Pre-op testing, wellness exams are fueling in-office diagnostics

Selling the benefits of in-office diagnostics? Four words just about sum it up: “convenience” and “better patient care.”

“All of us want convenience,” says Jason Hunsinger, district manager, Mid-Atlantic area, Butler Schein Animal Health. “We’re all short on time. Any time you [as a pet owner] take your pet to your veterinarian, whether he’s sick or in for a wellness exam, and you can get valuable information on the spot, that is worth its weight in gold.”

“If [a clinic] has [testing] capability in-house, they will do more testing, and that will in the end lead to more accurate diagnoses and better medicine,” says Greg Fischer, who covers southern Minnesota for Midwest Veterinary Supply. “And that’s what they’re after.”

Nor can the bottom line be ignored.

“A piece of equipment, whatever it may be, needs to pay for itself,” Fischer continues. “It behooves people like me to show how this can positively impact [the veterinary practice’s] bottom line.”

Veterinarians are facing tough competition on many fronts, including Internet pharmacies, says Tammi Lesser, marketing manager, IDEXX Laboratories. “But diagnostics is something the veterinarian can uniquely provide. And it helps patients live longer.”

Geographic differences

Hematology analyzers, chemistry analyzers, electrolytes and rapid tests have become commonplace in the veterinary clinic. “Most practices are pretty sophisticated,” says Rachel Schultz, practice consultant for the American Animal Hospital Association. Even those that still send many of their tests to an outside lab have in-house capabilities to test critically ill patients on an “I need to know now” basis. Still, Schultz has observed that rural clinics often have more comprehensive in-office labs than metropolitan ones, which have quick, convenient access to outside labs.

There are some geographical differences as well, particularly in the types of tests likely to be administered. “My industry experience comes from being in the Northeast,” says Hunsinger. Clinics in that part of the country are particularly strong in heartworm and parasite testing, he says. “Ten years ago, you saw strong follow-through in offering heartworm tests. Then it transitioned to heartworm/Lyme testing. With the prevalence of Lyme in the Northeast, people are extremely compliant.”

 Pre-op testing

While many veterinarians are convinced of the need for in-office diagnostics for emergency patients, they may not believe they see enough critically ill patients to justify acquiring sophisticated lab equipment, according to those with whom Vet-Advantage spoke. Be that as it may, there’s a good chance those clinics do engage in two other clinical activities that might justify it – pre-op testing and wellness exams.

Clients don’t want to bring their pet in for pre-op testing, then return home to wait for results, then return to the clinic for a procedure, says Schultz. They’d rather all necessary testing be performed the morning of the procedure.

“The pre-anesthesia test gives you insight into the well-being of the animal,” says Lesser. It provides the veterinarian insight into the functioning of the kidney and liver, for example. If the patient is anemic, oxygen levels will be compromised, she points out. The animal’s electrolyte levels may determine how quickly it will recover from anesthesia. Bottom line is, the results of pre-anesthetic testing may result in the clinic altering its protocol, the result being a better outcome for the pet.

Pre-op testing also provides valuable baseline parameters, says Fischer. “Going forward, as that pet gets older, the clinic can refer back to the early blood work and see what their normals were.”

In the not-so-distant past, some clinics feared that if they insisted on pre-surgical blood work, clients might object to the cost and go elsewhere, says Hunsinger. But when they have made testing mandatory, they have found that they don’t lose customers, as they feared they would. “[People] know how important testing is when we go in for procedures,” he says. “Clinics have done a really good job letting their clients know why they should do it for their animals, and how important it is to establish a baseline for the pet’s future health. You’d be hard-pressed to find a practice that didn’t see value in pre-surgical blood work.”

As with so many things in the clinic, the chances of success are greater if everyone in the practice – from the front staff to the doctor – deliver the same message to the client, continues Hunsinger.  “To have any kind of testing protocol work, you need the message to be consistent, from the technician in the room to the doctor. And you need people to be confident in what they’re talking about. If they’re not, the client will see that and question, ‘Is it really worth it to pay for this service?’”

Wellness

While pre-op testing has already proven itself as a driver for in-office lab diagnostics, wellness testing is another. And those to whom Vet-Advantage spoke consider it a strong one. Annual blood work can give the doctor a good look at the well-being of the animal, says Lesser. Hematology and chemistry screens can help the doctor pick up problems, such as renal disease, before the animal presents with symptoms. The prognosis is better, because the doctor can help the client take steps, such as putting his or her pet on a therapeutic diet, that not only will improve the pet’s health, but probably save the owner money in the long run, as he or she avoids expensive treatment down the line. 

Some clinics send preventive tests to outside labs, notes Lesser. “A major objection [to in-house testing] is, ‘It’s not critical that we have that information right away.’” But if the clinic can perform such tests at the beginning of a visit, the doctor can sit down, face to face, with the client before the animal leaves the building to talk about potential issues and their solutions, and schedule a follow-up visit.

“The owner gets the results of the test and satisfaction before they pay their bill,” she says. “The worst thing is when the clinic takes blood and the client is told, ‘We’ll call you if there are any problems, but if you don’t get a callback, everything’s OK.’ When they don’t get that callback, they’re wondering what they paid for.”

Some vets feel it’s important to call the client regardless of the test results. That’s good customer service, but it also eats up valuable time from the veterinarian’s day.

“We’re seeing a 40-percent increase in compliance with pet owners when [the veterinarian] can discuss test results face to face,” says Lesser. The client is more likely to understand what he or she is told, and more likely to commit and comply with the recommended course of treatment. Better that than getting the phone call to bring Fluffy back in, which means missing another day of work, etc.

Stumbling blocks

Not surprisingly, some veterinarians voice concerns about the cost of in-house testing. Not only are they concerned about the cost of acquiring analyzers and supplies, but they believe that in-house testing costs the client more money on a per-test basis than if the clinic sent the work out.

Many times, the comparison isn’t valid, says Lesser. That’s because the clinic may, in fact, be overpricing the cost of its tests. The fact is, reference labs mark up tests far less than most clinics. The solution is not to send out tests, but to adjust the price of tests done in-house, she says.

Another objection is time. Veterinarians may be concerned that in-office testing will consume too much of their techs’ valuable time.

“These pieces of equipment and these tests have made veterinary technicians smile, whether they admit it or not,” says Fischer. “The technology is proven, and because they trust it, they’re free to do other things that are important to the success of that practice.” Typically, techs perform multiple functions within their clinics. “As the technology evolves, it’s quicker, simpler and more accurate,” he says, pointing to hematology screening as an example. In the past, the tech had to look in the microscope and manually count cells, he says. “It’s tedious, and [the tech] might get pulled one way or another, or get asked to do something else. There’s plenty of room for error.”

Some veterinarians believe in-house testing will take up more time than sending tests out to the reference lab, says Lesser. “Our suite of instruments takes about 50 seconds hands-on time for the technician,” she says. Contrast that with the time spent sending out tests – filling out forms, spinning down samples, making callbacks to clients, etc.

Nor do today’s analyzers require a great deal of skill to run in order to obtain top quality results, she adds. They are simple to use, and manufacturers such as IDEXX offer a variety of training opportunities, including online courses. As a result, technicians find that in-house testing is a rewarding part of their job. “They feel they’re engaged in the well-being of the animals,” she says.

Reference lab vs. in-house

AAHA’s Schultz believes that veterinary reference labs still can guarantee higher-quality results than the typical in-house lab, and that clinics would be well-advised to continue to send many of their tests there.

Not everyone agrees. Lesser, for example, says that IDEXX analyzers perform internal quality checks with every run. The clinic is advised to perform external checks regularly, such as once a month, she adds. While it’s true that reference labs perform external checks much more frequently, that’s because their volume is many times higher than that found in the typical clinic.

In fact, it’s a false dichotomy to pit in-house labs against reference labs, according to some. “Testing begets testing,” says Lesser. As clinics run more tests, they uncover more issues, and often end up sending tests to the reference lab that they’re unable to perform in-house. She cites the example of one clinic that, after starting a wellness program for its patients, increased in-house diagnostics 49 percent, and reference lab testing more than 15 percent.

“When I was with IDEXX, one thing you learned was that the in-house lab will never replace the reference lab, and the reference lab will never replace the in-house lab,” says Hunsinger, who worked for IDEXX for nine years before joining Butler Schein. It goes back to the convenience store mentality, he says. “Every town has several 7-Eleven-type stores, but they also have grocery stores. At the end of the day, you’ll see more convenience stores, but you’ll also see supermarkets.”

The sale

Just as veterinarians need to be thinking more about wellness and preventive care, so too should distributor reps, says Lesser. For example, medication monitoring is an area in which reps can focus. “There’s a huge opportunity to look at, ‘What [medications] am I selling, and how can I help [the clinic] build programs that are better for the patient, for the practice and the pet owner?’”

Ideally, the distributor rep and manufacturer rep work as partners in the selling process, says Fischer, who considers his role to be qualifying clinics on behalf of his manufacturer partners, “I get the appointments and [clinics’] agreement to bring in the manufacturer,” he says. “They trust me because they know me.” Despite his 36 years in the industry, Fischer still leaves the sale to the product experts – the manufacturer.

One base he is sure to cover is the ability of the practice to link its new analyzers with the practice’s electronic practice management and medical records systems. He’s high on IDEXX, because its VetLab station laboratory information management system integrates diagnostic results with the clinic’s system. It’s better patient care, he points out. But it also is a huge financial benefit to the practice. “It keeps them from missing charges. Surveys have shown that in a busy clinic, with techs running tests and seeing patients, upwards of 25 percent of lab charges can be missed. You put a pencil to that; it’s a staggering amount of money.”

Clinics express concerns about the money and time spent on developing and operating in-house lab capabilities, says Hunsinger. “That’s where, as sales professionals, we need to work on understanding their current system, uncovering needs they might not even know they have, and then showing them solutions.” New analyzers on the market are more efficient, allowing the clinic to run larger profiles on multiple patients cost-effectively. “If a clinic can see these things, they should be a lot more comfortable bringing in equipment. It comes down to education.

“One of the biggest areas of growth [in the veterinary market] is diagnostics,” continues Hunsinger. I think that will continue for years to come. The biggest challenge [for sales reps] is to understand our customers and any concerns they have, and then address those concerns in a thoughtful way.”

