 readers! We hope you are as excited about today being Friday as we are and ready to take on the weekend. We are now officially less than a month from our first Fetch conference in Nashville, Tennessee. Join us in the Music City from May 17-18 to earn over 14 continuing education credits. This is Fetch’s first time in Nashville so secure your spot 

As we prepare for Fetch Nashville, here is what was popular this week on dvm360.com:

 that Zoetis’ bedinvetmab injection (Librela) and frunevetmab injection (Solensia) products caused pets to be sick instead of improving, Zoetis and other veterinary professionals speak out about the drugs and what they have experienced.

, Ken Yagi, MS, RVT, VTS (ECC), (SAIM), explains to listeners why it is important to make an emergency room a low stress experience for both patient and client, and how to accomplish that.

 a closer look at the work she is doing to help progress the veterinary profession through her work as the chief veterinary medical officer for Companions and Animals for Reform and Equity’s Urban Community Animal CARE Division in this Veterinary Profile from our April 

, Deb Zoran, DVM, PhD, director of the Texas A&M Veterinary Emergency Team (VET), discussed more about what the team responded do during its deployment to the Texas panhandle, where the Smokehouse Creek wildfire burned.

 the launch of 2 new laser to its product line, Domer Laser Class 3B cold laser therapy device and high intensity call 4 laser. The products can help veterinary professionals manage pain for tendon injuries, post-surgical or trauma wounds, nerve injury, and more.

Articles

Wrap up: Animal health company responds to safety concerns over OA drug, and other veterinary news 

The staff of Camp Leakey feed the wild and semi-wild orangutans daily at a feeding platform. This is to provide additional sustenance to make up for the difficulty of finding an adequate amount of food in the depleted rain forest. This routine has given the public a great opportunity to learn about orangutan conservation, and to see how their behavior is uncannily like ours.

Upon arrival at Camp Leakey in your klotok you dock at the entrance and walk through the camp to the feeding platform with a guide accompanying you the entire time. The guide is mandatory so that you do not get lost, and because you might encounter orangutans on your walk. The walk is on level terrain, but you will be stepping over large tree roots as you walk the paths to the platform.

Watching them being fed is a popular tourist activity. (Image courtesy of Carl Palazzolo, DVM, MBA) 

The food consist of bananas and pineapples with milk.

There is an orangutan “food hierarchy” at the feeding platform at Camp Leakey, and it starts with Doyak, the resident dominant male. He is there mostly as a show of his power and to assess which females are receptive to him; the food is not his primary reason for making an appearance.

We were warned to give him wide berth because he takes his role seriously and can inflict severe harm with his tremendous strength. He weighs 300 pounds and has the strength of 8 men, so we heeded the warning and pulled out the medium telephoto lenses to photograph him from 20 yards away at least.

Doyak “hangs out” at the tree next to the platform in order to be first in line for food.

This setup is a wildlife photographers dream since the orangutans are relaxed due to their habituation with this feeding method and you can get relatively close.A medium telephoto lens (70mm-200mm) works well for wide angle and close up shots at this distance.No flash is allowed which is routine for large primates like this, so photographers need to plan accordingly with the proper lens and camera settings.

After Doyak leaves the juveniles swoop in for their share. Some jump on the platform and grab the bananas and pineapples, while others hang from the trees and sneak food with their long arms. Either way, they stuff their mouths with bananas and climb back up into a tree to eat.

You need to be away from the feeding platform when Doyak decides to leave.

Once the juveniles are satisfied, a new batch of food to feed the females with their young is brought out and they jump on the platform with youngsters in tow (usually on their head). Everyone gets to eat, so there is minimal conflict amongst the different age groups or social ladder.

In part II of the feeding platform at Camp Leakey story you will see these juveniles and females with young during their turn to eat. I will also go over the logistics of setting this up for your rainforest trip some day before it is gone. At the current pace of deforestation in Borneo that is going to be sooner rather than later.

A wildlife photographer share more about the feeding platform for the orangutans 

The feeding platform at Camp Leakey 

Nationwide has analyzed its database of more than 1.2 million insured pets to determine the top conditions affecting canines and felines in 2023. The insurance company also provided the average costs associated with treatment for these common conditions. By the end of the year, members filed more than 1.5 million individual claims, leading to Nationwide discovering the top 10 medical conditions affecting both dogs and cats. According to a news release,

 the most common reason dogs visited the veterinary clinic was for dermatitis, while the top reason for cats was gastroenteritis.

