The time for the rise of the parasites begins-acknowledging, of course, that some warmer climates never quite lose them. So we asked a local veterinary clinic for what parasitology-related questions they have and snagged answers from 

-always ready to deliver crucial parasite prevention tips.

Do heartworm preventives with efficacy against intestinal parasites work for routine puppy deworming?

Depending on the active drug in the preventive, the treatment should be effective at removing 

 (whipworms). Ivermectin is not effective against 

, so animals receiving a preventive with only ivermectin would need a secondary product for treatment of infection with 

. Furthermore, tapeworm infections would need to be treated with either praziquantel or fenbendazole, depending on the tapeworm species. Finally, if dogs are being treated with ProHeart 6, they will also need to be given a monthly medication to control intestinal parasites.

Are some fleas resistant to flea preventives?

My overall feeling is that resistance is likely perceived because veterinarians are not educating owners about the need to perform thorough cleaning of the house to remove the larvae and egg stages. (Check out this 

What are the latest updates on microfilarial resistance to heartworm?

While there does appear to be some legitimate resistance of 

 microfilariae to at least some of the preventives, it's a minor issue compared to lack of owner compliance in administering monthly heartworm preventives to dogs and cats. Efforts should be focused on educating owners about the necessity of compliance with monthly administration of heartworm preventive. Furthermore, veterinarians should avoid the use of the slow-kill method for adult heartworms if at all possible. The use of slow kill greatly increases the chances of selecting for resistant strains of 

 microfilariae that may be transmitted to other canids.

What are the differences in efficacy between in-house fecal flotation versus outside diagnostic laboratory test versus centrifugation?

If in-house fecal flotation is being performed using centrifugation and the staff are trained in parasite identification, then this is sufficient for routine parasite detection. In cases where an unknown parasitic egg, larvae or oocyst is observed, fresh fecal samples should be submitted to a diagnostic laboratory employing trained parasitologists to identify the parasites. The use of centrifugation is superior compared with passive flotation for the detection of numerous eggs, oocysts and larvae. Often when centrifugation and passive floatation techniques are done side-by-side on the same sample, observers are surprised to see the increased number of parasite species and quantity of parasites with the centrifugation method.

genetically modifying mosquitoes to make them less capable of transmitting diseases

I am very much in favor of research to investigate options for genetically controlling vector-borne disease. I see this research as being similar to the release of sterile male screw worm flies that led to eradication of screw worms from the United States. Hopefully there is funding for such research projects in the future to test the efficacy of such genetically modified vectors.

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Longer days. More vegetation. Spring brings forth a sense of hope and, at the same time, more stuff to encourage parasite numbers. Here are some answers to what might be on your mind.

Here comes the sun: Are you ready for parasite season?

, we asked fellow speakers and Women's Veterinary Leadership Development Initiative (WVLDI) all-stars, Sarah Wooten, DVM, Kimberly-Ann Therrien, DVM, and Caitlin DeWilde, DVM, about the perils of maintaining a career in veterinary medicine while being a mom. They had a lot to say on the subject. Here's a primer.

Dr. Wooten cited a common characteristic among vets as being problematic: their work ethic. She says that with a full schedule of serious appointments and a sick child, somethings got to give. Can you guess which it is?

"It is an extraordinary hardship because I usually see kids that are sick sleeping in a kennel in the back," she says.

(We can only assume she mean with the door open.)

Maternity, motherhood and veterinary medicine

working moms control over their schedules

Dr. DeWilde brings up an obvious and nagging point: Daycare providers' hours generally don't overlap with veterinarians'.

"If your clinic is open until 8:00, but your daycare closes at 6:00 there's a big problem there with finding that shift coverage," DeWilde says.

"Family-centered events happen on weekends" 

Dr. Therrien echoes the above and adds weekends. She says that it turns into a struggle, particularly in the cases where the clinic is populated by working mothers.

Watch the video for more and stay tuned for more from this WVLDI trio.

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Moms—who are also veterinarians—chime in on what makes this arrangement difficult.

Motherhood and the veterinary profession: a series of hurdles

We tend to associate comfort rooms with euthanasia, but there's really no reason to limit them. Large examination rooms like these are useful every day of the week for a variety of purposes, provided they're comfortably furnished and decorated tastefully. Comfort rooms are great spaces for:

Procedures such as acupuncture that are typically done in larger exam rooms

Physical exams on the floor (because comfort rooms tend to be oversized).

