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22 VET REPORT VITALS VET REPORT VITALS species. Resistant Staphylococcus pseudintermedius was transmitted from pet to owner in Spain, 6 and numerous multidrug-resistant zoonotic bacteria have been encountered in companion animal practices with the potential to be spread bidirectionally between humans and their pets. 7 These reports provide evidence that companion animals provide a source of antimicrobial-resistant infections to—and are at risk for contracting them from—humans, making prevention or minimization of zoonotic spread a critical consideration for companion animal veterinarians. IMPLICATIONS FOR CLIENTS AMR has important implications for veterinary clients as well. In the interest of promoting good compliance within a successful veterinarian–client/patient relationship, veterinarians should consider these implications in decision-making and client communications. Many of the issues that affect veterinarians will be of equal or greater concern for clients because they directly affect their pet and finances. These issues include less effective treatments for infections, which could ultimately lead to worse outcomes, with greater morbidity and mortality. In addition, decreased effectiveness of available treatments and prolonged therapy are likely to result in higher veterinary bills. The WHO has shown that AMR is a drain on the global economy, with economic losses due to higher costs of treatment in human medicine. Although the significance of these costs in companion animal medicine is likely to be lower, the effect on the individual owner is likely to be more substantial. 1 Finally, the reality of the risk for AMR transmission between clients and their pets is a topic that cannot be neglected in educating clients on appropriate antimicrobial use. 6,7 In discussions of treatment options and plans with clients, conveying these longer-term implications may help improve client compliance. SUMMARY A major challenge in the judicious use of antimicrobials can be the discrepancy between the visible and invisible effects on patient outcomes and resistance development, respectively. In the short term, immediate patient needs and client expectations can make the dispensation of antimicrobial drugs the easier solution. This may provide coverage in case of infection and avoid the hassle and burden of a client returning later for a prescription if preventive and supportive measures have not been effective. These effects are visible outcomes of antimicrobial use and occur relatively quickly after a patient presents to the veterinarian, so they are more likely to be associated in the minds of the veterinarian and the client. The invisible consequences of AMR are the public health impacts, drug efficacy, and cumulative patient outcomes. Although serious, these consequences are often removed, both temporally and spatially, for the veterinarian and client, and therefore are harder to balance against the immediate, visible results. Keeping them in mind through education and conversation can help veterinarians balance their responsibilities as providers of treatment to pets in their care, including Molly McAllister, DVM, MPH Dr. Molly McAllister is the Director of Research for the Banfield Applied Research and Knowledge (BARK) team at Banfield Pet Hospital. She is a graduate of Oregon State University College of Veterinary Medicine and subsequently earned her master of public health degree from the University of Minnesota. Dr. McAllister is passionate about the role of preventive and proactive care in the health and quality of life of our pets, as well as the intersection of human, animal, and environmental health. She lives with her family and 4 pets in Vancouver, Washington, where they spend as much time outdoors as possible. Banfield has always been dedicated to using its extensive data to provide insights to the profession on topics that can improve veterinary care for pets. The first annual Banfield Veterinary Emerging Topics (VET) Report, supported by the collaborative educational efforts of the NAVC, focuses on a critical topic: antimicrobial resistance. It is titled "Are We Doing Our Part to Prevent Superbugs? Antimicrobial Usage Patterns Among Companion Animal Veterinarians." "We are proud to team up with the NAVC on the 2017 VET Report to raise awareness about the critical topic of antimicrobial resistance in companion animal practice and how veterinarians can address it in their own practices," said Dr. Karen Faunt, Vice President of Medical Quality Advancement at Banfield Pet Hospital. The full report is available at Banfield.com/VETReport or VetFolio.com/VETReport . VET REPORT VITALS continued on page 30