Shawn Messonnier, DVM, is the owner of Paws and Claws Animal Hospital and Holistic Pet Center in Plano, Texas. His special interests include holistic and functional medicine, exotic pets, dermatology, cancer and internal medicine. Dr. Messonnier is also a well-known speaker and author. He is the former radio host of the award-winning Dr. Shawn The Natural Vet for Martha Stewart Living Radio.Read Articles Written by Shawn Messonnier
Heartworm disease can cause high morbidity and mortality, yet it’s so easy to prevent. Knowing how to increase pet owner compliance so that a monthly preventive medication is administered is a sure-fire way to reduce the disease incidence.
A Picture Is Worth …
Showing pictures or even models of disease is great for client discussions, and this is especially true if you can display an actual diseased organ. In my practice, I have a real-life heartworm-riddled heart to communicate the dangers of not using monthly preventive medication. The demonstration persuades reluctant owners of the importance of having their pets tested and to begin using a preventive. It also opens a discussion about the lifecycle of the heartworm.
In all my chats with clients about heartworm infection and disease, I never met one who understood anything about heartworms, and all of them told me their prior veterinarian never discussed it. They were shocked to learn, for example, that many heartworm preventives last a short time in the body, yet the preventive works if given monthly. They are also surprised to hear how safe the medication is and are happy to hear that there is little to no toxicity even if their dog eats an entire six-dose box.
The extra minutes I spend teaching clients about heartworm infection and disease is often what is needed to move them from “no” to “yes,” which allows protection from such a tough disease to start.
I also love teaching owners about the dangers of not giving preventive. Once I explain that heartworm infections cost several thousand dollars to properly treat and that pet insurance might not cover the veterinary care, they are more motivated to agree to testing and preventive medication.
Finally, don’t forget to teach clients that if they purchase the preventive from you, the manufacturer typically covers the expense if the pet becomes infected or diseased while on the medication. This helps keep sales in your hospital while giving the pet owner the peace of mind that won’t come from purchasing the product online or at the local pharmacy.
Scan Your Records
Whenever a client comes in for any reason, the veterinarian, technician or receptionist should look over the medical record to see whether a heartworm preventive is due to be refilled or if the pet is overdue for an annual heartworm test. Most clients are receptive to being told a refill is needed, and it’s always better to flag this while the client is in the office.
While all of us are comfortable sending annual checkup reminders, most veterinary practice management software systems make it easy to alert clients when a pet is due for a preventive refill or heartworm test.
Don’t Forget the Winter
So many clients want to stop giving a heartworm preventive when the weather turns cold. While this might be safe in certain parts of the country where winter actually occurs, it’s not the case in the Southern United States. Here in Texas, we don’t have a true winter, so year-round heartworm prevention is imperative. Let clients know that regular prevention is essential to prevent infection. Skipping one month can easily lead to two or three months being skipped, and then the pet is no longer protected.
Don’t Forget the Dangers
Many pet owners think that skipping a dose is benign — no repercussions. Yet many of us have seen pets literally drop dead from heartworm disease. I’ve shared horror stories with my clients who refused heartworm preventive. I’ve told them about pets that were chasing rabbits in their yard and threw an embolus, resulting in sudden death. I tell them about a pet that died during routine radiography when I was a veterinary student and that the animal was discovered to be full of heartworms during the necropsy.
For those clients adamantly opposed to using a preventive (my ultra-holistic pet owners), I tell them to come in every six months for testing. I also remind them that if the pet ever tests positive for heartworm, I won’t have a proven, safe and effective natural cure.
A Level of Trust
As a holistic veterinarian, my biggest challenge is convincing anti-medication pet owners that giving a heartworm preventive is not only safe but necessary. My goal is to teach clients to say “no” to drugs unless the usage is absolutely safe, effective and needed. Unfortunately, so many holistic clients get information from the internet regarding the supposed danger of heartworm preventives, and it’s up to me to battle this misinformation.
Here are five ways I tackle the challenge.
- I hope my clients, even new ones, have some level of trust with me as I need to rely on the trust to win the battle. I remind them of my expertise and my openness to discuss concerns. I tell them I’ll support whatever they decide, although I will provide them with the facts about heartworm preventive.
- I review the pharmacology of heartworm preventives. I teach them the life cycle of the parasite and show them why the medication needs to be given only once a month. I remind them that despite what the internet says, giving the medication every 45 to 60 days is not safer. I tell them that the drug typically lasts in the body for just a few days.
- I remind them that preventive medications are much safer and less expensive than the therapies used to treat a heartworm infection.
- I let them know that if they purchase the product from me and administer it correctly, the manufacturer likely will pick up the cost of treatment in the unlikely chance that an infection occurs.
- I tell them that the first sign of heartworm infection is often sudden death. Even though I’m a great veterinarian, I can’t successfully treat that outcome.
I started my veterinary career in the 1970s, when heartworm disease was becoming more commonly diagnosed. Fortunately, at the time we could prevent the devastating infection and disease through the daily administration of medication. While daily dosing was safe and effective, the user failure rate was high, predisposing pets to becoming easily infected with heartworm larvae.
Since the advent of monthly preventive, heartworm disease has become much less common. Still, we have too many patients that are not properly protected.
Whenever possible, as spokespeople for our patients, we must search for ways to make sure all of them — canines, felines and even ferrets — are regularly protected. Look at your current efforts and see how you can improve educating clients about properly protecting their pets.
Open the lines of communication, search medical records for missed opportunities and increase monthly preventive compliance.