Handle concerns about the price of heartworm prevention

This article was contributed on behalf of the American Heartworm Society.

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If you're like a lot of veterinarians, you probably hear “no” to your recommendations for year-round heartworm prevention on a fairly regular basis. According to experts from the American Heartworm Society (AHS), expense is one of the leading objections clients give for forgoing heartworm prevention. In this article, four veterinarians who serve on the AHS board of directors describe how they handle some of the most commonly voiced objections to prevention. (And while you're here, click the graphic on the right to view and download this informative handout, courtesy of the American Heartworm Society.)

“Heartworm prevention is too expensive.”

Pet owners who assert that heartworm prevention is a luxury they can't afford may not be aware that there are low-cost options available-or understand how much treatment may set them back if they try to skimp on prevention. Is the pet a dog, cat or ferret? If it's a dog, is it a petite terrier or a massive mastiff? Does he only need heartworm prevention or should the product protect him from fleas, ticks, heartworms and hookworms? Annual costs for clients can range from $60 to $250 for dogs and from $140 to $200 for cats and ferrets, depending on the product's spectrum and whatever promotions are available from manufacturers. Within that range, most clients can find a cost they can live with while still meeting the needs of their pet.

Meanwhile, not every owner who finds cost to be a significant hurdle is vocal about it. “When I talk about year-round prevention in the exam room, I see a lot of head nodding from my clients,” says Chris Duke, DVM, of Bienville Animal Medical Center in Ocean Springs, Mississippi. “However, my staff members tell me it's not uncommon for owners to back out of the purchase once I've exited the scene.”

While it can be discouraging when pet owners insist on going home with prescriptions to fill through online services, Dr. Duke is an advocate of picking his battles. “We always stress that purchasing from our hospital provides our clients with important support," he says, "but refusing to provide written prescriptions can result in client alienation. We provide a prescription as long as we have a valid doctor-client relationship and the dog has had a heartworm test in the past year. However, we specify in writing that our prescriptions are only good for U.S. products and we limit refills to the point of a new blood check."

“My cat doesn't need heartworm prevention.”

Heartworm compliance can be an especially tough sell for cat owners, because many owners aren't convinced of the need. “In my practice, I have both clients who are cat owners and clients who are cat people,” explains Tom Nelson, DVM, medical director of Animal Medical Centers in Anniston, Alabama. “Cat owners have a cat. Cat people worship their cats and embrace the concept of prevention.”

Dr. Nelson stresses that advocacy must be grounded in the veterinary professional's own beliefs. “There's a big difference between a client hearing ‘I recommend heartworm prevention' and ‘Your cat needs heartworm prevention.' Some years back, our clinic participated in a feline heartworm necropsy study. Ever since my staff members saw me pull heartworms out of a local shelter cat that had died as a result of heartworm infection, they have become true believers in the dangers of feline heartworm. That, in turn, has significantly affected the compliance of our cat clients.”

“If my dog gets heartworm, I can always have him treated.”

The cost of treating heartworms in a dog is roughly 10 times the annual cost of preventives in most practices, but the cost of heartworms goes well beyond the dollars and cents of medications and veterinary fees. “I emphasize that the cost of prevention is a small price to pay to save pets from suffering the pain and permanent damage caused by heartworms,” says Jennifer Rizzo, DVM, of Friendship Pet Hospital in San Schertz, Texas. “Having dealt with emergencies such as heart failure, pulmonary thromboembolisms and caval syndrome in the ER, I can paint a vivid picture of just how scary heartworms are. I also emphasize that prevention is a small price to pay if owners want to protect their pets from suffering and help them live a longer, happier life.”

“I don't think heartworm prevention is worth it.”

Clients set their own priorities, but it can be helpful to remind them that-important as it is-there's more at stake than just their pets' health. AHS President Christopher Rehm, DVM, owner of Rehm Animal Clinics of Mobile and Baldwin Counties in Mobile, Alabama, says, “I explain to pet owners that there are four pillars in pet healthcare: protection from parasites; protection from infectious diseases; nutrition; and keeping the pet safe via proper housing, spaying or neutering and grooming. Failure to invest adequately in any one of these four areas can have disastrous results for the pet, the family and the wallet. Pillars one and two actually reach beyond the pet because some parasites and infectious diseases can be shared between pets and family members and can even represent public health concerns because of the risk of zoonotic infections.”

Dr. Rehm stresses the importance of remembering that clients are inundated with conflicting information from a wide variety of sources. “It's up to us to provide concise, consistent and compassionate information and to create confidence in our recommendations,” he explains. “As I tell my clients, who should they trust-a pet store worker, a TV commercial or a trained medical professional? We need to provide a winning experience at every visit-without exception-if we're going to maintain that trust.”

Whether veterinarians and staff members hear “It costs too much” once a day, once a week or once a month, finding ways to overcome financial objections to heartworm prevention has a definite pay-off for veterinary practices, pet owners and-most importantly-patients.