Fischer agrees. He speaks of one customer in rural Minnesota who, according to Fischer, “has blown up the idea that people won’t spend money for things like testing, because they don’t think it’s necessary.” When the vet arrived in town, the practice didn’t even have a tech on staff. Today, the practice has a complete in-house IDEXX lab and digital X-ray unit. “And this is in a town of about 4,000 or 5,000.”                                                                                                                                                               

KEY POINTS

Clients don’t want to bring their pet in for pre-op testing, then return home to wait for results, then return to the clinic for a procedure, says Rachel Schultz, practice consultant for the American Animal Hospital Association. They’d rather all necessary testing be performed the morning of the procedure.

Some veterinarians voice concerns about the cost of in-house testing. But the clinic may, in fact, be overpricing the cost of its tests. Reference labs markup tests far less than most clinics. The solution is not to send out tests, but to adjust the price of tests done in-house, says Tammi Lesser, marketing manager, IDEXX Laboratories.

“We’re seeing a 40-percent increase in compliance with pet owners when [the veterinarian] can discuss test results face to face,” says Lesser. The client is more likely to understand what he or she is told, and more likely to commit and comply with the recommended course of treatment.

Western Medical owner George Dunaians is up to the challenge of bringing his
family-owned company into the future

It’s challenging being a small business in a world of big competitors. “It is the larger distributors vs. the smaller ones,” says George Dunaians, owner of Western Medical Supply. “Ironically, in these times, when politicians are stressing, ‘We must encourage and help small businesses to succeed,’ we are experiencing just the opposite.” Even so, Western – a family-owned company – is thriving, through a combination of customer service and business smarts.

     Western Medical Supply is one of the oldest independent veterinary distributors in California. “For over 44 years, we have served loyal customers throughout California, Arizona and Nevada, with national and international clientele,” says Dunaians.

     “Our customers stay with us because they know we understand their needs,” he continues. “Most of all, they trust us to give them the very best service.” One of them is Betty O’Connor, DVM, San Luis Obispo, Calif. “I have been using Western Medical Supply for over 40 years, and they have been consistently helpful and knowledgeable, and they have a pleasant staff,” she says. O’Connor was recently recognized by Western for her continued support of the company.

     While personalized service is important, it’s not enough to be competitive in today’s business world, says Dunaians. “Most distributors are now nationwide, with warehouses in strategic locations across the country. Manufacturers today are always comparing the amount of business we are doing with their product lines and the ever-changing price margins. Quotas are a factor that often determines if you keep the line or not.”

     To remain competitive, Western has adjusted its business model to be more responsive to its customers’ needs. For example, “as a family owned company, serving a regional area, we are able to make adjustments with our inventory so we can better serve our customers,” says Dunaians.

    “I have always been an optimist. We are still here, and I look forward to reaching our 50th year in business,” he says. “With technology and the Internet leading the way to increased sales, I still feel that our most important asset is a qualified and knowledgeable sales force, as well as the support of our inside staff.”

By understanding the issues associated with heart disease and diagnosis, distributor reps can ensure their customers are well prepared to care for their patients.

By Laura Thill

Ensuring heart-healthy pets calls for regular preventive care checkups and an ongoing relationship between veterinarians and their patients. True, there are specialists in veterinary cardiology who are experts in the diagnosis and management of heart disease. But, it is often the general practitioners who man the front line of care.

     When it comes to heart disease, the good news for dogs and cats is that, compared to humans, they are equipped with a better network of arteries that feed the heart muscle. Whereas people have two central arteries, which are prone to becoming clogged by fatty foods, dogs and cats in particular are not susceptible to coronary artery disease. Still, they have their own set of concerns.

     Two types of heart disease that typically affect dogs are degenerative valve disease (also known as myxomatous valvular disease and chronic mitral valve disease) and dilated cardiomyopathy (DCM). The more common of the two, degenerative valve disease, typically affects smaller dogs at around nine years of age. The mitral valve is located on the left side of the heart, between the left atrium and the left ventricle. When the left ventricle contracts, the mitral valve must be in the closed position to force blood through the arteries to the rest of the body. Over the years, the mitral valve can wear out and become leaky in older dogs, and the blood is channeled back into the atrium. As such, cardiac output is reduced and less blood is circulated throughout the body.

     Degenerative valve disease is progressive. In its early stages, dogs may resist exercise, quickly run out of breath and develop a heart murmur. Later, they may develop a soft cough while lying down at night. In the final stages of the disease, the lungs become congested, causing dogs to have trouble breathing. Because the disease generally affects older dogs, pet owners may misinterpret symptoms as a product of age, notes Andrew Beardow, DVM, Boehringer Ingelheim.

     Dilated cardiomyopathy is a disease of the heart muscle that results in the thinning of the heart walls, weakened contractions and less effective pumping ability. Although dilated cardiomyopathy commonly affects larger breeds of dogs at around seven to nine years of age, it also affects some smaller breeds, such as Cocker Spaniels. Its symptoms are similar as those of mitral valve disease.

     Cats, too, are susceptible to heart disease, the most common of which is hypertrophic cardiomyopathy. The walls of the heart thicken, making the heart an ineffective pump. Because cats do not present a heart murmur and they sleep a lot whether healthy or sick, there often are no early warning signs. By the time the disease is discovered, it often is in its end stage.

 Frontline screening

Treating pets for heart disease means knowing not only when and how to treat, but when a disease should actually not be treated, according to N. Sydney Moise, DVM, MS professor of medicine, Cornell University, College of Veterinary Medicine. “Heart disease is often over-treated,” she points out. For instance, in the case of certain medications, timing can be critical. In addition, some animals may be at risk for heart disease, but not require medication for another couple of years. On the other hand, veterinarians must not rely on the notion of only treating a dog that has clinical signs. “We cannot know when a dog has symptoms, as they cannot speak and tell us how they feel. Consequently, dogs may need treatment before it is apparent to the owner that a problem exists,” she says.

     Particularly since many dogs and cats do not present clinical signs of heart disease early on, veterinarians need to examine patients and screen for the disease on a regular basis, Moise continues. “There is a lot of cardiac disease that can be managed in a primary care setting,” she says. “But, veterinarians must have a true understanding of the disease, and they must know where their comfort level is,” she adds, noting that it’s imperative that general practitioners know at what point they should reach out to cardiac specialists.

     A basic cardiac exam begins with a routine physical. A good stethoscope enables the veterinarian to detect heart murmurs as the blood moves in the wrong direction across the heart. In the case of a leaky valve, the veterinarian can get an idea of which valve is leaky and to what degree.

Although the stethoscope is a necessary tool for detecting heart disease, there are a number of devices available for diagnosing it, including the following:

• X-ray and/or radiography. X-ray and radiography provide a silhouette of the heart, enabling the veterinarian to see its size and whether the lungs are congested. However, the interpretation of an x-ray or radiograph is subjective, and if the animal is not positioned just so, the veterinarian may miss important signs. Also, in cats, the heart muscle expands equally on all sides, making it difficult to diagnose based on a silhouette image.

• BNP biomarker. At least one company offers a blood test designed to help diagnose or rule out heart disease in dogs and cats. It reportedly also helps differentiate heart disease from heart failure, and respiratory disease from heart disease. Because the test can be run in the veterinarian’s office, the veterinarian and client are provided with important information during the initial exam. Particularly for cats, who display no early warning signs of heart disease, a BNP test provides a dependable screen.

• Echocardiogram (ECG). Depending on the results of the x-ray or radiograph, the veterinarian will refer the patient to a cardiologist for an ECG, which can determine the existence of a cardiac arrhythmia or abnormal heartbeat.

• Doppler ultrasound. A noninvasive test that can be used to measure blood flow and blood pressure by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. (Whereas a regular ultrasound uses sound waves to produce images, it can’t show blood flow.

 As in the case of many diseases, diagnostic tools such as the above should be used in combination with one another to ensure the most accurate diagnosis. Veterinarians should begin with a general exam, including listening with a stethoscope for a heart murmur, says Beardow. They can follow up with a chest x-ray and a BNP biomarker. “The value of doing a chest x-ray – possibly every year [for high-risk pets] – is that it allows veterinarians to follow their patients closely and detect signs of heart failure early,” he explains. “We can follow the progression of the disease closely and know when the time is right to begin treatment (e.g., drugs).”  When necessary, veterinarians should follow up with an ECG, he says. “Many practitioners can do an ECG at their own practice,” he points out, noting that some veterinarians have anesthetic monitors with the capacity for ECG monitoring as well. And while some do have ultrasound, they often reach out to a specialist for this, he adds.

    Sometimes, veterinarians’ lack of awareness or financial concerns prevent them from adding new devices to their practice. Distributor reps may ask several questions, such as the following, to get their customers thinking about the value of diagnostic tools:

• “How do you currently examine and diagnose your cardiac patients?”

• “How do you evaluate heart murmurs?”

• “How do you determine which of your patients should visit a cardiologist?”

• It is especially important to focus on when each test or tool should be used and why it is applicable.

Newer treatments, better results

One of the biggest changes in the treatment of heart disease in recent years has been the more frequent use of pimobendan, a positive inotrope (a drug that improves heart function in cases of heart failure, heart attacks and various types of heart disease). While it has previously been used to treat animal heart disease in Europe, the drug only recently gained approval for use in the States.

     There are a number of large studies to support the use of pimobendan, says Beardow, and distributor sales reps can do their customers a service by keeping them apprised of such studies. For instance, the QUEST study – Quality of Life and Extension of Survival Time – is one of the largest global clinical studies involving dogs with congestive heart failure, he points out. The study, published in 2008, found that dogs with congestive heart failure receiving pimobendan plus furosemide (a diuretic used in the treatment of congestive heart failure) had significantly better outcomes than those receiving benazepril (an ace inhibitor) in combination with furosemide.

     “QUEST is a relatively new study that was published in the Journal of Veterinary Medicine, which not many general veterinary practitioners read,” says Beardow, adding that sales reps can become acquainted with the study and help educate their customers.

     Moise agrees. In order to keep their veterinarian customers up to speed on the latest advances in heart disease, distributor sales reps should become well acquainted with studies and attend conferences, she notes. Veterinary medicine is a fast-paced industry and new drugs are constantly being developed. “The drugs that work today will not necessarily be the ones we rely on five years from now,” she points out. As busy as veterinarians are, it’s imperative that they stay on top of the industry and its issues, she adds. Distributor reps can help them do so. “It calls for constant vigilance. We are all in the same boat [working to stay current].”

