PetVet March April 2019

WWW. PET VETMAGAZINE .COM

VOL. 2 ED. 2 • MARCH / APRIL 2019

A Practical Guide for Pet Health Professionals

3 VET VISITS

QUICK EXERCISES

YOU CAN DO BETWEEN

APPOINTMENTS

ON THE

RISE?

YOU MAY HAVE THE

MILLENNIALs

TO THANK

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MARCH / APRIL 2019

A Practical Guide for Pet Health Professionals

CONTENTS 6

Veterinarian Life Advice

7

PetVet Advisory Board

SUCCESSFULLY RIDE THE

NEW

No Pet Owner Left Behind

WAVE

12 The Veterinary Professional’s

3-Step Guide to Student Debt and Cash Flow

16

Does Diet Cause Dilated Cardiomyopathy (DCM) in Dogs?

OF CLIENT

EXPECTATIONS

20 Merrill Simpson’s Brave

BUSINESS TRENDS

New World

A

24 3 Quick Exercises You Can

Do Between Appointments Summoning Courage

32 PetVet 10: Ten Things to Do

This Month

ON THE COVER WWW. PET VETMAGAZINE .COM

VOL. 2 ED. 2 • MARCH / APRIL 2019

A Practical Guide for Pet Health Professionals

3 VET VISITS

QUICK EXERCISES

YOU CAN DO BETWEEN

APPOINTMENTS

YOU MAY HAVE THE

MILLENNIALs TO THANK

RI

Client expectations and services are

THE for the millennial client very ON different and, if your practice does not meet

SE?

and/or exceed these in the desired format, you will drive clients away instead of building loyalty.

practices approach the needs of this client. This is a generation of ease and efficiency; they want knowledge at their fingertips and immediately available. This translates into the essential need of having an accurate, up–to–date and very accessible (especially mobile) version of the hospital website, along with credible sources of continuing education and client handouts.

Many of our millennial clients are searching our website or the most recent diagnosis for information on their smartphones in the lobby as they wait to be checked You May Have the out. Rather than carrying a negative tone about searching Google or other sites, we must embrace the web and Client Expectations Surround the steer our clients in the direction we find most helpful.

Client “Experience” This includes the hospital’s own social media presence, its It’s common knowledge in the veterinary industry content and reinforcing engagement by being interactive that millennials have surpassed baby boomers as pet and responsive to client feedback. parents. This is very significant to how veterinary

TO THANK

ON THE

RISE?

s I celebrate my 42nd birthday this week, I am forced to acknowledge that my first years out in practice were nearly two decades ago, and new team members at my practice are telling me they were born in the 90’s—I suddenly felt OLD. But, after allowing myself a five–minute pity party, I had to remind myself that “old” can mean “experienced” and “with perspective”—which is a great thing! However, all of the other “seasoned” colleagues reading this have to remember something else of equal importance: we have to stay relevant in medicine, but we also have to adapt and flex with the new generation of clients coming through our door.

Client expectations and services are very different for the millennial client and, if your practice does not meet and/or exceed these in the desired format, you will drive clients away instead of building loyalty.

Let’s look at a few specific areas of client communication that can improve client service in your practice:

26

30 Overcoming Fears and

8

HOW TO

10 Access to Veterinary Care:

CLIENT SERVICES

8

PetVetMag

M

By Steve Dale

@PetVet_Magazine PETVET MAGAZINE

illennials are coming to the rescue? That’s studies have confirmed the problem. The AVMA, among right, they’re taking their heads out of their others, have provided information on why checkups phones and showing up at your clinic for for pets have been down, and offer several tools to help. preventive care.

They get it, and surprise—it’s cats However, by the real solution might be happeningInc, right970 West Copyright March 2019. PetVet Magazine is published bimonthly Barkleigh Productions, benefiting even more than dogs. However, their connow, with millennials leading the way.

Trindle Road, Mechanicsburg PA 17055.

Postmaster: Send change of address to Pet Vet Magazine c/o cerns and needs must be addressed.

When you think about it, millennial attachment Barkleigh Productions, 970has West Trindle PAa17055.

No ispart of this publication While petInc., ownership overall been on Road, the rise Mechanicsburg to their pets isn’t shocker. This the generation since 2000, routine care visits have suffered a significant that calls Editorial their pets “fur babies” 970 or refer to themselves may be reproduced without written permission of the publisher. offices: West Trindle Road, decline. The American Veterinary Medical Association as pet parents. Actually, according to the American Mechanicsburg PA 17055.

(717)for691–3388 FAX (717) 691–3381 Email: info@barkleigh.com response, called Partners Healthy Pets, and various Pet Products Association (APPA) Pet Owners Survey

26

PETVET MAGAZINE

PETVET MAGAZINE

5

VETERINARIAN LIFE ADVICE

Your Motivation Starts Here LIFE ADVICE FROM THE COOLEST VETERINARY PROFESSIONALS WE KNOW

“Having a rough day? Can’t stop thinking about your problems?

