Fight the giant

Biscuit, a 46-pound beagle, waddles into your reception area with his owner, Mrs. Franklin. As the receptionist greets Mrs. Franklin, she notices that Biscuit is panting heavily after the short walk from the parking lot to the practice door. When the technician comes to escort the pair to the exam room, she sees that Biscuit has to struggle to get up off the floor. Mrs. Franklin sees it too and says, "He's really slowed down now that he's old." The technician thinks to herself that Biscuit is only 6 years old.

Gina Toman

Obesity is a major epidemic facing pets today. Veterinary team members must be capable of recognizing the condition and be comfortable discussing it with clients. If not, people like Mrs. Franklin will leave thinking their pets' struggles really are age-related and pets like Biscuit will continue to suffer.

Round 1: Removing the stigma

What makes pet obesity different from other illnesses we encounter in our practices is that it parallels a problem people are battling. According to data from the 2003-2004 National Health and Nutrition Examination Survey, two-thirds of American adults ages 20 and older are overweight or obese. Obesity is seen as more of a social problem, almost like a moral assessment, so it often carries a stigma. You know clients won't be offended if you tell them their pets have arthritis, but you're not sure how they'll react to the news that their pets are obese. As a result, many team members feel uncomfortable talking to clients, especially those who are overweight, about pet obesity. But you shouldn't.

Obesity is a medical condition just like the others you and your team treat every day. You comfortably talk to clients about their pets' arthritis, kidney failure, or heartworm disease. Approach obesity in the same way. Discuss the facts, and don't make any personal judgements about the clients or their lifestyles. Begin the discussion by explaining that obesity increases the risk of many diseases and health problems. Sure, treating obesity isn't as easy as dispensing medication, but veterinary nutrition is fairly straightforward. You can provide clients with exact recommendations for their pets' diets. But first, every one of your team members must understand the components of your practice's obesity diagnosis and treatment program.

Calculate the calories pets need

Round 2: Preparing your team

Staff training and role-playing are crucial to ensuring that your team members provide a consistent message about your hospital's philosophy on obesity. Many team members groan when they think of role-playing, but it's a tried-and-true way to ensure everyone knows the practice's message. To make role-playing nonthreatening—even fun—get a doctor or senior team member to go first. This person will play the part of a team member. Then ask any staff member to assume the role of a client who doesn't believe his or her pet's weight is a problem. After acting out the scenario, discuss what worked and what statements or body language could have been more effective.

Team training sessions should include formal lectures, written notes, and testing. Our practice uses phase training to ensure all team members know their stuff. This type of training establishes written goals and measurable standards for every knowledge level or phase. Teach team members about the common diseases associated with obesity, how to recognize at-risk pets, the signs of related illness, and your hospital's treatment options. Following are five topics your education program should include.

1. Calories. The first order of business: The veterinarian examines the pet and determines its ideal or target weight. Then you can plug that number into the formula (see above) for calculating a pet's caloric resting energy requirement (RER), which is the energy a pet needs at rest to digest, absorb, and metabolize nutrients.

The client shouldn't leave without the exact number of daily calories the doctor recommends for the pet. Include this number on the client's discharge summary and provide a handout that explains the importance of calorie counting and safe weight loss. (Download the handouts at dvm360.com—search for "pet weight loss.") Decreasing a pet's food intake to the ideal or target weight RER should be sufficient for weight loss.

2. Body condition score. A pet's body condition score (BCS) is a quick indicator of whether it's overweight. On a scale of 1 to 5, 1 equals emaciated and 5 equals obese. To determine BCS, first feel the pet's ribs. A healthy pet's ribs should be easy to feel with a small amount of fat over them (BCS-3). If you can't feel the ribs at all, the pet is considered overweight (BCS-4 or -5). If you can see the ribs, the pet is too thin (BCS-1).