Program stresses the need to get cats into the clinic on a regular basis

Andria Saxon and the team at The Veterinary Hospital in Eugene, Ore., had heard and read industry reports about the failure of pet owners to get their cats the regular exams they need. That fact, combined with the recent economic downturn and resulting slowdown in client visits, convinced the clinic staff that they had to take action. When their Boehringer Ingelheim rep spoke to the team about the company’s “Have We Seen Your Cat Lately?” campaign, things clicked. By the end of June, The Veterinary Hospital had launched a comprehensive marketing program to promote regular feline visits.

     “Clients don’t understand the needs their cats have,” says Saxon, practice administrator. “That’s our fault – as an industry and as an individual practice. We haven’t taught them to make good wellness decisions about their cats.” But that’s changing.

     Launched in August 2010, the “Have We Seen Your Cat Lately?” campaign provides participating clinics with a kit containing educational materials and checklists to help veterinarians and staff members communicate better with clients about feline wellness. In-clinic tools include posters, window clings and buttons.

     “Clients have underestimated the needs of their cats,” says Saxon. “If they don’t understand what to look for and how to take care of their pets, they’ll end up with a much sicker cat in the future.” The message from The Veterinary Hospital is that prompt, regular medical attention not only results in healthier cats, but also keeps the owner’s overall costs down. “If we can catch [problems] early, maybe we can treat them through diet,” rather than through more costly measures, she says.

     “We feel many cat owners do not consider it important to bring their cats in for routine checkups and vaccinations,” says Robert Schachner, DVM, Cooper City, Animal Medical Center and Bird Clinic of Hollywood (Fla.), a participant in the “Have We Seen Your Cat Lately?” program. “The typical response we get to our question, ‘Why haven’t I seen your cat before,’ when the cat comes in with major disease, is, ‘My cat is indoors and there’s no way he’ll get sick.’ Obviously, they do, and unfortunately, that’s when we see them. There’s a disease process going on, or somehow the pet has fleas, which could have been preventable had we seen him on a routine basis.”

 The ideal routine

Ideally, the clinic would see cats every six months, or at least once a year, says Schachner. “Depending on age, we’d check for internal or external parasites, do a thorough clinical exam, listen to the lungs and heart, do any palpitations and skin checks for tumors or masses. We look for changes in weight, which can be very significant – either one way or the other. If the cat has gained too much, or unexplainably lost a lot of weight, we would be suspicious or diabetes or thyroid [disorder], which are quite common among cats.” The veterinarian would also check the cat’s oral health. “Just as with humans, the healthier we keep their teeth, the healthier we feel they’ll be in the long run.”

     Older cats receive a senior health check, consisting of blood and urine testing, says Schachner. Pet owners are more conscious of feline leukemia, feline AIDS and feline heartworm, “and we’re stressing it more and more,” he says.

    Adds Saxon, “There’s a huge difference between ‘My kitty’s sick and throwing up’ and bringing [the cat] in for an annual wellness exam. It’s our job to differentiate the two for our clients.” The clinic staff can do so by stressing that when the cat is brought in sick, the veterinarian may be unable to detect subtle signs of disease or disorder, which might be spotted during a wellness checkup.

     The annual exam helps the clinic make the owner aware of things like obesity. “Many people don’t realize they have obese cats,” says Saxon. Obesity can lead to arthritis, joint pain and diabetes. “We’re another set of eyes and another advocate for the patient.” Cats especially need that advocate, since by nature they tend to hide or mask their ailments.

     “Another condition that isn’t as obvious, and that people don’t consider treatable, is behavior,” says Saxon. Cats’ behavior can change as they age, or if a new pet or family member enters the picture. During the annual exam, the veterinarian can ask questions to uncover some of the underlying causes for behavioral changes. “People don’t have to live with [those changes],” she said. “There are a lot of options that many people don’t know about,” such as certified behaviorists. Only by seeing the pet regularly can the clinic staff make the owner aware of those options.

 Team effort

While cat owners have never been as diligent about regular checkups for their pets, the role the economy played “was the best wake-up call we could have had,” says Saxon. It was that drop-off in visits that spurred the clinic into action.

     The Veterinary Hospital launched “Have We Seen Your Cat Lately?” at a team meeting in June. “We talked about expectations for the program,” and even created a trivia quiz about feline health and information that pet owners might not know. “We gave that quiz to the team, we had drawings, and we had gift prizes,” says Saxon. The feline initiative is featured on the clinic’s website and Facebook pages, and is mentioned in its voice mail “hold” recording. From July through September, the clinic offered a “hot link organic catnip toy” to cats whose owners mentioned the “Have We Seen Your Cat Lately?” program.

 Just the beginning

The results haven’t been dramatic … yet. “I see this as the beginning of an educational campaign we will embrace for the rest of our business days,” says Saxon. “The questions we’ll ask ourselves are, ‘Are we making inroads? Are we educating our clients? Are we doing a better job?’

     “Are we talking about [feline health] more? Is there more top-of-mind awareness on our team’s part? Yes.” Still, she figures she won’t see the true rewards of the program for two or three years.

     “I think with our efforts to make people more conscientious about bringing their cats in for routine health care, we are seeing some increase [in cat visits],” says Schachner. “Is it significant? No. We need to get the word out more. Unfortunately, the majority of cats we see are sick cats. Certainly that’s what we’re here for. But our most important job is keeping pets healthy. That’s why we’d like to see more routine health checks.”

With the right plan, equipment sales can be a profit center for both reps and their customers

Selling equipment isn’t necessarily difficult, but it does force sales reps to step out of their comfort zones – and to bring their veterinary customers with them.

     “We believe that the front-line sales rep, whether it’s a field rep or inside sales rep, is the primary person to sell capital equipment to the customer,” says Mark Ziller, group president, companion animal health, Animal Health International Inc. “They have the relationship, the knowledge of the customer, and the most contact.” Yes, an equipment manager or specialist can be a valuable ally in the process, in that they can train the rep on the equipment and the sales cycle. But then it’s up to the rep, with help from the manufacturer, to close the sale.

     In one sense, selling capital equipment doesn’t differ from selling commodities.

      “For the majority of equipment, the skills necessary to sell capital equipment are the same as those necessary to sell consumables or drugs,” says Ziller. “It’s about communicating with the customer, discovering their needs, offering solutions. The majority of equipment isn’t necessarily technical.”

      But in another sense, the capital equipment sale is qualitatively different.

     “Equipment truly needs to be discussed as a profit center for the practice, whereas selling commodities or supplies is more of a buy/use everyday, small-dollar-type item,” says Clay Cass, national sales director, PCI Animal Health. “And also you need to be able to talk more like a banker and discuss financing, profitability, tax breaks. You truly need to have your financial hat on when discussing equipment.”

The selling climate

There’s no doubt that the gloominess of the U.S. economy has affected veterinary practices, and hence, their appetite for equipment. Still, there are some encouraging signs.

     “The market from our perspective is in a growth mode,” says Bill Murray, senior vice president, national sales manager, veterinary division, Bank of America Practice Solutions. “A lot of our veterinary clinics are making large investments, specifically in the digital area.” Practices are investing in electronic medical-records and practice-management systems, for example, and others are acquiring digital radiography systems. “We’re also seeing an increase in [the acquisition of] ultrasound and laser therapy,” he says.

     “We’re very fortunate to be in the industry we are,” says Ziller. “Clearly, we are in one of the deepest recessions in a generation or more. Despite that, while there have been challenges, it’s certainly not dire. Many, many industries have fared much worse. Overall, we’re in very fortunate circumstances. If we can help our customers weather this and continue to grow, that’s a positive picture for the long-term future.”

     Equipment maker Midmark Animal Health has seen steady growth, says Director of Sales Matt Bourne. “We’ve seen double digit growth over the last 24 months.” True, recent developments in the economy at large – the debt crisis, lingering unemployment and a depressed rate of consumer spending – continue to color the veterinary equipment market. “But we’re still seeing consumers invest in their businesses, which we think is important. When times are tough and people are unsure what to do with their money, they’re turning it toward themselves, in this case, their businesses. We think 2011 will finish well for us, and we expect the same for 2012.”

     Veterinary practices are looking for solutions that will ensure their financial stability and growth, says Bourne. Midmark’s VetPro high-speed dental delivery systems and Progeny imaging products can deliver on that count, he says. “But we’re also seeing strong numbers with our core products, even sterilizers. And that’s not typically something that a practice makes money on.” Still, it’s a sign of strength in the market.

Beginning the conversation

The equipment conversation with a customer begins in virtually the same place as any sale – with the reps’ eyes and ears wide open, according to those with whom Vet-Advantage spoke.

“There are lots of ways to start that conversation,” says Ziller. “One is asking the clinic for their plans for growth or expansion, or new areas they want to develop. ‘Are you interested in getting into dental work?’ ‘Do you want to do more lab work?’ Probe the customer, find out their plans and needs, and offer solutions.

     “And ask the customer, ‘Are you looking to modernize, to expand your practice?’ ‘Are you adding associates?’ ‘Do you have outdated equipment?’ A field rep who is able to walk into the clinic and go to the back room and see what’s new or old can offer recommendations that will make the clinic more efficient.”

     “Sales representatives who go into practices looking for their problems to be solved, their products to be purchased, are doomed to failure,” says Bash Halow, veterinary practice management consultant. “The vendors that are successful with the practice owners with whom I work are ones that form trusting relationships, access need, demonstrate empathy and understanding, then make a cogent argument for why their products solve the practice’s problems and concerns.

     “Veterinarians are searching for solutions to problems that beset the entire industry – increased Internet competition, a tighter economy, staff turnover, inadequate staff training, charge capture, decreased client visits, and a general consensus that it’s a hell of a lot harder to be a veterinarian today than it was 10 years ago,” says Halow. “Typically, an additional piece of equipment is viewed as something that will increase those problems, that is to say, will be underused, broken or used improperly by staff members, not pay for itself, etc.” The task for reps, then, is to demonstrate how new or upgraded equipment can help the practice address real problems. “I believe that is your calling card,” he says.

