Get a few episodes of the classic sitcom on DVD and get reinspired to help veterinary clients with senior pets that deserve a healthy, comfortable life as mature, senior and geriatric cats and dogs.
Bea Arthur (Dorothy), Rue McClanahan (Blanche) and Betty White (Rose) walk the red carpet for "The Golden Girls." (Shutterstock.com)Editors' note: These tips come from "Golden years: Boost senior healthcare to build clients and business," taught by Heidi Lobprise, DVM, DAVDC, and Bash Halow, LVT, CVPM, at CVC Kansas City (now Fetch dvm360!). Reporter Hilal Dogan, DVM, reports ...
Relative age of animals isn't old news to every client
Have you ever threatened someone by simply saying, "Shady Pines, Ma”? (For those of you who don't know, Dorothy was apt to repeat this veiled threat to send Sophia to a nursing home when the oldest Golden Girl was about to do something rebellious or if she said something out of line).
Heidi Lobprise, DVM, DAVDC might just threaten to do the same to all of you if you don't discuss relative age of animals with your clients. (Here's a handy PDF chart by pet weight from a few years ago, and here's guidance today in the AVMA's "Senior Pet Care FAQ.")
Age is a fact, but what will it look like for the pet?
Dorothy: Oh, c'mon, Blanche. Age is just a state of mind.
Blanche: Tell that to my thighs.
What's aging anyway? Dr. Lobprise explains it to clients as progressive changes after maturity, decreased organ function and decrease in capacity and depletion of physiological reserves.
"Our goal is to minimize the changes of aging as much as possible by working with our clients on preventive medicine."
Is your client with a senior pet bought in yet? There's more ...
When can preventive care make the biggest impact?
Blanche: This is strictly off the record, but Dirk's nearly 5 years younger than I am.
Dorothy: In what, Blanche, dog years?
Relative age is exceedingly important as the pet ages. Think about your oldest pet that you own: Do you ever think about what their relative age is? Likely not often. So if it's tough for even us veterinarians and veterinary technicians to remember how old our pets are. It's even tougher for our clients. So we need to remind them.
Don't take "no" for an answer
A lot of veterinary teams say pushing for preventive care for senior pets is a hard sell, according to Bash Halow, LVT, CVPM. (Maybe you too?) Pocket books are tight these days, right?
"Well, at least, if people decline the service, ask why," Halow says. "Don't you want to know?" Is it really money, or are you assuming? Maybe they just don't see the need for it and you're not explaining it in a way they'll get.
"Don't say, 'Fluffy needs a heartworm test and a vaccine ... and, oh, I don't know how you feel about it, but we also offer this senior wellness program,'" Halow says. "Don't waffle. Then it does end up sounding like a sales pitch. If you believe it, own it. That's how you'll really connect to your clients."
If you need a refresher, here's an example: For cats, "Mature" is 7 to 10, "Senior" is 11 to 14 and Geriatric is 15 and older. For dogs, we look at size ranges based on their weight and breed. If we start treating a Great Dane at 7 as a senior, you've missed the window for preventive care.
Age ain't nothin' but a number!
A large part of the Golden Girls' appeal was that they were all women over age 50 who were still actively working, volunteering in the community and, yes, dating and having sex. They showed the world that menopause didn't automatically equal resigning oneself to knitting afghans and baking cookies. In clinical terms, they had a great quality of life.
Show clients a pet's relative age so clients can think in human terms, but include a good quality of life assessment. This should be done as early as the mature years so you and the pet owner can start seeing trends:
> How happy does the pet appear? Does the pet get up to greet you?
> How has the pet's behaviour changed? Does the pet interact the same way?
> Has there been a switch in the sleeping cycle? Is the pet awake more at night?
Being a pet's body buddy
Blanche: I don't look right in American clothes. I have more of a European body.
Rose: Oh, in Europe, do they all have big butts too?
Too heavy? Too thin, too light? That can make an impact on older patients. It can be harder for pets the same as people to get back into shape when they're older. Clients can understand that.
Body Condition Score is a good start for gauging weight (VCA has a nice explanation here), but you can also help pet owners to see changes over time. Take pictures (or ask the pet owner to take them) from different angles as the animal ages, maybe every three or four months.
A changing metabolism can be a big contributor to unhealthy weight, of course. Basal metabolism rate (BMR) decreases as we age. Then, with cats at around 11 years old, the BMR actually increases. Unless those cats have kidney issues, they may need more protein.
Quality of remaining lean muscle mass is important. We lose muscle quality as we get older, so the BCS can fail you here if there's a lot of fat.
Check in on changes
Blanche: Girls, I have writer's block! It's the worst feeling in the world!
Sophia: Try 10 days without a bowel movement sometime.
Blanche: You just sit there hour after hour after HOUR!
Sophia: Tell me about it.
Ask your clients what their poop's like (the animal's, not the client's, although amazingly clients will share freely). Subtle changes over time can signal important things to you.
Do clients think their older pets are turning into teenagers with selective hearing? You know that might not be deliberately selective hearing. If eyesight's bad, tip off your clients not to rearrange the furniture.
Check in on your message
If you really are emphasizing the medical need for, and the very real value in, better care for senior pets at your hospital, make sure your website, your hospital, your team and your conversations emphasize that. Want to know if your current customers want to know more about, and have more access to, better care for their older pets? Organize a focus group of clients over dinner sometime to talk about your vision and create a safe place to explain and hear feedback about your vision. Want your team on board with the new focus? Talk to your reps to pay for a boarded specialist to visit and explain all the ins and outs of better senior care to your team. Great education, unlike people and pets, never gets old.
For older patients with mobility issues, suggest that pet owners put rugs down.
Ask clients to watch water consumption, although that can be difficult to track.
Are they eating hard or soft food? Is any food getting left in the bowl?
And, always, always do a dental exam.
All these different observations can help you truly assess your patient's health status.
Look into inner beauty
Blanche: Isn't it amazing how I can feel so bad and still look so good?
Sometimes looks can be deceiving, and no matter how many questions you ask, it's always best to go farther than skin deep.
Free senior screenings!
No, not for every client-for every team member.
"They'll become believers," says Bash Halow, LVT, CVPM, "and then you won't need to teach them to recommend it. They just will."
A great way to get client compliance on important senior diagnostics is by bundling it for a discount: twice-a-year physical exams, blood work, urinalysis, radiographs, pain management assessment and treatment and even acupuncture, if you do it.
As with any bundle or discount to improve client compliance, be sure to measure the percentage of clients you're reaching with your deal. If it's not working, change it.
Hilal Dogan, BVSc, owns the mobile veterinary practice Dogan Vet Care in Maui, Hawaii. She started the Veterinary Confessionals Project as a senior veterinary student at Massey University in New Zealand.