Topics discussed, examinations performed and strategies implemented during canine and feline booster vaccination consultations

Twenty-five components of a baseline, best-practice companion animal physical exam established by a panel of experts

OBJECTIVE

To establish the components of a best-practice, baseline companion animal physical exam (CAPE).

SAMPLE

25 small animal veterinary internists and 20 small animal primary care veterinarians, all teaching the CAPE at veterinary colleges in the US, Canada, and Australia.

PROCEDURES

Using the Delphi Method of Consensus, 3 rounds of online questionnaires were sent to participants. The first round included demographic questions, questions about teaching the physical exam, and an open-ended question allowing participants to record details of how they conduct a CAPE. In the second round, participants were asked to rate components of the CAPE, which were derived from round 1, as “always examine,” “only examine as needed,” or “undecided.” Following round 2, any component not reaching 90% consensus (set a priori) for the response “always examine” was put forth in round 3, with a summary of comments from the round 2 participants for each remaining component.

RESULTS

35 components of a baseline CAPE were identified from round 1. The 25 components that reached 90% consensus by the end of round 3 were checking the oral cavity, nose, eyes, ears, heart, pulse rate, pulse quality, pulse synchrony, lungs, respiratory rate, lymph nodes, abdomen, weight, body condition score, mucous membranes, capillary refill time, general assessment, masses, haircoat, skin, hydration, penis and testicles or vulva, neck, limbs, and, in cats only, thyroid glands.

CLINICAL RELEVANCE

The findings establish an expert panel’s consensus on 25 components of a baseline, best-practice CAPE that can be used to help inform veterinary curricula, future research, and the practice of veterinarians.

[Compliance of dog and cat owners in preventive health care]

Regular preventive health care is an essential part of our pets' health and quality of life. Preventive healthcare appointments can result in the prevention of disease development as well as lead to the detection and subsequent treatment of existing health problems at an early stage. In order to achieve optimal health care, the owners' compliance is of most importance in addition to the veterinary advice. However, dog and cat owners often seem to be unaware of the necessity for preventive health care appointments, often as a result of poor communication by the veterinarian. Educational conversations concerning the necessity of regular preventive health examinations are therefore essential. Communication is one of the key factors in building an owner-veterinarian relationship. Veterinarians are advised to invest sufficient time for communication, be aware of their verbal and non-verbal statements, and enable the owner to participate in treatment decisions. Older animals are presented less often for preventive health care appointments than younger animals, although the prevalence of age-related and chronic diseases increases with age. Owners should therefore be informed on the fact that early detection and treatment of these diseases increases their animals' health and survival. Cats are seen less frequently in preventive health care than dogs; many owners are not aware of the characteristics of cats tending to hide signs of disease. Another reason lies in the fact that many cats are stressed by being captured and transported in addition to the visit in the veterinary practice itself. Veterinarians therefore should educate cat owners concerning stress-reducing transportation measures and design their practice in a more cat-friendly fashion. Compliance can also be influenced positively by appropriate practice management, such as offering monthly instalment payments, establishing annual preventive care plans, as well as regular re-scheduling strategies. In addition to enhancing the animals' health, this can also result in increased owner satisfaction.

Developing practical recommendations for preventative healthcare consultations involving dogs and cats using a Delphi technique

Preventive healthcare is the focus of a large proportion of UK small animal veterinary consultations. The evidence base for how to optimise these consultations is limited. Therefore, evidence-based practical recommendations are needed for veterinary surgeons conducting these consultations. The aim of this study was to use an evidence-based methodology to develop the first consensus recommendations to improve dog and cat preventative healthcare consultations (PHCs).

Evidence from multiple sources was systematically examined to generate a list of 18 recommendations. Veterinary surgeons and pet owners with extensive experience of PHCs were recruited to an anonymous panel to obtain consensus on whether these recommendations would improve PHCs. A Delphi technique was followed during three rounds of online questionnaire, with consensus set at 80 per cent agreement or disagreement with each recommendation. Thirteen of the original 18 recommendations reached consensus (>80per cent agreement), while the five remaining recommendations did not reach consensus.

Globally, these are the first evidence-based recommendations developed specifically in relation to small animal general practice PHCs, generated via a Delphi panel including both veterinary surgeons and pet owners. Future work is needed to understand how these recommendations can be implemented in a range of veterinary practice settings.