Business reviews

Successful equipment selling is purposeful and direct, not haphazard or last-minute, says Bourne. “With any type of equipment, you have to be early and you have to be willing to ask exploratory questions and identify gaps in the customer’s business,” he says. “What we have to get away from is waiting for the fourth quarter to sell all your equipment. That’s when everybody else is trying to do the same thing. Why not differentiate yourself and be ahead of the game?”

     Distributors should consider holding regular business reviews with their customers, he says. “They’re focused on understanding and assisting the customer in developing goals for today and the future, and helping them set the path for what it will take to accomplish those goals. It’s going toward that sales consultant role, [and] not being afraid to be intimate with the customer. You have to be more than that friendly face. You have to ask the tough questions.”

     In other words, sales reps would be well-advised to move beyond dropping off a piece of literature or cut sheet. “It has to be more of a visionary approach,” says Bourne. The rep needs to ask that veterinarian, what are the challenges facing the practice, and how will the practice drive its business forward and prosper? “These questions are tough to ask. And you don’t want [your responses] to be canned. Instead, you want to listen to what that doctor is telling you, and shift your focus accordingly.”

     Having a branch manager on hand can make the meeting more impactful, and it can help the rep focus on what that doctor is saying, says Bourne. “You want to have several solutions that you’ve seen work, and experiences you or your manager can speak to, of clinics that have been in the same shoes as the hospital you’re calling on.”

Financial discussion

Because of the greater dollars involved, the equipment sale necessarily involves a financial discussion, not just a clinical one, according to those with whom Vet-Advantage spoke. And it behooves the sales rep to move deliberately, to ensure that the equipment helps the practice fulfill its mission.

     “We feel the sales rep should play a role in discussing financing and offering choices to the customer,” says Ziller. “Many times, clinics might not think of the cash flow implications of making a significant purchase. One of the sales rep’s roles is to share the experiences of other clinics and offer alternatives, and help explain some of those options, including referring trusted partners who can provide more information and offer financing solutions to the veterinarian.”

     Many veterinarians need the financial expertise and perspective that the rep can bring, says Halow. “Let’s face it, these talented men and women are doctors, not MBAs. They simply do not have the experience or knowledge to make smart decisions about equipment purchases, so they end up shooting from the hip, basing their decisions on their relationship with their vendors, what they hear at conferences or in local veterinary management groups, and from other associates within the practice. Customizing a financial feasibility calculator to the target practice would provide objective and, I believe, compelling data to the practice owner.”

According to Halow, reps can sell effectively by demonstrating how a piece of equipment:

• Increases revenue.

• Increases the clients’ perception of value.

• Is user-friendly, inexpensive, easily serviced, accurate and trouble-free.

• Provides an excellent ROI.

• Is easy to market.

• Improves charge capture.

• Increases patient care and well-being.

• Saves money and reduces waste.

     Reps need to be able to show the doctor or practice manager how much a piece of equipment will cost the practice on a monthly basis, and how much revenue it will bring in, advises Cass. They should also demonstrate how many procedures the practice would have to perform with the equipment in order to break even. “Remind the clinic it is all about good medicine and staying updated, and maybe adding a procedure they didn’t have before,” he says.

Equipment as part of the practice’s brand

In the past, equipment decisions were based primarily on need, says Bourne. “Someone needed something, something was broken and it couldn’t be fixed; or someone had a promotion. We were a bit fragmented in our approach.” But that’s changing, partly in response to growing sophistication on the part of veterinary practices.

     Veterinarians are starting to brand themselves and the clinical experience they want to deliver to their customers, he says. “It’s similar to what we saw in human health. Consumers are able to research and base their purchasing decisions on that. Veterinarians who realize that better medicine is better business, and who can market that, can pull ahead of the market.” Buying the right kind of equipment, then marketing its value, are keys to doing just that.

Selling the staff

While selling the doctor on the equipment is an essential first step, it cannot be the last, according to those with whom Vet-Advantage spoke. In fact, if the staff is not fully engaged and sold on the equipment, the practice will not maximize the benefits from it.

     “Return-on-investment, cost-benefit, payback should all be discussed; they’re very important when you’re talking about promoting and selling equipment,” says Bourne. “But if the clinical staff is not comfortable using it, discussing what the equipment does or billing its benefits, the veterinarian will be disappointed in the new investment.”

     If the practice is performing a procedure based on new equipment, “it’s up to the sales rep, the veterinarian, the office manager and the vet techs to build a culture around that new piece of equipment – and to promote it,” he continues.

     “Ninety percent or more of the practices I work with have a considerable untapped marketing potential,” says Halow. “Annually, there are literally tens of thousands of dollars worth of additional services that could be provided to our clients if only they were made aware of them. I see it over and over again.

      “The best remedy? Decide on a hospitalwide standard of care, then get the entire team to participate in its promotion. That means technicians, receptionists, assistants, everyone. Program the software to help out. Leverage your social media, blog posts, and website to educate about it.”

The financing discussion

Financing a new piece of equipment is a large part of any discussion about return-on-investment, says Murray. “Give your clients options,” he advises. What would monthly payments look like on a three-year-loan, a five-year-loan, or a seven-year one? The rep might help make payments more manageable and take away some sticker shock by performing such analyses, he says.

     And today’s veterinarians are ready for it. “Doctors are becoming more business-savvy,” says Murray, who recommends that sales reps learn as much about financing as their customers.

     It’s up to the rep to decide when to call the lender, says Murray. “Some distributor salespeople are comfortable having [financing] conversations with their customers, while others don’t want to engage the doctor in such conversations. We’ll work either way.

      “We’ll give distributor salespeople as much information as they need, and they can use it as they wish. If they want to engage us early in the conversation, we’ll do that. If they want us to come in at the end to validate what they’ve been saying, we’ll do that as well.”

Distributor and manufacturer

The distributor does have a valuable ally in equipment sales – the manufacturer rep. But that’s true only if the two have open lines of communication, and hence, trust.

     “We believe in the pre-call plan,” says Bourne. “Before every call we go on with our distributor partners, we try to understand what the focus is for the particular call, the customer’s history, and whether we have pricing prepared. And [we look for] very scripted post-call action steps to support the dealer and the manufacturer.

     “There has to be training, communication and shared experiences. If we do those three things, we will build that trust.”

KEY POINTS

Clay Cass, national sales director, PCI Animal Health, says equipment needs to be discussed as a profit center for the practice, whereas selling commodities or supplies is more of a buy/use every day, small-dollar-type item. Reps also need to be able to talk more like a banker and discuss financing, profitability, tax breaks.

Mark Ziller, group president, companion animal health, Animal Health International Inc., says there are lots of ways to start the equipment sales conversation. One is asking the clinic for their plans for growth or expansion, or new areas they want to develop. ‘Are you interested in getting into dental work?’ ‘Do you want to do more lab work?’ Probe the customer, find out their plans and needs, and offer solutions.

Distributor reps should consider holding regular business reviews with their customers, says Midmark Animal Health Director of Sales Matt Bourne. “They’re focused on understanding and assisting the customer in developing goals for today and the future, and helping them set the path for what it will take to accomplish those goals.”

Something your customers should know

Section 179 of the U.S. Internal Revenue Code allows business owners to deduct a substantial amount of money – up to $500,000 this year – of an asset’s value in the first year of ownership (more precisely, the first year the property or asset is put into service). It was created 30 years ago to encourage investment and stimulate growth in the economy.

To qualify for the section 179 deduction, the property must have been acquired by purchase. For example, property acquired by gift or inheritance does not qualify.

The total amount businesses can elect to deduct under section 179 for most property generally cannot be more than $500,000. If the business acquires and places in service more than one item of qualifying property during the year, it can allocate the section 179 deduction among the items in any way, as long as the total deduction is not more than $500,000. The business is not obligated to claim the full $500,000.

The IRS offers the following example to illustrate the point: In 2010, the business owner bought and placed in service $500,000 in machinery and a $25,000 circular saw. The owner elects to deduct $475,000 for the machinery and the entire $25,000 for the saw – a total of $500,000. The $25,000 deduction for the saw completely recovered its cost. The basis for depreciation is zero. The basis for depreciation of the machinery is $25,000. You figure this by subtracting the $475,000 section from the $500,000 cost of the machinery.

The business owner must keep records that identify each piece of qualifying section 179 property. These records must show how the business acquired the property, the person from which the property was acquired, and when the property was placed into service.

For more information, consult Internal Revenue Service, Publication 946, “How To Depreciate Property,”

http://www.irs.gov/pub/irs-pdf/p946.pdf

     During the show, Jim Cleary, President and CEO and John Ryan, VP of Marketing sat down with Vet-Advantage to discuss this past year’s activities, as well as what the future holds for the company. 

Top-line growth

“We saw tremendous growth over the past year,” Cleary said. During the first two quarters of 2011, for example, MWI saw 40 percent top-line growth. Nearly 25 percent of it was organic growth in the United States; the balance was due to an acquisition in the United Kingdom. As of press time, the company was anticipating over $1.5 billion of annual revenues; with agency, $1.9 billion.

     “A good deal of our growth has come from our value-added services,” added Ryan. Sales over the company’s e-commerce platform grew 51 percent during the first two quarters of the year, and MWI’s pharmacy fulfillment business grew 54 percent during the same time period.

     There’s no doubt MWI benefited in the first half of the year from what Cleary characterized as the unfortunate demise of Omaha, Neb.-based Professional Veterinary Products, which closed its doors in September 1, 2010. What’s more, it was too early to predict the impact of the March 2011 acquisition of Nelson Laboratories, whose total revenues in 2010 were approximately $35 million.

Infrastructure

“We have made a huge investment in infrastructure to handle our growth,” Cleary said. Over the past year, MWI has:

• Expanded its Visalia, Calif, distribution center from 52,000 square feet to an 82,000-square-foot super center (that is, one in which the company stocks virtually all the products it sells).

• Expanded its Edwardsville, Kan., distribution center from 105,000 square feet to 135,000 square feet.

• Expanded its coolers in its Edwardsville and Grand Prairie, Texas, facilities.

• Gained a distribution center in Sioux Falls, S.D., as part of the Nelson acquisition.

• Opened two additional pharmacies for its fulfillment program, in Sioux Falls and Indianapolis, Ind.

• Signed a lease on a new distribution center in Harrisburg, Pa., replacing the current 540,000-square-foot facility with a 110,000-square-foot facility.

• Signed an agreement with Atlanta, Ga.-based Manhattan Associates for the company’s warehouse management system.

