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Assisting From Afar

Telemedicine allows veterinarians to communicate with homebound clients, observe patients in a relaxed state and even suggest alterations to the pet’s environment.

Assisting From Afar
For clients who are immunocompromised or have limited transportation, telemedicine might be their only access to care.

I don’t think a single veterinary colleague of mine would disagree that 2020 has been one of the most challenging years professionally and personally. Abrupt changes to workflow, curbside appointments, the immediate need for instant digital communication and the exponential pet explosion involving many first-time owners have all occurred at once. The typically slow-to-change veterinary profession was forced to adapt and evolve almost overnight.

The stressful year hasn’t just affected humans. We are seeing more and more pet owners concerned about the behavior of their dogs and cats, ranging from inappropriate urination to the escalating incidence of separation anxiety when people working from home return to the office. And as curbside drop-off appointments become the norm, more clients are frustrated at leaving their pets when the dog or cat shows fearful, anxious and stressful body language.

These human stresses and pet anxieties can be decreased or even abated with the use of new handling techniques and approaches in the clinic and through telehealth platforms.

Pet Owners Expect It

Telemedicine is immensely popular in human medicine, and because of this, many pet owners, especially those in the millennial generation, are requesting the option.

While telehealth alone cannot solve every presenting complaint, there are situations in which it shines. And remember that telehealth isn’t just synchronous or real-time virtual visits. It also encompasses teletriage, emails with video attachments demonstrating a pet’s lameness or skin lesion, for example, and follow-up care. For clients who are immunocompromised or have limited transportation, telemedicine might be their only access to care. The newly formed Veterinary Virtual Care Association is advocating for the ability of all veterinarians, regardless of where they practice, to provide a variety of remote services for the diagnosis and treatment of animals.

Let’s look at a few examples of how telemedicine can enhance client education and reduce pet anxiety and fear.

Show and Tell

First, take the pet owner who is frustrated or concerned about not being physically present during the exam. A platform like Zoom, Skype or Facetime not only supports real-time remote conversations between the client and veterinarian, but it also — and more importantly — permits the practitioner to educate the client about pet fear, anxiety and stress. This can provide a virtual training session on how to read an animal’s body language, how to handle a dog or cat using gentle control and which accessories can be purchased to create a more relaxed setting in the pet’s home. Such products might include digital sound machines like iCalmDog and iCalmCat, nonskid mats for use under food bowls and on stairs, high-reward treats, and compression garments. The sessions usually can be recorded and emailed as a video to the client, especially if the veterinary team demonstrated a way to reduce stress during an ear cleaning or how to medicate the animal creatively.

Next, we can’t forget how helpful telehealth can be for felines. Inappropriate urination is one of the most common reasons a cat sees a veterinarian. And while we always want to rule out medical causes first, many of these cases stem from a lack of enrichment or a home’s improper setup for one or more cats. This includes litter box choices and placements, feeding regimens, and the ability of cats to have their own space and territory.

A telemedicine visit can be incredibly helpful to both the veterinarian and cat owner because it allows the practitioner to see the patient’s natural body posture and behavior. Veterinarians can help the cat owner look for signs of anxiety or overgrooming and add enrichment opportunities.

Another advantage of telemedicine is pain recognition. Due to cortisol release, many dogs and cats hide certain behaviors and body postures when they arrive at the hospital, and other fearful and anxious postures can make physical exams unrewarding. However, contrast that to a dog or cat in its home environment who is relaxed and allowed to navigate without restrictions. This can provide a wealth of observational information for the veterinary team.

These visual takeaways can be easily communicated to the client to not only encourage an in-person exam for diagnostics and pain management therapies but also to understand how pain can be a source of fearful, anxious and stressful behaviors.

The Role of Wearables

Finally, we can use wearable technologies to help us better understand a patient’s physical and emotional health at home. Perfect examples of this are the Animo Pet Activity and Behavior Monitor from Sure Petcare and the Vetrax from AGL. These wearables document all aspects of a dog’s life, including sleep, activity, barking and, for our purposes, shaking and scratching. This detail, when transmitted to a Bluetooth-enabled device, could be game-changing for the objective monitoring of client compliance and successful disease management.

“Wearables provide a source of objective insights into the pet’s condition, which can augment what the health care team observes during brief office visits and what the pet owners can provide,” said Joe Young, AGL’s chief operating officer.

For those of you late to embrace newer technology, realize that as of 2016, according to Grand View Research, the global pet wearables market was estimated at $1.07 billion. This includes not only the products above but also radio frequency identification and GPS technology. Spending in the space is only increasing as pet owners transition to becoming “pet parents” who are increasingly focused on their cat or dog’s physical, emotional and mental wellness. Eighty percent of millennials say they frequently worry about a pet when they are away, even when they run short errands.

If veterinarians want to grow alongside today’s pet owners, we need to understand, appreciate and integrate technology into our practice of medicine for easier direct communication, compliance and trust.

As we arrive at a new year and a new normal, and with so many of us tired and weary, I encourage my colleagues in all aspects of practice to seize the opportunity that this state of flux offers for our teams, clients and patients. Implementing telehealth offers another chance to support the physical and emotional needs of dogs and cats and continually improve and strengthen the human-animal bond.

Fearless columnist Dr. Natalie Marks is an educator, consultant and practicing Chicago veterinarian. Dr. Marks is a leader within the Fear Free movement, was a member of the original Fear Free advisory board and is Fear Free Certified Elite. She passionately believes that all veterinarians should be committed to the physical and emotional health of their patients.


SIGNS OF PAIN

A veterinarian conducting a telemedicine exam might be able to diagnose pain by asking these questions:

  • Is a gait abnormality now present?
  • How does the dog sit?
  • How does the dog stand at rest? Where is the foot placement?
  • Is the cat undergrooming or overgrooming?
  • Can the cat jump onto furniture or counters?
  • Is the cat grimacing?
  • Are painful body postures seen when the pet is at rest?

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