Educating clients about their cats' healthcare

Alex Martin was raised in a dog-friendly home. As a child, he shared a bedroom with his brother and a 60-lb Labrador retriever. Most of his family photos include various dogs the family owned over the years, but no cats are in the portraits. "Cats hung around the house, but were never considered part of the family," Martin says.

Ernest E. Ward Jr., DVM

Fast-forward 20 years to a high-rise apartment dwelling in Philadelphia. Cat bowls, cat toys, and photos of cats adorn the space. Seated on a couch surrounded by three bored but content felines is Alex Martin.

"After I moved into a place of my own, I felt the need to share my life with a pet. I'd grown up with dogs, but it wasn't practical to have a dog in an apartment or with my erratic work schedule. I never thought of myself as a cat person until I got to know a girlfriend's cat. After that, well, let's just say I'm a certified cat lover," he says.

Martin is not alone. Today, more than 30% of American homes are shared with cats, according to the 2003 AVMA U.S. Pet Ownership and Demographic Sourcebook. Almost half of these families have more than one feline companion, with an average of 1.8 cats per household. The total number of cats now exceeds the number of dogs by more than 10%, with almost 69 million cats in 2001 compared with a little more than 61 million dogs.

People's opinions about cats are also changing. About 55% of cat owners between ages 19 to 29 think of their cats as family members, while about 33% of owners 65 years and older feel the same way.1

These feelings are echoed at cash registers. Between 1996 to 2001, feline veterinary expenditures jumped 65% from $4 billion to $6.6 billion.1

Despite these encouraging signs, many cats still aren't receiving the same medical and preventive care as their canine counterparts. In 2001, dogs averaged about two visits to the veterinarian per year compared with only one visit for cats. The average amount of money spent on canine veterinary visits was more than double that of cats ($179 per year per dog compared with $84 per year per cat).1

So what can we do to encourage better healthcare for a growing cat population? It starts with education. According to "The Current and Future Market for Veterinarians and Veterinary Medical Services in the United States," a 1999 mega study prepared by KPMG LLP Economic Consulting Services, better educated clients took better care of their pets and spent more on veterinary services. By prioritizing feline healthcare issues, we can help our feline patients live longer, healthier, and more vital lives.

Figure 1. Common diseases of cats

Identifying opportunities

Rule No. 1: Cats are not small dogs. Cats have unique nutritional needs, behave differently, exhibit pain differently, and manifest diseases differently than their canine counterparts. Understanding these differences will lead to improved client compliance for feline healthcare recommendations.

It's our responsibility to identify prevalent feline health concerns and help clients avoid common mistakes that could rob their cats of good health. We need to address lifestyle, hereditary, and acquired-disease issues at every opportunity. If cats are only visiting us once a year, we'd better make it count.

And there's plenty of room for improvement based on recent data. The number of cats continues to escalate, but less than half of all cats currently receive the recommended core vaccinations. Only one-third are treated for parasites or receive senior screening tests, and only an estimated 1% receive dental prophylaxis, according to the 2003 AAHA Compliance Study and the Pfizer Animal Health Market Survey.Choose your battles and educate your clients.

Figure 2. Medical needs of older cats

Lifting the lip, tipping the scales, and getting older

Some of the most common feline diseases are preventable. Periodontal disease affects more than two-thirds of all cats, but proper dental care can reverse most of the damage.

More than 40% of cats are estimated to be overweight and as many as one-third of those are clinically obese. A proper diet will reduce weight and help prevent diseases such as type 2 diabetes mellitus, heart disease, and osteoarthritis. Typical age-related conditions such as kidney and thyroid disease affect up to 20% of cats. Early recognition and treatment can help prolong these patients' lives (Figures 1 & 2).

Oral health, weight management, and senior screening protocols are simple to implement in practice. And as the saying goes: You'll find what you're looking for. Too often we put on financial blinders or ignore the obvious in an effort to avoid rejection.

Not everyone will accept our recommendations. That's okay. But it's unacceptable to fail to look for easily preventable disorders (and ways to correct them) in the first place.

Veterinary medicine is a privilege and we must uphold the highest standards of care for those that entrust us with that responsibility. Anything less is a violation of that trust and ultimately diminishes the value of our profession.

And it's good business, too. A 10% increase in dental prophylaxis, therapeutic diet sales, and senior screenings in the average practice would lead to an increase of about $94,000 in revenue, according to the 2003 AAHA Compliance Study. That money could be used to increase staff wages and benefits, improve your facility, or purchase new equipment. This is all without purchasing a thing or spending money on advertising. It simply requires being consistent with client communication strategies and recommending what's in the patient's best interest during every appointment.