• Invested in additional warehouse automation for its distribution center in the United Kingdom.

     MWI’s May 2011 investment in Cubex, a provider of automated inventory control systems, has proven to be a valuable tool in helping the company’s clinic customers get a handle on their inventory, Cleary said. “We feel it’s a very good tool for our customers; it can help them increase charge capture and reduce inventory shrine.” In addition to Cubex, MWI also offers its customers the SWEEP inventory management system as well as a staff of inventory management consultants.

     Along with the investments in infrastructure, MWI has made an investment in people, said Cleary. During the past year, the company has added over 100 people in its distribution centers, five assistant managers and three pharmacists. 

E-commerce

E-commerce has been a strategic direction for MWI for some time, and will remain so, said Cleary. For the customer, it represents convenience. For MWI, it represents increased revenues and efficiencies, as Internet-based orders tend to be larger than those placed over the phone. And for the outside and inside sales reps, it has been a major contributor to an increase in compensation. In fact, when orders come in on MWI’s e-commerce platform, both the outside and inside reps get compensated.

     E-commerce also helps reps move away from taking orders, freeing them up to introduce new products, technologies and business processes to their customers. “E-commerce helps make our outside and inside reps more productive salespeople,” said Cleary.

     At the sales meeting, he announced a two-year initiative to increase revenues from the company’s e-commerce platform. “Today, those revenues are 36 percent of our revenues, and they’re growing by over 40 percent,” he said. In two years, he would like to see that 36 percent climb to 50 percent. “It will be positive for our customers, our suppliers, our sales reps, and our company.”

     E-commerce has been part of MWI’s offering for 11 years, he pointed out. In 2008, the program got a boost when MWI purchased the AAHA Services Corp., operating as AAHA MARKETLink, and entered into a long-term sponsorship and licensing agreement with the American Animal Hospital Association. The agreement made MWI the distributor of choice for AAHA members.

     Home delivery has become a larger part of MWI’s offerings as well, and will continue to grow, said Cleary. In 2007, the company launched ProxyRx, a companion animal pharmacy home delivery model. Two years later, it announced a partnership with Yardley, Pa.-based Vetstreet, an online communication and purchasing tool that connects pet owners with their veterinary practice and provides home delivery of supplies under the veterinary practice’s name. Prior to the recent national sales meeting, MWI announced a three-year extension of its agreement with Vetstreet, making MWI Vetstreet’s preferred supplier of products through its online store.

      “VetStreet has really worked hard to help veterinarians market themselves,” commented Ryan. “They have taken the concept to a new level and have been great for our customers.” Both Ryan and Cleary believe VetStreet has worked well with the industry and has been a part of the growth in MWI’s pharmacy business. “We are very pleased to be extending our agreement for the next three years,” added Ryan.

     MWI now has pharmacies in eight of its 13 distribution centers. “Our pharmacy programs right now are on a run rate of over $120 million a year in sales,” Cleary said. “We’ve really achieved some critical mass.”

What’s ahead for reps

MWI’s outside reps take relatively few orders in the field, said Cleary. Rather, they are “in the field doing technical details of products, acting as an extension of the manufacturers’ sales forces. In addition, they’re launching manufacturer programs, of which there are many going on at any time. They’re also launching MWI’s value-added services.” E-commerce should enable them to keep moving in these directions.

     Meanwhile, the role of the inside sales rep has changed as well, largely due to e-commerce, he added. “Over time, e-commerce will enhance the role of our inside sales reps, because it will enable them to spend their time on even higher-value activity. There’s a lot of value in taking customers’ orders, but e-commerce frees up time to answer customer questions, solve customer problems, and take advantage of any appropriate upselling opportunities.”

Key Points

The Boise, Idaho-based company will continue to invest in technology and its distribution infrastructure, such as its new, 110,000-square-foot facility in Harrisburg, Pa., which will allow MWI to continue its growth in the northeastern part of the country.

MWI will continue to expand its sales force; evaluate potential acquisitions that are a strategic fit; and focus on its value-added services, including its e-commerce platform, pharmacy fulfillment program and inventory management solutions.

All the while, the company will continue to focus on quality customer service, growth that exceeds that of the market, and a low operating expense structure.

Vet-Advantage readers will probably find themselves with another task on their plates a year from now, as they work with veterinary practices to help convince pet owners of the importance of regular checkups for their pets.

     Reps won’t be alone. They’ll have backup – plenty of it. But the thousands of face-to-face interactions that take place every day between sales reps and veterinary office staffs across the country mean that reps will be a key part of the effort.

     That effort is being coordinated by a newly formed organization called the Partnership for Preventive Pet Healthcare, which comprises the American Veterinary Medical Association, American Animal Hospital Association, Association of American Veterinary Medical Colleges, Banfield Pet Hospital, Veterinary Pet Insurance, and a number of healthcare manufacturers and distributors, including Butler Schein and MWI Veterinary Supply.

     “The key message will focus on helping pet owners understand the value of preventive healthcare for their pets,” AAHA Executive Director Mike Cavanaugh, DVM, DABVP, told Vet-Advantage. Secondarily, the message will attempt to re-establish the veterinary team as the go-to place for the best information about their pets, he says.

Ad agency

The Partnership has engaged New York-based ad agency Saatchi & Saatchi Healthcare Innovations to prepare a multiyear campaign to promote and engage the veterinary profession, and to drive pet owners’ awareness of the value of preventive healthcare, explains Cavanaugh. “The full scale of the direct-to-consumer advertising is under development,” he says. But veterinarians and the public at large could see national ads and other awareness initiatives in late 2012 or early 2013. One observer said the campaign could parallel those of other industries, such as the almost-20-year-old “Got Milk?” campaign from the California Milk Processor Board and “The Other White Meat” campaign, launched in 1987 by the National Pork Board.

     Partnership members don’t intend to be idle between now and the launch of the campaign. Rather, they will be working to prepare their respective constituencies, particularly the veterinarian community, for it, says Cavanaugh. For example, at press time, AVMA and AAHA were preparing to publish a set of “very, very simple, straightforward recommendations” about the type of care that dogs and cats need on an annual basis. 

‘Houston, we have a problem’

The initiative was unveiled in dramatic fashion in July at AVMA’s convention in St. Louis. “Houston, We Have a Problem” was the title of a presentation made there by AAHA President Michael Moyer, VMD, and AVMA CEO Ron DeHaven, DVM, MBA.

     “It was meant to be a call to action, a wake-up call to the entire profession that we have to accept the fact that something is going on here, and we have to work together to turn it around,” says Cavanaugh. That “something going on” is a drop in veterinary visits, dating back to 2004, long before the economy’s current woes, he points out. And the impact on pet health is clear.

     In St. Louis, Moyer and DeHaven cited the recently published Banfield Pet Hospital State of Pet Health 2011 Report (see July/August 2011 Vet-Advantage), which shows an increase in preventable and treatable illnesses in dogs and cats between 2006 and 2010. This includes diabetes (up 16 percent in cats and 32 percent in dogs), ear infections (up 34 percent in cats and 9.4 percent in dogs), internal parasites (up 13 percent in cats and 30 percent in dogs), and dental disease, which is the leading health condition that now affects almost 80 percent of dogs and 70 percent of cats over three years of age.

The question is, why have pet visits dropped off?

“Lots of different factors are coming into play,” says Cavanaugh. The recently released Bayer Veterinary Care Usage Study (conducted by Bayer Animal Health, Brakke Consulting and the National Commission on Veterinary Economic Issues), for example, demonstrates that pet owners are turning to the Internet as their first “go-to” source of information on their pets’ health. Some veterinarians report seeing pets two or three days sicker than they used to, as owners try to figure things out on their own using the Internet as their sole source of information. (See March/April 2011 Vet-Advantage).

     “There are certainly a lot more ways veterinary care is delivered today,” says Cavanaugh. “Think about the traditional model of 20 years ago, when all these freestanding animal hospitals existed. Today, there are a lot of different ways people can get veterinary care if they seek it out.”

Another factor could be vaccinations. Pet owners equate going to the veterinarian with getting shots or vaccinations, says Cavanaugh. Since many of these shots are no longer given on an annual basis, many owners forego the annual checkup.

“Put all these things together, and owners aren’t seeing the yearly visit as something that is really key to the health of their pets, even though they love them to death. They’re not making that connection.

“I think that we as a profession haven’t done the best job of articulating the value of the service we’re providing.” The Partnership intends to change that.

How will vets respond?

“It’s been proven that people are holding out, wondering whether yearly visits are necessary,” says Ben Coe, vice president of business development for Butler Schein Animal Health. “That’s the whole purpose of the Partnership – to show that it’s a wise decision to bring your pet in for at least annual visits, instead of waiting for something bad to happen.”

     Much of the success of the initiative will depend on how effective it is in getting veterinary practices in sync with the message, so they know how to respond to clients coming through their doors, adds Coe. The “macro” message must be specific and direct, so veterinarians know how to apply it on a local basis.

     Whatever happens, the entire staff – veterinarian, office manager, receptionist, vet techs, etc. – will have to be on board, according to those with whom Vet-Advantage spoke. “In the end, they’ll be the first line,” says Coe.

“Delivering a consistent message is key,” says Cavanaugh. “Not only the veterinarian, but the technicians and client-facing staff people need to be on board with this.”

     So do distributor sales reps. “We see the distributor reps as key messengers, if you will, to help carry the message,” says Cavanaugh. “We certainly will be developing tools they can use so they can get the word out.

     “Think of the number of face-to-face interactions those folks will have with veterinarians and technicians. They will be a critical part of getting out the message.”

     In addition to the companies and organizations mentioned above, Partnership members are Abbott Animal Health, Bayer HealthCare LLC Animal Health Division, Boehringer-Ingelheim Vetmedica Inc., Elanco Animal Health, Hill’s Pet Nutrition, Merck Animal Health, Merial, Novartis Animal Health US Inc. and Pfizer Animal Health.

For more information, view the Partnership’s website at www.pethealthpartnership.org.

   Jessy taught Rebecca Boyer-Mora the value of hard work. Foxy is her pride and joy. And Cracker’s full of potential. These teachers and friends are of the four-legged variety; they’re horses.

