alt="C01i002"/> MAIN CONCEPTS
To provide care that will last a lifetime, the veterinary healthcare team needs to be able to consider the needs of the individual across that lifetime, not just at specific points in time that correspond to scheduled office visits.
It is now possible to predict the needs of pets, from the time of puppy and kitten visits well into their senior years, realizing that this is a dynamic process and the model will need to be updated and tweaked throughout the pet's life (see 6.4 Creating a Pet‐Specific User's Manual).
When considering pet‐specific care across a pet's lifetime, it is also important to keep in mind that the goal is somewhat different from that of the standard model of disease treatment. In pet‐specific care, the goal is to keep the pet healthy, focusing on prevention and early detection, just as is done in human healthcare. Thus, our goal is not just to treat animals when they are sick, but to guide owners on the path to keeping their pets healthy and optimizing their pet healthspan, not just their lifespan (see 9.7 Continuum of Care and Convergence Schedules). The process starts with understanding the factors that most affect health, and that begins with appreciating risk.
1.2.3 Risk (Needs) Assessment
To truly appreciate an animal's need for appropriate care, it is important to first discern which factors may impact its healthcare risks, either positively or negatively (Figure 1.2.1). Some of these risks can be determined very early in an animal's life (some even before birth) by evaluating genotypic and phenotypic assessment of the animal, its parents, and/or close relatives.
Figure 1.2.1 Example of a canine risk assessment form.
Other assessments can be made based on local risk factors in the particular geographic area in which the animal lives. Location typically impacts the prevalence of many infectious diseases, environmental risks (snakebite, heat stroke, frostbite, toxicities, etc.), and other factors of significance. It is important not only to appreciate risks in the place of residence, but also in other environments in which the pet may find itself (e.g., travel, boarding, grooming, activities, etc.).
Assessing lifestyle information helps a practice determine the relative risks of one animal versus another in the same locale. Given a pet's risk factors from genetics, family history, and lifestyle, it is possible to discuss a lifelong customized healthcare plan that can be shared with the pet owner, so they can better anticipate the healthcare intervention that will be needed throughout a pet's life (see 2.7 Risk Assessment). A personalized pet profile can then be created to customize care for animals on an individualized basis (see Figure 1.3.1).
1.2.4 Risk Management
Once owners can appreciate the veterinary care that will be needed by animals over their anticipated lifespan, they can also better plan how they are going to pay for such services. Owners can use several risk management strategies to financially prepare for such veterinary care, including pet health insurance (see 10.16 Pet Health Insurance), payment plans (see 10.17 Payment and Wellness Plans), and third‐party payers (see 10.18 Financing Veterinary Care).
It is important for the veterinary healthcare team to reiterate that if pet owners want the most benefit from pet health insurance it should be initiated as quickly as possible, typically by 8 weeks of age, before there are any issues that could be considered preexisting.
1.2.5 The First Visit
Ideally, the first veterinary visit might be made even before the new pet is acquired (see 3.10 Advising Clients on Selecting an Appropriate Pet). If a specific breed has been selected, the veterinary team should be able to counsel the owners on possible breed‐related conditions to be aware of (see 11.4 Heritable Health Conditions – By Breed), and what documentation would be worthwhile from the provider of the animal (e.g., hip joint certification of parents, DNA testing of parents, etc.). Armed with this information, the situation is established where the veterinary team is the healthcare advocate, and this helps cement an appropriate doctor–client bond.
The veterinary practice will also want to evaluate the previous healthcare that the animal received. For example, many young animals are “dewormed,” have had some initial vaccinations, and perhaps other treatments. As the healthcare advocate, the veterinary team will want to safeguard the owner from any zoonotic conditions, protect any animals at home from infectious diseases (quarantine may be needed), and determine the appropriateness of any treatments to date.
Apart from thorough physical examination, the first visit is a great time to discuss overall healthcare strategies for the months and years ahead. Sometimes this is easier to discuss if the subject matter is broken down into routine healthcare, breed‐related concerns, behavioral counseling, neutering, dental care, nutrition, life stage issues, and unexpected care (emergencies, specialist consultations, etc.). Providing a written healthcare plan streamlines the process and means that the client can listen to instructions and appreciate the “big picture” without trying to take exhaustive notes. Although this might seem overwhelming to the client at first, it does set the stage for the anticipated care of the pet that will span a lifetime. This also helps owners budget accordingly and consider other ways to manage the costs of pet healthcare such as buying pet health insurance (see 10.16 Pet Health Insurance).
Many pet owners have unrealistic expectations of pet care because they have never been exposed to optimal care and never had anyone detail pet‐specific care guidelines for them (see 9.3 Guidelines). Most are appreciative of these clear‐cut guidelines and the ability to plan in advance for realistic costs as well as which risk management strategies might be most appropriate.
1.2.6 Subsequent Visits
Subsequent visits are opportunities to reinforce the healthcare plan and make any alterations needed on the basis of those visits, diagnostic testing, or treatments. Healthcare plans are dynamic and flexible and may be changed to reflect the realities of the situation. For example, if a Doberman pinscher is screened for von Willebrand disease and found to be at significant risk, this will likely change the process at the time of surgery, as well as the charges associated with such surgery. The identification of cardiomyopathy will change the previous plan regarding the interval between scheduled clinical examinations, and recommendations for ongoing monitoring.
Throughout the process, it is important to have ongoing conversations with pet owners about the important concepts of compliance and adherence. It is not enough that clients be prepared to purchase products from us for use in their pets. They need to understand the critical importance of following directions at home. There is often