Here are a few examples of these rooms being used for multiple purposes.

Wheat Ridge Animal Hospital, Wheat Ridge, Colorado

This oversized comfort room illustrates how a space may be used for floor examinations of elderly pets in addition to euthanasia. The ability to examine a pet on the floor can also provide the hospital with more flexibility for accommodating low-stress or Fear Free practice by doing exams where the patient is most comfortable.

Upstate Veterinary Specialists, Greenville, South Carolina

If you have enough examination rooms to limit your comfort room use to euthanasia, you can outfit it specifically for grieving families. One of the keys to this is appropriate lighting. Dimmable lighting creates a calming and respectful environment for the pet and the pet's family. If you're interested in using your comfort room more flexibly, place the dimmable ambiance lighting on a different switch from the regular room lighting.

Four Seasons Veterinary Hospital, Loveland, Colorado

A typical exam room is 8x10, 9x10 or 10x10 feet at its largest. A comfort room should be at least 10x10, but many are larger.

These bigger rooms can be furnished with much more comfortable, home-like furnishings, such as sofas and oversized lounge chairs. The most practical seating is made out of vinyl and can be wiped clean. The right fabrics could also work well; there are many good choices in product lines that cater to human medical spaces.

Note in this photo the use of natural lighting. Natural lighting is another good option for comfort rooms. Room lights can be completely turned off to create a peaceful atmosphere for difficult consultations and euthanasia appointments.

Indoor/outdoor examination rooms make exceptional comfort rooms. By definition, they're on the outside walls of the hospital, which allows for natural light and privacy, and for the possibility of an outdoor euthanasia, which many clients appreciate. When exam rooms are on or near the building exterior, accommodating a separate exit for grieving clients is a lot easier, affording them the dignity of not having to walk back through the lobby after saying goodbye to their pet.

Indoor/outdoor examination rooms are great for Fear Free practices, as some dogs are calmer and happier when being seen in an outdoor environment instead of an indoor exam room.

Heather Lewis, AIA, NCARB, is a partner at Animal Arts, an architecture firm in Boulder, Colorado and frequent HospitalDesign360 conference speaker. She's a lighting geek and a (seriously) devoted advocate of minimizing pets' stress and anxiety during their veterinary visits. She has designed practices and shelters that range in size from 1,200 square feet to 110,000 square feet. During grad school (as a break from “architorture”) she trained miniature horses to pull carts!

These rooms can be used for more than saying goodbye to veterinary patients. They make great spaces for a variety of appointment types, provided theyre outfitted appropriately.

Comfort rooms are cool

If you're trying to get veterinary clients to "yes" on a parasiticide by feeding them facts and figures, well, knock if off. This comes from 

 speaker Bash Halow, LVT, CVPM. He says that clients can tell the difference between a sales pitch and a heartfelt story.

"The reason that you-and the rest of your team members-believe in a product is because they've tried it on their own pet, or they've had a success with that particular product and they've seen first-hand the value of it," he says.

Halow urges members of the staff to become conversant in the products you offer and to try them out. This way they can tell customer how every choice works with confidence and bond those clients.

Click the video to hear Bash Halow deliver the message in the way only he can.

	At Fetch dvm360 conference, we're the support system you need. With every conference this year, we intend to nurture your mind (meaning quality CE for days) while also encouraging you to take stock of your physical and emotional health. 

Stop educating clients and tell them a story.

You're getting this wrong when it comes to parasite preventives

Generation Y, or millennials, are poised to be the generation that makes pet insurance the norm. As the largest pet-owning demographic, owning 35 percent of all pets in the United States, millennials have surpassed Baby Boomers in recent years, who make up 32 percent of pet ownership.

Generation Y includes those born in the early 1980s through the mid 1990s. And millennials are more likely to spend money on their pets, feeding them organic foods, giving flavored medications, paying for pet services, and entertaining them with pet parties and taking them on holidays, according to the 

 from the American Pet Products Association. A 2016 IDEXX Growth Strategy report found that 57 percent of millennials say their pet makes them happier than almost anything, and 80 percent say their pet is a member of the family.

“Millennials represent the largest pet-owning demographic now and are driving pet spending across most categories,” says Steve Shell, VP of veterinary services and partnerships with pet insurance company PetPlan. “This group is delaying having children, delaying home ownership, but they have the resources to spend. And they are the ones driving the subscription economy for things like BarkBox. Pet insurance fits into that subscription economy and helps them do what it takes to make their four-legged children healthy.”

