Focus on the 'fifth vital': Pet weight


Add nutrition to exam room discussions for healthier patients at your veterinary practice.

"He ain't heavy; he's my dog" is one of many responses pet owners may have made to veterinarians regarding their pets' expanding waistlines in years past. But these expressions are becoming less and less cute. As in human medicine, the veterinary profession is increasingly focused on health problems associated with obesity and poor nutrition. One example? The new nutritional assessment guidelines from the American Animal Hospital Association.

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But this trend for better pet nutrition is nothing new for Countryside Veterinary Hospital in Chelmsford, Mass. Doctors at Countryside have been recommending special diets for cats and dogs in need since the late 1980s, and in 2006 they instituted mandatory recording of the "fifth vital"—body condition score—in every patient record at every visit.

According to Countryside's practice manager, Gayle Craig, CVPM, the focus on nutrition and healthy weight has reaped health dividends for pets, better client compliance with food and exercise recommendations, and therapeutic diet sales of $486,000 (the practice sells two different brands) in 2009. Here are the cornerstones of Countryside's best practices when it comes to nutritional assessment, team training, and better pet health:

Focus on the 'fifth vital'

Nutrition and weight assessment is mandatory during patient visits at Countryside, says owner and administrator Dr. Brian Holub. "Just like a human physician talks to you about saturated fats and cholesterol during your annual exam, we consider body condition score the fifth vital assessment during a pet's wellness exam," he says.

To emphasize body condition scores even more, Dr. Holub and his team of doctors created a system a few years ago to make sure those scores are recorded in every patient chart at every visit. Doctors enter the scores on diagnostic code sheets, and technicians check to make sure the scores have been recorded during or immediately after a visit. Later, the technician manager evaluates the records from the doctor and technician teams and heads straight to the technician if something's been missed.

The practice uses the body-condition-score diagnostic codes first and foremost for nutritional counseling during outpatient appointments. In addition, the team uses the codes to identify clients with overweight pets who could benefit from educational materials and nutrition-based programs at the practice. One of the most successful of these programs is the "Fitter Critters, Longer Lives" club. Clients enter the Fitter Critters club by purchasing a recommended diet from the practice—with coupons provided by the manufacturer—and paying up front for six follow-up technician visits for weigh-ins and continued guidance.

Spread it around

Every team member at Countryside, from the receptionist to the practice manager, is on message when it comes to the importance of special diets for medical conditions, lifestyle characteristics, and weight control. Doctors note their nutritional recommendations on travel sheets, which client relations specialists follow up on at the front desk, Craig says.

"They'll mention that the doctor made a food recommendation for the pet and ask if they're interested in purchasing it that day," she says. Craig says reinforcement like this from well-educated staff members in multiple departments increases compliance.

This spread of knowledge happens even outside the practice's walls, says Craig, who's enthusiastic about AAHA's new nutritional assessment guidelines—they validate what Countryside has been doing for years. "If more veterinary hospitals incorporate body condition score as the fifth vital, clients will be more apt to accept nutrition as a standard part of a veterinary visit and follow a veterinarian's diet recommendations," she says. "This means pets benefit from eating healthier and live longer lives with their pet parents. And veterinary hospitals see increased revenue, especially clinics that aren't making nutritional assessments right now."

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