary Advantage asked that question of several managers who
recently earned the Certified Veterinary Practice Manager (CVPM) designation through the Veterinary Hospital
Managers Association. Following are edited responses from four.
Trisha Jones, CVPM, hospital administrator, Raintree
Veterinary Center and Olympia Pet Emergency,
Hoquiam, Wash.
Veterinary Advantage: How long have you been in veterinary medicine?
Trisha Jones: Since June 1999.
Veterinary Advantage: What are the greatest challenge(s) facing you and the veterinary
profession in the years ahead?
Jones: My greatest challenge will be to continue to grow
with the industry and help my team understand the changes we need to make to practice better medicine, increase
client service compliance, and keep the business healthy.
These are particular challenges that all hospital managers
face as we want our hospitals to grow and provide the
best care to our patients. A challenge for the profession is
to help clients better understand why higher quality medicine is best for their pets. Often our recommendations are
more than the pet owner would like to spend in a visit.
We are continually looking for new ways to make great
pet healthcare affordable to our clients and hospital. It is
challenging to offer top-of-the-line medicine and keep the
hospital profitable to industry standards.
Veterinary Advantage: What are the greatest opportunities
for you and the veterinary profession?
Jones: There are opportunities to help my team grow with
so much education available. I think organizations such as
AAHA, VHMA and IDEXX (and there are many more) are extremely beneficial to the hospital’s growth. They provide
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us with many tools. The challenges we face with pet owner
compliance are constantly being researched, and the
industry provides us with tools to try to make the situation better.
I think new programs like “Fear Free” and becoming a Cat
Friendly Practice are big opportunities too. The more we show
pet owners we truly care, the more compliance we will gain.
Veterinary Advantage: What are the practice manager’s
expectations of veterinary distribution reps? How can reps
be of value to practice managers and veterinary hospitals?
Jones: I have some fantastic reps that we work with at both
hospitals. I think it is very beneficial when the vendors listen
to our needs to make ordering streamlined and more costeffective. I have a particular MWI rep that I can ask for help
pricing, searching for equipment or any type of inventory
our hospital needs; he is very quick to respond. That is huge
time-saver for me as the manager. Also, the education they
provide for products and services is enormously valuable.
When we bring in a new product, or are looking at a new
product or equipment, I want my entire team engaged, and
team training is an important piece of that.
Tiffany Colton CVT, BASVT, CVPM, operations manager,
Oakhurst Veterinary Hospital, Seminole, Fla.
Veterinary Advantage: How long have you been in veterinary medicine?
Tiffany Colton: Fourteen years.
Veterinary Advantage: Your responsibilities at Oakhurst?
Colton: I oversee the “operations” side. I do inventory, staff scheduling, chart reviews,
training protocols, marketing, social media, monthly promos, community involvement,
mentor for interns and several other tasks.
Veterinary Advantage: What are
the greatest challenge(s) facing you
and the veterinary profession in the
years ahead?
Colton: I think the biggest challenge is trying to keep services offered at an affordable rate for clients while still managing to grow
profit for the hospital. We continue
to provide the best and most current medicine that we can for our
patients, but unfortunately, costs
continue to grow as well. Personally, my biggest challenge is that
I want to continue to learn new
things in the business side of
veterinary medicine.
Veterinary Advantage: What are
the greatest opportunities for you
and the veterinary profession?
Colton: There is always an opportunity to grow. There are always new
services that can be added, new
medications being introduced to the
market, and new products that may
benefit our patients. Veterinary medicine, like human medicine, is always
changing and developing.
Veterinary Advantage: What are
the practice manager’s expectations
“I personally appreciate it when a
rep lets me know about a similar
product that may be more costeffective than a product that I
order frequently, or when they
have ideas that may help lower our
cost of sales. I like to feel that they
are ‘connected’ with our practice
instead of just seeing us as a
‘weekly order.’”
– Tiffany Colton CVT, BASVT, CVPM, operations manager,
Oakhurst Veterinary Hospital, Seminole, Fla.
of veterinary distribution reps? How can reps be of value to practice managers
and veterinary hospitals?
Colton: We want the reps to be honest with us. We like to have information on
the most current changes to medications, products, diets, etc. We appreciate
being told ahead of time if a product will be on backorder, short supply or a
price increase. We like the reps who want to help build staff morale and contribute things to our staff. I personally appreciate it when a rep lets me know
about a similar product that may be more cost-effective than a product that
I order frequently, or when they have ideas that may help lower our cost of
sales. I like to feel that they are “connected” with our practice instead of just
seeing us as a “weekly order.”
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
67
»» Trends
Eric Young, CVPM, practice manager, Minooka (Ill.)
Animal Hospital
Veterinary Advantage: How long have you been in veterinary medicine?
Eric Young: Eight years as a manager. Before that, I worked at an animal shelter while in
college for four years.
Veterinary Advantage: What are the greatest challenge(s) facing you and the veterinary
profession in the years ahead?
“Our expectations of the reps are to keep
us informed and educated on current and
new products that are offered by their
company, and be our advocates for the
challenge of astronomical price increases
that sometimes occur.”
Veterinary Advantage: What are
the greatest opportunities?
Young: I think the greatest opportunities lie in the potential to take advantage of advances in technology,
veterinary equipment, and medical
abilities and techniques. Veterinary Advantage: What are the
practice manager’s expectations of
veterinary distribution reps? How can
reps be of value to practice managers and veterinary hospitals?
Young: Our expectations of the reps are to keep us informed
and educated on current and new products that are offered
by their company, and be our advocates for the challenge
of astronomical price increases that sometimes occur. They
can truly be of value by providing us with tools to educate
and reward staff, and ensure competitive pricing.
– Kipp Wingo, DVM, CVPM
Young: The greatest challenge facing me is to keep
up with the technological advances and improvements
of the rapidly changing veterinary industry. I think the
greatest challenge facing the veterinary profession as a
whole is to keep the industry growth in line with increasing costs of pharmaceuticals, veterinary equipment, and
rising inflation.
Kipp Wingo, DVM, CVPM
Veterinary Advantage: As a DVM, why did you decide to pursue certification in
practice management?
Kipp Wingo: I received excellent training in veterinary medicine and surgery from Texas A&M University. However, I was not prepared/trained to run a business. After 20+
years as a mediocre entrepreneur, the changing world rather forced me to study and,
hopefully, improve. I came to believe that a veterinary entrepreneur has two equal job
descriptions. The emphasis must be placed on “equal,” meaning that superior patient
care is EQUAL to superior business practices management. In addition, the radical and
ongoing changes in the world of business dictate either I learn to lead and manage effectively, or face potential failure. I will
not accept failure. I also found the process of preparing for CVPM certification quite enjoyable.
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Veterinary Advantage: What are the greatest challenge(s)
facing you and the veterinary profession in the
years ahead?
Wingo: In my opinion the veterinary entrepreneur faces
several challenges:
The income we’ve all enjoyed from our pharmacy is
shrinking and will continue to do so. We face the “WalMart” bill, Internet pharmacies, low-cost generics from
chain pharmacies, big-box retail outlets selling veterinary
products, etc. Our clients now view veterinary products as a
commodity, and therefore those products have nothing to do
with loyalty. The veterinary entrepreneur must adjust strategies to deal with this loss.
Increasing competition from the “not-for-profit” and
“low-cost” spay and neuter clinics, parking lot vaccine clinics, practices in pet stores. Most clients equate all services
as equal, therefore, they very often will utilize the lowest
cost service. The challenging economy has also forced the
low-cost spay/neuter clinics to start dispensing veterinary
products. These not-for-profit and low-cost organizations
are threatening income to privately owned, tax-paying, jobcreating veterinary practices.
The biggest challenge faced by the veterinary entrepreneur is the slow recovery from the “Great Recession.”
It is true that the average income of the middle class has
decreased; therefore, there is less discretionary income to
be spent on behalf of pets. We must face the fact that we
are in competition for discretionary or disposable income.
The availability of less discretionary income leads to fewer
patient visits, sticker shock, and product and procedure
price shopping. (This is a driving force for the competition
mentioned above.) To meet this challenge, many practices
have decreased fees or, more often, have delayed increasing fees; or the fee increases have not been sufficient to
keep up with the ever-increasing expenses. Ultimately, the
inevitable sequella is decreased profit. A decrease in profit
leads to many, often insurmountable, challenges. Contrary
to the belief of some, profit is not evil. Profit pays doctors
and supports team salaries, continuing education expenses,
equipment purchases, taxes, etc., etc.
Veterinary Advantage: What are the greatest opportunities?
Wingo: The challenges from the above have lead to many
wonderful opportunities. To protect pharmacy-related income,
the selection of FDA-approved veterinary drugs rather than human generic drugs should be considered. When appropriate,
injectable medications should be offered. Often, even when considering an equivalent drug, one realizes superior results due to
elimination of the need for client compliance. As a benefit, those
products are not available on Internet sites.
If the veterinary entrepreneur is to survive, then more
advanced medical and surgical procedures must be added
to our repertoire. Low-cost spay/neuter/vaccine clinics
are very unlikely to offer cutting edge procedures such as
advanced dental procedures, arthroscopic/laparoscopic
surgery, advanced ultrasonography, alternative medicine,
etc. One must choose a marketable advanced discipline(s),
then train, train and then train more. The attitude should
be, “We must be better (have better skill) than the typical
parking lot practitioner.”
The shrinking economy requires that the veterinary
entrepreneur’s leadership and management abilities be
intensively and continually finely tuned. When one focuses
their studies on leadership and management, opportunities such as improved profit will lead to improved patient
care, a happier client and a happier team – all of which is
a win-win situation.
Veterinary Advantage: What are the practice manager’s
expectations of veterinary distribution reps? How can reps
be of value to practice managers and veterinary hospitals?
Wingo: Sales representatives can be of the most value to practices and practice managers by striving to
achieve a “partnership” with the practice managers. The
relationship should be more of a symbiotic relationship
as opposed to a salesperson/customer relationship. By
helping the practice be profitable, the sales rep and their
company then becomes profitable. Sales reps should
disseminate information (educate). Effective sales reps
should know their practices well enough to inform them
of programs/products that suit the particular and unique
needs of said practice. Visits to the practice should be by
appointment only; otherwise, an unacceptable disruption
of flow will ensue. If the rep has a desire to meet with
a/the doctor, then an appointment should be required.
In other words, don’t simply show up unannounced and
disrupt my work.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
69
»» Partners for Healthy Pets
Words that Work
The best messages about preventive care are simple and to-the-point, says Karyn Gavzer
Karyn Gavzer believes in the power of
consistent, simple messages. She believes that words work.
Gavzer is a veterinary practice management consultant
who has helped industry, associations, and veterinary practices develop marketing and training programs for more
than 20 years. She is the former director of marketing for
the American Veterinary Medical Association, where she
worked with industry on behalf of the AVMA to bring the
first campaigns on heartworm awareness and “Pets Need
Dentistry, Too” to the public.
She currently speaks around the country on behalf of
Partners for Healthy Pets, a collaboration of the American
Veterinary Medical Foundation, AVMA, American Animal
Hospital Association and industry to ensure pets receive
preventive healthcare through regular veterinary visits.
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Her interest in prevention dates back more than 10
years, when the American Animal Hospital Association released “The Path to High Quality Care,” or what came to be
known as the compliance study.
At that time, veterinary products manufacturers challenged practitioners to demonstrate that their clients
were as compliant with preventive-health recommendations as practitioners thought they were. Funded by
industry, the AAHA undertook a medical records study to
find out. It was the first of its kind in veterinary medicine.
Eye-opener
The results were eye-opening for the veterinary community. “It said that we are wildly inconsistent in delivering
preventive healthcare,” she says. While most veterinarians
believed that a high percentage of their clients complied
with their recommendations, in fact, the study showed
many did not.
It was an eye-opener for Gavzer. “That’s when I woke
up and got really passionate about the possibilities of preventive care. There is nothing veterinarians will do to impact the health and well-being of pets more than provide
preventive care.”
She went on the road on AAHA’s behalf to talk to practices about compliance and to challenge them to audit their
medical records to help them see – by the numbers – the
difference between their recommendations about care, and
what their clients were actually doing.
“We talked about setting protocols for care, and suggested those protocols be set up
around preventive measures,” she
says. Those measures would include the number of pets on heartworm preventives and flea/tick preventives, the number of pets who
receive core vaccines, the number
of pets who receive regular dental
check-ups, and more
“Significant progress has been
made,” says Gavzer. But the road
hasn’t been smooth and the work is
not done.
Partners for Healthy Pets provides tools and resources
for practitioners to use to communicate the value and
benefit of preventive care, enhance the veterinary-client
relationship, and improve the overall quality of preventive
healthcare provided for patients. These tools include surveys to help practices gauge their level of client service
and satisfaction; guidelines to implementing AAHA/AVMA
canine and feline preventive healthcare guidelines; tools
to create Internet and social media marketing programs;
training videos and more.
In December 2013, Partners for Healthy Pets launched
a consumer advertising campaign promoting the importance of annual veterinary checkups. TV viewers, magazine
readers, Facebook and Twitter users, and clients bringing
“There is nothing veterinarians
will do to impact the health
and well-being of pets more
than provide preventive care.”
A vision of improved health
“Things came undone in 2008, when the recession
hit,” she says. Veterinarians were practicing excellent
medicine, but client visits dropped. In response, the
veterinary community asked their national associations – AAHA and AVMA – to develop a campaign to
urge pet owners to bring their pets in for regular preventive care – something the dental community had
done successfully three decades earlier. They did so,
with the help of industry partners, and Partners for
Healthy Pets was born.
Led by the AVMA and the AAHA, with support from
industry, Partners for Healthy Pets is a collaborative alliance of over 110 veterinary associations, colleges of
veterinary medicine and animal health companies, all
committed to a vision of improved overall health for pets.
their pets in for veterinary care are now seeing photos of
Henley and Oz – the dog and cat featured in the ads –
with a simple tag: “Special Instructions. Feed daily. Yearly
checkups. Love forever.” The message is simple and consistent: An annual visit to the family vet is as essential as
food and love.
