Sponsored by Elanco Animal Health
Adam Christman, DVM, MBA
The pet parents get so excited to come home with their puppy and everything. But they're also very hesitant to start classes or training. What recommendations would you provide with a pet parent that has like a puppy that's healing from Parvo?
Christopher Pachel, DVM, DACVB, CABC
I love that question. I think so many times when we think about socialization, our brains immediately go to puppy class, or we go to cool. Now we're going out into the world. Socialization is really about creating new experiences that inform that brain how to process new and different things. So socialization does include actual social time, but it also includes learning about different flooring and substrates...It's including learning about noises, or how to start developing kind of basic manners, and how do you navigate different life situations. And even something as I'm gonna say, simple and safe as taking the dog for a ride in the car, assuming that's comfortable for them. Go hang out near the park, open the door, let them see and hear. They don't need to put their feet out into the park and potentially risk their own safety. We can create social experiences for them from the get go, as long as we keep in mind to what makes that safe versus risky versus saying I need to put this puppy in a bubble in my basement and never let them experience the world. So again, socialization, yes or no? Or how do we do that? Through safe outlets.
Adam Christman, DVM, MBA
Right? And speaking of constraints...What would be your go to recommendations when they say, "Hey, I can't take them to the veterinarian; I can't afford therapy." What would be your go-to for some of these puppies?
Fathom Woods
Yeah, we fluids, antibiotics, and antiemetics, of course, for the nausea and vomiting. And it's extremely discounted. So we'll we'll charge $50 a day for 3 days. And then we'll do a recheck after 3 days, and a lot of times families can afford that versus a $2,000 vet bill. And you know, if they can't even afford the $150, we'll work with them. Because our main goal is to keep the pets with their owners. We don't want to take them into the shelter. We don't want them to have to surrender. So it's a really neat program we get to do, and they get to keep their pets.
Adam Christman, DVM, MBA
That's great. What does that look like from an ER perspective?
Erik Zager, DVM, DACVECC
So it can be difficult, especially when you have to run a hospital. You have to pay your staff. You have to pay the building and things like that. And so, it can be difficult and looking at kind of the outpatient protocol that was developed at Colorado, if you really dive down deep, the outpatient protocol was developed within patients in the hospital, still getting subcutaneous fluids and monitoring in the hospital setting, just kind of to recreate what looked like an outpatient scenario. And also with heavy case selection, this was not taking the patients that come in hypoglycemic shocky, giving them a dose of lung and antibiotics and sub qs and being like you're on your own. And so you really need to be cautious about that case selection. But I really encourage my ER staff and doctors to try to work with those patients as well. I think that once you get through that initial visit,, we go through lots of fluids in our hospital per day that are not contaminated, that are still clean. I tell them save those fluids, put on new sets, things like that we can give them for free to sub q fluids at home. We can do things to try to do anything that we can to use our resources to help with those patients. Because it's for the owners, it's also for your staff. And so I think that these are ones where if you can get them through the prognosis can be so good long term, that these are the ones that I'm willing to say, "All right, we can take a hit to our bottom line a little bit. And let's just make sure that we can do everything we can for these patients."
Adam Christman, DVM, MBA
That's excellent, wonderful.
Michael Lappin, DVM, PhD, DACVIM
Yeah, I think one of the things that's really important, at least at the veterinary teaching hospital, we do still try to instill into the mind of the student that you should always offer the best. Whether that you feel that they can afford the best, we still would offer a treatment plan that fits with the degree of illness for that animal because, as you mentioned, in the outpatient protocol paper, there was some selection going on there to get that 80% survival compared to the full blown 90% survival with with the whole isolation and critical care pathway. But we do believe that we should make sure that the students always offered the best. That's what we look at when we're evaluating a case is what was offered, not what the owner did. And so as long as we start with offering standard of care, even if they even know their financial history, you still need to give them here's the best for this puppy. And then from there, I think that's where all bets are off. And if they can't do that, then we'll do exactly what was already stated while doing anything to try to save a puppy and outpatient protocol. After a few hours of IV fluids in the exam room that you have to decontaminate anyway, you know, it already got contaminated with that Parvo puppy. And then treat and street the best we can.
Erik Zager, DVM, DACVECC
I 100% agree with what you're saying. It's so important that regardless of who walks in that door, what you might have preconceived notions of whether they're going to pay, what their situation is, always offer standard of care. Always recommend it and then work with them. I don't think that you should ever decide, oh, this person does not look like they're going to be able to afford care. I'm just going to say, hey, we're going to do outpatient care. As veterinarians, it is our duty to provide at least education and treatment and to anybody, regardless of any of those factors. And I think that is so important. It's so good to hear that that we're still teaching students that is that you never want to go in with a preconceived notion of what they are going to want to do. You need to teach, educate, and provide the best care that you can.
Adam Christman, DVM, MBA
Absolutely excellent.
