Contraindications to consider during treatment

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Contraindications and things to look out for while using CPMA for treatment

Sponsored by Elanco Animal Health

Adam Christman, DVM, MBA

Are there any indications not to use CPMA at all?

Michael Lappin, DVM, PhD, DACVIM

You know, the side effect rate is tiny on their pre licensing materials with the feds. And so from that standpoint, I think zero. The only thing that would potentially happen would be if it was another viral cause of enteritis, that's primary in that particular puppy. But that wouldn't be a side effect, that would actually just be a lack of efficacy. So those that look and smell like Parvo that are antigen positive, I can't see any personal reason that it wouldn't be indicated.

Erik Zager, DVM, DACVECC

One thing to think about is cats. Everyone likes to talk about dogs. And so cats, you sometimes test them with the same Parvo snap test that you can look for panleukopenia. But this is not for cats. UmHopefully, there's something new that in the future, but just because they're very, very similar viruses, this is still something that right now is only for dogs.

Adam Christman, DVM, MBA

Okay. It sounds like the CPMA injection would be used in conjunction with current modalities that we're using today. So what does that look like? We were just talking earlier about spectrum of care, financial concerns. So what does that look like in terms of cost perspective to a client? How do we make it affordable for everyone so that everyone wins? And the puppies can too? Okay.

Michael Lappin, DVM, PhD, DACVIM

Yeah, that's a great question. And that obviously has to go along with the manufacturer as well, because they ultimately set price points, what they have given us is a really good justification for the dose that we're administering, so it makes perfect scientific sense. This is the dose for that size to animal, how to factor that into the rest of the hospital without it just being part of our philanthropy, which you've mentioned already, you guys are treating for free. So you basically, you're gonna get treated either way, right? Whether they donate, that's not going to happen at CSU, we have some companion care funds and Care Credit and the other things, so we are going to have to find ways to fit within the budget they have after given the standard of practice lecture. But that's where the price point as is, is not out of reason for many of our folks that need to go with the outpatient protocol. And so I feel that it's going to be an easy thing to incorporate even for those that can't afford our isolation unit.

Adam Christman, DVM, MBA

And I also think of operation from a people perspective, because [it] can be pricey. So there probably could be a decrease in operational expense. And that regard from an ER perspective...

Erik Zager, DVM, DACVECC

I mean, the cost to the hospital, as far as the drug goes, is the cost of a drug and a freezer. You [can] buy it on Amazon, a freezer, So luckily, that's pretty, pretty low. And I'm looking forward, I'm sure there's going to be a flurry of studies as this becomes more more widely used as far as when the best time to intervene is what be used. And so while now I still recommend to my ER doctors, if costs are a concern, we still need to recommend the current standard of care, but I am definitely looking forward to a time where we can say, "Alright, when we're trying to figure out the the costs, the budget for what the owners have, where exactly this fits in earlier on that care."

Adam Christman, DVM, MBA

And you were just talking earlier, personally about your own testimony of having a dog with puppy Parvo. And the fact that you were also earlier suggesting celebrating them, like the "Thank You" card that you're gonna get... I think the price of having that client, saving their life is priceless, right? You have a lifelong client, [it seems] like you would get from that.

Erik Zager, DVM, DACVECC

Whether it's an emergency standpoint, whether it's a GP standpoint...any puppy that you save is now your client for life. And so that, I mean, that is hugely important. And so whenever thinking about financial things, which there's not a single vet in the country that is like, "Oh, my favorite thing to think about is the finances of all this." Trying to figure out ways that you can incorporate this with any of the other types of Parvo treatments so that you can think of a long term effect on your hospital and your staff and ways to approach it that way.

Adam Christman, DVM, MBA

And do you think as a behaviorist, it almost feels like it'd be priceless to me if I knew that I can have my puppy home with me quicker, so I can work with them and bond with them? I mean, the impact of that must be huge, right?

Christopher Pachel, DVM, DACVB, CABC

Absolutely huge. And I think I'm so glad that the communication aspect of this is being brought up, whether we're having that conversation within our teams, whether we're having the conversation with the pet owner, or you know, even within the industry to say what are we doing, how are we doing this? How do we communicate that and if we're able to have that conversation about care, versus going in with a preconceived notion again about what somebody can or can't do or what we think they might do? By having that gold standard treatment plan to be able to present that to the client and ask the question, honestly, and with compassion and empathy, is that doable for you? So many clients come in. And this could be the case, whether we're talking about this treatment or any high ticket item. And there's so much fear and anxiety around what is this going to do for us or to us, as we're making these treatment decisions and to be able to have that honest conversation, these are the numbers this is the likelihood of success, and to be able to then compassionately support them through whatever is actually doable for them. And to be able to create that treatment plan that's specific to the patient and fits within what the client is able to do and to realistically have that conversation about potential outcomes, for me is such an important part of this conversation.

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