“When will the results be back?” is a question heard daily in any veterinary practice. In a world where most things are available very quickly, client expectations have changed. Diagnostic testing has certainly evolved in recent years too, for humans and animals, with cutting-edge tests not available pretty much instantly in-house.
The animal diagnostic market is a major and flourishing sector: it accounts for 22 percent of the entire veterinary market and is worth US$4.2 billion (£3.2 billion) globally (Brakke Consulting, 2017). The biggest market is by far the United States of America, representing more than half of the global value, despite only having 25 percent of the estimated cat and dog populaiton. Delegates at the Idexx Investor Day (2016 and 2018) were told that whilst practices across the rest of the world achieve around 5 to 10 percent of their revenue from diagnostics, in America this reaches 15 percent.
Interestingly, the percentage of practices equipped with blood laboratory machines in the UK and US is very similar. So availability of the equipment does not explain the difference; it is only down to their usage. At the Idexx Investor Day, it was said that 70 percent of sick pets are blood tested in America, while the figure is around 30 percent for the UK. Prevention screening is also very well developed in the US, where 50 percent of pets presented for a routine/wellness visit are blood tested (only 10 percent in the UK).
Point-of-care diagnostic testing is a growing sector: more affordable machines with excellent accuracy have made inhouse testing very common and business friendly. Futhermore, the benefits of keeping tests in-house are numerous:
- For the patient: a quick result can save the animal’s life in an emergency situation, or improve anaesthetic safety
- For the client: satisfaction can be vastly improved with a short waiting time and more convenience. The perceived value of a test is also known to be higher if the results are instant
- For the practice: increased client satisfaction means more business, as customers are more likely to return and recommend a practice perceived as being well equipped. Profitability can also be increased
- For the clinician: clients are more likely to opt for a test if instant, improving the level of care, making medicine more interesting and avoiding having a client chasing for results daily
Tests such as biochemistry or haematology are well integrated in modern equipment, but newer tests are set to change the way vets practise. Canine C-reactive protein (cCRP) is a perfect example of how an in-house test can greatly improve the standard of practice. CRP testing comes from human medicine where it is performed widely and routinely for: post-operative follow up, clinical response evaluation, routine screening in toddlers, etc.
cCRP is a biomarker of inflammation which has three main advantages: it changes quickly (about four hours), it is positively correlated to the severity of inflammation and it is not influenced by stress or other drugs. Therefore, it may be used in numerous situations: monitoring recovery after surgery, assessing whether the animal is responding to the treatment initiated, or even for screening when the history is very vague. cCRP is usually more relevant if measured several times in order to compare and provide real-time assessment of the inflammatory process. Therefore, sending cCRP for external testing defeats the object slightly, but testing in-house gives the vet a very powerful tool and the client some instant quantifiable reassurance that their beloved pet is being looked after to a very high standard.
cCRP is only one example, but no doubt more and more tests will be made available in-house in the future, as the market keeps growing and companies continue to invest. This can only be a win–win situation for the vets.