Pet-Specific Care for the Veterinary Team. Группа авторов

Risk Assessment). For example, while osteoarthritis can be recognized in virtually any dog or cat, there are many breeds that have a higher prevalence of the condition, and underlying conditions that increase risk, so such pets should have screening to identify cases earlier, hopefully when they are subclinical and we have the most options for changing the trajectory of the disorder.

      Are there other situations that should make us more vigilant for the increased probability of osteoarthritis in our clinic populations? Yes! In addition to underlying problems that may be heritable (such as hip dysplasia), pets with prior history of trauma, those with co‐morbidities that may predispose to osteoarthritis and even those with weight management issues may be at increased risk and would benefit from early screening. These risk factors should prompt us to evaluate for osteoarthritis earlier and more consistently, but since all pets can develop osteoarthritis, and it usually presents in young adult to middle‐aged pets, routine screening should also be done for all pets earlier than typical profiles that get initiated in senior patients.

      Interestingly, pet‐specific care is about much more than just medical competence, since it also impacts customer satisfaction and retention. It should not be surprising that pet owners actually expect this level of care from veterinary teams, and believe they are already paying for this level of excellence. Consider for a moment the pet owner who dutifully brings in their pet for evaluation and pays for that visit. Is it fair that they expect the veterinary team they are entrusting with their pet's care to actually know the problems to which their pet is prone, and act accordingly? Is it fair that the pet owner of a Cavalier King Charles spaniel expects the veterinary team to know that their pet is prone to a variety of ills, including mitral valve disease, keratoconjunctivitis sicca, macrothrombocytopenia, primary secretory otitis media, and syringomyelia (among others), and that the veterinary team is prepared to counsel and assess accordingly (see 11.4 Heritable Health Conditions – by Breed)? While most veterinary practices will admit that they are not actually providing this level of service, most will reluctantly acknowledge that it is fair for paying clients to expect it. It is a commitment to pet‐specific care that creates the framework in which this can happen consistently.

      Similarly, is it reasonable for clients to expect that the veterinary team will take every precaution to determine if certain drugs could cause adverse effects in their individual pet (toxgnostics) or know that a pet that travels with its owners warrants different preventive care strategies, or that pets that engage in specific activities might have altered risk profiles? In the future, we will also likely be able to engage in what is currently being referred to as companion diagnostics, which is a way to test safety and efficacy of a drug specific to a target patient group, breed, or otherwise identified individual (biomarkers, genetic markers, etc.). So, there may come a time when we are able to screen individuals at risk (for example, for potential idiosyncratic reactions such as to nonsteroidal antiinflammatory drugs). We just need a system in place to take advantage of these developments, and pet‐specific care can be that system.

      Pet‐specific care is also client centric since decisions are ultimately made by caregiving pet owners. While it is important that veterinary teams focus on standards of care (see 9.4 Standards of Care), care pathways (see 9.6 Care Pathways), and regarding intervention on a continuum of care (see 9.7 Continuum of Care and Convergence Schedules), it takes more than that to deliver pet‐specific care. To deliver pet‐specific care effectively, veterinary teams need to also provide a specified level of care, which in turn is dependent on consistency of care (see 9.8 Ensuring Consistency of Care) within the practice. In addition to standards of care and level of care, veterinary teams also need to be aware that not all clients can afford recommended services, so a spectrum of care may be needed. Affordability of veterinary services is a real concern for some pet owners (see 2.10 Affordability of Veterinary Services), but options are still available (see 10.14 Providing Cost‐Effective Care for Those in Need; 2.2 The Role of Incremental Care; 7.8 Providing Care for Those Unable or Unwilling to Pay; and 6.5 Opportunities and Challenges of Providing Services for Low‐Income Families).

      1.1.3.1 Why Pet‐Specific Care Rather than Pet‐Specific Medicine?

      While the goal of pet‐specific care is better health outcomes, and there are many medical aspects to healthspan, it is also true that some of the most important aspects of success with pet‐specific care involve owner engagement in health management rather than disease management. Pet owners need to play an active role in keeping their pets healthy, not just bringing those pets in for veterinary care when something goes wrong.

      The nomenclature is not yet fixed, but pet‐specific care suggests that there are many important aspects to care that are not necessarily medical in nature. A commitment by pet owners to feed a nutritious and balanced diet, to promote appropriate behaviors, to ensure their pet remains within a normal body condition score, and to provide regular at‐home oral care are all very important health factors. So is ensuring pets have regular exercise, socialization, and access to enrichment in their environments. Some may even say that promoting behavioral health is one of the best ways of ensuring medical health, since behavioral issues are more likely to result in relinquishment than medical problems (see 6.9 Preventing Behavior Problems).

Pet owners need to consider home issues such as fencing and shelter, pet‐proofing their home to avoid mishaps, making plans for someone to care for their pets when they are away, as well as making financial decisions for how to care for their pet in sickness and in health. They also need to do more than just go to the veterinarian and buy recommended products. Compliance and adherence are critical factors, and owners need to be prepared to follow veterinary recommendations at home, when they are not under direct medical supervision (see 9.17 Improving Compliance and Adherence with Pet‐Specific Care). For all these reasons and many more, the term pet‐specific care is preferred (at least currently) over the variety of other synonyms that are being used.

      Veterinary healthcare teams definitely facilitate pet‐specific care, but owners must be engaged in the process and willingly accept their healthcare guardian role and take the responsibility seriously.

      While all pet owners should aspire to pet‐specific care, it is reasonable to predict that not all will embrace the topic initially, as well as be prepared to pay for it. Early adopters are likely to be owners of new pets, and the market segment known as pet parents. These are the early adopters, but when success is achieved with these individuals, it is possible to leverage that success across the entire hospital population. However, even a small contingent of proponents can have a powerful impact on pets and the teams that care for them. According to Pareto's principle, if 20% of clients embrace pet‐specific care, they can contribute to 80% of positive outcomes (see 10.2 The Importance of Practice Differentiation).

      1.1.4 Risk Assessment

      Pet‐specific care is all about managing risks, so the very first step typically involves assessing pets for risks based on their individual circumstances (see 1.2 Providing a Lifetime of Care). In most cases, this first happens during puppy and kitten visits, often at around 8 weeks of age.

      All animals have certain risks that pertain to their individual circumstances. By acknowledging and prioritizing risks, we can craft meaningful personalized action plans for our patients (see 1.3 Personalized Care Plans). In addition, once we have identified risks, pet owners