AT K E A

CONTACT Inquiries info@barkleigh.com (717) 691-3388

Editorial rebecca@barkleigh.com (717) 691-3388 (ext. 225) Advertising james@barkleigh.com (717) 691-3388 (ext. 224)

STAFF Publisher Barkleigh Productions, Inc. President Todd Shelly Vice President Gwen Shelly Chief Operations Officer Adam Lohr Executive Editor Rebecca Shipman Art Director Laura Pennington Senior Graphic Designer Jenn Barraclough

A

X A L E R D N

Know that everything will work out and you will get through it.”

Web Master Luke Dumberth Director of Marketing & Client Relations James Severs Administrative / Marketing Assistant Karin Grottola Marketing Coordinator Alyx Robertson

Merrill Simpson Colorado State Vet School Class of 2019

6

Junior Designer Jenny Thomas

PETVET MAGAZINE

Social Media / PR Coordinator Evan Gummo

ADVISORY BOARD

Meet our EDITORIAL

ADVISORY BOARD!

PetVet’s advisory board is here to help ensure quality content to motivate & educate Veterinarians and their staff.

Jenifer Chatfield DVM, DACZM

Courtney Campbell DVM “My passions ultimately drove me towards becoming a veterinarian, but when I was growing up I briefly flirted with the idea of becoming a magician. As a veterinarian, the ability to save lives, keep animals healthy, and strengthen the human–animal bond makes me realize there’s nothing more magical than that.”

Alberto Fernandez DVM, DACVECC

“People should be so lucky as to get to be a veterinarian. The broadbased education empowers us to be successful in multiple fields and affords us the opportunity to choose how we spend our professional time.”

Julie Legred CVT

"The human race will not be possible without the animal kingdom. It is our duty to take care of those that provide to us and to me it is an honor to do so."

Lisa Powell DVM, DACVECC

“I have had the privilege of working with a variety of animals in my career and my passion has allowed me to be involved in teaching veterinary students, interns, residents and other veterinarians. I continue to enjoy going to work every day to help critically ill dogs and cats, and love the client interactions as well. I am proud to be a part of this advisory board to help teach and spread my love for this profession to others in the veterinary community.”

Jill López DVM, MBA

“I have worked in many areas of veterinary medicine and veterinary technology over the last thirty five years, and it is amazing how far our profession has grown and paved the way for the betterment of animals' lives and happiness, as well as improving public health issues. It is an honor for me to be a part of this advisory board to offer additional education and opportunities to grow in our profession.”

A Practical Guide for Pet Health Professionals

“Do something every day to make an animal’s life better.”

S Q UA R E LO G O

A LT E R N

PETVETMAG PETVET_MAGAZINE

A Practical

DISP

CO LO R S

BE

808285 PETVET MAGAZINE

C0 M0 Y0 K60

7

HEAD

CLIENT SERVICES HOW TO

SUCCESSFULLY RIDE THE

NEW WAVE OF CLIENT

EXPECTATIONS

A

s I celebrate my 42nd birthday this week, I am forced to acknowledge that my first years out in practice were nearly two decades ago, and new team members at my practice are telling me they were born in the 90’s—I suddenly felt OLD. But, after allowing myself a five–minute pity party, I had to remind myself that “old” can mean “experienced” and “with perspective”—which is a great thing! However, all of the other “seasoned” colleagues reading this have to remember something else of equal importance: we have to stay relevant in medicine, but we also have to adapt and flex with the new generation of clients coming through our door.

Client expectations and services are very different for the millennial client and, if your practice does not meet and/or exceed these in the desired format, you will drive clients away instead of building loyalty.

Let’s look at a few specific areas of client communication that can improve client service in your practice: Client Expectations Surround the Client “Experience” It’s common knowledge in the veterinary industry that millennials have surpassed baby boomers as pet parents. This is very significant to how veterinary

8

by Natalie L. Marks, DVM, CVJ

Client expectations and services are very different for the millennial client and, if your practice does not meet and/or exceed these in the desired format, you will drive clients away instead of building loyalty. practices approach the needs of this client. This is a generation of ease and efficiency; they want knowledge at their fingertips and immediately available. This translates into the essential need of having an accurate, up–to–date and very accessible (especially mobile) version of the hospital website, along with credible sources of continuing education and client handouts.

Many of our millennial clients are searching our website or the most recent diagnosis for information on their smartphones in the lobby as they wait to be checked out. Rather than carrying a negative tone about searching Google or other sites, we must embrace the web and steer our clients in the direction we find most helpful.

This includes the hospital’s own social media presence, its content and reinforcing engagement by being interactive and responsive to client feedback.

PETVET MAGAZINE

In addition, millennials are seeking out an experience when interacting in areas of service. This means certain desired services are incredibly helpful to promote or add into veterinary hospitals, including but not limited to individualized vaccine counseling, delivery services, price matching for prescriptions or written prescriptions.

The Trap of “Over Promising & Under Delivering” Client loyalty is influenced by many variables, but this tried and true tenet encompasses many of the failures I see in this area of service. Nothing will upset a client of any generation more than telling them to expect a call with lab work that night and failing to call, being given the wrong prescription or food, or miscommunication between veterinarians or the veterinary team.

While we want to always strive for excellence in both medicine and client communication every day, we also have to set reasonable expectations for team members on what is absolutely expected in client and patient interactions where we commonly fall short. There are small ways that we can exceed or “over deliver” on service to build trust and loyalty.

