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The Nuclear Regulatory Commission (NRC) recently issued licensing guidelines for the use of Synovetin OA (Exubrion Therapeutics), a new veterinary device administered via intra-articular injection that is intended to reduce synovitis and associated pain in dogs with elbow osteoarthritis (OA). The NRC guidelines, issued to all relevant regulatory agencies, establish a protocol for veterinary practices that want to offer this treatment for their patients.

 in the US have OA, with most current treatments requiring daily administration and providing short-term relief. “For dogs with chronic elbow pain, Synovetin OA is a new, convenient, long-lasting, and safe option,” says Exubrion Chief Veterinary Officer John Donecker, VMD, MS, in a press release. “Synovetin OA puts the treatment right where it’s needed and offers up to a full year of relief.”

The active agent in Synovetin OA is the conversion electron radiotherapeutic Tin-117m. According to the product 

, Synovetin OA breaks the pain cycle in a single treatment by targeting and eliminating (or deactivating) pro-inflammatory macrophages and synoviocytes, the key drivers of pain and inflammation. Synovetin OA is administered in a minimally invasive, outpatient procedure and can provide up to a year of improved mobility and pain relief.

Safety and efficacy of Synovetin OA were demonstrated in 3 multicenter studies, showing a 92% treatment success rate in dogs with grade 1 and 2 elbow OA and a 71.4% success rate in dogs with grade 3 elbow OA. Pet owners and veterinarians reported up to 12 months of sustained effectiveness following a single injection, with no clinically significant systemic or local side effects observed.

“This procedure is commonly and safely performed in people,” explains Exubrion CEO Peter Selover in the release. “With the recent NRC guidelines, we expect to have at least 50 veterinary hospitals around the country licensed to use Synovetin in the first half of 2021, offering relief to pets whose pain may not be adequately managed by current therapies, and pet owners who think surgery may be their only option to relieve their dog’s pain.”

For more information, including the Synovetin OA package insert with instructions for use, visit 

Articles

With a single intra-articular injection of Synovetin OA, dogs with elbow arthritis may remain pain-free for up to a year. 

NRC guidelines open door for durable canine OA pain relief

Periodontal disease is easy to treat and prevent, but it is among the most common infectious conditions we see in our clinic. While many of our clients equate periodontal disease with dirty teeth or bad breath, we know that this infectious and inflammatory condition can contribute to serious problems including heart disease, diabetes, and immune disorders. There are multiple options for managing periodontal disease, but I will focus on 2 approaches: standard and platinum treatment.

*The progress examination is up to the veterinarian and can be done by a technician or doctor to review home treatment and evaluate the pet’s dental health if needed.

The basic approach is straightforward—clean the teeth and hope for the best. In my opinion, unless it is not economically feasible for your clients, preanesthetic evaluations such as examinations, labs, and ECGs are 

optional. (When did good health and common sense become optional?) If your patient expires under anesthesia, even with the owner opting out of preanesthesia evaluation, you are still liable for what happens to that patient. Unfortunately, defending your position legally in this scenario is rather challenging.

The basic approach addresses what is seen in the mouth but ignores deeper issues such as pain relief following a dental scaling. Although the teeth are technically cleaned, the disease remains present and has not been adequately treated.

The platinum approach involves much more than cleaning teeth. Following a supra- and subgingival scaling, teeth are polished to smooth microscopic indentations in the enamel to help reduce immediate tartar accumulation. Because a dental procedure is at the very least uncomfortable, when the pet awakens, topical lidocaine gel applied to the gingiva provides relief. OraVet and Clindoral are products that aid in periodontal healing by slowing tartar buildup. If a disease is severe enough to cause more pain, or if extractions are performed, additional analgesia such as nonsteroidal anti-inflammatory drugs, opioids, and local nerve blocks should be administered for patient comfort and safety. Additionally, dental radiographs can reveal deeper pathology that is not obvious during a visual examination of the oral cavity. Choosing the platinum approach or something similar allows proper systemic treatment of the disease.

More practices should treat periodontal disease better than they currently do with the basic approach. If a patient had a serious source of infection or inflammation anywhere else in the body, we would be extremely aggressive in explaining to clients why certain tests and treatments were necessary. I think we hesitate with proactively managing periodontal disease because we underestimate its impact on our patients’ health. I fell into this trap many years ago, wondering why I could not convince pet owners to clean their pets’ teeth. If I believe I am simply cleaning their teeth rather than treating disease, I cannot convince an owner to spend a lot of money just so their cat or dog can have a pretty smile. When I attended a cardiology seminar and heard the speaker say that the most important thing to do for a pet with heart disease is to treat that pet’s periodontal infection, it finally clicked for me.