Practices need to get involved
Though it is essential that pet owners get the message, it
won’t happen without the involvement of veterinarians and
their practice teams, says Gavzer.
Studies show that many veterinarians don’t fully buy
into the importance of preventive medicine themselves,
she says. They and their hospital team members fail to do
the things for their own pets that they recommend their
clients do. Many also feel guilty about how much money it
costs to take care of a pet today. “Clients pick up on that
lack of confidence,” she says.
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
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»» Partners for Healthy Pets
Prepaid wellness plans
Prepaid wellness plans offer clients an affordable way to make sure their pets get the
preventive care they need, says veterinary
practice management consultant Karyn Gavzer.
Such plans spell out upfront the preventive care
the pet will need for the next 12 months, and
allow the client to pay for that care in affordable
monthly payments. Most plans include unlimited
office visits, which often is all it takes to get a
hesitant owner, who may be fearful of high bills,
to visit the office regularly.
“It’s a plan that fits the times we live in,” she says.
Even so, annual wellness plans haven’t worked
well in some veterinary medicine. “Some were so
complicated, that the clients didn’t understand
them, and the staff couldn’t explain them. You have
to make them simple, and train staff on how to talk
to clients about them.”
What’s more, some pet owners confuse
wellness plans with insurance, she adds. Again,
the onus is on the veterinary practice to educate
owners. “They need to say, ‘Wellness plans are
great, because you know you will use them; and
insurance is good for those catastrophic events
that you can’t predict.’”
Gavzer has been a proponent of breedspecific wellness plans, that is, plans that take
into account the unique needs of various breeds.
Goldens, for example, are prone to cancer and
dysplasia; other breeds to blindness or Cushing’s.
Veterinarians can usually explain the unique wellness needs of young, adult and senior pets, but
they have an opportunity to take it a step further
and tailor wellness plans by breed. “Practices
that do are giving pet owners something they
can’t get anywhere else,” she says.
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Despite challenges, the message of prevention is taking
hold. Roughly 5,000 practices are participating in the Partners for Healthy Pets campaign, and the number is growing.
Some veterinary schools are opening wellness clinics. “Until
recently, there were no big opportunities for students to acquire those skill sets,” she says.
Distributor sales reps can play a role as well in carrying the
message of prevention, says Gavzer. Some ideas:
• Help practices “re-boot” on Partners for Healthy
Pets. Reps did a good job encouraging practices to
enroll in the earliest days of the campaign. Since
then, the program has introduced its toolbox and
promotional materials. It’s time to re-energize
practices and start encouraging them to use these
tools, says Gavzer.
“Perhaps it’s [illustrating]
an easy way to explain
prevention to a client, or
how to make the ‘call
to action’ to take the
next step in their pet’s
preventive care plan.”
– Karyn Gavzer
•H
elp practices set goals (assuming the rep has
established the kind of relationship that can allow
that to occur); offer training programs associated
with products or equipment that address
preventive care.
• Help them find the “words that work” to talk about
prevention at the front desk, exam room, and
throughout the practice. “Perhaps it’s [illustrating]
an easy way to explain prevention to a client, or how
to make the ‘call to action’ to take the next step in
their pet’s preventive care plan,” says Gavzer.
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»» Sales Meeting
Anesthesia Equipment
Veterinarians are looking to provide safe anesthesia at a reasonable cost.
By understanding the needs of their clinics, sales reps can help them do so.
Each veterinary clinic has a unique set of needs
with respect to the layout and design of its surgical and treatment areas. The right
configuration of anesthesia machines depends on a clinic’s workflow. By knowing
the types of procedures performed, how oxygen will be supplied, how waste gas
will be disposed of, and what monitoring and other peripheral equipment (e.g.,
dental carts) will be used in the care zone, reps can help their customers evaluate
their options.
So, for instance, an anesthesia machine designated primarily for use in a treatment room may need to be used at several treatment tables. If the oxygen is centrally supplied through outlets, and hoses and floor space are at a premium, then a
compact tabletop unit may best meet that clinic’s needs. Or, if oxygen is supplied
by a small e-tank, a rolling stand with a single or double yoke block to hold the
oxygen tanks may be the answer.
Improvements in
quality, enhanced
patient safety
Today’s anesthesia machines are better
and safer than ever before. Enhancements in technology may include:
• A negative pressure relieve
valve, which provides room
oxygen to the patient when, in
rare cases, the oxygen source
is completely depleted.
• Occlusion valves, which
have made it possible for
veterinarians to close the APL
valve (used to manage excess
waste gas) with the touch of
a button. In the past, they had
to turn a dial to close the valve
and then remember to open
it to avoid over-pressurizing
the machine and putting the
patient at risk.
There have been improvements
in anesthetic protocol as well, and
more veterinarians have come to
realize the importance of monitoring capnography during a procedure to determine the level of
carbon monoxide in the patient’s
expired breath.
Still, a number of factors, such
as the condition of the anesthesia
equipment, the staff’s expertise or
the age and condition of the patient,
can contribute to the degree of risk
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Introducing Alfaxan (alfaxalone 10 mg/mL)
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your practice, Alfaxan® helps to support a stress-free anesthetic procedure for clinic staff as well as repeatable, reliable induction,
transition, maintenance and recovery for their patients. That’s why it has become the induction agent of choice for many veterinarians
around the world. It is one small step that you can take to introduce a new level of care into your anesthesia protocols.
Contact your distributor sales representative or Jurox at 1-844-ALFAXAN
to learn how your practice can benefit from this innovation in anesthesia.
INDICATIONS: Alfaxan® is indicated for the induction and maintenance of anesthesia and for induction of anesthesia followed by maintenance with an inhalant anesthetic, in cats and dogs.
Important Alfaxan® Risk Information: Warnings, Precautions and Contraindications: When using alfaxalone, patients should be continuously monitored, and facilities for the maintenance of a patent airway, artificial ventilation, and
oxygen supplementation must be immediately available. Alfaxan® does not contain an antimicrobial preservative. Do not use if contamination is suspected. Strict aseptic techniques must be maintained because the vehicle is capable of
supporting the rapid growth of microorganisms. Careful monitoring of the patient is necessary due to possibility of rapid arousal. Alfaxan® is contraindicated in cats and dogs with a known sensitivity to alfaxalone or its components, or when
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»» Sales Meeting
involved in sedating animals. Veterinarians can reduce
the level of risk to the patient by developing a patientspecific anesthetic protocol, as well as providing appropriate vital signs monitoring. They can also minimize
post-anesthetic risks by monitoring patients with a vital
signs monitor designed to measure parameters such as
blood pressure, temperature and oxygen saturation in
the blood. Other products that can aid veterinarians in
their patients’ recovery include fluid pumps and patient
warming devices.
medical tape is not sufficient to prevent waste gas expired by the patient from leaking into the clinic.
A return on investment
As important as it is to replace outdated anesthesia
equipment, some veterinarians may be reluctant to
make the investment. Sometimes, they may not recognize the increased risk the outdated equipment is placing on the patients and staff. In this case, sales reps
can help the clinician identify unnecessary expenses
his or her practice is incurring due
to wasted oxygen or anesthetic
agent, or some other factor. Reps
can also focus on the return on
investment associated with new
anesthesia equipment.
Similarly, when a veterinarian
is considering expanding his or her
clinic, sales reps can discuss the potential for increased revenue that a
new anesthesia machine could bring.
The ability to perform more procedures means additional revenue for
the clinic.
There have been improvements in
anesthetic protocol as well, and more
veterinarians have come to realize the
importance of monitoring capnography
during a procedure to determine
the level of carbon monoxide in the
patient’s expired breath.
Although cost is almost always a factor for your
customers, when it comes to selecting quality anesthesia equipment, veterinarians get what they pay for.
Machines range in price from $2,100 to $6,800, depending on the types of accessories needed and the
level of sophistication required for measuring oxygen
and anesthetic agents. Higher priced units generally are
constructed of high quality materials that last longer
and are less likely to leak, according to experts. And,
they often include safety features, technical support
and compliance to International Organization for Standardization (ISO) manufacturing standards.
Price aside, a well-maintained machine can last many
years. Still, when veterinarians continue to use worn or
outdated anesthesia equipment, they risk the safety of
their patients and staff. It’s important for them to know
that covering holes in breathing circuits with porous
Some good probing questions reps may ask their veterinarian customers to initiate a discussion about anesthesia
equipment include the following:
• “Doctor, what types of procedures do you
typically perform?”
• “Do you find yourself doing more or less of these
procedures? Why is that?”
• “Have you noticed abnormally high oxygen or anesthetic agent use? If so, would you like me to perform
a leak test on your anesthesia equipment?”
Even if a leak test does not reveal issues with the veterinarian’s anesthesia equipment, the rep has proven himself
or herself that much more valuable to the clinic. What better
opportunity than to help customers improve the safety of
their patients and staff, while generating additional revenue
for their clinic?
Editor’s note: Veterinary Advantage Magazine would like to thank Midmark Corp. for its assistance with this piece.
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»» Equine
By Jennifer Ryan
Cell by Cell Recovery
Equine veterinarians are increasingly using stem-cell
therapy to help repair bone, ligament and tendon injuries
Preston Hickman, DVM, has tried several different
from the tail head area. The sample
will be processed to concentrate the
stem cell technologies in some of his performance horse patients from bone marregenerative cells. Then, the horse will
row derived stem cells to various methods of processing adipose (fat) into stem
be sedated again while the stem cells
cells. However, he wasn’t overly impressed with the results.
are administered to the affected areas.
There
are
two
avenues
for veterinarians wanting to in“We thought it would open up new frontiers by utilizing
clude stem-cell therapies in their equine practice: They can
regenerative medicine, but after my first few stem cell treatinvest in the equipment and individual kits to harvest, isolate
ments using available processes, I didn’t see the dramatic
and activate the stem cells; or they can harvest adipose tisimprovement that I was expecting,” recalls Dr. Hickman,
sue and send the samples to a central lab for stem cells to
owner of Wichita Equine and Sports Medicine in Wichita,
be isolated. Therapeutic doses are then mailed back.
Kan. “I was a skeptic.”
In either case, the horse’s
Then, Dr. Hickman encountered Zoe, an advanced level
own cells must be collected.
dressage horse with a two-year history of lameness and
Then, a patient-specific theraa fractured sesimoid. After many other conventional treatpy must be developed. The rements failed, he again turned to stem cells. This time he
sulting therapy is best targeted
tried a different method from MediVet-America that used
for tendons, ligaments and
adipose – or fat – adult stem cells collected from the patient.
bone fractures. However, re“About 50 days later, she was sound and the owner was back
search into laminitis treatment
on the horse,” he says. “I thought, ‘this has got to be a fluke.’”
is also being pursued and iniNearly two years later, Dr. Hickman has treated some 85
Jeremy Delk
tially appears to be effective.
horses with this type of activated stem-cell therapy and has
Some horses receiving stem cell therapy are perforseen a positive response in every case. It’s been enough to
mance horses. Unlike some drugs, there are no restrictions
convince him of the value of the technology.
by competitive organizations on using stem-cell therapy. It’s
not considered a performance enhancement to repurpose
The process
the body’s own cells.
Stem cells are essentially undifferentiated cells waiting to turn
into specific cells such as skin, fat, muscle, bone or cartilage.
Adult stem cells (such as from fat) can differentiate into most
The investment
cell lines with proper stimulation. Only adult stem cells from
MediVet America, LLC, has developed a kit to allow veterithe horse being treated are used in equine stem cell therapies.
narians to develop therapies in their own clinics. The comIt takes a large number of adult stem cells to help heal
pany works with Henry Schein Inc. and Patterson Veterinary
an injury, which is why fat cells are often used. Fat has sevSupply to distribute kits to veterinarians across the country.
eral hundred times higher concentrations of stem cells than
“We have developed the technology to allow the veteribone marrow or blood and is much less invasive than bone
narian to harvest, isolate cells and activate these dormant
marrow aspiration.
cells so they can re-introduce back into the patient, in real
To collect fat stem cells, the veterinarian will sedate the
time promoting repair and healthier joint environments,”
horse and collect approximately two to four tablespoons of
says Jeremy Delk, CEO of MediVet, based in Nicholasville,
fat (40 grams) using liposuction or surgical incision, usually
Ky. “By isolating, activating and re-injecting the body’s own
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The Vet-Advantage
Price Index
Helping Veterinarians
Optimize Retail Pricing
This app helps animal hospitals properly price their retail
products and recapture important, high margin business
that may have been lost to online retailers and big box
stores. It allows users to:
• Evaluate pricing strategy and
find the optimum price points
• Look at historical pricing data
on the largest retail SKUs
• Set margins or margin dollars
with a built-in calculator
• Improve retailing practices with
weekly tips on best practices
This app takes the guesswork out of the retail business so
vets can stay in the game and better manage this part of
their business. It can be found in the Apple App Store at a
price of $25.
Vet-Advantage takes no role in establishing any of these prices and the
information is representative of the market only as a reflection of products that
are available in publicly published Internet pricing. Volume discounts from
certain sources may/may not be represented depending on how such
discounts are presented to search engines used to gather consumer pricing.
Now available at the app store
»» Equine
repair properties, we are just aiding in the fight of degeneration vs regeneration, by isolating these cells in high numbers and maintaining high viability.”
Available since 2010, the MediVet kit includes enzymes
and consumables. These kits allow an in-clinic solution for
nearly half the cost of utilizing laboratory processing through
the mail. The equipment offers a small footprint with minimal investment and on-site installation.
“We wanted to be able to make this more effective, but
more commercially viable and affordable,” Delk says. “What
we try to do is take a conservative approach. Stem cells
are not a panacea, although when good case selection is
practiced they can offer a truly revolutionary tool in the veterinary tool box. The future is very bright, and we continue
to draw from the research.”
The future
Current commercial equine therapies rely on adult stem
cells derived from either bone marrow or adipose tissue.
Sarah Reed, Ph.D., assistant professor of equine science at
the University of Connecticut, is researching how umbilical
cord stem cells may work in future therapies.
