Pet-Specific Care for the Veterinary Team. Группа авторов

rod‐cone degeneration^a, sensory ataxic neuropathy English bulldog Anasarca, brachycephalic syndrome, entropion, factor VII deficiency, fold dermatitis, hip dysplasia, hyperuricosuria^a, hypothyroidism, laryngeal paralysis, multifocal retinopathy (CMR1)^a, pulmonic stenosis, sacrocaudal dysgenesis, ventricular septal defect Beagle Cataracts, cryptorchidism, diabetes mellitus, factor VII deficiency^a, glaucoma (POAG)^a, hip dysplasia, juvenile polyarthritis, Musladin–Leuke syndrome^a, night blindness^a, patellar luxation, pulmonic stenosis, pyruvate kinase deficiency^a, retinal dysplasia French bulldog Atopic dermatitis, brachycephalic syndrome, cataracts^a, corneal ulcers, factor VIII deficiency^a, factor IX deficiency^a, histiocytic ulcerative colitis, necrotizing meningoencephalitis, hyperuricosuria^a, multifocal retinopathy^a, cone‐rod dystrophy I^a Poodle Cataracts, epilepsy, factor VIII deficiency, Legg–Calvé–Perthes disease, mucopolysaccharidosis^a, neonatal encephalopathy^a, organic aciduria, oxalate urolithiasis, progressive rod‐cone degeneration^a, sebaceous adenitis, von Willebrand disease^a Rottweiler Cervical vertebral instability, cruciate ligament rupture, fragmented coronoid process, gastric dilation/volvulus, leukodystrophy, membranous glomerulopathy, myotubular myopathy^a, patent ductus arteriosus, polyneuropathy and neuronal vacuolation^a, short tail^a Yorkshire terrier Atlantoaxial instability, cataracts, cryptorchidism, L2‐hydroxyglutaric aciduria^a, lymphoproliferative disease, necrotizing meningoencephalitis, patellar luxation, patent ductus arteriosus, primary lens luxation^a, progressive rod‐cone degeneration^a Boxer Brachycephalic syndrome, cardiomyopathy^a, cystinuria, factor II deficiency, hyperadrenocorticism, neoplasia, progressive axonopathy, pulmonic stenosis, short tail^a, sphingomyelinosis, subaortic stenosis, ulcerative colitis

      ^a DNA testing is available.

      Lifestyle also plays a role in determining risk for pets, including the part of the country in which they live, their exposure to other animals (boarding, grooming, social activities, etc.), the protection they are already being provided (e.g., parasite control, vaccination, etc.), and their role in the family – pets in close contact with family members need more rigorous preventive care (for parasite control, etc.) than animals without such contact. This is often best determined by risk assessment (see 1.2 Providing a Lifetime of Care).

      Testing can also identify risk (see 4.7 Embracing Early Detection). In some cases, it is genetic testing as previously mentioned, but in many other cases we rely on phenotypic testing to identify risk. Thus, if we perform radiographs as part of routine patient screening and identify that a pet has hip dysplasia, we know this increases the risk that the pet will develop osteoarthritis later in life.

      Armed with all this information, the veterinary team is in a much better position to determine pet‐specific care that is relevant to the pet and client and allows for earlier intervention, when the best clinical outcome is typically achievable (see 5.10 Discussing Pet‐Specific Care).

      1.3.4 Practice Pet Populations

To personalize care for clients, it is first necessary to determine the breeds most represented in a practice, and this can be achieved through appropriate fields in the practice management software system. In the United States, approximately 54% of dogs are purebreds and 46% are mixed‐breeds [2]. For cats, the vast majority seen in practice are mixed‐breeds, often referred to by terms such as domestic shorthair or domestic longhair (see 3.19 Mixed‐Breed Considerations). Although many purebred animals might be pedigreed and have their family lineage documented with a registry organization, many others are purebred in name only and are without such documentation. Others might have documentation from a breed registry but bear little resemblance to the breed standard.

      Among the mixed‐breed dogs in a practice, it is often tempting to identify them based on perceived physical characteristics (e.g., beagle x) but this practice is to be discouraged because it is wrong at least as often as it is right, and it might lead to inappropriately associating risk factors that don't belong and missing ones that do belong [3]. Within the medical record, if the owners don't know with certainty which breeds contributed to their pets and if DNA testing has not been done to determine likely heritage, then the pet should be recorded as a mixed‐breed or other suitable term. This should only be done proactively with new pets, and the medical record not changed for existing clients unless DNA testing has been done and there is a valid reason to change the medical record, with a copy of the DNA results maintained in the medical record to substantiate a medico‐legal reason for amending the record.

      1.3.5 Components of Personalized Pet Care Plans

      Prevention is the cornerstone of personalized pet care and fundamental to the concept is that diseases should preferably be prevented whenever possible, on a risk/benefit basis (see 1.1 Overview of Pet‐Specific Care). Not only is it easier to prevent problems than it is to treat them, but from a client perspective it is also more cost‐effective to prevent disorders than to try to manage them. For example, heartworm can be effectively prevented with either injectable medications (with ensured compliance) or with monthly oral or topical medications (which practices should remind clients to administer to improve adherence). Compliance and adherence are critical in this regard, because prevention is only as good as the assurance that the pet has received the medication as directed (see 9.17 Improving Compliance and Adherence with Pet‐Specific Care).

      Vigilance is involved in the early detection component of our personalized pet care (see 4.7 Embracing Early Detection). As a wellness initiative, vigilance involves reviewing the risk factors for an individual pet and performing screening tests to identify problems while still subclinical and before more permanent damage has taken place (see 11.4 Heritable Health Conditions – By Breed). For example, in an animal with a family history of hip dysplasia, radiographic assessment is warranted, typically by 2 years of age at the latest, to determine if the animal shows early evidence of the disease. An animal with a breed predisposition for von Willebrand disease (vWD) would benefit from DNA testing during puppyhood, and certainly clotting evaluation before any surgeries might be performed. A kitten with genetic testing suggesting risk of polycystic kidney disease will warrant enhanced scrutiny for kidney disease and monitoring of renal function. For all animals, it is worth performing routine testing from time to time (e.g., hemogram, biochemistries, urinalysis, radiography, blood pressure, etc.) just to be aware of unanticipated risks that might be developing, even if still subclinical. Recommended tests to consider on a breed basis are available for both dogs (www.ofa.org/browse‐by‐breed) and cats (https://icatcare.org/advice/cat‐breeds).

      Management of diagnosed conditions must also be personalized. Practices should have protocols for dealing with the most common entities treated, and care pathways