Customer service representatives (CSR’s) have the incredibly challenging job of dealing with client demands and/or complaints, and these typically stem from not being able to easily and efficiently resolve their issue without escalation. We should empower our team to become solution seekers for clients and try to resolve their typically small issue in the moment, rather than transferring the client to a manager and having to re-explain the situation again with increasing frustration.

In these scenarios, it also helps to train team members on how to use positive customer-support phrases that are genuine and open-ended to encourage client feedback and validation. We

work in an emotional profession and recognition of the emotional state of the client should help direct the phrasing used to either calm or encourage rational and respectful communication headed towards resolution.

The Changing Role of Pets in the Family I don’t think this final point is breaking news to anyone in the industry.

But the reason I mention it again with such emphasis is because, while we all have seen the significant increase in dogs traveling with owners, becoming emotional service animals and serving the role of “children” of the pet parent, our messaging to clients has not changed.

Discussions in exam rooms regarding workups, treatment plans and, most importantly, pet parent goals for the future of that patient HAVE to include the role of that pet in the pet parent’s life.

Do not forget about the more recent advances in veterinary behavioral medicine, appetite stimulation, pain control, physical therapy and earlier diagnostics for many chronic diseases. Clients WANT to know about these options,

PETVET MAGAZINE

and the veterinary hospital should be the FIRST source for this information. The trust between a veterinarian and a client can be weakened when new advances are not discussed in the appointment, but instead found online, from a friend or even another animal hospital.

Keeping these points in the forefront of all team members’ minds and implementing appropriate training in communication to address the changing demographics will help your practice stay current and growing while exceeding expectations!  Dr. Marks is the medical director of Blum Animal Hospital, a ten doctor small animal practice in Chicago, IL, just south of Wrigley Field. Dr. Marks is also a national educator on many topics, including canine influenza, leptospirosis and canine allergic disease and is involved in media campaigns. In her spare time, Dr. Marks enjoys spending time with her family, especially her 3 fantastic children and furry child Samantha, also cooking, traveling, reading, going to concerts and being anywhere there is a beach!

9

WHY IT MATTERS TO ME ACCESS TO VETERINARY CARE

NO PET

OWNER LEFT

BEHIND

By Michael J. Blackwell, DVM, MPH

“We must endure overwhelming challenges to make the world a better place.

Get involved. Your determination will make the difference.”

I

t is estimated that 29 million dogs and cats live with families that participate in food stamp programs and there are millions more middle–class pet owners that, due to living expenses, may live paycheck to paycheck.

With limited discretionary funds, many families forgo veterinary care for their pets.

These families deserve the companionship and love that comes through a relationship with their pets and they also should be able to access veterinary care when their pets need it.

Maddie’s Fund funded a study by the Access to Veterinary Care Coalition (AVCC) to better understand barriers to veterinary care. Here are some of the study’s key findings: • Cost of care is still the most significant barrier to pet ownership.

• Not knowing where to access care is frequently a problem.

• Younger pet owners are more affected.

• Preventative and sick care were reported as more often presenting a barrier than emergency care due to finances.

• Prevention of zoonotic diseases is imperative to protect the health of the human members of the family and community.

The study raises a number of questions needing further research. Central to these questions is the need to better understand the impacts of barriers to veterinary care among diverse, underserved pet owners, and how to provide quality veterinary care for the most families while controlling costs.

The veterinary industry is aware that this is a significant problem for millions of pets and have acknowledged that a new model of veterinary care will help reduce the number of pets not receiving any care.

To read the entire study, please visit: http://avcc.utk.edu/avcc-report.pdf

A life of public service is what exemplifies Dr. Michael Blackwell. Like his father, he earned a doctor of veterinary medicine degree from Tuskegee University. He also earned a Master of Public Health degree from Loma Linda University. He currently serves as the Director of the Program for Pet Health Equity, College of Social Work, University of Tennessee, Knoxville. His mission is to improve access to veterinary care, especially for families with limited means. He chairs the Access to Veterinary Care Coalition. He also owned and operated private veterinary practices in Oklahoma and Maryland.

10

PETVET MAGAZINE

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By Bryan Gum

&

T

he number one thing that we see blocking young veterinarians from financial freedom is this — you don’t know where your money goes!

Many of you will begin your career as a veterinarian, start earning “big kid” money after years of surviving on student loans, and think you are set! Not so fast… by now you’ve hopefully realized that those student loans aren’t going anywhere, and yes, you are expected to pay them back.

So how do you go about doing this?

Step 1: Know Where Your Money Goes The first step in crafting any kind of financial plan is to get a lay of the land, which requires you to answer these four basic questions: • How much do you need to Live on per month (from housing to insurance, to Netflix)?

• How much do you want to Give to the people and causes that are important in your life?

• How much do you Owe in student loans and/or taxes?

• How much do you need to save and Grow to accomplish your goals?

12

If you can answer these Live, Give, Owe, Grow questions, then you are already miles ahead of most young veterinarians attempting to make sense of their money. The next step is implementation; no matter how much money you make, you must track your spending. There are many apps and websites that make this part really easy, but you must know what’s coming in each month, and what’s going out (cash flow!).