Sixty-eight percent of all U.S. households own at least one pet. The number of pet-owning households is 84.6 million, with 48 percent owning a dog and 38 percent owning a cat. Pet ownership is consistently trending upwards through the last two decades, according to the APPA. Of those, still only 10 percent of dog owners and 5 percent of cat owners have invested in health insurance for their pets. That equates to nearly 9 million insured dogs and more than 4.5 million insured cats. Sounds like a lot, but that number someday could be higher-much, much higher.

“With the humanization of pets becoming more prevalent, this younger generation is the one that could absolutely make pet insurance common,” says Shell, who is also the Veterinary Relations Chair with the North American Pet Health Insurance Association (NAPHIA). “I don't fit the demographic, but even in my own house my kids talk about our dog as their sister. And we've started putting her on our Christmas cards. She has become our child. With millennials, who are travelling more with their pets, seeking out pet-friendly restaurants, even taking pets on dates with them, pet insurance just makes sense.”

, the average cost for pet insurance in the U.S. is $43 per month. Of course, much depends on the pet breed, age and coverage included in the policy.

The IDEXX study shows that 61 percent of millennials are willing to make trade-offs in their finances to afford care for their pets, versus 57 percent of Gen X and 50 percent of Baby Boomers. Only 13 percent say they wouldn't make any tradeoffs to pay for their pets' needs.

Shell says he hopes the increasing status of pets in the home means veterinarians will be a leading voice in educating clients about the existence of pet insurance.

“You don't have to sell it or negotiate it, just make sure clients know pet insurance exists, especially with new clients or those with puppies and kittens,” Shell says. “Send them to pet insurers, and we'll take care of the rest.”

Sarah A. Moser is a freelance writer in Lenexa, Kansas

Increased humanization of pets amongst younger pet owners might lead to more acceptance of pet health insurance.

Future trend? Millennials could be the boost pet insurance needs

Are you carrying around tension or upper back soreness from the daily grind in the clinic? We're here to help.

 wellness ambassador and certified yoga instructor Torry Chamberlayne, RVT: the shoulder blade stretch. She says it's a great way to release stress in this area that is difficult to stretch. Here's what to do:

As you gently tilt your chin downward, imagine the space between your shoulder blades slowly expanding.

Take five deep, slow breaths in the prescribed position, then switch your arms around and repeat.

This practice is great for staff members who spend long hours at the front desk hunched over computers, for those who wrangle all manner of patients or for those who end up on their feet for hours. Right-that's everyone in your clinic.

She recommends going through the sequence a few times a day, especially just when you start to notice the tension building up.

Added bonus: Chamberlayne-a new mama in her own right-says this is also an excellent exercise for mothers who carry lots of tension from holding the baby, nursing etc.

Have you built up stress and tightness working in the veterinary practice? Stretch out this hard-to-reach spot and push it all away.

Yoga in the vet clinic: Shoulder blade stretch

Frequent treat administration-or high-value, long-lasting treats-are a hallmark of the Fear Free experience in the veterinary exam room, and Julie Reck, DVM, shared a new idea for distributing peanut butter or other soft treats at a recent 

Inexpensive silicone pot holders, or trivets, can be found 

 and often have a texture that's great for smearing soft treats on. You can drop it on the floor for the pet and then wash it after the appointment is finished. Often the pot holders come in multipacks, meaning they can be deployed during concurrent appointments for a minimal investment. 

Dr. Reck recommends using single-serving containers of peanut butter during exams. They may be a bit more expensive, but they're beneficial for three reasons: 

1. They're quick and easy to open and administer, while being less messy-no sticking your hand down into the bottom of the jar and coming out with peanut butter on your hands. 

2. You won't lose your client's attention if you accidentally double-dip into a standard multi-use container. Some clients are grossed out by a popsicle stick being licked by a pet and then put directly back into the peanut butter jar, Dr. Reck says. Then the client loses focus on what you're trying to tell them. 

3. If you don't use the whole single-serving package during the appointment, you can send it home with the client as a bonus treat-something that will play a part in bonding them to your practice.  

Veterinary teams can use a few inexpensive silicone pot holders to distract canine patients, says Dr. Julie Reck.  

Vetted February 2019