Research shows umbilical cord stem cells are more like
embryonic stem cells, which indicates their uses for equine
therapies can be broader than adult stem cells. Specifically,
future therapies might be able to recreate tendon cells and
even produce collagen.
“That’s one of the limitations with repairing tendon injuries,” Reed says. “When it repairs, it doesn’t repair like
new. We did some comparisons and found umbilical cord
stem cells really do differentiate more rapidly and tend
Key points
Robert J. Harman, DVM
• Adult stem cells can differentiate into many cell lines.
• Only adult stem cells are used safely in equine therapies.
• The horse’s own cells must be collected for a patient-specific therapy.
• Commercial therapy options rely on stem cells from adipose, or fat, tissue.
• Stem cell therapy is best targeted for tendons, ligaments and bone fractures.
• Research is progressing for the use of adult stem cells into many other equine
diseases and injuries.
Vet-Stem, Inc. also relies on adipose tissue to collect stem
cells. In this model, the veterinarian collects the fat sample and
then sends it to a central laboratory. The company returns therapeutic doses via FedEx within 48 hours of sample collection.
There is less investment in equipment and training in this
method, says Robert J. Harman, DVM, founder and CEO of the
company, which is based in Poway, Calif. Vet-Stem also stores
extra doses in case additional treatments are needed in the future.
“It’s an exciting area that started 10 years ago, and it
will be exciting to see where it will go in five more years,”
Dr. Harman says. “I started in horses and at that time you
couldn’t repair these injuries. You just kept getting scar tissue. When I saw the research on stem cells on the human
side, it made sense to me as a natural healing mode.”
Vet-Stem works with Animal Health International, Inc.,
to reach equine veterinarians. Distributors knowledgeable
about the technology will be better positioned to grow as the
technology is adopted, Dr. Harman says.
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to produce higher amounts of collagen, suggesting they
might be a better option.”
However, drawbacks to using umbilical cord stem cells
include access to the source material. The horse’s own umbilical cord must be collected during foaling, which would
be years in advance of when an injury might occur.
Despite research and commercial adoption, the specific
mechanism by which adult or embryonic stem cells work
still isn’t known.
“We do know that the presence of these cells causes
a slight immune response that attracts and secretes
growth factors to the area, which tends to promote healing and increase cellular activity,” says Reed. “We don’t
know what those growth factors are. What we do know is
that when we inject the stem cell into the area, regeneration is improved, but it’s a big black box. We don’t have
a good idea what actually these cells are doing and how
they do it.”
COMMUNITY
People
A passion followed
Karen McGarrah uses the skills – and passion – she learned
as a healthcare supply chain executive to help rescue horses
Supply chain management is in her blood. So are
horses. That could explain why, following a 32-year career in healthcare supply chain management, Karen McGarrah now spends most days working with
rescue horses in southern California.
Born in Columbus, Ga., McGarrah’s father was a purchasing agent for a large
construction company that built dams in the Southeast. The family moved regularly until Karen reached the fourth grade, when they settled down in Alabama.
She got her first full-time job at age 12 in order to pay for the upkeep of her
horse. “My dad borrowed my first horse to see if I would take care of it,” she
says. “He ended up buying it for me six months later. The rest is history.”
Healthcare career
McGarrah joined Baptist Health System in Birmingham in May 1981, as director
of materials management for the hospital system’s Montclair facility.
“Montclair was one of only four facilities in Baptist Health System at the
time, and none of them had an internal materials management system,”
Karen McGarrah and Marigold.
she says. “I was the first person
hired in the Baptist system. It was
my role to provide internal structure and establish the foundation of materials management for
Baptist to build the future internal
materials system. This included
creating an infrastructure of communications and a systemic structure of internal partnerships within
the corporate headquarters.”
Over the years, Baptist expanded
in size, encompassing many more
hospitals. McGarrah grew with the
organization as well, ultimately becoming vice president of shared
services. “We had a great time at
Baptist,” she says today. “We were
cutting edge, doing things others
weren’t doing,” including innovative work with consultants medical/surgical distributors, and group
purchasing organizations.
“I am most proud of being the
leader of a seasoned team of veterans who were recognized nationally
for their innovation,” she says. “We
had the full support of our CEO and
senior vice president, and all of our
accomplishments were as a team.
We were the industry leaders of surgical innovations in addition to materials creation and functional areas.
We established a company doing
business locally for sterilized packs.
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COMMUNITY
People
Our laundry accommodated laundry for other facilities. We
had an integumentary nurse for all our facilities. We had a
PhD-prepared nurse who conducted all our clinical studies.
We had a five-year strategic plan that was reviewed annually. We had so many things to be proud of as a team.”
Supplier side of healthcare
In January 1997, McGarrah jumped from the provider to the
supplier side of the industry, joining IntePlex, a consulting
company for Bergen Brunswig Corp., a national pharmaceutical and medical distributor. (The company’s medical unit
was acquired by Cardinal Health in 2000. One year later,
Bergen Brunswig Corp., the pharmaceutical wholesaler,
merged with AmeriSource Health Corp. to form AmerisourceBergen Corp.)
Preparing red meal buckets.
IntePlex’s mission was to create a “one-stop shop”
for hospitals, that is, a vendor that could bring both
pharmaceuticals and medical supplies and equipment
(product lines which, in the hospital supply chain, are
traditionally carried by separate distributors).
In 2000, McGarrah made another big career move, joining Broadlane, a healthcare group purchasing organization
(acquired by MedAssets Inc. in 2010). “Group purchasing
was something I had not done in the past and was the missing link in my resume. I felt it would be a great opportunity for
me to learn the last piece of my total trade of supply chain.”
In 2009, she became senior regional director for MedAssets Inc., a national group purchasing organization.
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As such, she worked with senior vice presidents, regional
directors of materials management and buyers, C-level
executives, physician executives and others to promote
use of the group purchasing contract portfolio and to
drive savings for hospital participants. Then in September
2013, she switched gears.
The switch
While working for MedAssets (and living in Long
Beach, Calif.), McGarrah began volunteering at Red
Bucket Equine Rescue, which at the time was located
in Huntington Beach.
A 501(c) 3 corporation, Red Bucket was founded in 2009,
one year after founder Susan Peirce rescued a starving
thoroughbred filly from a run-down stable, whose manager
stopped feeding her since he wasn’t
being paid. Peirce bought 50 pounds
of carrots and a red bucket, and fed
the filly – whom she named Harlow –
to health. In January 2009, she went
to the same stable and found nine
additional abandoned horses, one
of whom subsequently died. Soon
thereafter, she formed the non-profit
organization. By May 2009, the rescue had grown from 9 horses to 71.
As of May 2014, Red Bucket’s volunteer team had saved 249 horses and
placed 131 of them in new homes.
In September 2013, McGarrah made one more major
life/career decision. “I left healthcare because I decided it
was time for me to spend my life serving our Red Bucket
horses, which has become my passion,” she says. “Volunteering is very rewarding, and I wanted to spend more time
with the horses that I love so much.” (Roughly two years
ago, Red Bucket moved to Chino Hills. McGarrah followed,
and now lives about five minutes from the rescue.)
Though she had left Alabama, years earlier, she never
really left horses. In fact, she still owns a 60-acre farm in
her home state, with 10 horses on it. “I have never been
without a horse since I was a kid,” she says. She still gets
back to the ranch three or four times a year.
“Although I am in a volunteer position, I spend more time
at the ranch than I spent on the job, and I spent a great
deal more than 40 hours a week working,” she says. “I
am at the ranch seven days a week working with the
horses and volunteers. I am probably in the best health of
my life. The ranch is 4.3 acres, and I walk it from end to
end many times per day.
“The horses we serve come to us abused by humans and
have no reason to ever trust humans again. The mission of
Red Bucket is ‘To save and rehabilitate horses, restore their
trust in humankind, and find them safe, loving, permanent,
adoptive homes.’ This is what we do every day. What is more
worthy of my time and talent than this mission in life?”
As volunteer ranch coordinator, McGarrah manages all
ranch maintenance and projects, including:
• Managing the volunteers for special ranch projects, stable service day, ranch care, cleaning of
feed buckets, polo wraps, stall pipes, Sunday stall
cleaning, water buckets, store rooms, painting, and
overall ranch repair.
• Managing vendors and volunteer specialists, such
as electricians, plumbers and ranch care donations.
• Helping keep the ranch clean.
• Helping repair items for horses.
• Supporting the overall maintenance, bedding, water
bowls, and safety of the Red Bucket horse stalls.
• Overseeing removal of manure in an
environmentally friendly way.
• Bringing the barn up to fire safety codes.
Volunteers groom and turn out each horse every day,
says McGarrah. The horses are fed according to their individual health plans, each out of his or her own red bucket,
with his or her name on it.
Some volunteers ride the horses, others simply choose
to clean buckets, prepare hay or prepare meals. And everyone works to keep Red Bucket clean. “All you have to
do is walk on our ranch to see how healthy our horses
are,” she says. “The first thing people who come here say
is, ‘This is the cleanest place I’ve ever seen.’”
COMMUNITY
Learning to trust
Three-part model
of rescue
Rescuing slaughter-bound, starving and abused
horses is just Part 1 of the mission of Chino Hills,
Calif.-based Red Bucket Equine Rescue.
“The second part of our mission is where the
real work occurs,” says Karen McGarrah, volunteer ranch coordinator. “Our horses are carefully assessed, rehabilitated, and trained. They
have been victims of unspeakable abuse, and at
Red Bucket, they receive the time they need to
recover and regain confidence in mankind, and in
themselves.” The average weight gain for a Red
Bucket rescued horse is 300 pounds, she adds.
And Part 3? “When they are ready, the horses
are matched with a suitable adopter, and the
horse and adopter continue to receive field support after the horse goes home. We continue to
support our adopters and provide ongoing training
and counsel, removing any barriers to the horse
staying in their new home.
“Because of the strength of our program, and
our commitment, we have a very low return rate,
and are developing a strong reputation in the
equine and animal welfare communities.”
Most important, each volunteer is trained in the Red
Bucket Way, which stresses consistency in how people
interact with the horses. “A horse who has been abused
has to be treated and touched the same way every day,”
she says. “Every time a volunteer walks in, the horse anticipates how it will be touched, because of the abuse
factor. The animal has expectations that aren’t good, so
we want to be sure they’re treated the same way every
time we walk into the stall.”
Supply chain skills
And yes, McGarrah is able to call upon the skills she picked
up during her healthcare supply chain career. “The art of
negotiation, skills of communication, leadership, integrity
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COMMUNITY
in dealing with employees and vendors are all skills I have
brought with me to Red Bucket,” she says. “Being a 501(c)3
is extremely difficult in hard economic times, such as we
are having today. I am using all of my skills to help the
horses I love to recover from abuse through better health,
better veterinary care, and healthier lives for the future.
“I have become engaged more and more with the
purchasing of equipment and supplies,” she continues.
“We are doing everything within our power to be prudent
stewards of the funds being donated to Red Bucket.”
More than 98 percent of all donations are used to take
care of Red Bucket horses. The remainder is salary for
Red Bucket’s lone full-time employee – the trainer.
One thing that Red Bucket lacks is a full-time veterinarian.
“One of our priorities is to raise the proper funding to have an
in-house veterinarian,” she says. That said, several veterinarians volunteer their time, talent and supplies to the rescue.
“We are so very thankful for this. We know we can call and
discuss issues as they arise. They are available to us at moment’s notice. We are blessed with our veterinarians, who
believe in what we are doing and help us help the horses.”
“Nearly every five minutes, an American horse in good
condition is brutally slaughtered for human consumption,” says
McGarrah. “If they’re not slaughtered, the horses are abandoned, starved, savagely abused or are left to die painful deaths.
“This is why we work so hard in using every penny of
our money wisely.”
Red Bucket Equine Rescue gladly seeks donations to continue its work. Visit its website at www.
redbucketrescue.org.
Volunteering at Red Bucket
There’s plenty of work to do at Red Bucket Equine Rescue. “Red Bucket has something for everyone, and we need
many special talents and skills to help the horses,” says volunteer ranch coordinator Karen McGarrah. Examples of
volunteer responsibilities:
• Feed crew: Feeds daily and removes blankets in the winter. The horse receives their bucket as a supplemental
feeding during nighttime wellness checks. Diets are prepared based on a horse’s individual needs and are assessed
and adjusted throughout their stay at Red Bucket.
• Horse care: A dedicated team of veterinarians, farriers, horse transport and equine specialists donate their time,
skills, expertise, and trade to address the unique needs of abused and abandoned horses. In addition volunteers
groom the horses daily and ensure they get exercise, and make sure their individual health care and daily enrichment needs are met.
• Apparel: Volunteers organize, sell, and promote Red Bucket apparel.
• Fundraising.
• Stall and ranch care: The stall care team manages the overall cleaning, maintenance, bedding, water bowls, and
safety of the Red Bucket horses.
• Newsletter: A team of volunteers write, edit, coordinate, and publish the monthly newsletter.
• Marketing: This team protects and promotes the Red Bucket brand.
• Communication: Internal and external communication including writing, finding sources to share horse’s stories,
editing, and fundraising.
• Finance: This team protects ensures that Red Bucket has the funds to care for the horses and the ranch.
• Event coordination.
• Recycling.
• Visitor center and tours.
• Photographers: Horses are videoed and photographed for the Red Bucket calendar, website, media events, promotional materials, “Because of You campaign,” etc.
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AAFP video series intended
to enhance feline quality-of-care
The American Association of Feline Practitioners has launched
an eight-part video series offering a glimpse into Cat Friendly
Practices, and more specifically, how such practices are able
to provide the highest quality of care while showing owners a
commitment to address the distinct health needs and special
considerations of feline patients.
According to the Bayer Veterinary Care Usage Study
III, 83 percent of cats are taken to the veterinarian in the
first year of ownership, yet over half of them don’t return,
according to the association. Currently, more than 1,400
practices have started AAFP’s Cat Friendly Practice program, and more than 600 have been designated.