Once I gained this understanding, I was able to adjust my approach to managing periodontal disease. If you opt for the platinum approach, you must get your team to agree that cleaning teeth helps to end pain and save lives. Market your platinum approach to your clients with handouts, videos, and email newsletters. Replace terms like “teeth cleaning” or “dental” with “periodontal treatment" or "therapy,” thus improving client acceptance. Additionally, start discussing dental health at the first veterinary visit, even for puppies and kittens. Make sure you educate your clients about the seriousness of periodontal disease.

The platinum approach shows that there is more to assisting a sick pet than just hospitalization and fluids. To determine the best treatment approach for your patient, consider the potential nature of the illness, severity/chronicity, age of the pet, and the ability of the owner to afford the treatment.

Finally, the platinum approach includes items that are also incorporated in human hospitalizations. For example, technicians are provided to patients and clients are charged for their services. Pet owners are also charged for medical waste removal. For critical cases, sick pets may require ongoing monitoring (ECG, SpO2, etc).

In addition to fluid therapy, I have found it extremely beneficial to include vitamins, injectable herbs, and other homeopathic remedies to support the immune system, detoxify the pet, and hasten healing and well-being.

As a holistic veterinarian, I rarely use conventional medications indiscriminately. However, there are certain circumstances when antibiotics are needed. Additionally, believing that no pet should die without the benefit of steroids, I often use injectable dexamethasone to enhance recovery and support pets with undiagnosed Addison disease. A daily fee for the doctor exam is included, and a pet’s condition should be assessed daily during hospitalization.

Shawn P. Messonnier, DVM, owns Paws & Claws Animal Hospital and Holistic Pet Center in Plano, Texas, and serves on the 

 Editorial Advisory Board. He has written multiple books on marketing as well as holistic veterinary medicine.

Two options for managing this condition, plus how to help your clients determine which plan is best for their pet.

Better medicine, better business: Periodontal disease

This week, we will post a robust mix of engaging news content including:

An informative article highlighting 2 different treatment approaches for periodontal disease.

Nuclear Regulatory Commission's (NRC) recently issued licensing guidelines

 for the use of Synovetin OA (Exubrion Therapeutics).

A brand-new Episode of The Vet Blast Podcast: Pam Hale DVM, MBA, discusses the significance of diversity in veterinary medicine and shares her personal journey.

Stay tuned on dvm360.com for our most recent coverage of the veterinary industry.

A sneak peek at this week’s headlines and industry news.

This week on dvm360: Managing periodontal disease, plus more veterinary news

Brand awareness is vital for the success for any company, including veterinary practices. But the reality is that most practice owners and managers don’t find the time for marketing. This work demands time, money, and regular monitoring to make sure it’s yielding positive results. Multi-pronged, sophisticated marketing tactics require significant input from the management team (always in short supply). Trying to get it all right slows down the whole process. My recommendation is to focus on a limited number of channels, giving the most attention to those that complement each other and yield the best returns.

Here are what I see as the best digital marketing tips for veterinary practices. Hit some aspect of these 5 throughout your year, and you’ll be in good shape.

Search engines decide what pet owners see when they go online to find a veterinary practice in their area. Search engine optimization (SEO) is the most important part of that process. In competitive markets, there’s a first entrant advantage that veterinary practices starting on this later need to counter tactically.

But SEO can cut both ways. If the tactics are appropriate and the message is appealing, you can get fantastic results in terms of new clients. But if you’re spending a lot of money in competitive environments, graduating to a higher website ranking and showing up earlier in search results can be a very slow process. SEO should be both on page and off page.

—what appears on your individual web pages—involves posting visually attractive, quality content and ensuring that your words are pithy and free of unnecessary repetition. Great care should be given to the process of tagging. Meta tags facilitate viewing for both search engines and pet owners, and offer a favorable experience once someone clicks through to a particular page on your website. Every page should have both a title tag (preferably fewer than 55 characters) and a meta description (preferably fewer than 150 characters). Structure your website and web page headings (H1) and subheadings (H2 and so on) carefully. you don’t want too many—just enough to honestly and helpfully highlight key aspects of your brand. Internal linking should be minimal (don’t go crazy with hyperlinks to other pages on your own website), and the site needs to be mobile-friendly (which makes sure it looks good on any size tablet or smartphone).

—which includes links to and from other reputable websites—should involve plenty of backlinks, especially to reputable ones such as educational and government domains. It’s better to have a few quality links to other websites than lots of low-ranking ones. 

