Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/815220
26 AHS HEARTWORM HOTLINE HEARTWORM HOTLINE If heartworm prevention or a heartworm test is declined, this should be noted in the clinic record. If the pet later becomes infected, the opportunity for reeducation is always there. REMINDER SYSTEMS For the Veterinary Practice Every time a heartworm prevention product is sold, it should be linked to a refill reminder to be e-mailed, texted, or delivered via traditional postal service. A simple reminder is one of a practice's strongest compliance enhancers. In our practice, annual heartworm tests are commonly performed in conjunction with annual examinations, but resale or renewal opportunities for prevention products often coincide with semiannual visits at 6-month intervals. In some veterinary clinics, a team member calls the client with a reminder on a given date. Regardless of the products stocked or the communication method used, the main objective is to compel the client to return to the clinic for more heartworm preventives—and to use them. Free and convenient resources are available. All the major pharmaceutical manufacturers that sell heartworm preventives provide incentives, discounts, or rebates to help market their products. These offers can be used to help educate your clients and distribute the product. For Clients Once your clients have purchased heartworm medication, they must be encouraged to administer it. Enhancing client compliance at home is as important as getting clients to the clinic. Consider two useful approaches: 1. Clients who use a smartphone can add a reminder to alert them when their pet requires dosing. The app used by our practice generically reminds clients that heartworm and flea prevention should be administered on the first of the month, whether a monthly, every-3- months, or every-6-months product is used. 2. Clients can use their at-home calendar to remind them when doses are due or can use the check-off panels on the prescription boxes if applicable. It is important to improve compliance on heartworm prevention with an electronic or more traditional reminder system within the comfort zone of the client. BOX 1. A Tale of Two Heartworm-Positive Cases A principle of adult learning is the use of narrative: people learn through stories. In our clinic, telling stories of past patients is one of the most effective ways to emphasize the importance of heartworm prevention, testing, and treatment. Owners who are concerned about adopting a heartworm-positive rescue dog might be inspired to learn about Maya. Those who are questioning the importance of year-round prevention or whose buying history indicates lapses in compliance likewise may benefit from hearing how Rock's unfortunate outcome might have been averted. Maya Maya was a 4-year-old mixed-breed rescue dog. When she was spayed at a local shelter, she was tested for heartworms and diagnosed with asymptomatic heartworms. She was then referred to our hospital for treatment. The hospital staff promptly started her on a course of doxycycline for 30 days and a monthly dose of ivermectin, following the AHS heartworm treatment protocol. Maya was placed in foster care for the next 2 months, then brought back for melarsomine therapy. She completed the treatment without complications. Shortly after treatment ended, a foster group asked to have her shipped from the Gulf Coast to Connecticut. Maya is now happily settled in her new home, with a new veterinarian. She is now receiving year-round heartworm prevention to avoid a repeat episode. Rock Rock was a 10-year-old neutered male bulldog whose owners had discontinued use of heartworm prevention. At diagnosis of heartworm infection, he presented clinically with heavy, labored breathing, pale gums, and ascites on his abdomen and had been anorectic for 3 days. The staff worked valiantly to improve his condition through supportive IV fluids, antibiotics, and other drugs; however, after watching Rock's condition deteriorate over 3 days in the hospital, the owner elected to have him euthanized. It was too late for Rock to be helped. This outcome was preventable. There are many ways to share anecdotes such as these. Tell stories of successful heartworm treatment and rescue dog turnarounds on your Facebook page (if the owner/foster volunteer consents). Feature stories on your clinic website. Share them on Twitter. The goal is to turn these compelling stories into messages that reinforce the importance of heartworm prevention, testing, and treatment. HEARTWORM HOTLINE continued on page 95