2. Gastroenteritis (Diarrhea/intestinal upset). Cost of treatment: $614

3. Otitis externa. Cost of treatment: $280

4. Degenerative arthritis. Cost of treatment: $ 446

6. Dental disease. Cost of treatment: $1072

7. Urinary tract infection. Cost of treatment: $499

8. Valvular heart disease. Cost of treatment: $565

9. Respiratory infection. Cost of treatment: $548

10. Liver disease. Cost of treatment: $500

1. Gastroenteritis (Diarrhea/intestinal upset). Cost of treatment: $747

2. Urinary tract disease. Cost of treatment: $904

3. Kidney failure. Cost of treatment: $ 694

4. Dental disease. Cost of treatment: $1300

5. Degenerative arthritis. Cost of treatment: $447

6. Hyperthyroidism. Cost of treatment: $547

7. Respiratory infection. Cost of treatment: $1575

8. Diabetes mellitus. Cost of treatment: $967

9. Inflammatory bowel disease. Cost of treatment: $967

10. Atopic or allergic dermatitis. Cost of treatment: $289

Dental disease showed to be an expensive treatment cost for pet owners, with the most expensive for dogs and the second most costly for cats.

According to Nationwide, this is the 12th year atopic or allergic dermatitis is the most common health issue for dogs. The company had 410,500 individual claims received in 2023, which was up from 373,000 the year before in 2022. This means that skin allergies represented 20% of total claims for dogs.

 Likewise for cats, Nationwide received more than 25,000 individual claims for gastroenteritis.

“We know that veterinary healthcare teams are well aware of how common many of these conditions are and how costly it can be to manage them,” said Jules Benson, BVSc MRCVS, AVP, chief veterinary officer at Nationwide, in the release.

 “Every year, Nationwide’s top claims report brings that awareness to pet families – this year, it is boosted in 2024 by the addition of our 

. This digital resource brings together individual pet risk data, costs, breed info, and fun facts, helping educate pet families on the common (and uncommon!) conditions that their pets might be prone to.”

Dermatitis, gastroenteritis among most common conditions that prompt veterinary visits. News release. Nationwide. April 18, 2024. Accessed April 19, 2024. 

https://news.nationwide.com/041824-dermatitis-gastroenteritis-most-common-conditions-prompt-vet-visits/#:~:text=In%202023%2C%20top%2010%20conditions,million%20Nationwide%C2%AE%20pet%20claims&text=Columbus%2C%20OH%20%E2%80%93%20Treating%20conditions%20like,be%20unsettling%20for%20pet%20families

Nationwide reveals the most common reason pets sought out veterinary care in 2023

Pet insurance company reports most common veterinary visits

On Thursday, April 18, 2024, the United Nations (UN) announced that the transmission of avian flu to mammals, including humans, is a "significant public health concern," according to UN medics.

 In a public statement shared by the UN, Jeremy Farrar, PhD, chief scientist at the World Health Organization (WHO) also said the highly pathogenic avian influenza (HPAI) virus “has become a global zoonotic pandemic.”

H5N1 primarily infects wild birds and poultry but has also been detected in mammals including cattle, mink, foxes, bears, seals, cats, dogs, and goats.

 In Texas, an individual with avian influenza had contact with infected dairy cows that are believed to be the source of transmission to a human.

Meanwhile, the CDC is continuing to encourage veterinarians, veterinary staff, and other individuals to minimize their risk of avian influenza A (H5N1) virus infection by taking precautionary steps when working with animals such as poultry and livestock or materials possibly or confirmed to be infected.

Globally, there were 887 cases of human H5N1 infection—from January 1, 2003, to February 26, 2024—of which 52% were fatal, according to WHO.

 The H5N1 case in Texas is the United States’ first reported human infection of 2024. It is also the second human case to ever be confirmed in the US, with the previous infection occurring in 2022, in Colorado.

According to Kay Russo, DVM, MAHM, DACPV, an industry veterinarian, who has worked as a private dairy practitioner, WHO’s documented mortality rate may be higher than the actual mortality rate in humans because of a bias related to the severity of illness in those who sought care. However, she noted, we still need to have a healthy respect for what this virus is capable of. “The human cases in this current dairy situation are underrepresented due to a lack of testing,” Russo said in an interview with 

Thus far, no human-to-human transmission has been reported. However, the UN and WHO addressed the issue while announcing updated language for consistency with airborne pathogen descriptions. The goal of the language changes is to increase international cooperation in the event of a new global pandemic, according to the UN.

The CDC recommends minimizing the risk of human infection by avoiding unprotected direct or close physical contact with birds, livestock and other animals that are sick, as well as animal carcasses, feces or litter, and raw milk. Water and surfaces that could be contaminated with animal excretions should also be avoided.