Step 2: Owe and Grow the “Smart Way” Once you have answered the four questions and have an understanding of your monthly cash flow, you can now get to work on implementing financial habits… and as a veterinarian, there are specific tools that can help you work smarter, not harder.

OWE

Student Loans are no joke. According to the AVMA1, the average student loan debt for veterinary school graduates (including those with $0 in debt) was $143,757.82. And if we assume an interest rate of 5%, then the average veterinarian has to pay nearly $7,200 per year before even making a dent!

Because of this massive challenge many of you face,

PETVET MAGAZINE

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you need to know your options.

(We believe it’s very important that you work with a professional and/or contact the AVMA for guidance in this area.) For all of the below plans, you must have federal student loans, and we recommend visiting StudentLoans.gov to see if your loans are eligible: • Income–Based Repayment (IBR): For new borrowers on or after

July 1, 2014, your monthly payment is capped at 10% of your discretionary income (15% for borrowers before July 1, 2014), and offers loan forgiveness after making regular payments for 20 years.

• Pay As You Earn (PAYE):

Payments are calculated as 10% of your monthly income, and offers loan forgiveness after making regular payments for 20 years. You must not have taken a federal loan prior to October 1, 2007 nor received a disbursement of

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• Revised Pay As You Earn (REPAYE): Payments are capped at 10%

of your discretionary income, and offers loan forgiveness after making regular payments for 20 years (and 25 years for loans taken for graduate school).

• Income–Contingent Repayment (ICR): This is the only

income–driven plan that allows Parent PLUS loans. Payments are the lesser of 20% of discretionary income or the standard payment on a 12–year payment schedule. The ICR plan offers loan forgiveness after making regular payments for 25 years.

• Public Service Loan Forgiveness (PSLF): If you work in

a role that qualifies as a public service, then you may be eligible for income– driven payments which may be forgiven after only 10 years of regular payments.

Don’t Get Bitten By Taxes Just because your student loans are forgiven doesn’t mean you won’t pay anything. If you have federal student loans forgiven under one of the above plans, then you will pay ordinary income taxes on the balance of the loan in the year it’s forgiven (with the exception of PSLF…this loan forgiveness is not taxed as income).

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Use tax–advantaged accounts to save for the long–term. Just like your debt, it’s important to know your options for saving and growing your wealth. Here are some options to consider: • If you work as an employee, consider participating in your employer’s 401(k) Plan (especially if they will match your contributions!).

• If you are self–employed, meet with a professional to weigh the pros and cons of opening your own retirement accounts (SEP–IRA, Simple IRA, Roth IRA or Traditional IRA… or perhaps even a solo–K). This is all to get you moving in the right direction.

PETVET MAGAZINE

• Know you have options, and work with a professional to start saving the smart way.

Step 3: Have a Plan & Roll with the Punches As you start your career and begin to make financial decisions for your future, you need to have a plan! Without one, you’re more likely to get lost in financial confusion and fall behind on your most important goals. Each quarter, consider writing down your financial goals, and the next action step you are going to take to accomplish them. If your goal is to be debt–free, take action to get on the right repayment plan for you. If your goal is to travel annually, make sure you save enough each month to take that trip! Don’t wait for life to happen to you. Be proactive, and roll with the punches.

That’s it! Three easy steps to kick start your veterinary career with some financial peace of mind. Do not overwhelm yourself trying to do everything at once. Start simple.

Good luck! 

References 1. https://www.avma.org/About/SAVMA/ StudentFinancialResources/Pages/ default.aspx

Bryan Gum, CFP® is a Financial Life Planner with Triune Financial Partners, LLC. Based in Kansas City, he serves couples and business–owners all around the country by helping them take the stress out of money and crafting customized plans for financial freedom. As a Certified Kingdom Advisor®, Bryan teaches his clients to avoid short–term gratification and empowers them to make wise decisions that lead to long– term contentment.

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INDUSTRY NEWS

M

DOES

DIET CAUSE

DILATED CARDIOMYOPATHY

(DCM)IN DOGS?

By Natalie Stilwell, DVM, MS, PhD

Dilated cardiomyopathy, or DCM, is characterized by an increased heart size due to weakened pumping ability of the heart muscle. In many patients, DCM eventually leads to

HEART FAILURE AND DEATH. 16

PETVET MAGAZINE

ultiple studies have recently revealed a correlation between certain dietary ingredients and the development of DCM in dogs. In particular, an association between DCM and the feeding of grain–free diets is suspected, but not yet definitively proven.

In a recent article in JAVMA, specialists from veterinary colleges throughout the U.S. explained what is currently understood about diet-associated DCM. The FDA Center for Veterinary Medicine and Veterinary Laboratory Investigation and Response Network are also currently working with veterinary cardiologists and nutritionists around the world to identify the complex causes of this condition2.

The Relationship Between Diet & Dilated Cardiomyopathy In the 1980s, an association between DCM and diet was first identified in cats affected with the condition3. Eventually, researchers discovered that taurine deficiency was the culprit, as cases could be effectively reversed with oral taurine supplementation and dietary modification.