     Boyer-Mora is a sales rep for Butler Schein Animal Health who calls on companion animal and equine practices in Coastal California, a stretch of 250 miles or so. It’s a large territory, and calls for her to be away for as much as one week a month. When she’s not selling, she’s at Rancho Arroyo Grande with her husband, Cody, in Arroyo Grande, Calif., where Cody trains horses. Or she’s competing in a rodeo somewhere in the state.

     Born in 1981, Boyer-Mora was put onto her first horse at the age of 18 months. She was raised on a ranch outside of Wheatland, Calif., where she “grew up on a generator and a cellphone.” Her parents competed in “cutting,” an event in which a horse and rider are judged on their ability to separate a single animal away from a cattle herd and keep it away for a period of time.

     She didn’t start rodeo until she was in high school. “Coming from the cutting horse/ranching world, rodeo was not my father’s favorite thing,” she says. “He used to say it would ruin a good horse.” Generally speaking, many rodeo events are faster than cutting, and can be harder on a horse, she points out. “But when he found out I could cut in high school rodeo, he gave in, and I proceeded, not knowing what the heck I was doing.”

Fourth in the nation

She used her mom’s cutting horse for the cutting, and a ranch horse – Jessy – for everything else. “I competed in five out of six events on this one horse, where most kids had a different horse for almost every event,” she says. “Although we were both learning together, it was a very hard feat for a young kid to train her own horse. Jessy taught me the value of hard work.”

     Boyer-Mora attended California Polytechnic State University in San Luis Obispo, and made it to the college finals rodeo in the breakaway roping, finishing fourth in the nation on a horse that she trained – Foxy. (In breakaway, the rider is timed on how quickly she can throw a rope around the neck of a calf. Once the rope is around the calf’s neck, the rider stops the horse suddenly, causing a string connecting the rope to the horn of the saddle to break. Hence the name, breakaway roping.)

     It was at Cal Poly that she met her husband, Cody Mora, himself a rodeo competitor and horse trainer. Like that of Boyer-Mora, rodeo is in Cody’s blood. His parents are stock contractors; through their company, West Coast Rodeo, they provide bulls, horses and calves for rodeos throughout the state. Today, he is a competitive team roper, and he competes in reined-cow-horse events as well. (Team roping calls for two riders to rope a steer, one around the horns, the other around the hind feet in the fastest time. Reined-cow-horsing, on the other hand, calls for the horse to “work” a single cow, performing a series of maneuvers, such as circling the cow, boxing it and turning it. “These are two very different disciplines,” Boyer-Mora points out.)

The science behind a cauliflower

Boyer-Mora graduated in 2005 with a degree in agriculture science and minors in agriculture business, agriculture communications, wine and viticulture, and a partial minor in agriculture marketing. Her first job was with Harris Moran Seed Company, which breeds vegetable varieties. Boyer-Mora sold seeds through a dealer network. But she also was involved in product development, that is, bringing new varieties of vegetables – such as cauliflowers, beans, tomatoes or cucumbers – to market.

     Through direct trials in the field, she would monitor the development of new, experimental vegetable seeds in the field. With those seeds that thrived, she would try to convince growers to plant an acre or so. Those seeds that passed muster would ultimately be brought to market. “In my three years with the company, I was able to bring three new products to market,” she says. “To put that into perspective, it usually takes four to five years to bring one product to market.”

     “I really liked it,” she says of her work in the fields. “It’s incredibly interesting how much science goes behind producing a head of cauliflower.” Still, the pressure to develop new products was formidable.

     After working a short time for a seed dealer, Boyer-Mora ran into a friend who was in veterinary sales, and they talked about possibilities in that profession. After many interviews, she began working for Butler Animal Health, shortly before the company merged with Henry Schein.

      “Veterinary sales is different [from seed sales] in the fact that you have a lot more to sell,” says Boyer-Mora. “I had a ton of sales experience, but I didn’t have the clinic knowledge.” And she had a lot of product knowledge to gain as well. “It was pretty humbling in that I had learned all this about the vegetable seed industry, and now I was starting completely over. I felt like I was drinking out of a fire hose.”

Breakaway winner

Despite the learning curve, Boyer-Mora didn’t give up riding. In fact, in 2009, she started competing in the California Cowboy Pro Rodeo Association, a regional organization that sanctions rodeos in California, with co-approvals in Nevada, Washington and Oregon. She and Foxy ended the year by winning the state breakaway event. Today, Boyer-Mora competes in roughly 20 rodeos a year in the breakaway roping. She discontinued team roping after tearing her shoulder four years ago.

     The Moras have six horses, all of which are kept at Rancho Arroyo Grande. At press time, Cody was preparing to ride one of them – a Quarter Horse named DualinBowmans, or Dually, for short – at the Snaffle Bit Futurity in Reno, Nev. (“Snaffle bit” refers to a type of bit used in horses. Horses entered in the futurity are three-year-olds, and are shown in a snaffle bit in three different disciplines – herd work, such as cutting; rein work, and cow work.)

     The horses are well-taken-care-of, says Boyer-Mora. “The ones we compete on regularly are very closely regulated for any sort of lameness. If one comes up lame, we immediately take them to the vet to determine the problem.” The horses get monthly Adequan (joint therapy) shots, bimonthly worming, seasonal shots, and weekly TheraScope™ (micro-current stimulation) therapy. The TheraScope treatment helps the horses heal more quickly, and it helps prevent injuries as well, she says. Horses that are well-taken-care-of can compete until age 20 or even beyond, she says.

A healthy balance

“I think my horses definitely molded who I am today,” she says. Taking care of horses from childhood teaches kids responsibility. “You can’t not take care of them, you can’t not ride them,” she points out. Caring for a horse can also help keep a kid out of trouble (though Boyer-Mora maintains she wouldn’t have gotten into much trouble anyway).

     And horses provide a healthy balance in her life. “In this job, as in most jobs, it’s easy to become so involved, you forget about life outside work. My horses keep me sound. They are my therapy from stress, and my best friends.

     “I love to compete,” she adds. “If I did not, I would not have chosen sales for my career. But I think that rodeo teaches you how to compete better in your daily life.” After Boyer-Mora lost a competition, for example, Cody reminded her that “you have to learn how to lose before you learn how to win.”

     “The key word was ‘how,’” she says. “The ‘how” means your attitude. It is hard to learn how not to get an attitude and be mad when you lose a rodeo or a sale, but if you have a good attitude about it, you can look into the things that came from it – like your horse working really well, or what you learned from the sale you lost.”

     While horses usually stop competing by their early 20s, riders can stay in the saddle for much longer than that. “A person can compete for as long as you have the will to do so,” she says. “There are even old-timer events at some rodeos. I know a man who is 80 years old who still team ropes.”

By Rick Purnell

The two biggest names in animal health distribution became one in June. Animal Health International, Inc. (AHII) launched into a new chapter after a merger between Lextron, Inc. and the parent company of Walco International, Inc. The premier food and companion animal health distributor adopted the name “Animal Health International,” and will be headquartered in Greeley, Colo.

The quarter-billion dollar transaction creates a company that now brings more than 100 years worth of knowledge and expertise to livestock producers and veterinarians.

John Adent will serve as president and CEO, working with an integrated management team made up of Dave Wagley, executive vice president and CFO; Doug Harris, Chub Klein, Paul Krause, Kevin Pohlman, Chuck Vander Ploeg and Mark Ziller, all regional presidents; Steve Leinenbach, senior vice president of operations and Shelley Iwasaki, senior vice president of human resources. (See Sidebar: Team Leads AHII.) Adent envisions new opportunities for customers, employees and the industry overall.

“I believe AHII will have benefits for all customer segments – veterinarians, dealers and producers,” Adent says. “The combined experience and reputation of both companies will allow us to make real differences in animal health by offering higher service standards and more value-added services. This venture also gives us the ammo to be around for another 100 years.

What’s really important is that we’ll be able to offer customers the highest standards of service, while being more efficient and more innovative in implementing our new technologies.”

More than 13,000 veterinary clinics become customers of AHII. Half of these are companion animal clinics, which receive supplies from a network of eight distribution centers. Sales representatives are located in 36 states.

Channel-focused

“We really look at how we can differentiate ourselves by channel,” Adent says. “We’ll bring a full range of service offerings by customer segment. By focusing on the needs of each one, we can continue to differentiate the company and its professionals.

“We run pharmacy and prescription services for our veterinary clients, as well as dedicated truck routes for them,” he adds. “For the cattle side, we have our delivery system that allows operators the flexibility they demand for the ever-changing needs in their business.

“For swine producers, we have a one-stop shop for everything they need. Whether it’s clothing, pharmaceuticals or equipment, anything they need is packaged. This allows them to focus on genetics and other management considerations to produce the highest-quality pork possible.

“We have a tremendous amount of marketing and merchandising expertise we provide to our dealer customers.”

As it already does, newer technology will continue to play a vital role in delivering value to each channel. Each sales representative can enter orders remotely via laptops and wireless connections.  Business-to-business, direct interfaces between AHII and large integrator systems already allow EDI ordering and inventory control. Adent says this will get even better over time.

AHII is also getting more active with veterinary clients, not just with order/entry, but also by managing prescriptions. Under its drug authorization program, AHII is reminding clinic personnel that a renewal is due and asking if they want to continue the prescription or do something differently.

“This offers veterinarians the time to focus on their clientele, offer their best advice and worry less about having to manage all the paperwork,” Adent says. The same premise holds true for companion animal practices.”

When it comes to feed additives, Adent says AHII monitoring is second to none.

“With our micro machines and our ability to track all the inputs that go into an animal in the feedlot, we can track feed and pharmaceuticals, literally anything that goes into an animal,” Adent adds. “This gives us a strong advantage over some competitors because it’s an integrated system that’s seamless and flows easily into their accounting packages.”

Dealers are a big part of the picture, as well.

“We show them ways to create displays and generate more sales per square foot,” Adent says. “Plus, with our data, we can analyze what’s selling in their specific region.”

This technological advantage can deliver value and help to other channels, Adent predicts.

For example, he says that as larger dairies expand in size and number, and as some even begin branding their products, they’ll need to differentiate themselves. In doing so, they’ll need to control more of the feedstuffs chain and know exactly what’s going into each cow. AHII already has micro machines in some dairies. Adent says that segment will continue to grow as the need for tighter management, ingredient control and quality control increases. He adds that AHII personnel have the expertise to use a holistic approach to help lead dairy producers to implement these quality enhancement measures.