Additionally, the CDC recommends that veterinarians, veterinary professionals, and other individuals working with sick or dead animals, including backyard bird flocks, or materials that could contain H5N1 wear personal protective equipment (PPE). After washing hands with soap and water, the agency suggests putting on PPE in the following order: fluid-resistant coveralls, waterproof apron, NIOSH-approved respirator, fitted unvented or indirectly vented safety googles or face shield, head or hair cover, gloves, and boots. Care should also be taken while working in PPE to avoid touching eyes, mouth and nose; and while removing and disposing of PPE to avoid personal contamination and contaminating clean areas.

In Texas, potential vaccines, antiviral drugs, and antibody therapies that may protect humans against avian influenza are being studied. The nonprofit Texas Biomedical Research Institute (Texas Biomed) in San Antonio, recently announced its work targeting strains of the HPAI virus including H5N1.

"Thankfully, the risk of the current H5N1 case becoming widespread among people remains low," Larry Schlesinger, MD, Texas Biomed president and CEO, said in a news release.

 "But viruses adapt and evolve–especially influenza viruses–which is why it is so critical to be studying them and developing vaccines and treatments well before they are needed."

In 2023, investigators at Texas Biomed received approval from the USDA and the CDC to pursue work on avian influenza. According to the institute, work on this initiative began in March—after laboratory preparations—to evaluate whether existing vaccine, antivirals and antibodies are effective against H5N1 strains of avian influenza.

Texas Biomed investigators are applying advanced tools and techniques that they use to study viruses like seasonal influenza and COVID-19, according to the institute. Their work takes place in a higher biosafety level laboratory, following protocols approved by federal biomedical research regulators.

"The genetic sequencing analysis from the CDC indicates that the H5N1 strain found in the [human] patient does not have any mutations associated with resistance to current antiviral drugs," Luis Martinez-Sobrido, PhD, a professor at Texas Biomed who leads the laboratory researching potential avian influenza therapies, said in the release.

 "However, it is important to continue developing an array of countermeasures in case existing ones lose effectiveness."

Over the past century, there have been numerous epizootic events with avian-origin influenza viruses, according to Russo. “Influenza viruses, particularly influenza type A viruses, are concerning because of their ability to mutate, pick up virulence, and adapt to different hosts like humans, cows, and cats…We’re seeing unprecedented mortalities in avian and mammalian species, even in the waterfowl, which is considered the natural reservoir for these influenzas,” Russo said.

Rare in humans, H5N1 has been spreading worldwide over the past few years through transmission from migratory birds to terrestrial and domestic birds. "We still don't know a lot about this virus, for example, what are the genetic determinants that enable this virus to transmit from avian hosts to other mammals?" Ahmed Elsayed, PhD, a staff scientist with Texas Biomend, who has studied avian influenza for 16 years, said in the release.

 "We need to study this virus as a 'One-Health' approach to be able to face it."

Russo emphasized that early detection and intervention in the form of antivirals are critical to avoid any severe health outcomes from this virus. “Should this virus develop the ability to spread from human to human, [other] individuals living in the household of the infected individual may be at risk. Testing and proper follow-up are strongly encouraged by the CDC. All testing is anonymous,” Russo said.

This article was updated on April 19, 2024 to include additional information.

Pandemic experts express concern over avian influenza spread to humans. United Nations. Accessed April 18, 2024. 

https://news.un.org/en/story/2024/04/1148696

Texas Biomed researching vaccines and treatments for highly pathogenic avian influenza. News release. Texas Biomedical Research Institute. April 18, 2024. Accessed April 18, 2024. 

https://prnmedia.prnewswire.com/news-releases/texas-biomed-researching-vaccines-and-treatments-for-highly-pathogenic-avian-influenza-302120203.html

Parkinson J. Avian flu reported in first American this year. 

. April 2, 2024. Accessed April 18, 2024. 

https://www.contagionlive.com/view/avian-flu-reported-in-first-american-this-year

Recommendations for worker protection and use of personal protective equipment (PPE). CDC. April 15, 2024. 

Accessed April 19, 2024. https://www.cdc.gov/flu/avianflu/h5/worker-protection-ppe.htm

Human infection with avian influenza. World Health Organization. March 22, 2024. Accessed April 17, 2024. 

https://cdn.who.int/media/docs/default-source/wpro---documents/emergency/surveillance/avian-influenza/ai_20240322.pdf?sfvrsn=22ea0816_43

Veterinary professionals working with certain animals are advised to take precautionary steps to minimize risk of infection, while researchers in Texas study potential H5N1 vaccines, antivirals, and antibody therapies for humans

UN, WHO address public health concern over avian flu transmission to humans

Наталья Евтехова / stock.adobe.com

Domer Technology has released 2 new lasers in its product line: Domer Laser Class 3B cold laser therapy device and high intensity class 4 Laser. These cold laser therapy devices can be used on both humans and animals. These laser devices can help manage pain from treat joint, ligament, or tendon injuries; post-surgical or trauma wounds; nerve injury; inflammation; muscle sprains or strains; bone arthritis, fracture, or dysplasia; and more.