Canine DCM is traditionally considered an inherited condition that predominantly affects certain large and giant dog breeds, such as the Doberman, Great Dane, and Irish Wolfhound. Unlike with DCM due to taurine deficiency, supplementing taurine in the diet is not an effective treatment for genetically caused DCM. Since the mid–1990s, however, reports have been increasing in unlikely dog breeds, as well as mixed–breed dogs. In a worldwide survey of veterinary cardiologists, Ryan Fries, D.V.M.,

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discovered more than 240 potential cases of diet–associated DCM over a 2–year period1. Most of the affected dogs were mixed–breeds, while frequently affected breeds included the Golden Retriever, Labrador Retriever, German Shepherd Dog and Cocker Spaniel.

“BEG” Diets Eventually, researchers determined that many of the affected dogs were fed diets containing certain ingredients, often for months to years before developing clinical signs. Collectively, these were termed “BEG” diets, standing for Boutique (i.e., small manufacturer), Exotic protein sources, and/or Grain–free.

BEG and homemade diets have recently gained popularity in the pet trade.

Many pet owners switch to BEG diets in the pursuit of wholesome, high–quality ingredients, and some grain–free diets are even marketed specifically for the management of certain health conditions, such as food allergy.

While BEG diets are appealing for well–intended owners, they often

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lack scientific support. Boutique diets made by small manufacturers are not always tested to meet the Association of American Feed Control Officials (AAFCO) standards or World Small Animal Veterinary Association (WSAVA) guidelines; therefore, they may be missing one or more important nutrients.

Exotic ingredients in diets fed to DCM–affected dogs have included novel meat sources (such as kangaroo, duck, buffalo and venison), flaxseed, fruit, probiotics, and starch and fiber derivatives. Grain–free diets frequently list peas, lentils, legume seeds or potatoes as the main ingredient.

Dr. Fries’ cardiologist survey revealed that many affected dogs had low blood or plasma taurine levels1. It’s important to note that not all dogs with diet–associated DCM were deficient in taurine.

Instead, they may have been affected by other, currently unknown dietary factors.

The FDA is currently investigating possible causes of diet–associated DCM, such as a deficiency or decreased bioavailability of another nutrient or, alternatively, the presence of a cardiotoxin in the diet2.

DCM In Golden Retrievers A recent study suggests that Golden Retrievers may be particularly susceptible to diet–associated DCM. In the study, 24 client–owned Golden Retrievers were diagnosed with DCM and taurine deficiency, which the authors defined as <250 nmol/mL of taurine in whole blood4. Eleven of the dogs were severely affected and displayed signs of congestive heart failure that necessitated diuretic therapy.

At the time of diagnosis, all dogs were fed diets that did not meet AAFCO standards or WSAVA guidelines. Out of the 13 identified diets, 12 were advertised as grain–free, and 10 of these instead contained a legume as the main ingredient. After

DCM IN GOLDEN RETRIEVERS OUT OF THE

13 DIETS

}

12

10

were advertised

as grain-free.

contained a legume as the main ingredient.

dietary modification and supplemental taurine, nearly all dogs showed significant clinical improvement, and congestive heart failure resolved in 9 of 11 dogs. This encouraging outcome suggests that diet-associated DCM is largely reversible in dogs when the underlying cause is addressed.

What to Do If You Have a Suspect Case The FDA currently recommends reporting suspected cases of diet–associated DCM. Diagnostic workup should include a review of the brand, product and flavor of the main diet, as well as any treats and supplements. Look for these key factors: 1) BEG ingredients, 2) low protein, 3) high fiber, 4) vegetarian, 5) vegan, or 6) homemade diets.

Whole–blood taurine levels should be measured to examine the patient’s long–term taurine status. However, it is worth noting that Golden Retrievers with diet–associated DCM often maintained whole–blood taurine levels of 200–250 nmol/L, staying within the low end of the reference range for dogs4.

As recent studies suggest, dietary change and supplemental taurine are the mainstays of treatment, though it may take several months to observe patient improvement.

Echocardiogram is the most sensitive method for assessing a recovering patient’s cardiac status during followup4.

}

After dietary modification & supplemental taurine, nearly all dogs showed

SIGNIFICANT CLINICAL IMPROVEMENT.

REFERENCES 1. Freeman LM, Stern JA, Fries R, Adin DB, Rush JE. Diet-associated dilated cardiomyopathy in dogs: what do we know? JAVMA. 2018; 253(11): 1390-1394.

2. US FDA. FDA investigating potential connections between diet and cases of canine heart disease. July 12, 2018. www. fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ ucm613305.htm. (accessed December 13, 2018) 3. Pion PD, Kittleson MD, Rogers QR, Morris JG. Myocardial failure in cats associated with low plasma taurine: a reversible cardiomyopathy. Science. 1987; 237: 764–768.