Opportunities within

Adent is adamant there are ongoing opportunities for AHII to grow and to contribute more to the industry.

“I see growth in all segments,” he says. “We have an exceptional team and the more of our employees I meet, the more excited I get. Fortunately, our respective cultures are keenly focused on customer satisfaction. We tailor our service packages to meet the needs of the respective channels. More importantly, we try to understand what each one of our customer’s views as value and meet those demands.

That commonality of cultures is one of many opportunities Adent sees for employees, as well as customers.

“Anytime two industry leaders come together, there are going to be redundancies and this merger is no exception,” he says. “As we consolidate locations to Greeley, we have no changes to employee structure planned at this time. It’s exciting. We’re already implementing a number of integration objectives directed at building the premier animal health company. Our employees, or partners, will be able to reach new markets.”

Adent says employees will find new opportunities in the combined organization that didn’t exist in the singular companies. While some have yet to be realized or even discovered, he says there’s little doubt that employees will have new ways to reach new customers more effectively and increase value to existing customers.

“We’re going to show this to employees and customers by delivering on our promises,” he affirms. “They’re going to see the best of both companies in action.”

Mastering the practice of delivering that “best” to customers can be a challenge, but it can be done well, says Jim Whitt, organizational development and employee engagement consultant. See sidebar, Form, Function, Purpose. He says it all comes down to understanding an organization’s purpose.

Prepare for the future

While change is inevitable, preparing for it makes events surrounding it flow more smoothly. More importantly, investing in change by investing in future leaders and supporting is part of the AHII charge. 

“I believe it’s very important for everyone involved to support this industry,” he says. “We were deeply involved with Dr. Ron DeHaven and the American Veterinary Medical Association (AVMA) in helping to secure funding for the rural veterinarian debt reduction program. We’ve continued to support this program. We focus our charitable giving around 4-H and FFA. (See sidebar: Help for rural vets)

“In addition to financial support of these great causes, we also give our time,” he adds. “Our future depends on the young people in this industry. I will be the chairman of the sponsor’s board for FFA in 2012 and I’m currently on the executive board. We talk a lot about the business side of things, but this is just as important. We have to continue to develop our youth in agriculture. In addition, we have to find ways to get our message out to the general population, as there are fewer and fewer of us in the business. We need to tell the story that people involved in agriculture truly are the stewards of the environment. A lot of Vet-Advantage readers came through one or both of these organizations and it’d be great if they could give back, as well.”

AHII employees are strongly encouraged to be involved in their communities. Adent says he can’t fathom the number of volunteer hours employees contribute on an annual basis, but proudly admits it’s a “really big number.”

“There are so many examples of community involvement among our employees,” he says. “As I meet more and more of them, I’m astounded at how many nights, weekends and even daylight hours our people give to 4-H, FFA and other organizations that are important to them. I applaud that; it’s an important part of our culture.”

Culture, ethos or practice; no matter what you call it, is a prime component of what the new AHII is bringing to its customers and its employees. It also contributes to what Adent says is all a part of being more efficient and more competitive to help our industry continue to improve.

Sidebars

Help for Rural Vets

Animal Health International, Inc. (AHII) is one of the industry leaders supporting the Food Animal Veterinarian Recruitment and Retention Program, a combined effort of the American Veterinary Medical Association (AVMA) and its charitable arm, the American Veterinary Medical Foundation.

Dr. Bob Hummel, chairman of the board of AHII, worked closely with Dr. Ron DeHaven, executive vice resident of AVMA, to encourage development of the program by USDA.

“This program supports the greater mission of AHII to give back to our industry and help it remain innovative and progressive,” Hummel says.

Form, Function, Purpose

Jim Whitt is an organizational development and employee engagement consultant with Purpose Unlimited in Tulsa, Okla. He’s helped lead many agricultural firms through transitions. He says that while change is difficult under any circumstance, a merger brings unique challenges.

“I follow a simple formula for organizational design: ‘Form follows function and function follows purpose,’” he says. Merging two organizations allows for tremendous improvement in efficiency because you can consolidate, centralize and streamline so many functions. The form of the new organization has to be designed to effectively perform those functions. But, the most critical and challenging thing to accomplish is blending the two organizations into one culture.”

Whitt adds that building on success is but one part of a strong foundation.

“With AHII, you have two organizations with very successful histories. Each has a way of doing things that has contributed to that success. The key to capitalizing on the strengths each brings to the party is to identify the common purpose of the new entity. That purpose becomes the brand of the new culture.

“To borrow a page from the old west, a brand not only identified a ranch’s cattle, it was a symbol of pride and loyalty for its cowboys – they rode for the brand. People today want to be partners in a cause that is purposeful, heroic, adventurous and idealistic. Like cowboys of yesterday, they want to ride for the brand,” Whitt says.

Put simply, he says, “An organization is simply a group of people bound together by a common purpose. And, that’s where you start – form follows function and function follows purpose.”

(Whitt is author of Riding for the Brand: The Power of Purposeful Leadership.)

A team made up of Animal Health International, Inc. (AHII) and Lextron, Inc. executives will lead the newly formed business.

John Adent will establish direction and implement strategic goals and objectives as president and CEO. He joined Lextron as CEO in 2004 and was named president and CEO in 2007. He is a member of the executive council of the National FFA Foundation will service as its 2012 chairman.

Serving as executive vice president and CFO is Dave Wagley. He joined Lextron as vice president of finance and CFO in 2005.

Steven Leinenbach will direct corporate and field operation functions for AHII and lead the AHII Technology Business and EXL Laboratories Dairy Hygiene.

Doug Harris is one of six regional presidents having served in increasingly responsible roles with Walco since 1981.

Chuck Vander Ploeg, Midwest regional president, started in the animal health industry in 1978. He most recently served as president of the VetPharm Division of Lextron.

Chub Klein, regional president, joined Lextron in 1979 as a field sales representative with Parker Livestock Supply. He joined the leadership team in 1992.

Regional President Paul Krause has a 16-year tenure with Walco, most recently serving as president of the production animal group for the Eastern U.S.

Starting as a sales manager with the southeast division in 2001, Kevin Pohlman, regional president, assumed oversight of the marketing department in 2008.

Mark Ziller, regional president, founded TW Medical Veterinary Supply and since its acquisition in 2008, has served as vice president of companion animal. He is also currently president of the American Veterinary Distributors Association and was a founding board member of the American Association of Veterinary Blood Banks.

Shelley Iwasaki will lead and coordinate the human resources function as senior vice president of human resources. She was previously with PepsiCo and Frito-Lay. It’s almost like coming home for her. Her first job out of college was with Lextron as a junior accountant.

Banfield’s first “State of Pet Health” report demonstrates the wisdom of prevention of the most common diseases.

The numbers don’t lie. And the numbers bear out what many Vet-Advantage readers and their customers have already come to believe, namely:

• Diabetes among cats and dogs is on the rise. So is obesity.

• The most common disease in dogs and cats is dental disease.

• The second most common is otitis externa.

• Heartworm, fleas and ticks remain stubborn problems in many parts of the country.

• Healthy-pet visits drop steadily as pets age.

• And yes, your customers are caring for more small dogs than ever before.

But if there is a bottom line to the numbers, it is this: An ounce of prevention is, indeed, worth a pound of cure. With good preventive care, many of these issues would diminish.

This spring, Banfield Pet Hospital released its State of Pet Health 2011 Report, its first-ever report compiling medical data from pet visits at its 770 hospitals. Last year, Banfield associates, including 2,400 licensed veterinarians, cared for 2.1 million dogs and nearly 450,000 cats. The company uses a proprietary electronic medical records system, information from which is downloaded daily to the company’s medical database at its main campus in Portland, Ore.

“People ask, ‘Why didn’t you do this before,’” says Jeffrey Klausner, DVM, senior vice president and chief medical officer, Banfield Pet Hospital, speaking of the report. “We could have. We’ve been collecting data since the practice got started. But we felt we had enough data and that it was a good time to look back over the last five years. We’ll be doing this every year, probably looking at different diseases.”

It is Klausner’s hope that the data will offer veterinarians, clients and veterinary schools valuable information on important companion-animal diseases, so pet health can improve.

The State of Pet Health 2011 Report contains details of the most common and medically important diagnoses affecting dogs and cats in the United States, according to their age, breed and geographical location, according to Banfield. They are: diabetes mellitus, heartworm disease, dental disease, otitis externa (ear infection), fleas, ticks and internal parasites (roundworms, hookworms, tapeworms and whipworms).

In addition, the report contains details on how the prevalence of these diagnoses has differed over the last five years and how it changed according to geography and season in 2010. The diagnoses were selected because they are either the most common, preventable, transmittable to humans (zoonotic disease) or medically important due to the effect on a pet’s overall health and lifespan.

Diabetes

The prevalence of diabetes mellitus in dogs increased from 13.3 cases per 10,000 in 2006 to 17.5 cases per 10,000 in 2010 – a 32 percent increase, according to Banfield. The prevalence of diabetes mellitus in cats increased from 55.5 cases per 10,000 in 2006 to 64.3 cases per 10,000 in 2010. Although this represents only a 16 percent increase, diabetes mellitus is much more common in cats than in dogs.

The incidence of diabetes is among Klausner’s greatest concerns, because of the difficulty in treating it, he says.

In 2010, Iowa, Rhode Island, Idaho, Nevada and Delaware had the greatest prevalence of diabetes mellitus in dogs, while Massachusetts, Rhode Island, South Dakota, Nevada and New Hampshire had the greatest prevalence in cats.

Although diabetes mellitus was not listed in the top 10 diagnoses of pets seen in 2010, the diagnosis of overweight or obese – which are risk factors for diabetes mellitus – was high on the list, according to Banfield. For young adult, mature adult and geriatric dogs, it was in the top five diagnoses, and for cats of the same age ranges, it was in the top three.

Among cats, the link between obesity and diabetes has been documented, says Klausner. “We know the prevalence of obesity has gone up in cats, so it’s not surprising to see a rise in diabetes.” But in dogs, while there may be an association between diabetes and obesity, it is not as convincing. Still, the incidence of obesity among dogs has increased over the past five years, he says.

Twice-a-year examinations can help veterinarians detect clinical signs of diabetes mellitus early, according to the report. In addition, keeping pets from becoming overweight or obese through proper exercise, nutrition and dietary management can reduce the risk of diabetes mellitus and other serious diseases.