The videos are intended to educate veterinary teams
on becoming cat-friendly, better understanding cats, tips
to incorporate into your feline appointments, and how to
educate cat owners on the importance of routine veterinary care. The series begins with a brief overview, and
specific techniques and recommendations are detailed in
the remainder of the videos:
Part 1 — How to Make Feline Friendly Changes.
Part 2 — Understanding Feline Behavior.
Part 3 — Understanding & Preparing for the
Feline Veterinary Visit.
Part 4 — Being Flexible During Feline Examination.
Part 5 — Enhancing the Feline Examination.
Part 6 — Feline Friendly Handling during Veterinary Visits.
Part 7 — Doing Procedures in the Examination Room.
Part 8 — Now You Can Begin to Make Changes in Your Practice.
Find more information at www.catvets.com
Pet owners confuse flea/tick protection methods
Sixty-three percent of people who purchased flea control
products or flea control/heartworm preventive combo products that are not effective against ticks, actually believe that
the products do kill ticks, according to the results of a pet
owner survey from Merial. Thirty percent of people who say
they would only purchase a product that kills ticks actually
purchased products that are not effective against ticks.
“Fleas and ticks are two very different parasites,”
said Dr. Michael Murray, DVM, Merial, was quoted as
saying. “Products that kill fleas don’t automatically kill
COMMUNITY
News
disease-carrying ticks too. You have to read the label to
see what parasites a product is effective against.”
Experts of the Companion Animal Parasite Council
(CAPC) note that a number of tick species are commonly
identified in areas where they have not been present historically, reports Merial. As these tick species move into
new areas, they will bring the diseases that they transmit
with them, including canine ehrlichiosis, anaplasmosis,
Lyme disease, Rocky Mountain spotted fever, hepatozoonosis and babesiosis. According to a national survey
of veterinary clinics, dogs have tested positive for Lyme
disease, ehrlichiosis, and/or anaplasmosis in most states.
The survey questioned 1,000 U.S. residents – 21 percent from the Northeast, 22 percent from the Midwest,
34 percent from the South and 23 percent from the West
– and featured responses from people of all ages, 68 percent of whom said they had used a flea or flea/tick control
product in the past year.
Bayer Animal Health names Scott Ethridge
the Brand Manager for Seresto
Bayer Animal Health has announced that Scott Ethridge
has accepted the position of Brand Manager for Seresto.
Ethridge, his wife Amy, and their three children Sabrina,
Brody and Fischer will be moving to the Kansas City area
from Oklahoma City later this summer. Ethridge brings
diverse career experience to his new role. He joins CAP
Marketing from the CAP Strategic Accounts team where
he has been working as a Key Account Manager calling
on major distributor customers. He was previously a Territory Sales Manager for Bayer CAP calling on veterinary
clinics, and was a Bayer Council award winner in 2010. Putney announces new appointments
Putney, Inc., announced the addition
of Kelley Shimansky to its senior leadership team. As Vice President of Human Resources, Shimansky will focus
on organizational design and optimiKelley
zation to ensure the team achieves
Shimansky
its growth goals. Shimansky comes
to Putney from WEX, where she was Vice President of
Organizational Development. In that role she created a
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COMMUNITY
News
consolidated corporate standard for talent assessment
and management, implemented a global HR technology
platform and designed the onboarding program to shorten
time to effectiveness of new hires.
Putney also announced recent changes to its commercial team. Shannon Lancaster has been promoted to
Senior Director of New Business Development and Strategy. Putney has also hired Sam Spina as Director of National Channel Sales, responsible for leading the direct,
distribution and customer service teams to build relationships that deepen market penetration of existing products
and gain rapid market share for future product launches.
Putney announced two additional promotions in conjunction with the sales team development. James Morin has
been promoted to Sales Analyst and Chris Kelly has been
promoted to Inside Sales Representative.
via best practices that better protect pets from parasitic
infections while reducing the risk of zoonotic parasite
transmission. The organization produces a number of
leading industry resources that are recognized by the veterinary profession. These include the CAPC guidelines for
parasitic prevention and control measures for ectoparasites, heartworm and intestinal parasites, and the CAPC
parasite prevalence maps, which monitors vector-born
and heartworm disease activity at the local and county
levels across the United States.
Virbac awards several distributor reps,
veterinarians on “once-in-a-lifetime” sailing trip
Virbac Corporation recently invited several distributor reps and select veterinarians to a once-in-a-lifetime
opportunity to sail on the Virbac-Paprec 70’ tri-hulled
catamaran in New York City Harbor, around the Statue of
Putney CEO Jean Hoffman wins New England
Ernst & Young Entrepreneur of the Year™ Award
Jean Hoffman, president and CEO of Putney, Inc., was
named the New England Ernst & Young (EY) Entrepreneur
of the Year™ 2014 in the Life Sciences. Upon receiving
the award at EY’s 28th annual Entrepreneur of the Year
Awards Gala in New England, Hoffman credited her team
who she said is “overcoming obstacles and accomplishing our goal of making pet healthcare more affordable.”
As a New England award winner, Hoffman is nominated
to EY’s national Entrepreneur of the Year 2014 program.
Award winners in several national categories, as well as
the Entrepreneur of the Year National Overall Award winner, will be announced at the annual awards gala in Palm
Springs, California, on Nov. 15, 2014.
VPL becomes a corporate sponsor of CAPC
Veterinary Products Laboratories (VPL) announced it has
become a corporate sponsor of the Companion Animal
Parasite Council (CAPC). “We are proud to align ourselves
with this organization in support of its overall mission,
doing our part to help improve the health of our pets
and further strengthen the bond between pets and pet
owners.” Founded in 2002, CAPC was formed with the
express purpose of changing the way veterinary professionals and pet owners approach parasite management,
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Liberty. Dr. Jean-Pierre Dick, son of Virbac’s founder, Dr.
Richard-Pierre Dick, and skipper of the boat was in New
York City with his crew for a week dedicated to exclusive
sailing sessions with customers and also to receive one
of the highest honors in sailing. He was recognized by the
world renowned NYC Yacht Club for extraordinary courage at sea while competing in the Vendée Globe solo race
around the world. Virbac’s invited guests sailed on the Virbac-Paprec 70’ MOD tri-hulled catamaran in NYC Harbor,
around the Statue of Liberty, Ellis Island with unique view
on lower Manhattan and the new Freedom Tower. One of
Virbac’s guests, Henry Schein Animal Health Sales Representative Dennis Meyers, said “I’ve been in the industry
for 32 years and this is by far the best experience among
many award trips!”
Virbac Corporation announced that Dr. Alan Taylor has
been named Vice President of Business Development,
effective July 14, 2014. In this role, Dr. Taylor will
be responsible for generating external growth for Virbac North America and the Commonwealth Countries,
through the acquisition or licensing-in of new products, and through the merger and acquisitions of third
party companies. Additionally, he will support the R&D
internal organization through the licensing-in of opportunities of selected new actives or new technologies that could be further developed internally. Before
joining Virbac, Dr. Taylor held the position of head of
Business Development North America and Global Pets
for Merial Ltd.
Veterinary Hospital of the Year
winner features Midmark equipment Mueller Pet Medical Center was recently recognized
with the 2014 Hospital of the Year Award for excellence
in veterinary hospital design in the 49th annual Veterinary Economics Hospital Design Competition. Midmark worked with distribution partner, MWI Veterinary
Supply, Inc., to provide a solution that would meet the
needs of the veterinary hospital. The new design featured Midmark casework throughout the entire facility as well as Canis Major® Lift Tables in every canine
exam room.
Dechra Veterinary products
expands to Canadian market
Dechra Veterinary Products announced its entry into
the Canadian Veterinary Animal Health Market. Its
newly established subsidiary will be managed by Paul
Ray, who brings over 20 years of sales and marketing
experience in the Canadian animal health industry,
according to Mike Eldred, President of North American Operations. “Additionally, we will be hiring key
personnel to support our endocrinology and dermatology products who will be focused on providing the
highest level of service and education to the veterinary profession,” Eldred said.
COMMUNITY
Virbac names Dr. Alan Taylor
as VP of Business Development
Henry Schein Animal Health’s Dawn
Burdette to serve on AVMA’s Veterinary
Economic Strategy Committee
Henry Schein Animal Health announced the appointment of Dawn
Burdette, Executive Director of Sales
Leadership and Development at Henry
Schein Animal Health, to the AmeriDawn Burdette
can Veterinary Medical Association’s
(AVMA) Veterinary Economics Strategy Committee as
an At-Large Representative by the AVMA Executive
Board. Burdette was appointed to the Committee at
the April 10-12, 2014 AVMA Executive Board Meeting and will serve in this position from July 2014 to
July 2017. The Committee is charged to advise the
AVMA’s Executive Board on the broad scope of economic issues affecting veterinary medicine and make
recommendations to develop strategies for addressing
economic issues. Nominations were solicited from the
general membership and other stakeholders, and all
members of the Committee will be eligible to serve a
second term of three years.
Dechra expands Equine
and Companion Animal division
Dechra Veterinary Products announced it has
expanded its Equine and Companion Animal divisions
with the hiring of Dr. Marian Little, Greg Underwood
and Denise Piekarski. Marian G. Little, DVM joins
Dechra as the Equine Technical and Professional
Services Manager. Dr. Little comes from Boehringer
Ingelheim Vetmedica, Inc. where she held the position of Field Equine Professional Services Veterinarian since 2007. Greg Underwood has joined the
Dechra Team as Director of Corporate Accounts and
Distributor Relations. With over twenty years of experience in the animal health industry, Underwood
will be responsible for corporate veterinary groups
and distributor relations for Dechra. Piekarski joins
Dechra as Marketing Manager and will be responsible for developing the recently acquired Phycox ®
brand of joint supplements, as well as other key
new products.
www.vet-advantage.com • Veterinary advantage
«« July/August
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COMMUNITY
News
Jurox selects Kansas City Animal
Health Corridor for U.S. Headquarters
DEA approves making tramadol
a schedule IV controlled substance
Jurox Pty Ltd, an Australian veterinary pharmaceutical
company, announced that it has selected Kansas City,
Mo., as in the KC Animal Health Corridor, for its U.S. headquarters. Bob Marcusse, president and CEO of the Kansas City Area Development Council, said, “The KC Animal
Health Corridor’s high concentration of animal health entities paired with accessibility to distribution and service
providers makes the Kansas City area an ideal location
for Jurox to grow their presence and succeed in the U.S.”
Jurox will create 13 jobs based in Kansas City and an
additional 31 positions located throughout the U.S. The
company selected the KC region due to its concentration
of skilled workforce, intellectual capital and accessibility
to service providers.
The Drug Enforcement Administration (DEA) recently published its decision to schedule tramadol as a
Schedule IV controlled substance, according to an
AVDA email to members. The rule will become effective August 18 of this year. “The DEA’s action
was fairly swift, having published its proposal to
schedule tramadol just eight months ago,” the email
said. AVDA indicated its support for DEA’s consideration to schedule tramadol, in part, because distributors will be able to operate more efficiently and
consistently nationwide.
Brakke Consulting and Trone Brand Energy
to forecast pet pharmaceutical market
Brakke Consulting, Inc., and Trone Brand Energy, announced they are joining forces to paint the picture of
the future U.S. pet pharmaceutical marketplace. The first
place pet owners go to purchase veterinarian-prescribed
medicines is beginning to change as new distribution
models and proposed legislative measures are evolving
to give consumers more choice. New research by Brakke
and Trone Brand Energy will define how this change of
the pet pharmaceutical industry will affect manufacturers, distributors, retailers and veterinarians once a critical
mass of consumers begin to adopt new models. “Changes to the pet pharmaceutical marketplace are going to
present opportunities and challenges unlike any the industry has seen,” said Ron Brakke, president of Brakke
Consulting. “We have partnered with Trone Brand Energy
to help broaden the scope of the insights we gather. Companies that participate in the research will be offered a
comprehensive body of implications on how they should
change their business models to adapt to the new dynamics.” Companies wishing to participate in the study
at a discounted rate can contact David Goodnight at 830285-1259 by July 31, 2014.
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Henry Schein Animal Health to host 2014
Veterinary Technology Summit in September
Veterinarians and their staff seeking to gain valuable insights into state-of-the-art practice management, attend cutting-edge software training classes,
and experience the latest veterinary technology solutions can attend the Henry Schein Veterinary Technology Summit, which takes place Sept. 3-5, 2014,
at the Renaissance Schaumburg Convention Center
Hotel in Chicago. Registration for this technologyfocused industry event remains open through August 31. Summit keynote speakers, including Andy
Roark, DVM, MS; Mark Opperman, CVPM of VMC,
Inc.; Wendy S. Meyers of Communication Solutions
for Veterinarians Inc.; and Amanda L. Donnelly, DVM,
MBA of ALD Veterinary Consulting, will cover topics
including effective use of social media, blending old
and new tactics for more effective practice marketing, boosting client communication and compliance,
enhancing and promoting preventive care, and improving staff management and leadership. In addition, Stanley M. Bergman, Chairman of the Board
and Chief Executive Officer of Henry Schein, Inc. and
Kevin Vasquez, President and CEO of Henry Schein
Animal Health, will discuss key trends impacting the
animal health industry. To register or receive more
information, visit www.VetSummit.com
Product Announcements
Jurox introduces Alfaxan® CIV
(alfaxalone 10 mg/mL) intravenous injectable
anesthetic for use in cats and dogs
Alfaxan® is indicated for the induction and maintenance
of anesthesia and for induction of anesthesia followed by
maintenance with an inhalant anesthetic, in cats and dogs.
Alfaxan® is a registered trademark of Jurox Pty. Limited,
Fel-O-Vax® is manufactured with PureFil™ Technology,
which includes improved purification processes and
tighter manufacturing profiles, resulting in more serialto-serial consistency. PureFil™ Technology is designed
to reduce vaccine reactions associated with extraneous
proteins and cellular debris.