Socialization for puppies affected by Parvo
The panel explains how Parvo affects early development for puppies and shares advice for pet parents
EP: 1.Meet the canine parvovirus panel
EP: 2.How Parvo is wreaking havoc on the pet community
EP: 3.COVID-19's impact on Parvo management
EP: 4.The learning process while managing Parvo
EP: 5.Parvo and hospital morale
EP: 6.Socialization for puppies affected by Parvo
EP: 7.The new canine Parvovirus monoclonal antibody
EP: 8.Comparing CPMA with previous treatment options
EP: 9.Contraindications to consider during treatment
EP: 10.Optimizing the use of CPMA to best treat patients
EP: 11.How CPMA affects survivability
EP: 12.Limitations during Parvo treatment
EP: 13.Looking into the future of Parvo treatment
Sponsored by Elanco Animal Health
Adam Christman, DVM, MBA
The pet parents get so excited to come home with their puppy and everything. But they're also very hesitant to start classes or training. What recommendations would you provide with a pet parent that has like a puppy that's healing from Parvo?
Christopher Pachel, DVM, DACVB, CABC
I love that question. I think so many times when we think about socialization, our brains immediately go to puppy class, or we go to cool. Now we're going out into the world. Socialization is really about creating new experiences that inform that brain how to process new and different things. So socialization does include actual social time, but it also includes learning about different flooring and substrates...It's including learning about noises, or how to start developing kind of basic manners, and how do you navigate different life situations. And even something as I'm gonna say, simple and safe as taking the dog for a ride in the car, assuming that's comfortable for them. Go hang out near the park, open the door, let them see and hear. They don't need to put their feet out into the park and potentially risk their own safety. We can create social experiences for them from the get go, as long as we keep in mind to what makes that safe versus risky versus saying I need to put this puppy in a bubble in my basement and never let them experience the world. So again, socialization, yes or no? Or how do we do that? Through safe outlets.
Adam Christman, DVM, MBA
Right? And speaking of constraints...What would be your go to recommendations when they say, "Hey, I can't take them to the veterinarian; I can't afford therapy." What would be your go-to for some of these puppies?
Fathom Woods
Yeah, we fluids, antibiotics, and antiemetics, of course, for the nausea and vomiting. And it's extremely discounted. So we'll we'll charge $50 a day for 3 days. And then we'll do a recheck after 3 days, and a lot of times families can afford that versus a $2,000 vet bill. And you know, if they can't even afford the $150, we'll work with them. Because our main goal is to keep the pets with their owners. We don't want to take them into the shelter. We don't want them to have to surrender. So it's a really neat program we get to do, and they get to keep their pets.
Adam Christman, DVM, MBA
That's great. What does that look like from an ER perspective?
Erik Zager, DVM, DACVECC
So it can be difficult, especially when you have to run a hospital. You have to pay your staff. You have to pay the building and things like that. And so, it can be difficult and looking at kind of the outpatient protocol that was developed at Colorado, if you really dive down deep, the outpatient protocol was developed within patients in the hospital, still getting subcutaneous fluids and monitoring in the hospital setting, just kind of to recreate what looked like an outpatient scenario. And also with heavy case selection, this was not taking the patients that come in hypoglycemic shocky, giving them a dose of lung and antibiotics and sub qs and being like you're on your own. And so you really need to be cautious about that case selection. But I really encourage my ER staff and doctors to try to work with those patients as well. I think that once you get through that initial visit,, we go through lots of fluids in our hospital per day that are not contaminated, that are still clean. I tell them save those fluids, put on new sets, things like that we can give them for free to sub q fluids at home. We can do things to try to do anything that we can to use our resources to help with those patients. Because it's for the owners, it's also for your staff. And so I think that these are ones where if you can get them through the prognosis can be so good long term, that these are the ones that I'm willing to say, "All right, we can take a hit to our bottom line a little bit. And let's just make sure that we can do everything we can for these patients."
Adam Christman, DVM, MBA
That's excellent, wonderful.
Michael Lappin, DVM, PhD, DACVIM
Yeah, I think one of the things that's really important, at least at the veterinary teaching hospital, we do still try to instill into the mind of the student that you should always offer the best. Whether that you feel that they can afford the best, we still would offer a treatment plan that fits with the degree of illness for that animal because, as you mentioned, in the outpatient protocol paper, there was some selection going on there to get that 80% survival compared to the full blown 90% survival with with the whole isolation and critical care pathway. But we do believe that we should make sure that the students always offered the best. That's what we look at when we're evaluating a case is what was offered, not what the owner did. And so as long as we start with offering standard of care, even if they even know their financial history, you still need to give them here's the best for this puppy. And then from there, I think that's where all bets are off. And if they can't do that, then we'll do exactly what was already stated while doing anything to try to save a puppy and outpatient protocol. After a few hours of IV fluids in the exam room that you have to decontaminate anyway, you know, it already got contaminated with that Parvo puppy. And then treat and street the best we can.
Erik Zager, DVM, DACVECC
I 100% agree with what you're saying. It's so important that regardless of who walks in that door, what you might have preconceived notions of whether they're going to pay, what their situation is, always offer standard of care. Always recommend it and then work with them. I don't think that you should ever decide, oh, this person does not look like they're going to be able to afford care. I'm just going to say, hey, we're going to do outpatient care. As veterinarians, it is our duty to provide at least education and treatment and to anybody, regardless of any of those factors. And I think that is so important. It's so good to hear that that we're still teaching students that is that you never want to go in with a preconceived notion of what they are going to want to do. You need to teach, educate, and provide the best care that you can.
Adam Christman, DVM, MBA
Absolutely excellent.