Does this all sound overly complicated? Well, somebody you or a talented team member or an outside consultant or an outside service—needs to think about it. It’s not as hard it sounds, but it takes a bit of time to learn and understand.

This is advertising placed in search engines (eg, Google, Bing). Every time a viewer enters the relevant keywords or search phrases, the search engine results pages show up with your ad displayed. If the viewer clicks on your ad—moving to your website—you pay a charge. There are a number of pay-per-click options for you or your marketing person to choose from. a paid search can yield faster results than organic search. These ads are flexible and can be scheduled to be turned on and off so you advertise when you want.

Social media can enhance brand awareness, but the question is which platforms should you use? you need a presence on Facebook, but it could help to survey your current clients to find out where they are. Maybe they want to hear from you on Twitter. Maybe they want to see cute pet pictures (like theirs!) on a Pinterest board or Instagram.

The great thing about social media is that these platforms have access to users’ geographic location, age, gender, and interests. That makes it easier for advertisers (like you) to target audiences, and those interactions on the platform can provide testimonials as well.

Remember, though, digging into social media and building a presence on any platform isn’t just about throwing up some ads. at least 1 team member needs to be somewhat active. This takes time and effort as well as a sensitivity to the fact that social media users get irritated with pitches. your content needs to be heavily focused on interesting facts, pictures, videos, and helpful resources, distracting users from the overall pitch that you are the best veterinary hospital in the area and they’ve just got to swing through your doors.

Email continues to be a useful direct strategy to address prospects and nurture existing clients. It’s best to schedule promotional and educational messages with specific “calls to action” you need to inspire the email reader to do something after seeing your message.

Email marketing allows for specific messages for distinct categories, tailoring your pitch to different segments of your clientele or other locals if you’re paying to use someone else’s email list. Emails also allow for “word-of-mail” cascade for the brand, just as word-of-mouth publicity does for you now.

Would it be worth it to build a multimedia public relations (PR) campaign or contract with someone to do that for you? a multimedia PR thrust under the aegis of a reputable PR organization can definitely create a high level of brand awareness. If affordability is an issue, there are tools available that allow you to run your own in-house PR campaign, and it’s likely your local competitors don’t use them yet. Popular PR software tools allow you to write a press release and share your news with reputable news websites (eg, PressCable and PrWeb), enhancing brand awareness and developing valuable backlinks to your veterinary website.

As the veterinary marketplace becomes more competitive, it’s harder and harder to ignore marketing efforts. Practice owners and managers should learn a little about digital marketing and then decide how deep to go themselves with or without outside help. But if you include these 5 items in your marketing strategy over the months and years, you’ll be way ahead of most of your local competitors for a long time to come

Naren Arulrajah is president and CEO of Ekwa Marketing, a complete internet marketing company that focuses on SEO, social media, marketing education, and online reputations for practice owners.

Want to build brand awareness and increase your patient roster? Here are the 5 things you (or an affordable marketing person) should be doing.

5 Marketing musts for every veterinary hospital 

The road to veterinary medicine is not always linear, especially for first-year veterinary student Stacey Thomas. Unlike many of her peers, she entered the profession later in life.

“It’s [been] a bit of a winding road. It’s not a straight shot in comparison to many of my classmates…this will be a second career [for me], as I am starting veterinary school at the young age of 43 after having a very exciting career in human medicine,” she explains. “I’ll be looking at 46 when I graduate, but that’s okay because I don’t feel like that’s a bad thing.”

In this episode of The Vet Blast Podcast, Adam Christman, DVM, MBA, talks with Thomas about her transition from human to animal medicine, the life-changing moment that sparked her switch, and what it’s been like starting veterinary school during a pandemic.

Thomas tells Christman that an incident back in 2008 was the driving force behind her career change. She and her partner at the time, were on their way to a New Year’s Eve party when the car in front of them hit a dog and left it for dead. Wrought with emotion, Thomas was bombarded with thoughts like, “How do I help this dog?” and “Is there someone I can call to get help for this dog?” She realized there was no ambulance for pets, so she and her partner took the dog to get care. Fortunately, the lucky pooch made a full recovery.

Soon after this life-altering event, Thomas and her partner started a nonprofit pet ambulance service. After learning animal first aid and CPR, she decided to take veterinary school prerequisite courses. Her life, however, took a few unanticipated turns, so she wasn’t able to start veterinary school until last year.