4. Kaplan JL, Stern JA, Fascetti AJ, Larsen JA, Skolnik H, Peddle GD, Kienle RD, Waxman A, Cocchiaro M, Gunther-Harrington CT, Klose T, LaFauci K, Lefbom B, Machen Lamy M, Malakoff R, Nishimura S, Oldach M, Rosenthal S, Stauthammer C, O’Sullivan L, Visser LC, William R, Ontiveros E. Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets. PLoS ONE. 2018; 13(12): e0209112. https://doi. org/10.1371/journal. pone.0209112

Conclusions The FDA and other study groups are still working to fully understand the relationship between dietary ingredients and the development of DCM in canine patients. Until more information is known, dietary assessment and case reporting should be performed for newly diagnosed cases of DCM, particularly for those dogs not belonging to high–risk breeds for genetic DCM. Veterinary practitioners can also help reduce the risk of diet–associated DCM by advising pet owners to only feed diets that meet AAFCO and WSAVA guidelines. 

PETVET MAGAZINE

Natalie Stilwell combined her love of animal health and writing to create Seastar Communications and Consulting, a veterinary writing and consulting business based in Athens, Georgia. Through her business, “Dr. Nat” practices aquatic animal medicine and provides veterinary and scientific materials for a variety of clients.

She lives with her husband Justin (a fellow fish vet) and their furry, feathered, finned, and shelled “kids”.

19

PETVET PROFILE

MERRILL

SIMPSON’S

BRAVE

By Jill López, DVM, MBA

I

n just a few weeks, Merrill Simpson will officially become “Dr. Simpson” when she graduates from Colorado State School of Veterinary Medicine.

She will be joining more than 1,500 new veterinary graduates from the 30 accredited US schools. But what makes Simpson’s graduation extra special is that it almost didn’t happen.

Like most of us, Simpson grew up with an innate desire to help animals. She always planned on attending veterinary school. However, during her senior year at Rutgers University, this New Jersey native had a major change in plans.

“I was academically exhausted,” she explains, “I did

20

not want to continue being a student for four more years.”

Simpson applied for a pharmacovigilance position at a Fortune 500 company and started immediately after graduation.

“My new plan was to begin a career in the animal health industry,” says Simpson.

Simpson worked as a Drug Safety Specialist where she reported cases of adverse reactions and product efficacy issues.

In 2014, she joined some of her colleagues on a veterinary mission in Nicaragua. During the mission, Simpson helped vaccinate thousands of animals as an effort to stop the spread of preventable diseases like rabies.

PETVET MAGAZINE

I N NICARAGUA “Visiting an under–developed country changes your outlook on life,” says Simpson of her experience, “Things that we take for granted like clean water and medical care are extremely limited in those areas.”

Although Simpson enjoyed her time in the corporate world, she couldn’t stop the lingering feeling that she may have made a big mistake.

“Volunteering in Nicaragua made me realize that if I didn’t pursue my dream of attending veterinary school, I would likely spend the rest of my life feeling incomplete,” says Simpson.

Soon after, Simpson began the grueling process of applying to veterinary colleges. Much to her delight, she was accepted at her top pick, CSU. One of her best

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friends joined her for the road trip to Fort Collins, driving more than 2,000 miles in her red Mini–Cooper.

She entered veterinary school with a plan to specialize in equine medicine, but later decided to pursue other interests.

“In my junior year I realized that critical care was my passion,” says Simpson, “I enjoy the fast–paced, adrenaline rush of emergency medicine.”

Simpson also says that following renowned criticalists Dr. Justine Lee and Dr. Garret Pachtinger of VETgirl has further influenced her decision.

“The transparency of Dr. Lee’s and Pachtinger’s lives on social media has given me a front row seat view of emergency medicine,” says Simpson, “The good days and the bad days…and the really bad days.”

While Simpson is considering emergency medicine internships at this time, she does offer advice for those looking to hire new grads, “My advice to attract millennial vets would be to offer an inclusive culture that embraces work/life balance and provides mentorship support.”

You can follow the future “Dr.” Merrill Simpson at https://www.linkedin.com/in/ merrillmsimpson/. You can also listen to her new podcast show, Vet Candy on PetLife Radio: https://www.petliferadio.com/ vetcandy.html 

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Simpson also says that following renowned criticalists Dr. Justine Lee and Dr. Garret Pachtinger of VETgirl has further influenced her decision.

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23

3 QUICK

EXERCISES YOU CAN DO BET WEEN

APPOINTMENTS

By Dr. Courtney Campbell

1

LIFESTYLE

W

e have all been there; the work day gets off to a rip–roaring start and there is no letup in sight. Then it’s 3pm, and the fatigue starts to set in. Everyone’s making a beeline for the hospital’s coffee pot for an afternoon pick–me–up. But, remember, exercise can be just as powerful, if not more powerful when you need that afternoon boost.

No gym available? No problem. That’s where calisthenics play a role.

Calisthenics are strength exercises done without any special equipment and their primary advantage is the flexibility and ease of practicing in any place, at any time. All you need is a couple square feet of space and you can practice these exercises in between appointments to stay energized.

DOWNWARD FACING SWOOP One of my favorites. Begin in a standard plank position (palms of your hands on the floor, directly under the shoulders—slightly wider than shoulder–width apart—like you’re about to do a pushup) but modify it so your legs are slightly wider than your body and your hips are high in the air above your head. Tighten your abs and recruit your shoulder muscles as you lower your body and rock forward in a gentle body arc. Do this while you’re lowering your hips back down to normal position. Repeat 15 times while keeping your abs tight until the next appointment is ready.

