How to Talk to Clients About Additional Testing for Healthy Pets
There are a number of common scenarios when you might find yourself having to explain to clients why specific testing is necessary for their seemingly healthy pets. Whether it's routine screening, further testing for asymptomatic abnormalities, or follow-up diagnostics for common problems, effective communication can help clients understand the value of these efforts.
Explain the Benefits of Routine Testing
When it comes to the "invisible" problems that pet owners might overlook, it can be helpful to refer to human medical practices that people generally recognize. When recommending annual geriatric bloodwork, you can remind clients that just like in people, there are diseases that develop as animals get older, and if you can catch them early—before a pet is obviously sick—you can often do something to help.
Another reminder for owners in this situation: Pets can't always communicate when there is something wrong. A dog can't describe a headache or explain that they always have an upset stomach after eating chicken. And waiting for clinical signs to become severe enough that pets can no longer compensate can lead to underdiagnosis of common diseases or delay diagnosis until those diseases are very severe. Hypertension is a good example of one of these commonly overlooked problems. Studies suggest that at least a quarter, and maybe over half, of cats with chronic kidney disease (CKD) have hypertension. In fact, a study from the Journal of Feline Medicine and Surgery about hypertension in cats with CKD showed that only 3% of owners reported hypertension as a concern, indicating that most cats with hypertension will not show any overt signs that their owners can pick up on.
Provide Visuals When Discussing Trends and Tests
There are many diseases and conditions for which routine monitoring is critical to maintaining appropriate treatment. For example, the International Renal Interest Society recommends rechecks every three months for CKD, and the American College of Veterinary Internal Medicine recommends rechecking dogs with asymptomatic mitral valve disease every six to 12 months.
Some reference labs offer diagnostics tools that have graphs of certain analytes over time, and these can be beneficial to share with clients. Showing an image of a cat's creatinine concentrations slowly rising from 0.8 to 1.1, and then to 1.7 makes it easier for a pet owner to understand and accept a diagnosis of Stage 2 CKD in their seemingly normal cat. Plus, having them on board with tracking that graph over time makes follow-up appointments smoother as they probably want to track that visual just as much as you do, to see if their efforts are making a difference.
Test a Hypothesis
It can be hard for clients to understand the value of tests their veterinarians routinely recommend if they don't understand how the results are interpreted. Setting up a diagnostic test as a hypothesis, and explaining to owners what you will do differently if one result or the other is returned, makes this more concrete.
An example that you might see in primary care practice is finding a mild to moderate anemia in an otherwise normal cat; the cat might not be showing clinical signs, but now you're asking owners to pay for hemotropic mycoplasma PCR. Consider explaining that if the PCR is positive, you could give an antibiotic to make that anemia go away, but without the PCR test, you wouldn't feel comfortable giving that antibiotic. When it comes to prescribing medication, most clients understand the need for receiving a specific test result.
Annotate Test Results
Build trust with new clients by showing them the results via a printout or on a screen and annotating it as you're explaining the interpretation, showing them what you learned from each result. This can be especially valuable for things like a chemistry panel, where you can point out the "useful normals," and what that means for ruling out chronic diseases. For instance, do you see normal blood glucose levels? That indicates no diabetes mellitus. Normal total T4? You're probably not dealing with hypothyroidism.
In deciding how aggressive or hands-off to be with follow-up tests and monitoring in otherwise healthy pets, every case is different. Ultimately, it's up to your clients to make the decision for their pet. That said, making sure you're effectively communicating with your clients so that they understand your recommendations, and can make an informed decision, is key.