It is important to note that cold laser therapy is not designed to be a direct cure for conditions or diseases, but it has been investigated as a supplementary approach to symptom management and enhancing overall well-being.

 The cold laser therapy process increases blood flow and cellular growth, which can help support the decrease of inflammation and improve overall cellular function.

The Class 3B Domer Laser adopts 500mW per laser diode continuous output, while the Class 4 laser has 1 or more laser beams with an output of over 500mW. The Class 4 needs professional training before using, however Domer Technology offers free training for veterinary professionals.

 Acoording to Domer Technology, the Class 4 laser reduces the treatment time, with only 5-10 minutes per laser treatment.

Laser therapy can be utilized as an alternative or complementary approach to medication for pain management alongside other holistic approaches like acupuncture, massage therapy, and hydrotherapy.

 Tom Walsh, DVM, CCRP, MBA, owner of PrimePet Rehabilitation Therapy in Myrtle Beach, South Carolina, argued that laser therapy can decrease pain, support post-operative recovery, and restore function in limbs that may have been impacted by disease or trauma. Even without a previous disease or trauma in the patient’s history, Walsh indicated that laser therapy can boost the immune system and improve overall range of motion and strength in the body. He also recommended laser as a treatment option for patients who do not qualify for surgical intervention.

In a previous interview with Leslie Gallagher McMahon, CCMT, CCRT, CEO and founder of Two Hands Four Paws in Los Angeles, California, she stated, “So we use laser on probably most of our clients…You can also use it for otitis media, you can use your ear infections, you can use it for skin infections. But that tends not to be our focus here. What our number one concern of our clients here is pain management. So rehab laser is always going to be addressing the pain that these dogs are either the geriatrics that have severe osteoarthritis or the dogs recovering from surgery that have an awful lot of pain of post-op pain. Laser has been just miraculous in healing for us to get these dogs better. It's really been a game-changer.”

Cold laser therapy. Domer Technology. Accessed April 18, 2024. 

What is veterinary laser therapy? American Animal Hospital Association. Accessed January 15, 2024. 

https://www.aaha.org/your-pet/pet-owner-education/ask-aaha/laser-therapy/

Walsh T. Why Conventional Thinking About Laser Therapy is Wrong and What That Means to Your Practice. Presented at: Fetch dvm360 conference; Long Beach, California; December 1-3, 2023

The Domer Laser can treat joint, ligament, or tendon injuries, post-surgical wounds, nerve injury, and more

New cold laser therapy devices

Q. When our schedule is full and clients call with sick pets, we offer drop-off appointments. Can you suggest a better name?

 I agree that “drop-off” may confuse clients and devalue professional services. The term is defined as a brief delivery—hand you the leash or cat carrier and go. You would never drop off a beloved family member on a hospital’s doorstep.

 to indicate that pets will be admitted to your hospital for care. Client service representatives (CSRs) should express empathy, explain the admission process, and share the fee upfront.

I’m concerned that your pet is sick. Although our schedule is full, we can admit your pet to the hospital for the day. For 15 minutes, you will meet with a technician who will ask you questions about your pet’s symptoms and get its vital signs. A doctor will examine your pet during the day and then will contact you about the next steps. We will provide a treatment plan and get your approval in advance. You may pick up your pet between 4 and 6 pm. Because we will provide nursing care for your pet throughout the day, there is a day admission fee of $__. A technician can admit your pet at 8 or 8:30 am. Which do you prefer?

Let’s break down the talking points in this script. The word concerned expresses empathy. Explain the importance of getting symptoms and vital signs during admission. When a client says her cat isn’t doing well, the technician’s assessment may identify a possible urinary obstruction, which is an emergency. Let clients know that once a veterinarian examines their pet, they will be given treatment plans, including services and fees, before the pet receives care. Tell the client when pets can be picked up.

Charge a 1- to 12-hour hospitalization fee to cover nursing care in addition
to the urgent care exam fee and other services provided. 