2

AIR SQUATS These are perfect because they work your legs, help your posture and increase your heart rate. After a few sets of these, you will feel charged and ready to go. Stand up straight with your feet slightly wider than shoulder width and your toes slightly outward. Bring your shoulders together like you are squeezing a tennis ball between your shoulder blades, keep your abs tight and squat until your knees break 90 degrees. Your arms should come straight out in front of you as you do this movement. Then stand up slowly to the starting position. Try as many as you can in one minute, using a controlled explosive motion.

24

PETVET MAGAZINE

3

Seated Dog Press

This exercise recruits your legs, abs and arm muscles while working on isometric, concentric and eccentric movement.

Assume a squat–style stance with your back flat against a wall and knees at 90 degrees.

Contract your chest muscles tightly as you slowly press both palms out in front of your chest for a count of 3 seconds. Then, raise both hands simultaneously above your head so your arms form a wide V. Slowly pull your hands down as you contract your back muscles until your hands are at your shoulder height. Repeat the arms movement while you are in the seated position as many times as you can in one minute.

Remember to have fun and only challenge yourself in a safe way after consulting your physician.

PETVET MAGAZINE

Dr. Campbell attended the University of Delaware for his undergraduate training and graduated from Tuskegee University School of Veterinary Medicine in 2005.

He is currently the head of the surgical department at CARE Emergency and Specialty Animal Hospital in Santa Barbara, California. Dr. Campbell is a regular guest on programs such as The Doctors, Hallmark Channel’s Home and Family, The Real, and The Pet Collective’s YouTube channel Ask a Vet. He is now the co-host of National Geographic’s Pet Talk, a first of its kind talk show dedicated to the wonderful world of pets.

25

BUSINESS TRENDS

ON THE

RI

SE?

You May Have the

TO THANK

By Steve Dale

M

illennials are coming to the rescue? That’s right, they’re taking their heads out of their phones and showing up at your clinic for preventive care. They get it, and surprise—it’s cats benefiting even more than dogs. However, their concerns and needs must be addressed.

While pet ownership has overall been on the rise since 2000, routine care visits have suffered a significant decline. The American Veterinary Medical Association response, called Partners for Healthy Pets, and various

26

studies have confirmed the problem. The AVMA, among others, have provided information on why checkups for pets have been down, and offer several tools to help.

However, the real solution might be happening right now, with millennials leading the way.

When you think about it, millennial attachment to their pets isn’t a shocker. This is the generation that calls their pets “fur babies” or refer to themselves as pet parents. Actually, according to the American Pet Products Association (APPA) Pet Owners Survey

PETVET MAGAZINE

70%

OF

DOG CARETAKERS

&

2017–2018, just over 70 percent of millennial dog caretakers and 55 percent of millennial cat caretakers say their pet “is like a child.”

While all age groups partake in social media, many millennials live there in a sort of an “alternative reality.” But they don’t live alone—their pets are right there with them. And who would have predicted that cats would become the hottest topic on the net?

Cat cafes not only exist in most major American cities today, but when they are visited, a super highway of cute images flood Instagram, where some celebrity cats have thousands or even millions of followers around the world. Grumpy Cat, Maru, Lil Bub, Venus, and Cole and Marmalade are among the rock star celeb cats who are household names. All of this has been driven by millennials.

Now, combine all that with some additional data. Only 21 percent of millennials are married, while 42 percent of Baby Boomers were married at the same age. Most millennials do have at least one pet. And living in apartments in greater numbers today than previous generations, they are also more likely to have cats than Baby Boomers at the same age.

Millennials may not start out with financial resources to pay for all care.

Debt does exist, for sure, but that decreases significantly among older millennials. Most importantly, according to the APPA survey, millennials are

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5

SURPRISING FACTS ABOUT

1

Millennials are carrying almost $1 trillion in student debt.

2

The average millennial carries $45,000 in debt.

3

More than 60% have a bachelor’s degree but only 48% work in jobs that requires one.

4 5

64% percent of Millennials would take a job making less money with a job they love than to take one for more money that they don’t.

Millennials are the most diverse generation, only 56% identify as Caucasian.

willing to spend on their pets.

So, if millennials perceive their beloved fur child isn’t being treated well, or that they are not receiving value for what they paid—they won’t hesitate to find another clinic which better matches their expectations.

Still, while loyalty isn’t what it once was, there are ways to bond even fickle millennials to practices.

According to a Human Animal Bond Research Initiative and Banfield study, Millennials and the Human Animal Bond: • 77% of millennials would have a more favorable view of their veterinarian if they discussed the health benefits of the human-animal bond with them.

• 74% of millennials would be more likely to visit their

veterinarian if they discussed the health benefits of the human– animal bond with them.

• 25% of millennials always talk to their veterinarians about the health benefits of pet ownership, more than other generations.

There’s no doubt that Fear Free has been responsible for a major paradigm shift. Not only in about three years’ time do most veterinary professionals know about this initiative, the public is actually now seeking out Fear Free certified professionals and Fear Free practices.

