Have a heart: Focus on veterinary cardiac medicine


Don't wait until it becomes a more serious problem. Start educating your clients about heart disease today.

In between appointments recently, I signed up some of my team members for a client compliance seminar that's making its way across the country this summer. Shortly after that, my veterinary technician gave me the history on my next patient, a coughing dog. I grilled my technician for more information: time of day when the coughing occurred, frequency of the cough, and the pet's energy level. I wanted the technician to think beyond kennel cough and consider heart disease as well. The patient was active and his coughing was infrequent, and though he had a heart murmur, I wasn't quite convinced of a diagnosis yet. The client consented to chest radiographs, and, lo and behold, the results showed a very enlarged heart.

With compliance and marketing on my mind, it dawned on me that many practitioners don't do a good job of educating clients about heart disease and how prevalent it is. According to IDEXX Reference Laboratories, 15 percent of young dogs have heart disease. As dogs get older, that number approaches nearly 40 percent. The prevalence of subclinical disease in felines may be as high as 16 percent in the general population. The reality is that many doctors wait for heart disease to become a serious issue before taking action. This is not the right approach. We should be educating clients about heart disease before it becomes a bigger problem.

My clinics are planning Have a Heart month and marketing it like we do Dental Health Month. As doctors, we can do a better job of screening for cardiovascular problems on a regular basis. Consider bundling diagnostics in a slightly discounted package that includes a pro-brain natriuretic peptide (proBNP) test, a blood pressure reading, an electrocardiogram, and chest radiographs. This would be a good package for any patient with a heart murmur, arrhythmia, heartworm disease, exercise intolerance, or any other cardiovascular red flag. It would also be an excellent cardiac wellness screen, especially for senior pets.

Another idea? Promote this package at the time of dental and surgical procedures. It's an ideal time to add on chest radiographs to our sleeping, easy-to-X-ray patients. While the cost of a normal set of thoracic radiographs regularly exceeds $100 at my clinics, I can deeply discount them in this wellness scenario because it's new business and new revenue. I tell my team that radiographs and anesthesia are expensive because of the investment in equipment, but the actual cost to shoot an image or provide inhalation anesthesia is minimal.

Finally, I scheduled a local cardiologist to give a presentation at our practice on what's new in the diagnosis and treatment of cardiac disease. I'm excited about our upcoming compliance seminar, but Have a Heart Month sounds good, too. Who knows, our client compliance may be higher with our own program. I'll keep you posted.

Veterinary Economics Editorial Advisory Board member Dr. Jeff Rothstein, MBA, is president of Progressive Pet Animal Hospitals and Management Group in Michigan.

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