How to Get More Pet Owners to Bring in Fecal Samples
Intestinal parasites are ubiquitous and impact nearly every dog and cat at some point. Thanks to parasites' vertical transmission and clever survival strategies, all pets are at risk for infestation. As veterinary professionals, we're responsible for educating pet owners about parasite risks and emphasizing the importance of routine fecal parasite testing.
Pet owners know that "worms" are a problem, but most don't understand the intricacies of transmission or the potentially serious infestation effects. Clients underestimate fecal sample testing's importance because their pet appears healthy, and they may fail to comply with recommendations. Others intend to follow through, but forget to bring a sample, and the task falls off their radar once they leave the veterinary practice.
Helping clients understand fecal testing's importance and offering more convenient ways to collect samples is a good start to improving compliance.
The Importance of Fecal Testing in Pets
Most dogs and cats are born with intestinal parasites and will likely encounter them in the future. Dog parks are a major infection source because while park entrance doesn't require fecal checks, nearly any environment where dogs or wildlife are found can act as an environmental reservoir for parasites. And, although some pets tolerate mild parasitic infections with no serious effects, others can suffer from chronic—and sometimes deadly—effects.
Infected pets often have acute or chronic diarrhea. Additionally, heavy worm burdens in young, old, or otherwise debilitated pets can lead to anemia, unthriftiness, or death in the worst-case scenario. Even infected pets that are asymptomatic carriers spread eggs or cysts everywhere they go. Routine screening protocols can ensure infections are treated before serious complications occur and signficantly reduce infection rates.
The Companion Animal Parasite Council (CAPC) recommends fecal testing at least four times during a pet's first year of life, and then twice annually and specifically, fecal antigen testing to ensure the "widest breadth of detection of intestinal parasites." Samples are typically collected by the pet owner before their scheduled veterinary visit and repackaged and sent to the lab by technical staff. Fecal loop collection is inappropriate in most cases, as the technique rarely yields an adequate sample and may cause the patient stress and discomfort.
Fecal Sample Collection Pitfalls
Sample collection difficulties can impact diagnostic accuracy and cause a trickle-down effect on a pet's overall treatment and preventive care plan. Samples must be fresh, appropriately handled, and large enough to provide a valid result. Causes of potential test result interference include:
Small sample size: A sample smaller than three to five grams is insufficient.
Aged sample: If it has been longer than 72 hours since collection, the sample is too old. Room temperature or refrigerated storage are acceptable until testing.
Prolonged ground contact: Feces should not sit on the ground for more than 30 minutes to avoid contamination by free living nematodes or pseudoprasites.
Freezing: Samples should not be stored outdoors and should be collected immediately in cold climates.
Many infections evade detection because of poor sample quality. These pets may develop a worsening worm burden and subsequent illness, and possibly pass parasites to other household members, including pets or children. A false negative fecal result can also lead to more expensive and invasive diagnostic testing or inappropriate treatment for a pet with chronic gastrointestinal (GI) symptoms.
How To Improve Client Compliance and Sample Quality
Obtaining a quality sample—or any sample—hinges on client buy-in and compliance. We can improve client compliance by providing:
Education: Ensure pet owners understand the prevalence of parasites and how they may impact pets and people in the household and community. You can do this during visits and use your social media channels for additional outreach.
Instruction: Instruct clients to bring a fresh stool sample to each wellness visit or whenever the pet has a GI problem. Include the instructions on email and text appointment reminders, so the client sees them multiple times.
Follow-up: Follow up on all fecal sample results, negative or positive. Contact clients personally with positive results, but you can use an email template or automated reply for negative results. Reiterate the importance of continued monthly parasite preventives and routine testing in these communications.
Convenient test options: Clients who forget the sample are unlikely to return with a sample at a later date, which would require an extra trip. However, you can provide clients with a convenient at-home test, including an all-in-one collection kit and a pre-addressed box they can send straight to the reference lab. Studies show such convenient options can increase compliance by 20%.1
Testing all pets for intestinal parasites can improve the health of individual pets and the community as a whole. You can test more patients by educating pet owners on testing's importance, viable sample collection, and why parasite screening should be included in the overall preventive care plan. Making convenient at-home tests available can also increase compliance by eliminating collection hassles and ensuring more of your patients receive the preventive care services they need.
1. Data on file at IDEXX Laboratories, Inc. Westbrook, Maine USA.