So far, Thomas says veterinary school has been both a rewarding but challenging experience. “It’s a mixed bag of everything that I thought it would be, and nothing of what I thought it would be.” She didn’t anticipate starting school in a pandemic and taking all courses and exams from home. But overall, she says it’s been a great experience. Between the copious amount of coffee she’s been drinking, the lack of sleep, and late-night studying, she’s been working on finding a balance.

Listen below to hear more about Thomas’s unconventional journey.

Podcasts

In this episode of The Vet Blast Podcast, Dr Adam Christman is joined by first-year veterinary student Stacey Thomas, who shares how and when she discovered her calling in veterinary medicine, and what it’s been like starting school during the pandemic.

Episode 38: From human to animal medicine: One vet student’s unique journey

Veterinary clinics dramatically shifted their protocols during the coronavirus disease 2019 pandemic, most notably with the implementation of curbside care, according to Mary Lopez, hospital manager at Hendricks Veterinary Hospital in Boise, Idaho.

Although a 2020 survey showed that most people prefer curbside service,

Lopez says that in veterinary medicine, this sudden shift in protocols presented unique challenges. Appointment times are staggered , services are limited, and cleaning protocols have increased, resulting in more frustrated clients, she told attendees at a recent Fetch dvm360® virtual conference.

Additionally, there has been a spike in pet adoptions, significantly increasing clientele. With an ongoing shortage of veterinary staff across the nation, many clinics are struggling to meet these new demands, says Lopez.

To help improve patient care, enhance client experience, and reduce burnout and compassion fatigue among staff members, Lopez and her team made adjustments to curbside protocols.

Here are 5 strategies Lopez implemented at her clinic that you can incorporate in your practice to provide a gold standard for curbside care.

Paper forms are tedious and time consuming for clients and veterinary team members. To reduce check-in times, try converting to digital forms. At Lopez’s hospital, clients complete forms digitally using SnoutID (a pet health app) before the appointment, saving her team 30 minutes during the check-in process. SnoutID also allows clients to review payment estimates, limiting the sharing of pens and direct contact with paperwork. Other digital signature platforms include JotForm and DocuSign, says Lopez.

2. Collect medical history prior to appointment

During the pandemic, phone lines and email inboxes have been jammed, delaying communication with clients, says Lopez. To help facilitate prompt communication with pet owners, Lopez and her team decided to collect medical history before appointments, using SnoutID. This app has its own staff of veterinarians and technicians who handle data consents for records transfer, she says. The platform also helps retrieve health records throughout the United States, she adds.

Busy phone lines have made it difficult for clients to alert staff to their arrival, says Lopez. Trying to locate cars in a packed parking lot is challenging without proper labeling. “Sometimes, we would get clients that would call to check in and they would say, ‘I’m in the silver car.’ How many times have you been out and looked for silver cars? That can be a little confusing,” says Lopez.

To help standardize arrival, Lopez has clients click the “I’m here” button or send a message on the Snout ID app, and the team is immediately notified of the client’s arrival. Lopez also recommends labeling parking stalls. She says a staffer’s husband built labeled parking signs to help locate clients.

Collecting payments over the phone can present security concerns, including credit card fraud, and clients can easily dispute charges without the backup of a signature. “It was very vital that we created a secure payment system for our clients, to make their safety and ours,” says Lopez, who recommends the following secure payment options:

Use card readers like Clover or Square. Make sure you have strong Wi-Fi because you must go to your client’s vehicle.

Utilize digital invoicing systems such as PayPal, for example.

Collect payments ahead of time using an app like SnoutID.

“It’s so important to effectively communicate with your clients. You need to explain the new process to them because if you don’t communicate, it’s going to be very difficult for you and your staff,” says Lopez, adding that you should regularly update all of your communication platforms.

Be sure to send a mass email to all clients and update them once a month. You can also utilize 2-way texting to keep pet owners informed. Additionally, make sure your latest updates are pinned at the top of your social media pages. To accommodate your less tech-savvy clients, add signage to your practice door. Put up banners to let clients know you are offering curbside service, including contact information. Make the text large and use an easy-to-read font style and color.

Finally, educate your customer service representatives and your technicians about all new protocols and how to best discuss them with clients.

“Clients were anxious at first. We had to deal with a lot of emotion. So, I had to create these talking points or scripts for my team so that they have a professional way to respond to these clients,” Lopez says.

COVID-19 & the future of commerce: a look at the dramatic shifts in consumer shopping behavior. Medallia Zingle. Accessed January 19, 2021. https://cdn2.hubspot.net/hubfs/393073/2020%20Consumer%20Report/MedZing2020-Future-Of-Commerce-Report-FNL.pdf

One veterinary hospital manager shares key strategies for enhancing curbside protocols at your practice.

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