IDEXX Laboratories introduces Whipworm
Antigen Test Capable of Detecting Adult Parasite
Australia and is a unique anesthetic molecule to the U.S.
veterinary market. Jurox is an established family owned
veterinary pharmaceutical company that manufactures
and markets in excess of 120 proprietary animal health
products in over 20 countries. With global headquarters
in the Hunter Valley Australia, Jurox maintains commercial
operations in New Zealand, United Kingdom and has recently established their U.S. headquarters in Kansas City,
Missouri. For more information you can reach the Jurox
team at 844-ALFAXAN.”
IDEXX Laboratories, Inc. announced the introduction of a
breakthrough technology to detect more whipworm infections in dogs earlier than current diagnostic methods.
As the industry’s first enzyme-linked immunosorbent assay (ELISA) for whipworm antigen detection, it is the only
test capable of directly detecting the presence of an adult
whipworm parasite, according to a release. Until now,
diagnostic tests could only detect whipworm infections
by the presence of eggs in the feces. Since it can take
up to three months for an adult whipworm to produce
eggs, infected dogs may go untreated for months. Data
collected through IDEXX Reference Laboratories shows
that the Whipworm Antigen ELISA can detect more than
double the number of infections in dogs when the ELISA
is run with traditional ova and parasite testing, allowing for earlier diagnosis, management and treatment. To
learn more about the IDEXX Comprehensive Fecal Panel
and the Whipworm Antigen ELISA, call 877-278-1470 or
visit www.idexx.com/whipworm
Bayer is proud to introduce
Boehringer Ingelheim Vetmedica, Inc.
launches ULTRA™ Fel-O-Vax®
Boehringer Ingelheim Vetmedica, Inc. (BIVI) announced
the launch of ULTRA™ Fel-O-Vax®, the first ½ mL vaccine line for cats. ULTRA™ Fel-O-Vax ® joins its partner canine product line, ULTRA™ Duramune®, as the
only pet vaccine lines on the market with 50 percent
less volume per dose, according to a release. ULTRA™
See advertisement on page 99
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«« July/August
2014
89
Product Announcements
Merck Animal Health announces FDA
approval of BRAVECTO™ (fluralaner)
Merial re-launches HEARTGARD®
(ivermectin) tablets for dogs
Merck Animal Health announced the U.S. Food and
Drug Administration’s approval of BRAVECTO™ (fluralaner) chewable tablets for dogs (112.5 mg, 250 mg,
500 mg, 1000 mg, 1400 mg). BRAVECTO is the first
and only treatment that has been shown to quickly and
effectively kill fleas and multiple tick species for 12
weeks in a single dose. BRAVECTO also is effective for
eight weeks against Amblyomma americanum ticks.
Merial announced the re-launch of its HEARTGARD®
(ivermectin) Tablets. Dogs with food allergies now have
a monthly heartworm preventive that does not include
any food ingredients that may trigger an allergic reaction.
HEARTGARD Tablets help protect against heartworms that
can lead to serious illness in dogs. Merial re-introduced
these tablets to ensure that every dog has an option for
heartworm disease prevention. “Many dogs suffer from
food allergies and most oral heartworm preventives have
meat components in their formulation,” said Dr. Michael
Murray, Technical Marketing Director of U.S. Pets Parasiticides at Merial. “Merial is committed to providing dogs
with food allergies an alternative that delivers the same
heartworm disease prevention found in HEARTGARD Plus
(ivermectin/pyrantel), which is a real beef chewable.” To
learn more about HEARTGARD products and availability,
visit http://www.heartgard.com.
Kinetic Vet introduces EquiShield® IBH Spray
Kinetic Vet branded products by Kinetic Technologies has released EquiShield® IBH Spray. EquiShield® IBH
Spray is a soothing anesthetic spray
with antiseptic and anti-inflammatory
properties featuring the active ingredients Chlorhexidine Gluconate 2%,
Pramoxine HCI 1%, Citronella Oil 1%
and Hydrocortisone 0.5%. Call 877786-9882 or visit www.KineticVet.com
for more information.
Virbac Corporation announces
the return of IVERHART PLUS®
Virbac Corporation announced the return of IVERHART
PLUS® (ivermectin/pyrantel) Flavored Chewables. IVERHART PLUS Tablets are effective in preventing heartworm
infections in dogs and are available in a flavored chewable tablet. They provide a cost-effective alternative in an
effort to make heartworm prevention available to more
dogs and dog owners. IVERHART PLUS Tablets also provide protection against intestinal parasites.
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Midmark launches Canis Major®
Lift Tables promotion
Midmark Corporation introduced a new promotion
within its animal health
division that runs until
Sept. 30, 2014. During the
promotion, Midmark is offering a $750 rebate on
both the Canis Major® Wet
Dental/Treatment Lift Table and the Canis Major®
Exam Lift Table. Important
promotional dates include:
• Promotion order period: July 1 – Sept. 30, 2014
• Veterinary facility invoice must be dated:
July 1 – Oct.31, 2014
• Last date to take delivery of products: Oct. 31, 2014
• Last date to claim incentives: Nov. 30, 2014
For product inquiries, call the Midmark Animal Health
Customer Experience Department at 1-800-MIDMARK or
visit midmarkanimalhealth.com. For questions regarding
the promotion, call ext. 7575.
CAUTION: Federal (US) law restricts this drug to use
by or on the order of a licensed veterinarian.
BRIEF SUMMARY: Please consult package insert
for complete product information.
Indications: For use in dogs to prevent canine heartworm
disease by eliminating the tissue stage of heartworm larvae
(Dirofilaria immitis) for a month (30 days) after infection
and for the treatment and control of roundworms (Toxocara
canis, Toxascaris leonina), hookworms (Ancylostoma
caninum, Uncinaria stenocephala, Ancylostoma braziliense),
and tapeworms (Dipylidium caninum, Taenia pisiformis).
WARNINGS: For use in dogs only. Keep this and all
drugs out of reach of children. In safety studies, testicular
hypoplasia was observed in some dogs receiving 3 and
5 times the maximum recommended dose monthly for
6 months (see Animal Safety). In case of ingestion by
humans, clients should be advised to contact a physician
immediately. Physicians may contact a Poison Control Center
for advice concerning cases of ingestion by humans.
PRECAUTIONS: Use with caution in sick, debilitated,
or underweight animals and dogs weighing less than
10 lbs (see Animal Safety). The safe use of this drug
has not been evaluated in pregnant or lactating bitches.
All dogs should be tested for existing heartworm
infection before starting treatment with IVERHART MAX
Chewable Tablets, which are not effective against adult
D. immitis. Infected dogs should be treated to remove adult
heartworms and microfilariae before initiating a heartworm
prevention program.
While some microfilariae may be killed by the ivermectin
in IVERHART MAX Chewable Tablets at the recommended
dose level, IVERHART MAX Chewable Tablets are not
effective for microfilariae clearance. A mild hypersensitivitytype reaction, presumably due to dead or dying microfilariae
and particularly involving a transient diarrhea, has been
observed in clinical trials with ivermectin alone after
treatment of some dogs that have circulating microfilariae.
ADVERSE REACTIONS: In clinical field trials with ivermectin/
pyrantel pamoate, vomiting or diarrhea within 24 hours of
dosing was rarely observed (1.1% of administered doses).
The following adverse reactions have been reported
following the use of ivermectin: depression/lethargy,
vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering,
convulsions and hypersalivation.
ANIMAL SAFETY: Studies with ivermectin indicate that
certain dogs of the Collie breed are more sensitive to the
effects of ivermectin administered at elevated dose levels
(more than 16 times the target use level of 6 mcg/kg) than
dogs of other breeds. At elevated doses, sensitive dogs
showed adverse reactions which included mydriasis,
depression, ataxia, tremors, drooling, paresis, recumbency,
excitability, stupor, coma and death. No signs of toxicity
were seen at 10 times the recommended dose (27.2 mcg/lb)
in sensitive Collies. Results of these studies and
bioequivalence studies support the safety of ivermectin
products in dogs, including Collies, when used as
recommended by the label.
In a laboratory safety study, 12-week-old Beagle puppies
receiving 3 and 5 times the recommended dose once weekly
for 13 weeks demonstrated a dose-related decrease in
testicular maturation compared to untreated controls.
HOW SUPPLIED: IVERHART MAX Chewable Tablets are
available in four dosage strengths (see Dosage section)
for dogs of different weights. Each strength comes in a box
of 6 chewable tablets, packed 10 boxes per display box.
STORAGE INFORMATION: Store at 20°C -25°C (68°F77°F), excursions permitted between 15°C-30°C (59°F86°F). Protect product from light.
For technical assistance or to report adverse drug reactions,
please call 1-800-338-3659.
Manufactured by: Virbac AH, Inc. Fort Worth, TX 76137
NADA 141-257, Approved by FDA
IVERHART MAX is a registered trademark of Virbac
Corporation.
© 2014 Virbac Corporation. All Rights Reserved. 7/14 14846
TRESADERM (thiabendazole-dexamethasone-neomycin sulfate solution) Dermatologic
Solution CAUTION: Federal (U.S.A.) law restricts this drug to use by or on the order
of a licensed veterinarian. DESCRIPTION: Dermatologic Solution TRESADERM®
(thiabendazole-dexamethasone-neomycin sulfate solution) contains the following
active ingredients per ml: 40 mg thiabendazole, 1 mg dexamethasone, 3.2 mg
neomycin (from neomycin sulfate). Inactive ingredients: glycerin, propylene glycol,
purified water, hypophosphorous acid, calcium hypophosphite; about 8.5% ethyl
alcohol and about 0.5% benzyl alcohol. INDICATIONS:Dermatologic solution
TRESADERM is indicated as an aid in the treatment of certain bacterial, mycotic,
and inflammatory dermatoses and otitis externa in dogs and cats. Both acute and
chronic forms of these skin disorders respond to treatment with TRESADERM. Many
forms of dermatosis are caused by bacteria (chiefly Staphylococcus aureus, Proteus
vulgaris and Pseudomonas aeruginosa). Moreover, these organisms often act as
opportunistic or concurrent pathogens that may complicate already established
mycotic skin disorders, or otoacariasis caused by Otodectes cynotis. The principal
etiologic agents of dermatomycoses in dogs and cats are species of the genera
Microsporum and Trichophyton. The efficacy of neomycin as an antibacterial agent,
with activity against both gramnegative and gram-positive pathogens, is well
documented. Detailed studies in various laboratories have verified the significant
activity thiabendazole displays against the important dermatophytes. Dexamethasone,
a synthetic adrenocorticoid steroid, inhibits the reaction of connective tissue to
injury and suppresses the classic inflammatory manifestations of skin disease. The
formulation for TRESADERM combines these several activities in a complementary
form for control of the discomfort and direct treatment of dermatitis and otitis externa
produced by the above-mentioned infectious agents. DOSAGE AND ADMINISTRATION:
Prior to the administration of Dermatologic Solution TRESADERM, remove the
ceruminous, purulent or foreign materials from the ear canal, as well as the crust
which may be associated with dermatoses affecting other parts of the body. The
design of the container nozzle safely allows partial insertion into the ear canal for ease
of administration. The amount to apply and the frequency of treatment are dependent
upon the severity and extent of the lesions. Five to 15 drops should be instilled in the
ear twice daily. In treating dermatoses affecting other than the ear the surface of the
lesions should be well moistened (2 to 4 drops per square inch) with Dermatologic
Solution TRESADERM twice daily. The volume required will be dependent upon the
size of the lesion. Application of TRESADERM should be limited to a period of not
longer than one week. PRECAUTIONS: On rare occasions dogs may be sensitive to
neomycin. In these animals, application of the drug will result in erythema of the
treated area, which may last for 24 to 48 hours. Also, evidence of transient discomfort
has been noted in some dogs when the drug was applied to fissured or denuded
areas. The expression of pain may last 2 to 5 minutes. Application of Dermatologic
Solution TRESADERM should be limited to periods not longer than one week. While
systemic side effects are not likely with topically applied corticosteroids, such a
possibility should be considered if use of the solution is extensive and prolonged. If
signs of salt and water retention or potassium excretion are noticed (increased thirst,
weakness, lethargy, oliguria, gastrointestinal disturbances or tachycardia), treatment
should be discontinued and appropriate measures taken to correct the electrolyte and
fluid imbalance. Store in a refrigerator 36°-46°F (2°-8°C). WARNING: For topical use
in dogs and cats. Avoid contact with eyes. Keep this and all drugs out of the reach of
children. The Material Safety Data Sheet (MSDS) contains more detailed occupational
safety information. To report adverse effects in users, to obtain an MSDS, or for
assistance call 1-888-637-4251. HOW SUPPLIED: Product 55871- Dermatologic
Solution TRESADERM Veterinary is supplied in 7.5-ml and 15-ml dropper bottles, each
in 12-bottle boxes.
www.vet-advantage.com • Veterinary advantage
VIRC-14846 IVMax Ad 1ThirdSumVetAdv PI prt.indd 1
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VETROPOLYCIN®
(bacitracin-neomycin-polymyxin)
Veterinary Ophthalmic Ointment
TM
(carprofen)
WARNING: Do not use this product as a pre-surgical ocular
lubricant. Adverse reactions of ocular irritation and corneal
ulceration have been reported in association with such use.
soft chewable tablets
VETROPOLYCIN® HC
Non-steroidal anti-inflammatory drug
For oral use in dogs only
BRIEF SUMMARY:
Before using quellin soft chewable tablets, please consult the
product insert, a summary of which follows:
CAUTION: Federal Law restricts this drug to use by or on the
order of a licensed veterinarian.
PRODUCT DESCRIPTION: quellin (carprofen) is a non-steroidal
anti-inflammatory drug (NSAID) of the propionic acid class that
includes ibuprofen, naproxen, and ketoprofen.
INDICATIONS: Carprofen is indicated for the relief of pain
and inflammation associated with osteoarthritis and for the
control of postoperative pain associated with soft tissue and
orthopedic surgeries in dogs.
CONTRAINDICATIONS: Carprofen should not be used in dogs
exhibiting previous hypersensitivity to carprofen.
WARNINGS: Keep out of reach of children. Not for human
use. Consult a physician in cases of accidental ingestion by
humans. For use in dogs only. Do not use in cats. All dogs
should undergo a thorough history and physical examination
before initiation of NSAID therapy. Appropriate laboratory tests
to establish hematological and serum biochemical baseline
data prior to, and periodically during, administration of any
NSAID should be considered.
