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Today's VeTerinary PracTice | september/october 2015 | tvpjournal.com aHs HearTWorM HoTLine Peer reviewed 78 • some pet owners state they have indoor pets or perceive they don't have a mosquito problem where they live. • clients may once have been compliant with prevention but over time have become lax without immediate consequences. Whatever the reason, the result is that far too many pets go unprotected. Educate, Educate, Educate Education is a lifelong process for the pet owner. Veterinarians cannot assume that an owner remembers a heartworm prevention discussion— and is still in agreement—because it was discussed at the pet's initial visit, but never thereafter. at my hospital in Mobile, alabama, we talk about heartworm prevention at every visit . if compliance is up to par, our staff can pat the owner on the back and encourage them to keep up the good work. if compliance is poor, we know we need to discuss again the risks of HWd, as well as the cost/beneft of prevention versus treatment. as part of this discussion, it is also important to explain how heartworm preventives work. oral heartworm preventives, for instance, only remain in the pet's body for about 3 days, during that time preventing larvae from maturing into young adults. The window of heartworm larval susceptibility is approximately 30 days, so it is apparent why skipping or delaying a dose can put the pet at risk of infection. Build Trust another factor in human compliance is the quality of communication and level of trust between the medical professional and the patient. 6 extrapolating this to heartworm preventive compliance, it is an important reminder that how the veterinarian talks about HWd with clients is as important as what he says. effective communication tips: • Make eye contact with clients when you talk to them, and show empathy for both pets and their owners. • Be empathetic to owners for whom heartworm preventive is marginally affordable or those who have a number of pets and are forced to make compromises. • Don't rush. Pet owner data show that compliance is highest when appointments were more than 10 minutes long (but only 25% of appointments lasted this long). 3 • Make continuity a priority. While staff turnover is inevitable, studies have shown that pet owners who see the same veterinarian at each visit reported higher compliance rates (50% of clients reported not seeing the same doctor from visit to visit). 3 Enlist Staff in Heartworm Education staff members are vital to good client communication and relationships, and a unifed message coming from all staff members is essential. consider whether a culture change is needed in your practice. does each member of the team keep his or her own pets on year-round heartworm prevention? There's no more compelling message than when a staff members can say, "Here's what I do for my pet ." conversely, if staff members don't practice what they preach, they will quickly lose the high ground. in my practice, new staff members attend weekly training meetings and shadow experienced members to ensure they understand the clinic's protocols as well as how to discuss them with clients. you can also ask staff members to create a reminder system. When dispensing heartworm medication, set up an automatic reminder to refll one month prior to the expected expiration of the prescription. Avoid the term "monthly" when referring to heartworm preventives. instead, use the phrase "every 30 days" to avoid confusion as to the dosing frequency. 7 Linking the heartworm administration to another monthly task, such as the rent check, may be helpful. Chri S topher rehm Christopher Rehm, DVM, a member of the American Heartworm Society board of directors, received his DVM from Auburn College of Veterinary Medicine. He began practicing in Mobile, Alabama, more than 30 years ago. What began as one veterinary clinic, Rehm Animal Hospital, PC, has grown to 4 American Animal Hospital Association (AAHA) certifed hospitals in 2 counties in lower Alabama. Rehm Animal Clinic has won numerous "best clinic" and "reader's choice" awards from local newspapers. In addition to practicing veterinary medicine, Dr. Rehm has written a syndicated pet column, hosted live public service spots, and served as a speaker at veterinary meetings. Visit tvpjournal.com to view these articles. dogS heartworm diagnostics: What do the latest american heartworm Society Canine guidelines tell us? (November/December 2014 issue) Canine heartworm disease: principles of treatment (March/ April 2015 issue) CatS the Facts about Feline heartworm disease (January/ February 2015 issue) FerretS diagnosis, treatment, & p revention of heartworm disease in Ferrets (July/ August 2015 issue)