Increase in interest in supportive therapy - Veterinary Practice
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InFocus

Increase in interest in supportive therapy

Richard Gard attended an event at Devon practice, with discussions ranging from the use of hydrotherapy to nutrition and nutraceuticals in treating osteoarthritis and other conditions.

MANY veterinary practices have clients with multiple pets and these people make routine demands on veterinary support. As the animals age so the demands are likely to increase.

Over the years our household calls on a veterinary visit for horses and “while you are here” thrusts forward the collie for various minor afflictions. With age, the ability of the dog to run, jump and skip has fallen away until he has become unwilling to accompany the horses on rides, preferring to loiter around the homestead.

It was this background that led to a “proper” veterinary assessment, together with an anal growth removal. The result was a diagnosis of arthritis in the front joints and an invitation to attend a practice evening meeting to hear about the ongoing WAR (weight, arthritis and rehabilitation).

So, together with a wide age range of clients we attended the practice on a bright sunny evening for drinks, nibbles and education. It proved to be a very worthwhile activity.

Pregnant paws

Last year we were adopted by a feral cat that, surprise surprise, turned out to be pregnant. Some months later the location of the kittens was unknown until she was hit by a car and received a badly injured back, to the point of nearly being put down.

After 48 hours at the vets, the hungry two-week-old kittens were located and reunited with the cat; kittens and cat spent 10 days in hospital and have thrived ever since. A very expensive feral cat but the time involved, subsequent conversations with vets and nurses, three spays, vaccinations and an abscess, does create some sort of bond. So the meeting, with product uses for cats, dogs and horses, was appropriate on many levels.

Shelley Jefferies manages hydrotherapy at the practice, providing water treadmill therapy, and following a slide presentation many people crowded into the unit to watch a collie enjoying the facilities. It became clear that this was a targeted activity to overcome particular issues that had been identified by veterinary assessment.

For animals that have difficulty with movement, for whatever reason, buoyancy from the water clearly assists activity. The first question raised was about costs and the second whether use of the treadmill would be covered by insurance. It would be interesting to know whether these units have been assessed for their impact on recovery and whether the overall bill for long-term treatment is actually reduced.

Quality graphics

Jack Newton of Hill’s Pet Nutrition produced quality graphics to highlight the cartilage wear and tear with osteoarthritis. He made a point which may seem obvious, but had been overlooked in the past.

On two or three occasions a tin of Hill’s had been provided and fed to the animals but it was not eaten and thrown away. So, the slow transition of prescription diet over seven days was a sit-up-and-notice point. There were also a number of technical points about the role of the constituents but the questions were more to do with cost comparisons against supermarket alternatives.

The idea that “vet food” is expensive was handled with humour and confidence and the interaction may well help the nurses and staff to discuss these queries openly in future. The challenge, “to improve mobility in 21 days”, is a positive proposal.

Jonathan Wood encouraged his clients to consider the history of joint surgery. Various surgical tools were produced that had been used to poke and prod, with experiences of routine and heroic outcomes. Air surgery was performed with radiograph slides showing bone breaks and deformations, with the tools twisted and pulled to indicate the procedures, without the need for blood and gore.

All were enthralled, but the most enthusiasm was reserved for the titanium foam wedge.

Passing this around the audience with a request not to lose it, the benefits of this advance were enthusiastically presented.

This presentation brought home the hard core of veterinary work that underpins the rest of the activity. Although the practice may well sell products, with client choice to be able to buy elsewhere on many items, when serious pet work is needed to restore an animal, the veterinary surgery is the only option.

A question of quality

The big question about nutraceuticals appears to be the quality of ingredients. Beth Wilson of Nutravet is clearly within her comfort zone when talking to staff and clients of a veterinary practice.

Despite a glitch with the computer connection, the points made to the meeting and the subsequent discussions with individuals provided an in-depth assessment.

As a former veterinary nurse, her experience is valuable but a quick glance on the web indicates that the use of nutraceuticals is wide, varied and competitive. The name was coined some 25 years ago as a hybrid between nutrition and pharmaceutical but the regulatory process has yet to catch up with the claims.

The latest company literature emphasises that the UK-manufactured products are only available through veterinary practices and the audience responded to the point that high resource and production standards mean that each capsule contains the same dose.

For a pharma product this is mandatory but the indication is that high street options may have variable doses. The performance of glucosamine hydrochloride over glucosamine sulphate, in improving cartilage formation, was emphasised. The comparative cost was also addressed and the point made to compare the cost of treatment, not the cost per capsule.

One of the other important factors appears to be that nutraceutical products can be administered together with anti-inflammatories.

The literature and packs, made of recycled card, were available to the clients and it was noticeable that many located reading glasses to view the details. The fact that they did so before moving on indicated genuine interest. Clear pictures of dogs, cats and horses are strong visual indicators of species use.

The practice is finding an increase in interest in supportive therapy. Clients are taking a more long-term view of the health of their pets. Listening to the nurses and other staff dealing with the concerns of clients, it is apparent that the reputation of the practice is linked to the performance of products as well as the veterinary attention received.

And so the management of our collie with arthritis comes down to four options. Carry on with the usual diet, let him loiter and risk an increase in weight and a worsening of his condition with more pain; utilise the water treadmill or administer NSAIDs regularly or feed Hill’s j/d or give Nutraquin+ capsules – possibly all four or perhaps there are other options to be considered. A review is due shortly.

  • My thanks to Jonathan Wood and the staff of his practice in Crediton, Devon, for their help and information.

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