PRECAUTIONS: As a class, NSAIDs may be associated with
gastrointestinal, renal and hepatic toxicity. Effects may result
from decreased prostaglandin production and inhibition of the
enzyme cyclooxygenase which is responsible for the formation
of prostaglandins from arachindonic acid. When NSAIDs inhibit
prostaglandins that cause inflammation they may also inhibit
those prostaglandins which maintain normal homeostatic
function. These antiprostaglandin effects may result in
clinically significant disease in patients with underlying or preexisting disease more often than in healthy patients. Carprofen
is an NSAID, and as with others in that class, adverse reactions
may occur with its use. The most frequently reported effects
have been gastrointestinal signs. vents involving suspected
renal, hematologic, and neurologic, dermatologic, and hepatic
effects have also been reported. Concomitant use of carprofen
with other anti-inflammatory drugs, such as other NSAIDs or
corticosteroids, should be avoided because of the potential
increase of adverse reactions, including gastrointestinal
ulcerations and/or perforations. Carprofen is not recommended
for use in dogs with bleeding disorders, as safety has not been
established in dogs with these disorders. The safe use of
carprofen in animals less than 6 weeks of age, pregnant dogs,
dogs used for breeding purposes, or in lactating bitches has
not been established.
ADVERSE REACTIONS:
During investigational studies for the caplet formulation with
twice-daily administration of 1 mg/lb., no clinically significant
adverse reactions were reported. Some clinical signs were
observed during field studies which were similar for carprofen
caplet and placebo treated dogs. Incidences were observed
in both groups: vomiting (4%), diarrhea (4%), changes in
appetite (3%), lethargy (1.4%), behavioral changes (1%), and
constipation (0.3%).
For a copy of the Material Safety Data Sheet (MSDS) or
to report adverse reactions call Bayer Veterinary
Services at 1-800-422-9874. For consumer questions call
1-800-255-6826.
ANADA 200-555 Approved by FDA
©2014 Bayer HealthCare LLC. Bayer (reg’d), the Bayer Cross
(reg’d), quellin™ are trademarks of Bayer.
Bayer HealthCare LLC, Animal Health Division, PO Box 390,
Shawnee Mission, KS 66201
GHG061914
January 2014
92
July/August 2014
NADA # 065-016. Approved by FDA.
18827
»» Veterinary adVantage • www.vet-advantage.com
(bacitracin-neomycin-polymyxinhydrocortisone acetate 1%)
Veterinary Ophthalmic Ointment
NADA # 065-015. Approved by FDA.
CONTRAINDICATIONS: Ophthalmic preparations containing
corticosteroids are contraindicated in the treatment of those
deep, ulcerative lesions of the cornea where the inner layer
(endothelium) is involved, in fungal infections and in the presence
of viral infections.
WARNINGS: All topical ophthalmic preparations containing
corticosteroids with or without an antimicrobial agent, are
contraindicated in the initial treatment of corneal ulcers. They
should not be used until the infection is under control and corneal
regeneration is well under way. Clinical and experimental data
have demonstrated that corticosteroids administered orally or by
injection to animals may induce the first stage of parturition if
used during the last trimester of pregnancy and may precipitate
premature parturition followed by dystocia, fetal death, retained
placenta, and metritis. Additionally, corticosteroids administered to
dogs, rabbits, and rodents during pregnancy have resulted in cleft
palate in offspring. Corticosteroids administered to dogs during
pregnancy have also resulted in other congenital anomalies,
including deformed forelegs, phocomelia, and anasarca.
The INFORmATION belOW ApplIeS TO bOTh VeTROpOlYCIN
AND VeTROpOlYCIN hC.
STeRIle - ANTIbACTeRIAl
CAUTION: Federal law restricts this drug to use by or on the order
of a licensed veterinarian.
pReCAUTIONS: Sensitivity to these ophthalmic ointments is rare,
however, if a reaction occurs, discontinue use of the preparation.
The prolonged use of antibiotic-containing preparations may
result in overgrowth of nonsusceptible organisms including fungi.
Appropriate measures should be taken if this occurs. If infection
does not respond to treatment in two or three days, the diagnosis
and therapy should be reevaluated. Animals under treatment
with VeTROpOlYCIN hC (bacitracin-neomycin-polymyxin with
hydrocortisone acetate 1%) should be observed for usual signs
of corticosteroid overdose which include polydipsia, polyuria
and occasionally an increase in weight. Use of corticosteroids,
depending on dose, duration, and specific steroid, may result
in inhibition of endogenous steroid production following drug
withdrawal. In patients presently receiving or recently withdrawn
from systemic corticosteroid treatments, therapy with a rapidly
acting corticosteroid should be considered in unusually stressful
situations. Care should be taken not to contaminate the applicator
tip during administration of the preparation.
ADVeRSe ReACTIONS: Itching, burning or inflammation may
occur in animals sensitive to the product. Discontinue use in such
cases. SAp and SGpT (AlT) enzyme elevations, polydypsia and
polyuria have occurred following parenteral or systemic use of
synthetic corticosteroids in dogs. Vomiting and diarrhea (occasionally bloody) have been observed in dogs. Cushing’s
syndrome in dogs has been reported in association with
prolonged or repeated steroid therapy.
manufactured for:
Dechra Veterinary products
7015 College boulevard,
Suite 525
Overland park, KS 66211
866-933-2472
NADA 141-426, Approved by FDA
BRIEF SUMMARY (For full Prescribing Information, see package insert)
Caution:
Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.
Indications:
Bravecto kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis) and the treatment and control of tick
infestations [Ixodes scapularis (black-legged tick), Dermacentor variabilis (American dog tick), and Rhipicephalus sanguineus (brown dog tick)] for 12 weeks in dogs
and puppies 6 months of age and older, and weighing 4.4 pounds or greater.
Bravecto is also indicated for the treatment and control of Amblyomma americanum (lone star tick) infestations for 8 weeks in dogs and puppies 6 months of age
and older, and weighing 4.4 pounds or greater.
Contraindications:
There are no known contraindications for the use of the product.
Warnings:
Not for human use. Keep this and all drugs out of the reach of children. Keep the product in the original packaging until use, in order to prevent children from
getting direct access to the product. Do not eat, drink or smoke while handling the product. Wash hands thoroughly with soap and water immediately after use of
the product.
Precautions:
Bravecto has not been shown to be effective for 12-weeks duration in puppies less than 6 months of age. Bravecto is not effective against Amblyomma americanum
ticks beyond 8 weeks after dosing.
Adverse Reactions:
In a well-controlled U.S. field study, which included 294 dogs (224 dogs were administered Bravecto every 12 weeks and 70 dogs were administered an oral active
control every 4 weeks and were provided with a tick collar); there were no serious adverse reactions. All potential adverse reactions were recorded in dogs treated
with Bravecto over a 182-day period and in dogs treated with the active control over an 84-day period. The most frequently reported adverse reaction in dogs in the
Bravecto and active control groups was vomiting.
Percentage of Dogs with Adverse Reactions in the Field Study
Adverse Reaction (AR)
Bravecto Group: Percentage of
Dogs with the AR During the
182-Day Study (n=224 dogs)
Active Control Group: Percentage
of Dogs with the AR During the
84-Day Study (n=70 dogs)
Vomiting
7.1
14.3
Decreased Appetite
6.7
0.0
Diarrhea
4.9
2.9
Lethargy
5.4
7.1
Polydipsia
1.8
4.3
Flatulence
1.3
0.0
In a well-controlled laboratory dose confirmation study, one dog developed edema and hyperemia of the upper lips within one hour of receiving Bravecto. The
edema improved progressively through the day and had resolved without medical intervention by the next morning.
For technical assistance or to report a suspected adverse drug reaction, contact Merck Animal Health at 1-800-224-5318. Additional information can be found
at www.bravecto.com. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at
http://www.fda.gov/AnimalVeterinary/ SafetyHealth.
How Supplied:
Bravecto is available in five strengths (112.5, 250, 500, 1000, and 1400 mg fluralaner per chew). Each chew is packaged individually into aluminum foil blister packs
sealed with a peelable paper backed foil lid stock. Product may be packaged in 1, 2, or 4 chews per package.
Distributed by:
Intervet Inc (d/b/a Merck Animal Health)
Summit, NJ 07901
Made in Austria
Copyright © 2014 Intervet Inc, a subsidiary of Merck & Company Inc.
All rights reserved
141487 R2
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93
CHEWABLE TABLETS
Brief Summary: Before using PREVICOX, please consult the product insert, a summary of which follows:
Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian.
Indications: PREVICOX (firocoxib) Chewable Tablets are indicated for the control of pain and inflammation
associated with osteoarthritis and for the control of postoperative pain and inflammation associated with softtissue and orthopedic surgery in dogs.
Contraindications: Dogs with known hypersensitivity to firocoxib should not receive PREVICOX.
Warnings: Not for use in humans. Keep this and all medications out of the reach of children. Consult a physician
in case of accidental ingestion by humans.
For oral use in dogs only. Use of this product at doses above the recommended 2.27 mg/lb (5.0 mg/
kg) in puppies less than seven months of age has been associated with serious adverse reactions,
including death (see Animal Safety). Due to tablet sizes and scoring, dogs weighing less than 12.5 lb
(5.7 kg) cannot be accurately dosed.
All dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy.
Appropriate laboratory testing to establish hematological and serum baseline data is recommended prior to
and periodically during administration of any NSAID. Owners should be advised to observe for signs of
potential drug toxicity (see Adverse Reactions and Animal Safety) and be given a Client Information
Sheet about PREVICOX Chewable Tablets.
For technical assistance or to report suspected adverse events, call 1-877-217-3543.
Precautions: This product cannot be accurately dosed in dogs less than 12.5 pounds in body weight.
Consider appropriate washout times when switching from one NSAID to another or when switching from
corticosteroid use to NSAID use.
As a class, cyclooxygenase inhibitory NSAIDs may be associated with renal, gastrointestinal and hepatic toxicity.
Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced
adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest
risk for adverse events are those that are dehydrated, on concomitant diuretic therapy, or those with existing
renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs
should be carefully approached and monitored. NSAIDs may inhibit the prostaglandins that maintain normal
homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients
with underlying or pre-existing disease that has not been previously diagnosed. Since NSAIDs possess the
potential to produce gastrointestinal ulceration and/or gastrointestinal perforation, concomitant use of PREVICOX
Chewable Tablets with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided.
The concomitant use of protein-bound drugs with PREVICOX Chewable Tablets has not been studied in dogs.
Commonly used protein-bound drugs include cardiac, anticonvulsant, and behavioral medications. The influence of
concomitant drugs that may inhibit the metabolism of PREVICOX Chewable Tablets has not been evaluated. Drug
compatibility should be monitored in patients requiring adjunctive therapy. If additional pain medication is needed
after the daily dose of PREVICOX, a non-NSAID class of analgesic may be necessary. Appropriate monitoring
procedures should be employed during all surgical procedures. Anesthetic drugs may affect renal perfusion,
approach concomitant use of anesthetics and NSAIDs cautiously. The use of parenteral fluids during surgery
should be considered to decrease potential renal complications when using NSAIDs perioperatively. The safe use
of PREVICOX Chewable Tablets in pregnant, lactating or breeding dogs has not been evaluated.
Adverse Reactions:
Osteoarthritis: In controlled field studies, 128 dogs (ages 11 months to 15 years) were evaluated for safety when given
PREVICOX Chewable Tablets at a dose of 2.27mg/lb (5.0 mg/kg) orally once daily for 30 days. The following adverse
reactions were observed. Dogs may have experienced more than one of the observed adverse reactions during the study.
Adverse Reactions Seen in U. S. Field Studies
Adverse Reactions
Vomiting
Diarrhea
Decreased Appetite or Anorexia
Lethargy
Pain
Somnolence
Hyperactivity
PREVICOX (n=128)
5
1
3
1
2
1
1
Active Control (n=121)
8
10
3
3
1
1
0
PREVICOX (firocoxib) Chewable Tablets were safely used during field studies concomitantly with other therapies,
including vaccines, anthelmintics, and antibiotics.
Soft-tissue Surgery: In controlled field studies evaluating soft-tissue postoperative pain and inflammation, 258 dogs
(ages 10.5 weeks to 16 years) were evaluated for safety when given PREVICOX Chewable Tablets at a dose of 2.27 mg/
lb (5.0 mg/kg) orally approximately 2 hours prior to surgery and once daily thereafter for up to two days. The following
adverse reactions were observed. Dogs may have experienced more than one of the observed reactions during the study.
Adverse Reactions Seen in the Soft-tissue Surgery
Postoperative Pain Field Studies
Adverse Reactions
Vomiting
Diarrhea
Bruising at Surgery Site
Respiratory Arrest
SQ Crepitus in Rear Leg and Flank
Swollen Paw
Firocoxib Group (n=127)
5
1
1
1
1
1
Control Group* (n=131)
6
1
1
0
0
0
*Sham-dosed (pilled)
Orthopedic Surgery: In a controlled field study evaluating orthopedic postoperative pain and inflammation, 226 dogs
of various breeds, ranging in age from 1 to 11.9 years in the PREVICOX-treated groups and 0.7 to 17 years in the control
group were evaluated for safety. Of the 226 dogs, 118 were given PREVICOX Chewable Tablets at a dose of 2.27 mg/lb
(5.0 mg/kg) orally approximately 2 hours prior to surgery and once daily thereafter for a total of three days. The following
adverse reactions were observed. Dogs may have experienced more than one of the observed reactions during the study.
Adverse Reactions Seen in the Orthopedic Surgery
Postoperative Pain Field Study
Adverse Reactions
Vomiting
Diarrhea
Bruising at Surgery Site
Inappetence/ Decreased Appetite
Pyrexia
Incision Swelling, Redness
Oozing Incision
Firocoxib Group (n=118)
1
2**
2
1
0
9
2
Control Group* (n=108)
0
1
3
2
1
5
0
A case may be represented in more than one category.