Next, feel along the shoulders, spine, and hips. These areas should also have a thin layer of fat (BCS-3). Again, if you see the bones, the pet is too thin (BCS-1). Likewise, if you can't feel the bones, the pet is overweight (BCS-4 or -5). Next, check the rump area or near the base of the tail following the same criteria. Then take a look at the pet from above. It should have a defined waist, an area behind the ribs that's more narrow than the chest (BCS-3). If there is no waist, the pet is considered overweight (BCS-4 or -5). For more information about BCS and many other weight-related topics, visit petobesityprevention.com.

As you work to determine the pet's BCS, teach the client about what you're doing. Explain what you're looking for at every stage. Then discuss your findings, whether good or bad, with the client. This helps clients learn how to check their pets' BCS at home so they can monitor weight gain and loss.

3. Obesity-related health risks. Obese pets commonly suffer from other conditions, including osteoarthritis, Type 2 diabetes, heart disease, hypertension, and cancer. To teach team members about these diseases and conditions, break each one down into signs, systems, testing, and treatments. It's crucial for team members to understand the importance of testing patients for these health risks. Before recommending a change in diet, you must first rule out other possible causes for weight issues. If an underlying disease goes undiagnosed, the pet's weight-loss program will not be successful.

4. Exercise. Before you and the veterinarian suggest an exercise program, consider the pet's age and general fitness level. You must recommend a safe amount of activity. And clients must take care that their pets don't overdo it—unfortunately, pets can't say when they've had enough. Also warn clients that the environment can affect their pets' safety. For instance, pets may suffer from heat stroke or frostbite when they're exercising outside. Then encourage clients to exercise along with their pets. Some of the activities you could suggest include walking, jogging, playing catch, and using interactive cat toys like laser pointers.

5. Nutrition. For clients, choosing a diet for their pets can be just as confusing as picking out a healthy breakfast cereal for themselves. This is where you and your team come in. Every team member must be comfortable discussing the veterinarian's food recommendations. This includes talking about how to gradually change a pet's diet, as well as explaining how to read pet food labels, especially the caloric content.

Determining the calories in pet food can be difficult for clients. On a food label, calories are stated in terms of metabolizable kilocalories per kilogram (ME kcal/kg) of food or as calories per unit of some household measure, such as per cup or per can. It's your responsibility to teach clients how to read the label, because as much as you want to believe clients will stick to the diet plan, history says they'll likely stray. If you arm them with the nutrition facts, they'll be more apt to make proper diet choices for their pets.

The TKO: Solidifying compliance

Your team's communication skills and expertise level are vital links in fostering client loyalty, improving the well-being of pets, raising clients' perceived value of the services you provide, and increasing your practice's profitability. If clients don't understand and trust your recommendations, they're less likely to follow them.

Don't overwhelm your clients with medical jargon or scientific terms. This only frustrates them. Instead, provide clients with the facts, answer all of their questions, and empower them to make the right decision. This not only makes the client feel in control, but it also creates a strong bond between the client and your team.

Ideally, every pet owner will follow your recommendation to feed their pet a healthy diet and help it get regular exercise. But this isn't going to happen instantly. We as a profession must work together to knock out the obesity threat that's overtaking our pet population. The match will be fought mostly outside your practice, so you must help clients lace up their gloves.

The first step is equipping your team with the tools to eloquently communicate about pet obesity. Then you must talk to your clients about it. Develop programs at your hospital that encourage a change in diet and promote physical activity. Recommending a walk with the dog helps pets—and owners, too. Be sure to engage clients in their pets' healthcare. Make the weight-loss program easy-to-follow, fun, and obtainable. Setting unrealistic weight-loss goals leads to noncompliance and might even cause clients to forfeit the fight.

The final step in beating pet obesity is accepting the idea that it's a condition that needs to be prevented rather than treated. Discussions about BCS, exercise, and nutrition aren't just for clients whose pets are overweight. Talk about these topics with every single client your practice encounters. Only then will we defeat the giant.

Gina Toman is a veterinary assistant at Seaside Animal Care in Calabash, N.C. For first-hand information about pet weight loss and nutrition, head to CVC West, Oct. 31 to Nov. 3 in San Diego. Learn more by visiting thecvc.com or e-mailing us at firstline@advanstar.com.