Train the troops

Once you've identified the feline healthcare issues you want to target, it's time to train your staff. Let's use feline heartworm and flea prevention as examples. Assemble your facts, figures, and feelings about feline parasite control and present them in writing to your staff. If you're having trouble getting started, contact your pharmaceutical representative for training materials to jumpstart the initiative. If you're not already conducting formal staff training, begin by having a brown-bag seminar on the chosen topic.

Provide the written materials, give a short lecture, and then role-play with your staff members to allow them to practice and get comfortable delivering the message.

Figure 3. Feline history questionnaire.

It's vital to your success that the team be fully immersed in the mission's goal. Make sure your team members are caring for their own cats in the manner you're recommending. If you engage your team in the healthcare initiative before they deliver the message to clients, you'll see an increase in compliance and team satisfaction because they're talking about something they genuinely believe in. For example, if your goal is improved feline heartworm and flea prevention, your team needs to administer preventives regularly to their cats. To drive dentistry, require that your team members' pets have their teeth cleaned. An employee with an overweight cat fed a storebrand food will have a hard time understanding the benefits of a premium weight-loss diet. It's difficult to convince others to do something you personally don't believe in or practice yourself. You've got to walk the walk before you can talk the talk.

Talking the talk

You may not consider feline heartworm disease a hot-button topic, but according to a 2003 Gallup poll, more than 44% of all cat owners were "extremely" to "somewhat concerned" about feline heartworm disease. The problem is that many cat owners don't know they can do something to prevent it. Many clients are already familiar with canine heartworm disease and its lethal consequences, so understanding the feline equivalent isn't difficult. More than 90% of all cat owners stated they would be "very likely" to "likely" to try a parasiticide for their cat, according to a 2002 market survey conducted by Pfizer Animal Health.

So why are less than an estimated 1% of cats protected against potentially fatal heartworm disease? Besides clients not knowing about preventives, we're not recommending them. The 2003 AAHA Compliance Study noted that the No. 1 reason veterinarians failed to recommend a needed service or product was that they thought it was too expensive for their client. Yet less than 10% of clients stated that cost was a reason they refused a recommended service or diet.

In this example, you must make it your mission to ask every cat owner what type of heartworm and flea preventive they're administering. Once this is done consistently, the number of cats protected from parasites will increase, and you'll be fulfilling your oath to improve patients' quality of life.

Tailor the message

You'll need to vary your bedside manner and communication techniques for cats and cat owners. A quieter, calmer examination environment is critical for reducing feline stress. Nothing says "reduced veterinary visits" better than a hissing and spitting cat glued to the top of a carrier.

Cat-only waiting and examination rooms stocked with feline healthcare educational materials are ideal. Escort loud, barking dogs into separate exam rooms as soon as possible. Train your team to talk in more subdued tones during cat examinations and to allow more time for cats to become accustomed to them before removing them from the carrier.

Also be aware that cats are perceived as somewhat delicate (especially those couch kitties in designer pet carriers). Even the slightest amount of restraint may be viewed as rough or uncaring.

Avoid making negative comments when a cat does hiss or strike. Instead, comfort the cat by slowing down. Reassure the owner that this is acceptable behavior for a nervous cat and that you're doing everything you can to make the visit as stress free as possible.

Checks and balances

Let's face it: One of the primary reasons we fail to recommend services and products is that we simply get too busy or forget it.

To help reduce appointment amnesia, I recommend patient history questionnaires (Figure 3). Questionnaires ensure that each patient receives a thorough history and that you discuss the target health issues. This will also help less experienced team members because the questionnaires serve as a "cheat sheet" to remind them of important questions. Patient histories also prevent experienced employees from overlooking the basics. They may also reduce the number of timewasting, intraoffice "What are they feeding Fluffy?"-type questions. Regardless of education and experience, patient questionnaires provide a framework for gathering consistent information from clients.

Focusing on feline healthcare isn't a fad or a fashion. It's the way of the future. As pet populations stabilize and the trend toward urbanization continues, cats will continue to play an increasingly important role in the lives of their caregivers. Address feline healthcare opportunities and your practice will benefit. What we do is no longer just pet care. It's also people care-helping those who love pets as much as we do. The value of pet ownership transcends good feelings. Pets improve our well-being. They are much more than our special friends with four legs; they're therapeutic specialists with hearts and souls.

Reference

1. AVMA U.S. Pet Ownership and Demographic Sourcebook © 2002 AVMA, Membership and Field Services, AVMA.

Ernest E. Ward Jr., DVM, is the chief of staff at Seaside Animal Care in Calabash, N.C., and owner of the consulting firm, E³ Management. Dr. Ward is the author of Creating the Veterinary Experience (E³ Management, 2000). He is a lecturer and a Veterinary Economics Editorial Advisory Board member.