, 11th ed, reports an average fee of $48.94 for hospitalization without intravenous administration and no overnight stay for a 25-lb dog, $49.97 for a 60-lb dog, and $47.28 for a cat. For consistency and simplicity, set a flat rate for a day admission appointment, such as $50. Share the day admission appointment fee with the explanation of “because we will provide nursing care throughout the day.”

Set guidelines on the number of day admissions allowed per day so your team knows when patient capacity has been reached. CSRs should check with the medical team before referring clients to emergency hospitals once patient capacity is full.

Q. Our technicians offer wellness testing during checkups. Approximately 30% of clients say yes. How can we be more persuasive when talking with clients?

 I’m a raving fan of preventive screening because 2 of my cats had health concerns identified thanks to testing. Your team can use 5 strategies to increase compliance:

1. Say “early detection screen” instead of “wellness test.”

 My 13-year-old cat, Caymus, runs Formula 1-like laps through the house every morning and appears to be in perfect health. I might assume a wellness test is just a recommendation and is not medically necessary.

Clients are familiar with early detection screens in human medicine at milestone ages, such as mammograms starting at age 40 and colonoscopies beginning at age 50. Many understand the importance of early detection for better outcomes.

 Help clients understand their pets’ ages in human years. Age analogy charts can be posters on exam walls, laminated flyers, or PDFs on exam room computers. A 10-year-old dachshund is 60 in human years, and 60-year-olds need preventive screening.

Download a dog age analogy chart at www.pethealthnetwork.com/dog-health/ dog-checkups-preventive-care/how-old-your-dog-people-years and a cat chart at www.pethealthnetwork.com/cat-health/cat-checkups-preventive-care/ how-old-your-cat-people-years.

3. Set affordable prices for preventive screening.

 Just as dog owners accept heartworm and tick screens for their pets every year, you need to persuade clients to agree to recurring early detection screens. Price sick-patient tests 25% higher than preventive screens. An attractive fee gives your team confidence to resell testing each year. Sick-patient testing requires veterinarians to evaluate results, diagnose conditions, identify treatment solutions, and discuss findings and next steps with clients. Because sick-patient tests require more time from the doctor, they merit higher fees.

To help your team know which fee to charge, use “test” for sick patient workups and “screen” for preventive screening. 

 reports an average of $158.68 for a complete blood count with 16 to 24 chemistries and thyroxine.

 You can remind clients every 6 or 12 months based on the patient’s age and disease stages. The same test may be performed as a sick-patient workup with a fee of $198.35, which is 25% higher for additional doctor time.

Although you may use the same reference laboratory code for both tests, they have different names (test vs screen) for pricing and reminder purposes.

 Just as you send reminders for intestinal parasite and heartworm-tick screens, do the same for early detection screens. Text this: “

<Pet name> is due for an early detection screen by <date>. This blood and urine test assesses overall health and identifies changes early. We will collect samples during a 15-minute technician appointment. Book online, download our app, or call <phone number>.

” Hyperlinks lead clients to click and schedule.

 Every team member should use the same talking points for consistent client messages. Share benefit statements to gain acceptance.

Say this: “Your 10-year-old dachshund is 60 in human years. Because pets age more quickly than people, changes may happen quickly. Our early detection screen will identify changes early. Think of this screen as an internal physical exam that lets us see inside to check the health of organs. Our early detection screen is the most comprehensive and affordable. This includes your dog’s annual heartworm/ tick screen, intestinal parasite screen, thyroid function, and urinalysis to determine hydration and kidney function. Our early detection screen is $___. Shall I collect your dog’s blood and urine samples, or do you want to talk with the doctor?”

This script explains the affordability of bundled tests along with the fee. Use the 2 “yes” options technique to ask for a commitment: (1) Yes, collect samples now or (2) Yes, I need to learn more from the veterinarian. During the exam, the doctor may find health concerns that further support testing. Hearing about screening from a technician and veterinarian creates repetition of the message, which a study by the American Animal Hospital Association found increases compliance.

Laboratory, imaging, and diagnostic services comprised 18% of hospital revenue in 2022.

 Run a report in your software to compare your practice’s performance with this benchmark. Set a compliance goal and track your progress monthly.

Need a script for a client conversation? Submit your scenario to info@csvets.com for consideration in future columns.

Best known as the “Queen of Scripts,” 

, has taught communication and client service skills for more than 2 decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Wendy was a partner in a specialty and emergency practice. Visit Csvetscourses.com to learn more.

1. American Animal Hospital Association. 

2. American Animal Hospital Association. 

3. Veterinary Industry Benchmark Report. iVET360. 2023. Accessed March 5, 2024. https://ivet360.com/2023-veterinary-industry-benchmark-report/

Scripts for confident client conversations include wellness testing woes