There’s no data (yet) to demonstrate that millennials are leading the way, but there is data to demonstrate they lead the way in increasing veterinary visits, so extrapolating an association isn’t a stretch. There’s no

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PETVET MAGAZINE

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doubt that Fear Free and the idea of addressing emotional health and well–being is exactly what the doctor ordered for millennials.

Cat Friendly Practices has compelling data on how practices are benefiting, beginning with 75% agree that feline check-up visits are up, 80% of clients respond with positive feedback to the Cat Friendly approach, and 79% of Cat Friendly Practices note an increase in revenue.

Clearly what millennials are seeking is answered with bond–centered approaches. Millennials want and may be able to afford the best medical care ever, but trust in you to deliver not only medically for their “fur babies”, but also their emotional well–being.  Steve Dale, CABC (Certified Animal Behavior Consultant) is the author of a popular blog, www. stevedalepetworld.com. He is the host of two national radio shows, and is heard on WGN Radio, Chicago. His many TV appearances include Oprah to National Geographic Explorer, and is a contributor on syndicated “HouseSmarts TV.” Steve edited “Decoding Your Dog,” authored by American College of Veterinary Behaviorists, and has contributed to many books and publications. Steve speaks around the world at animal behavior and veterinary conferences and serves on the Boards of the Winn Feline Foundation and Human Animal Bond Association.

His many awards and honors include the AVMA Humane Award, and he was inducted into the Dog Writer’s Association Hall of Fame.

PETVET MAGAZINE

29

Beyond the Stethoscope

By Angela Demaree, DVM, MPH, CHPC Photo by U.S. Air Force photo/Senior Airman Brett Clashman Use of military rank, job titles, and photographs in uniform does not imply endorsement by the Department of the Army or the Department of Defense.

W

ho among us has had a big dream, thought about going for it and then immediately talked yourself out of it? Because, after all, who am I? Who do I think I am that I can stand up and do that big amazing thing; apply for that job, give a big speech or lead a critical project?

After all, people I respect—who are older or more experienced or more accomplished—haven’t even tried to do what I’m thinking about, and when I mention it, they wrinkle their nose and look at me as if I were an alien from outer space.

I’m often asked how I had the courage to run for Congress, run for President–Elect of the AVMA or join the U.S. Army Reserves. If I said I was never scared, or even terrified, I’d be lying. But then I think about all of the wonderful, amazing accomplishments in the world today.

More than 40 years ago, Microsoft and Apple began

30

as ideas in someone’s garage. Bill Gates and Steve Jobs weren’t famous, and there was no such thing as a personal computer, an iPhone or an intuitive operating system. They had to have the courage to stand up and do something that had never been done before. They had to not only step, but leap outside of their comfort zones and stay there.

Just imagine the unwavering vision, focus, intentionality and courage it took to be different, to think differently and change the world as we know it today. To be both supported and laughed at; simultaneously encouraged and discouraged, to listen to the market while ignoring the criticism, quite simply, takes courage.

We often hear about having a growth mindset and that leaders should have a willingness to grow and try new things. That can be scary! What have you accomplished that took courage this week? Last month? Last year? We’ve all stepped outside of our comfort zones. It

PETVET MAGAZINE

REMIND YOURSELF

YOU

CURRENT

CAREER

discourage you? Did they believe in you? How did you know that you could succeed? Why were you willing to try? What experience do you have with success that you can apply to your current goals and dreams?

Sometimes we need to be reminded that we’ve been there before; we’ve been afraid, but we pursued our dreams anyway, and we succeeded.

21st century veterinary compounding pharmacy. Angela is a Major in the U.S. Army Reserves, a Certified High Performance CoachTM and the host of Beyond the Stethoscope, the podcast for veterinarians and busy professionals who want actionable, implementable solutions surrounding work-life balance, accomplishing your goals and living your dreams. She spends her free time with her horse, Tommy and teaching her Quaker parrot the Purdue Fight Song. You can connect with Angela on Twitter and LinkedIn @DemareeDVM

SUMMONED TO PURSUE YOUR

could have been as simple as reaching out on LinkedIn to ask a colleague you don’t yet know for advice, calling a client with bad news, agreeing to speak for the first time at your local veterinary association or train for a 5k run.

Everything we do on a daily basis took amazing courage the first time we did it. The more we try, learn and grow, the easier it is to take significant steps outside of our comfort zones to reach for our goals and live out our dreams. If you had even more courage, what would you immediately start doing? What would you immediately stop doing? Sometimes it takes more courage to stop doing something that has become easy, or routine than it does to summon the courage to start something new.

So often, the reason we decide to avoid doing something isn’t due to a lack of courage but rather due to fear.

We are afraid of losing, we are afraid of the hardships we may endure if we pursue our dreams or we are afraid of the outcome. We can even be fearful of succeeding as much as we are afraid of failure because our lives may be forever changed in ways that we cannot yet foresee or understand.

Now think about that big, scary goal or dream. Remind yourself of the courage you summoned to pursue your current veterinary career. Did others

OF THE

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Dr. Angela Demaree currently serves as the Chief Operating Officer for Pinpoint Pharma, www.petsgetit.com, a

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