Heartworm

At least as alarming as the rise in diabetes is the persistence of heartworm disease, says Klausner. “It’s a bad disease, and it’s relatively easy to prevent,” he says. “But the veterinary community has not gotten onboard with prevention.”

Heartworm disease shows a distinct geographic trend, with states in the Southeast having the highest prevalence of positive tests, according to Banfield’s data. In 2010, 6.7 percent of heartworm tests performed in dogs in Mississippi were positive, as were 6.3 percent in Arkansas, 5 percent in Louisiana, 2.9 percent in Alabama, 2.6 percent in Texas and 2.1 percent in South Carolina. Although heartworm disease is more common during the warmer months, it is a year-round condition and has been diagnosed in every month and every state in which Banfield has a hospital.

Clinical signs most commonly observed in pets with heartworm disease include cough, lethargy, difficulty breathing and sometimes hemoptysis (coughing up blood), according to Banfield. Sudden death occurs rarely in dogs, but occurs more commonly in cats.

“There’s a myth that you only need to treat in spring and summer, and that in the cold states, you don’t need to do it in winter,” says Klausner. “Both these myths have been proved wrong. Dogs can get heartworm disease any month of the year and in just about any state of the country.”

Prevention of heartworm disease is clearly preferable to treatment, according to the Banfield report. That’s because treatment is neither simple nor risk-free. The most common post-treatment complication is the development of pulmonary
thromboembolism (clots within the lungs), caused when fragments of dead worms lodge in blood vessels within the lungs. Some degree of pulmonary thromboembolism will occur whenever heartworm disease is treated. Widespread blockage of pulmonary arteries can occur when worms die in great numbers.

“The message has to be, this is a disease, like distemper or rabies, that we should get rid of,” says Klausner. “Every dog that gets this terrible disease but doesn’t get treated, gets put to sleep. After treatment, you have to restrict exercise for weeks. So it’s alarming that the veterinary community isn’t up in arms about it, and that every single client isn’t getting preventive treatment.”

Fleas and ticks

The persistence of fleas and ticks as pet problems also puzzles Klausner. “There are so many products out there; why aren’t we getting rid of this?”

In 2010, fleas were among the most common parasites found in both dogs and cats, according to Banfield’s data. Overall, the prevalence of infestation in dogs has increased 16 percent with slow but steady growth since 2006. Among cats, the increase has been 12 percent.

The incidence of fleas increases through spring and summer before peaking in early fall and decreasing in winter. October is the peak month for fleas in both dogs and cats, while May and June are the peak months for ticks in both dogs and cats. Among both species, fleas are generally more common in the Southeast and the West Coast.

Flea allergy dermatits is one of the most common skin conditions in dogs and cats, according to the Banfield report. As fleas bite to eat, they inject saliva under the skin causing an irritation that can lead to scratching, hair loss and infections. In addition to the irritation caused by the bite, fleas can also transmit tapeworms and spread certain infectious diseases. Large numbers of fleas can even consume so much blood that a puppy, kitten or small pet can die as a result of blood loss.

Ticks, meanwhile, are small insects that live by sucking blood from mammals, such as animals and humans, according to Banfield. They are found in most parts of the United States and can transmit diseases such as Lyme disease or Rocky Mountain Spotted Fever to dogs, cats, humans and other mammals. The number of dogs diagnosed with Lyme disease has more than doubled since 2006, and in 2010, Lyme disease was detected in more than 11,000 dogs seen in Banfield hospitals.

“We need to do a better job with preventive care,” says Klausner. Veterinarian visits are down, which may explain the continual rise in flea and tick infestation. “I really believe [pet owners] should come in twice a year, but once a year is better than nothing. And the veterinarian needs to educate clients better about these preventable diseases.”

Dental disease

Dental disease is the most common disease in dogs and cats, affecting 78 percent of dogs and 68 percent of cats over the age of 3, according to Banfield. Since 2006, the prevalence of dental disease among dogs has risen 12.3 percent, with steady growth each year. Among cats, the rise has been 10.2 percent. In 2010, tartar was the most common dental diagnosis in dogs (toy, small, medium and large breed) as well as cats.

Dental disease includes any health issue affecting the mouth, including inflammation, tartar, gingivitis and periodontal disease, says the Banfield report. The first stage of periodontal disease was found in the top 10 diagnoses of dogs while gingivitis was in the 10 top diagnoses in cats. Periodontal disease grades 1 and 2 were in the top 10 diagnoses for small dogs, while toy, medium and large breed dogs mostly presented with dental tartar. The top five canine breeds most likely to develop periodontal disease are Toy Poodle, Yorkshire Terrier, Maltese, Pomeranian and Shetland Sheepdog, according to Banfield.

“Many people don’t realize that dental disease can result in disease outside the mouth,” including liver and kidney disease, says Klausner. “The other thing is, it’s much easier and less expensive to do a routine dental cleaning once a year, than to wait until teeth get bad.” Small dogs might require it even more often than that. Veterinarians also need to teach clients how to do dental cleanings at home between visits, he adds.

Prevention early in life can help reduce the frequency and severity of dental disease later in life, according to the Banfield report. Professional cleanings are vital because they include measures pet owners can’t take at home, including a thorough examination of a pet’s teeth and gums, dental radiographs to evaluate the entire tooth and check for bone loss or abscesses, and the use of special tools to remove tartar below the gum line.

Otitis externa

Last year, otitis externa – inflammation of the outer ear canal – was the most common diagnosis in dogs and cats after dental disease in the Banfield pet population. Almost 16 percent of dogs and 7.4 percent of cats were diagnosed with it. Among cats, incidence has risen 34 percent over the past five years; among dogs, it has risen 9.4 percent.

Dogs are more likely to develop ear infections than cats due to their lifestyle. Swimming, outdoor activities and large amounts of hair in the ears contribute to the increased risk in dogs. Certain pets, such as dogs with allergies, may be predisposed to recurrent ear infections.

Banfield is currently engaged in a study to determine whether pet owners can reduce the incidence of otitis externa by cleaning their pets’ ears weekly. “That study is ongoing,” says Klausner. “But it’s something we will do more and more of, particularly with common diseases. We will look to see if we can find therapies that are simple and inexpensive.”

Internal parasites

Internal parasites are on the rise among the Banfield pet population:

• There has been a 30 percent increase in hookworm prevalence in dogs and a 3.5 percent increase in prevalence in cats since 2006.

• Over the past five years, there has been an 8 percent increase in whipworm prevalence in dogs. Although whipworm infection remains uncommon in cats, there has been a 27 percent increase.

• Since 2006, there has been a 4.6 percent decrease in roundworm prevalence in dogs but a 12.6 percent rise in prevalence in cats.

• Tapeworm remains the most common parasite in cats despite a 15.5 percent decrease in prevalence over the past five years.

• In 2010, Arkansas had the highest prevalence of whipworm and tapeworm in cats; it is also in the top five states for hookworm, whipworm and roundworm in dogs.

• Other states with high prevalence of internal parasites for both dogs and cats include Mississippi, Texas and South Carolina.

Smaller animals

Over the past 10 years, there has been a considerable increase in the popularity of smaller dogs, particularly Chihuahuas (+116 percent) and Shih Tzus (+87 percent), and a decrease in the popularity of larger breeds, specifically Labrador Retrievers (-20 percent) and German Shepherds (-40 percent), according to Banfield’s data. In addition, Pit Bulls have increased in popularity by 47 percent over the past 10 years. Last year, three new dog breeds were added to the most common list of breeds cared for at Banfield – the Standard Poodle, Yorkshire Terrier and Maltese.

These trends could change the way veterinarians practice medicine, as large breed and small breed dogs are prone to different diseases, according to Banfield. While large-breed dogs are more prone to arthritis, hip dysplasia and twisted stomachs, small-breed dogs are more prone to diabetes mellitus, periodontal disease and dislocated kneecaps.

“The study might point veterinarians in a direction toward more education around diseases that affect small breed dogs,” says Klausner. It can help educators pinpoint issues that need to be emphasized in veterinary school.

Simple things

The report underscores the fact that many of the major diseases affecting pets are preventable, says Klausner. “If all dogs and cats were on preventive [heartworm] medication 12 months of the year…we would really reduce the number of heartworm-positive dogs and cats in the United States. If people would visit their veterinarian once or twice a year, with good counseling, we would reduce the prevalence of obesity and diabetes. With fleas and ticks, pet owners are making a mistake not seeing their veterinarian. [Consequently], we’re seeing more rather than less [fleas and ticks]. It’s really simple things.

“The report helps frame why pet owners should visit their vet regularly. It’s better to prevent disease. It’s better for the animal, the family and the pocket book.”

Sidebar

KEY POINTS

Banfield Pet Hospital’s State of Pet Health 2011 Report compiled medical data from pet visits at its 770 hospitals. Last year, Banfield associates, including 2,400 licensed veterinarians, cared for 2.1 million dogs and nearly 450,000 cats.

The prevalence of diabetes mellitus in dogs increased from 13.3 cases per 10,000 in 2006 to 17.5 cases per 10,000 in 2010 – a 32 percent increase, according to Banfield. The prevalence of diabetes mellitus in cats increased from 55.5 cases per 10,000 in 2006 to 64.3 cases per 10,000 in 2010.

Heartworm disease shows a distinct geographic trend, with states in the Southeast having the highest prevalence of positive tests, according to Banfield’s data. In 2010, 6.7 percent of heartworm tests performed in dogs in Mississippi were positive, as were 6.3 percent in Arkansas, 5 percent in Louisiana, 2.9 percent in Alabama, 2.6 percent in Texas and 2.1 percent in South Carolina. Although heartworm disease is more common during the warmer months, it is a year-round condition and has been diagnosed in every month and every state in which Banfield has a hospital.

The report underscores the fact that many of the major diseases affecting pets are preventable, says one expert. “If all dogs and cats were on preventive [heartworm] medication 12 months of the year…we would really reduce the number of heartworm-positive dogs and cats in the United States. If people would visit their veterinarian once or twice a year, with good counseling, we would reduce the prevalence of obesity and diabetes. With fleas and ticks, pet owners are making a mistake not seeing their veterinarian. [Consequently], we’re seeing more rather than less [fleas and ticks]. It’s really simple things.”