How to Break the Habit of Only Deworming
Routine treatment for intestinal worms without performing faecal testing alongside it is commonplace in many European countries. However, routine faecal testing is vitally important to monitor owner compliance and the efficacy of routine treatment in pets. Without it, anthelmintic drug resistance can remain undetected, shedding of zoonotic ova can still occur, or potentially pathogenic parasites can remain in place.
Given how important testing is, how do we break the habit among veterinary practices and pet owners of routine deworming without testing?
The Value of Faecal Testing
Before clients can be persuaded of the value of faecal testing, veterinary professionals need to appreciate the benefits it provides. This is true of the whole practice team, so inconsistent or confusing messages are not passed on to clients.
There are two key points regarding routine treatment and testing that everyone should be familiar with:
- No preventive treatment regime is 100% effective. Lapses in treatment frequency, poor compliance with the application of a product, drug resistance, and the spectrum of activity of products may all lead to treatment gaps and a range of parasites, including hookworm, Toxocara, whipworm, Echinococcus, and flea tapeworm, still being present. Risk assessments are extremely important to ensure overtreatment does not occur. Testing then becomes invaluable in seeing if the parasites that pets are deemed at low risk of harbouring are present. Treatment for flea tapeworm, for example, is often deemed unnecessary in the face of routine flea treatment. It can still be present, though, due to hunting activity, grooming off dead fleas, or if flea control is inadequate. In the latter situation, the presence of flea tapeworm is an excellent sentinel for lack of flea control and the potential presence of more severe flea pathogens, such as Bartonella species.
- Frequency of testing is important. How often routine faecal testing needs to be carried out if patients are on preventive dewormers is subjective, but factors to consider include the frequency of deworming, the range of parasites covered by treatment, and the results of previous tests. Testing should be carried out at least once a year, but this frequency should ideally be increased to two or four times a year if parasites have previously been identified by testing or if the spectrum of treatment is narrow after risk assessment. More frequent testing should also be considered if pets are on a deworming frequency of four or fewer times a year.
Getting Client Buy-In
Clients must appreciate the value of routine faecal testing, too. If a risk assessment has been carried out, and pets are on a preventive deworming regime—they may not see the value in testing their pets for parasites. This is why pet owners need to understand the benefits of both a positive and a negative faecal result.
Positive results are not inherently bad, but they indicate that a change in treatment frequency or spectrum is required. Regular negative tests in pets on routine preventive treatments are also beneficial, as they demonstrate value to the client, showing good treatment efficacy and compliance.
The issue of drug resistance is something many pet owners will engage with and be concerned about without necessarily realising the role of regular faecal testing in surveillance for resistance. These benefits can be promoted to clients during in-practice visits or via information on practice websites, social media, waiting room posters, or leaflets.
Making It as Easy as Possible for Veterinary Clients
Even when pet owners are completely sold on the idea of routine faecal testing, they will more likely bring samples if this is made as easy as possible for them. Even small barriers will reduce compliance.
Small but effective measures can make the process of sample collection much simpler. These include:
- Integrate faecal testing into routine exams. Making faecal testing a normal part of routine wellness exams will help clients remember to bring them in, as doing so will mean not having to make extra visits to the practice.
- Provide gloves, pots, and collection devices. As hard as it might be for a faeces-appreciating parasitologist to understand, many pet owners don't like handling the faeces of their pet! Providing gloves, pots, and collection devices can make faecal handling simpler and improve compliance.
- Keep the faecal sample as small as possible. Keeping the amount of faeces required to a minimum without affecting the sensitivity of the test means pet owners won't have to cope with large volumes of faeces in their cars or homes. Tests are now available that can detect faecal parasites without the large volumes of faeces previously required.
Tracking Faecal Testing
Once faecal antigen testing becomes part of veterinary practice protocols, and pet owners start bringing samples in, it can become easy to assume that compliance with faecal testing is high, and that it is taking place at desired frequencies. Keeping track of the number of clients performing faecal testing for their pets, and whether it is occurring at the required frequency, is beneficial to see if pet owner compliance is improving over time.
If you notice numbers are slipping, identify and address the issues causing the dip by engaging pet owners. Routine wellness checks are the perfect time to see if individual pet owners brought faecal samples in at their last check and, if not, learn what those barrier factors might be.
By discussing routine faecal testing in practice, examining the testing methods available, and actively engaging with pet owners, faecal testing can be increased in pets—and treatment compliance, surveillance, and local information about parasite distributions will improve as a result.