*Sham-dosed (pilled).
**One dog had hemorrhagic gastroenteritis.
94
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Post-Approval Experience (Rev. 2009): The following adverse reactions are based on post-approval adverse
drug event reporting. The categories are listed in decreasing order of frequency by body system:
Gastrointestinal: Vomiting, anorexia, diarrhea, melena, gastrointestinal perforation, hematemesis, hematachezia,
weight loss, gastrointestinal ulceration, peritonitis, abdominal pain, hypersalivation, nausea
Urinary: Elevated BUN, elevated creatinine, polydypsia, polyuria, hematuria, urinary incontinence, proteinuria,
kidney failure, azotemia, urinary tract infection
Neurological/Behavioral/Special Sense: Depression/lethargy, ataxia, seizures, nervousness, confusion,
weakness, hyperactivity, tremor, paresis, head tilt, nystagmus, mydriasis, aggression, uveitis
Hepatic: Elevated ALP, elevated ALT, elevated bilirubin, decreased albumin, elevated AST, icterus, decreased or
increased total protein and globulin, pancreatitis, ascites, liver failure, decreased BUN
Hematological: Anemia, neutrophilia, thrombocytopenia, neutropenia
Cardiovascular/Respiratory: Tachypnea, dyspnea, tachycardia
Dermatologic/Immunologic: Pruritis, fever, alopecia, moist dermatitis, autoimmune hemolytic anemia, facial/
muzzle edema, urticaria
In some situations, death has been reported as an outcome of the adverse events listed above.
For a complete listing of adverse reactions for firocoxib reported to the CVM see:
http://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm055394.htm
Information For Dog Owners: PREVICOX, like other drugs of its class, is not free from adverse reactions. Owners
should be advised of the potential for adverse reactions and be informed of the clinical signs associated with drug
intolerance. Adverse reactions may include vomiting, diarrhea, decreased appetite, dark or tarry stools, increased
water consumption, increased urination, pale gums due to anemia, yellowing of gums, skin or white of the eye due
to jaundice, lethargy, incoordination, seizure, or behavioral changes. Serious adverse reactions associated with
this drug class can occur without warning and in rare situations result in death (see Adverse Reactions).
Owners should be advised to discontinue PREVICOX therapy and contact their veterinarian immediately
if signs of intolerance are observed. The vast majority of patients with drug-related adverse reactions have
recovered when the signs are recognized, the drug is withdrawn, and veterinary care, if appropriate, is initiated.
Owners should be advised of the importance of periodic follow up for all dogs during administration of any NSAID.
Effectiveness: Two hundred and forty-nine dogs of various breeds, ranging in age from 11 months to 20 years,
and weighing 13 to 175 lbs, were randomly administered PREVICOX or an active control drug in two field studies.
Dogs were assessed for lameness, pain on manipulation, range of motion, joint swelling, and overall improvement
in a non-inferiority evaluation of PREVICOX compared with the active control. At the study’s end, 87% of the
owners rated PREVICOX-treated dogs as improved. Eighty-eight percent of dogs treated with PREVICOX were also
judged improved by the veterinarians. Dogs treated with PREVICOX showed a level of improvement in veterinarianassessed lameness, pain on palpation, range of motion, and owner-assessed improvement that was comparable
to the active control. The level of improvement in PREVICOX-treated dogs in limb weight bearing on the force plate
gait analysis assessment was comparable to the active control. In a separate field study, two hundred fifty-eight
client-owned dogs of various breeds, ranging in age from 10.5 weeks to 16 years and weighing from 7 to 168 lbs,
were randomly administered PREVICOX or a control (sham-dosed-pilled) for the control of postoperative pain and
inflammation associated with soft-tissue surgical procedures such as abdominal surgery (e.g., ovariohysterectomy,
abdominal cryptorchidectomy, splenectomy, cystotomy) or major external surgeries (e.g., mastectomy, skin tumor
removal ≤8 cm). The study demonstrated that PREVICOX-treated dogs had significantly lower need for rescue
medication than the control (sham-dosed-pilled) in controlling postoperative pain and inflammation associated with
soft-surgery. A multi-center field study with 226 client-owned dogs of various breeds, and ranging in age from 1
to 11.9 years in the PREVICOX-treated groups and 0.7 to 17 years in the control group was conducted. Dogs were
randomly assigned to either the PREVICOX or the control (sham-dosed-pilled) group for the control of postoperative
pain and inflammation associated with orthopedic surgery. Surgery to repair a ruptured cruciate ligament included
the following stabilization procedures: fabellar suture and/or imbrication, fibular head transposition, tibial plateau
leveling osteotomy (TPLO), and ‘over the top’ technique. The study (n = 220 for effectiveness) demonstrated that
PREVICOX-treated dogs had significantly lower need for rescue medication than the control (sham-dosed-pilled) in
controlling postoperative pain and inflammation associated with orthopedic surgery.
Animal Safety: In a targeted animal safety study, firocoxib was administered orally to healthy adult Beagle dogs
(eight dogs per group) at 5, 15, and 25 mg/kg (1, 3, and 5 times the recommended total daily dose) for 180 days.
At the indicated dose of 5 mg/kg, there were no treatment-related adverse events. Decreased appetite, vomiting,
and diarrhea were seen in dogs in all dose groups, including unmedicated controls, although vomiting and diarrhea
were seen more often in dogs in the 5X dose group. One dog in the 3X dose group was diagnosed with juvenile
polyarteritis of unknown etiology after exhibiting recurrent episodes of vomiting and diarrhea, lethargy, pain,
anorexia, ataxia, proprioceptive deficits, decreased albumin levels, decreased and then elevated platelet counts,
increased bleeding times, and elevated liver enzymes. On histopathologic examination, a mild ileal ulcer was found
in one 5X dog. This dog also had a decreased serum albumin which returned to normal by study completion. One
control and three 5X dogs had focal areas of inflammation in the pylorus or small intestine. Vacuolization without
inflammatory cell infiltrates was noted in the thalamic region of the brain in three control, one 3X, and three 5X
dogs. Mean ALP was within the normal range for all groups but was greater in the 3X and 5X dose groups than
in the control group. Transient decreases in serum albumin were seen in multiple animals in the 3X and 5X dose
groups, and in one control animal. In a separate safety study, firocoxib was administered orally to healthy juvenile
(10-13 weeks of age) Beagle dogs at 5, 15, and 25 mg/kg (1, 3, and 5 times the recommended total daily dose)
for 180 days. At the indicated (1X) dose of 5 mg/kg, on histopathologic examination, three out of six dogs had
minimal periportal hepatic fatty change. On histopathologic examination, one control, one 1X, and two 5X dogs had
diffuse slight hepatic fatty change. These animals showed no clinical signs and had no liver enzyme elevations.
In the 3X dose group, one dog was euthanized because of poor clinical condition (Day 63). This dog also had a
mildly decreased serum albumin. At study completion, out of five surviving and clinically normal 3X dogs, three
had minimal periportal hepatic fatty change. Of twelve dogs in the 5X dose group, one died (Day 82) and three
moribund dogs were euthanized (Days 38, 78, and 79) because of anorexia, poor weight gain, depression, and in
one dog, vomiting. One of the euthanized dogs had ingested a rope toy. Two of these 5X dogs had mildly elevated
liver enzymes. At necropsy all five of the dogs that died or were euthanized had moderate periportal or severe
panzonal hepatic fatty change; two had duodenal ulceration; and two had pancreatic edema. Of two other clinically
normal 5X dogs (out of four euthanized as comparators to the clinically affected dogs), one had slight and one had
moderate periportal hepatic fatty change. Drug treatment was discontinued for four dogs in the 5X group. These
dogs survived the remaining 14 weeks of the study. On average, the dogs in the 3X and 5X dose groups did not gain
as much weight as control dogs. Rate of weight gain was measured (instead of weight loss) because these were
young growing dogs. Thalamic vacuolation was seen in three of six dogs in the 3X dose group, five of twelve dogs
in the 5X dose group, and to a lesser degree in two unmedicated controls. Diarrhea was seen in all dose groups,
including unmedicated controls. In a separate dose tolerance safety study involving a total of six dogs (two control
dogs and four treated dogs), firocoxib was administered to four healthy adult Beagle dogs at 50 mg/kg (ten times
the recommended daily dose) for twenty-two days. All dogs survived to the end of the study. Three of the four
treated dogs developed small intestinal erosion or ulceration. Treated dogs that developed small intestinal erosion
or ulceration had a higher incidence of vomiting, diarrhea, and decreased food consumption than control dogs.
One of these dogs had severe duodenal ulceration, with hepatic fatty change and associated vomiting, diarrhea,
anorexia, weight loss, ketonuria, and mild elevations in AST and ALT. All four treated dogs exhibited progressively
decreasing serum albumin that, with the exception of one dog that developed hypoalbuminemia, remained within
normal range. Mild weight loss also occurred in the treated group. One of the two control dogs and three of the
four treated dogs exhibited transient increases in ALP that remained within normal range.
Made in France
Marketed by: Merial Limited, Duluth, GA 30096-4640, U.S.A.
1-877-217-3543
NADA 141-230, Approved by FDA
Rev. 07-2012
®PREVICOX is a registered trademark of Merial.
©2014 Merial. All rights reserved.
CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.
Description:
NEXGARD™ (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and
puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/
lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5- [3-chloro-5-(trifluoromethyl)phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N-[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl.
Indications:
NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis),
and the treatment and control of Black-legged tick (Ixodes scapularis), American Dog tick (Dermacentor variabilis),
and Lone Star tick (Amblyomma americanum) infestations in dogs and puppies 8 weeks of age and older, weighing 4
pounds of body weight or greater, for one month.
Dosage and Administration:
NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg).
Dosing Schedule:
Body
Weight
4.0 to 10.0 lbs.
10.1 to 24.0 lbs.
24.1 to 60.0 lbs.
60.1 to 121.0 lbs.
Over 121.0 lbs.
Afoxolaner Per
Chewables
Chewable (mg)
Administered
11.3
One
28.3
One
68
One
136
One
Administer the appropriate combination of chewables
NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose,
and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If it
is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration, redose with
another full dose. If a dose is missed, administer NEXGARD and resume a monthly dosing schedule.
Flea Treatment and Prevention:
Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly
treatment with NEXGARD should continue the entire year without interruption.
To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved
flea control product.
Tick Treatment and Control:
Treatment with NEXGARD may begin at any time of the year (see Effectiveness).
Contraindications:
There are no known contraindications for the use of NEXGARD.
Warnings:
Not for use in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a
physician immediately.
Precautions:
The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs
with a history of seizures (see Adverse Reactions).
Adverse Reactions:
In a well-controlled US field study, which included a total of 333 households and 615 treated dogs (415 administered
afoxolaner; 200 administered active control), no serious adverse reactions were observed with NEXGARD.
Over the 90-day study period, all observations of potential adverse reactions were recorded. The most frequent reactions
reported at an incidence of > 1% within any of the three months of observations are presented in the following table.
The most frequently reported adverse reaction was vomiting. The occurrence of vomiting was generally self-limiting and
of short duration and tended to decrease with subsequent doses in both groups. Five treated dogs experienced anorexia
during the study, and two of those dogs experienced anorexia with the first dose but not subsequent doses.
Table 1: Dogs With Adverse Reactions.
Treatment Group
Afoxolaner
Vomiting (with and without blood)
Dry/Flaky Skin
Diarrhea (with and without blood)
Lethargy
Anorexia
N1
17
13
13
7
5
% (n=415)
4.1
3.1
3.1
1.7
1.2
Oral active control
N2
25
2
7
4
9
% (n=200)
12.5
1.0
3.5
2.0
4.5
1
Number of dogs in the afoxolaner treatment group with the identified abnormality.
2
Number of dogs in the control group with the identified abnormality.
In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the
first dose and on the same day after receiving the second dose of NEXGARD. This dog experienced a third seizure one
week after receiving the third dose. The dog remained enrolled and completed the study. Another dog with a history of
seizures had a seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study.
A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study.
To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at 1-888637-4251 or www.merial.com/nexgard. For additional information about adverse drug experience reporting for animal
drugs, contact FDA at 1-888-FDA-VETS or online at http://www.fda.gov/AnimalVeterinary/SafetyHealth.
Mode of Action:
Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine
ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA),
thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes. Prolonged afoxolaner-induced
hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines.
The selective toxicity of afoxolaner between insects and acarines and mammals may be inferred by the differential
sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors.
Effectiveness:
In a well-controlled laboratory study, NEXGARD began to kill fleas four hours after initial administration and demonstrated
>99% effectiveness at eight hours. In a separate well-controlled laboratory study, NEXGARD demonstrated 100%
effectiveness against adult fleas 24 hours post-infestation for 35 days, and was ≥ 93% effective at 12 hours post-infestation
through Day 21, and on Day 35. On Day 28, NEXGARD was 81.1% effective 12 hours post-infestation. Dogs in both the
treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment
(0-11 eggs and 1-17 eggs in the NEXGARD treated dogs, and 4-90 eggs and 0-118 eggs in the control dogs, at 12- and 24hours, respectively). At subsequent evaluations post-infestation, fleas from dogs in the treated group were essentially unable
to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs).
In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of
NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively.
Collectively, the data from the three studies (two laboratory and one field) demonstrate that NEXGARD kills fleas before
they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations.
In well-controlled laboratory studies, NEXGARD demonstrated >94% effectiveness against Dermacentor variabilis and
Ixodes scapularis, 48 hours post-infestation, and against Amblyomma americanum 72 hours post-infestation, for 30 days.
Animal Safety:
In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the
maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for
a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to
treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or
coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar
incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment.
In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines,
anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions
were observed from the concomitant use of NEXGARD with other medications.
Storage Information:
Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F).
How Supplied:
NEXGARD is available in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each
chewable size is available in color-coded packages of 1, 3 or 6 beef-flavored chewables.
NADA 141-406, Approved by FDA
Marketed by: Frontline Vet Labs™, a Division of Merial Limited.
Duluth, GA 30096-4640 USA
Made in Brazil.
1050-4493-02
Rev. 4/2014
™NexGard and FRONTLINE VET LABS are trademarks of Merial.
©2014 Merial. All rights reserved.
xng222320_LaunchTradeAd-VetAdvantage-PI-3.25x8.75_RSg.indd 1
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For Animal Use Only
141-342
CIV
(alfaxalone 10 mg/mL)
Intravenous injectable anesthetic for use in cats and dogs.
BRIEF SUMMARY OF PRESCRIBING INFORMATION
This summary does not include all the information needed to use Alfaxan® safely and
effectively. See full package insert for complete information.
CAUTION:
Federal law restricts this drug to use by or on the order of a licensed veterinarian.
INDICATIONS:
Alfaxan® is indicated for the induction and maintenance of anesthesia and for induction of anesthesia
followed by maintenance with an inhalant anesthetic, in cats and dogs.
DOSAGE AND ADMINISTRATION (highlights): Please refer to the complete package
insert for full prescribing and administration information before use of this product.
Administer by intravenous injection only. For induction, administer Alfaxan® over approximately
60 seconds or until clinical signs show the onset of anesthesia, titrating administration against the
response of the patient. Rapid administration of Alfaxan® may be associated with an increased
incidence of cardiorespiratory depression or apnea. Apnea can occur following induction or after
the administration of maintenance boluses of Alfaxan®. The use of preanesthetics may reduce the
Alfaxan® induction dose. The choice and the amount of phenothiazine, alpha2-adrenoreceptor
agonist, benzodiazepine or opioid will influence the response of the patient to an induction dose
of Alfaxan®.
When using Alfaxan,® patients should be continuously monitored, and
facilities for the maintenance of a patent airway, artificial ventilation,
and oxygen supplementation must be immediately available.
Alfaxan® does not contain an antimicrobial preservative. Do not use if contamination is suspected.
Strict aseptic techniques must be maintained because the vehicle is capable of supporting the
rapid growth of microorganisms. Failure to follow aseptic handling procedures may result in
microbial contamination which may cause fever, infection/sepsis, and/or other life-threatening illness.
Once Alfaxan® has been opened, vial contents should be drawn into sterile syringes; each syringe
should be prepared for single patient use only. Unused product should be discarded within
6 hours. Alfaxan® should not be mixed with other therapeutic agents prior to administration.
INDUCTION OF GENERAL ANESTHESIA:
CATS: Induction dose guidelines range between 2.2 - 9.7 mg/kg for cats that did not receive a
preanesthetic, and between 1.0 - 10.8 mg/kg for cats that received a preanesthetic. The Alfaxan®
induction dose in the field study was reduced by 10 - 43%, depending on the combination of
preanesthetics (dose sparing effect). To avoid anesthetic overdose, titrate the administration of
Alfaxan® against the response of the patient.
DOGS: Induction dose guidelines range between 1.5 - 4.5 mg/kg for dogs that did not receive a
preanesthetic, and between 0.2 - 3.5 mg/kg for dogs that received a preanesthetic. The Alfaxan®
induction dose in the field study was reduced by 23 - 50% depending on the combination of
preanesthetics (dose sparing effect). To avoid anesthetic overdose, titrate the administration of
Alfaxan® against the response of the patient.
The average Alfaxan® induction dose rates for healthy cats and dogs given alfaxalone alone, or
when alfaxalone is preceded by a preanesthetic, are indicated in species specific tables found in
the full package insert. These tables are based on field study results and are for guidance only.
The dose and rate for alfaxalone should be based upon patient response.
MAINTENANCE OF GENERAL ANESTHESIA:
CATS: Following induction of anesthesia with Alfaxan® and intubation, anesthesia may be
maintained using intermittent Alfaxan® intravenous boluses or an inhalant anesthetic agent.
Please review the full package insert for guidance on recommended intermittent doses of Alfaxan
and their expected duration of effect. Clinical response may vary, and is determined by the dose,
rate of administration, and frequency of maintenance injections.
DOGS: Following induction of anesthesia with Alfaxan® and intubation, anesthesia may be main-
tained using intermittent Alfaxan® intravenous boluses or an inhalant anesthetic agent. Please
review the full package insert for guidance on recommended intermittent doses of Alfaxan and
their expected duration of effect. Clinical response may vary, and is determined by the dose, rate
of administration, and frequency of maintenance injections.
Alfaxan® maintenance dose sparing is greater in cats and dogs that receive a preanesthetic.
Maintenance dose and frequency should be based on the response of the individual patient.
Inhalant anesthetic maintenance of general anesthesia in cats and dogs: Additional low doses
of Alfaxan®, similar to a maintenance dose, may be required to facilitate the transition to inhalant
maintenance anesthesia.
WARNINGS:
When anesthetized using Alfaxan®, patients should be continuously monitored, and facilities for
the maintenance of a patent airway, artificial ventilation, and oxygen supplementation must be
immediately available.
Rapid bolus administration or anesthetic overdose may cause cardiorespiratory depression, including hypotension, apnea, hypoxia, or death. Arrhythmias may occur secondary to apnea and
hypoxia. In cases of anesthetic overdose, stop Alfaxan® administration and administer treatment
as indicated by the patient’s clinical signs.
Cardiovascular depression should be treated with plasma expanders, pressor agents,
anti-arrhythmic agents or other techniques as appropriate for the treatment of the clinical signs.
HUMAN WARNINGS:
Not for human use. Keep out of the reach of children.
Exercise caution to avoid accidental self-injection. Overdose is likely to cause cardiorespiratory
depression (such as hypotension, bradycardia and/or apnea). Remove the individual from the
source of exposure and seek medical attention. Respiratory depression should be treated by
artificial ventilation and oxygen.
Avoid contact of this product with skin, eyes, and clothes. In case of contact, eyes and skin
should be liberally flushed with water for 15 minutes. Consult a physician if irritation persists. In
the case of accidental human ingestion, seek medical advice immediately and show the package
insert or the label to the physician.
The Material Safety Data Sheet (MSDS) contains more detailed occupational safety information. To report
adverse reactions in users or to obtain a copy of the MSDS for this product call 1-844-253-2926.
DRUG ABUSE AND DEPENDENCE:
Controlled Substance: Alfaxan® contains alfaxalone, a neurosteroid anesthetic and a class IV
controlled substance.
Abuse: Alfaxalone is a central nervous system depressant that acts on GABA receptor associated
chloride channels, similar to the mechanism of action of Schedule IV sedatives such as benzodiazepines
(diazepam and midazolam), barbiturates (phenobarbital and methohexital) and fospropofol. In a drug
discrimination behavioral test in rats, the effects of alfaxalone were recognized as similar to those of
midazolam. These biochemical and behavioral data suggest that alfaxalone has an abuse potential
similar to other Schedule IV sedatives. Physical dependence: There are no data that assess the ability
of alfaxalone to induce physical dependence. However, alfaxalone has a mechanism of action
similar to the benzodiazepines and can block the behavioral responses associated with precipitated
benzodiazepine withdrawal. Therefore, it is likely that alfaxalone can also produce physical dependence
and withdrawal signs similar to that produced by the benzodiazepines. Psychological dependence:
The ability of alfaxalone to produce psychological dependence is unknown because there are no
data on the rewarding properties of the drug from animal self-administration studies or from human
abuse potential studies.
PRECAUTIONS:
1. Unpreserved formulation: Alfaxan® injection does not contain an antimicrobial preservative. Do
not use if contamination is suspected. Strict aseptic techniques must be maintained because the
vehicle is capable of supporting the rapid growth of microorganisms. Failure to follow aseptic handling
procedures may result in microbial contamination which may cause fever, infection/sepsis, and/or
other life-threatening illness. Any solution remaining in the vial following withdrawal of the required
dose should be discarded. Once Alfaxan® has been opened, any unused product should be discarded
within 6 hours. Alfaxan® should not be mixed with other therapeutic agents prior to administration.
2. Rapid arousal: Careful monitoring of the patient is necessary due to possibility of rapid arousal.
3. Preanesthesia: Benzodiazepines may be used safely prior to Alfaxan® in the presence of other
preanesthetics. However, when a benzodiazepine was used as the sole preanesthetic, excitation
occurred in some dogs and cats during Alfaxan® anesthesia and recovery.
4. Apnea: Apnea may occur following administration of an induction dose, a maintenance dose
or a dose administered during the transition to inhalant maintenance anesthesia, especially with
higher doses and rapid administration. Endotracheal intubation, oxygen supplementation, and
intermittent positive pressure ventilation (IPPV) should be administered to treat apnea and
associated hypoxemia.
5. Blood Pressure: The myocardial depressive effects of Alfaxan® combined with the vasodilatory
effects of inhalant anesthetics can be additive, resulting in hypotension. Preanesthetics may
increase the anesthesia effect of Alfaxan® and result in more pronounced changes in systolic,
diastolic, and mean arterial blood pressures. Transient hypertension may occur, possibly due to
elevated sympathetic activity.
6. Body Temperature: A decrease in body temperature occurs during Alfaxan® anesthesia unless
an external heat source is provided. Supplemental heat should be provided to maintain acceptable
core body temperature until full recovery.
7. Breeding Animals: Alfaxan® has not been evaluated in pregnant, lactating, and breeding cats.
Alfaxalone crosses the placenta, and as with other general anesthetic agents, the administration of
alfaxalone may be associated with neonatal depression.
8. Kittens and Puppies: Alfaxan® has not been evaluated in cats less than 4 weeks of age or in dogs
less than 10 weeks of age.
9. Compromised or Debilitated Cats and Dogs: The administration of Alfaxan® to debilitated patients
or patients with renal disease, hepatic disease, or cardiorespiratory disease has not been evaluated.
Doses may need adjustment for geriatric or debilitated patients. Caution should be used in cats
or dogs with cardiac, respiratory, renal or hepatic impairment, or in hypovolemic or debilitated
cats and dogs, and geriatric animals.
10. Analgesia during anesthesia: Appropriate analgesia should be provided for painful procedures.
ADVERSE REACTIONS:
The primary side effects of alfaxalone are respiratory depression (apnea, bradypnea, hypoxia) and
cardiovascular derangements (hypertension, hypotension, tachycardia, bradycardia). Other adverse
reactions observed in clinical studies include hypothermia, emesis, unacceptable anesthesia
quality, lack of effectiveness, vocalization, paddling, and muscle tremors.
Adverse drug reactions may also be reported to the FDA/CVM at 1-888-FDA-VETS or
http://www.fda.gov/AnimalVeterinary/SafetyHealth/ReportaProblem/ucm055305.htm
OVERDOSE:
Rapid administration, accidental overdose, or relative overdose due to inadequate dose sparing of
Alfaxan® in the presence of preanesthetics may cause cardiopulmonary depression. Respiratory
arrest (apnea) may be observed. In cases of respiratory depression, stop drug administration,
establish a patent airway, and initiate assisted or controlled ventilation with pure oxygen.
Cardiovascular depression should be treated with plasma expanders, pressor agents,
antiarrhythmic agents or other techniques as appropriate for the observed abnormality.
HOW SUPPLIED:
Alfaxan® is supplied in 10 mL single-use vials containing 10 mg alfaxalone per mL.
Manufactured for:
Jurox Inc.
4520 Main Street, Kansas City,
MO 64111, USA
Alfaxan is a registered trademark of Jurox Pty Limited.
US Patent # 7,897,586
www.vet-advantage.com • Veterinary advantage
«« July/August
2014
97
»» Editor’s Note
Senior pets
demand our attention
When Christopher Byers, DVM, worked as a technician in the
mid-90s, “if an old dog or cat came into the office with his or her family, honestly, they were often
treated just like any other patient – with care and compassion, yes, but they weren’t considered a
special patient population with unique healthcare needs. Today, we recognize that geriatric patients do
have unique health needs, and the sooner we identify them, the better they will likely be in both the
short and long term.”
in the discussion about the senior pet. “Animals
are living closer to us, so we can see when they
By Mark Thill
don’t feel right,” Dr. Crumley tells us. “And people
care intensely about making the quality of their
pets’ lives better.”
There’s another interesting dynamic, closely
related: “The general population of pet owners
is aging a bit, so people are sensitive to what’s
ailing their pet,” says Dr. Crumley. “‘What I am
experiencing, are my pets experiencing that as well?’”
Many primary care hospitals have
developed protocols specifically for
geriatric care, and they have trained
their nursing staffs and client services
teams to educate pet owners and promote this specific aspect of preventive healthcare, Dr. Byers tells us. As
a result, practices are educating their
– Kate Crumley, DVM, president of the American Animal Hospital Association
clients about the potential for osteoarthritis, heart disease, hyperthyroidism and
20 years ago, when I came out of school. It dechronic kidney disease in their senior pets.
pends on breed and species, but gaining years
Prior to bringing their older pets in to Twin
on the pet’s life is pretty common. It’s expected
Cities Animal Rehabilitation and Sports Medithese days.”
cine Clinic, Burnsville, Minn., clients are asked
Improved medical technology – surgical equipto fill out a mobility questionnaire related to their
ment and supplies, pharmaceuticals, nutrition – is
pets, explains Julia Tomlinson, BVSc. That’s beplaying a big role. What’s interesting is how the atcause arthritis and mobility issues are common
titudes and actions of pet owners and their veteriamong senior pets, she tells us.
narians are influencing the trend as well.
The growth in the number of senior pets is
In the past couple of issues of Vet-Advanongoing. With it come challenges and opportutage, we have reported on the significance of
nities for Vet-Advantage readers.
the human-animal bond. This bond plays a role
In this month’s issue of Vet-Advantage, we
draw attention to the care being provided to senior companion animals, and the role that distributors of veterinary products and equipment
can play in that effort. Of course, any pet owner
already knows that life expectancies are longer
than ever. Says Kate Crumley, DVM, president
of the American Animal Hospital Association,
“Pets certainly are living longer than they did
“Animals are living closer to
us, so we can see when they
don’t feel right. And people
care intensely about making the
quality of their pets’ lives better.”
98
July/August 2014
»» Veterinary adVantage • www.vet-advantage.com
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