Why Chemistry Should Be Part of Your Preventive Care Protocols
In a veterinary practice, chemistry is not only essential for good working relationships among your team but, in a medical sense, also critical for positive patient outcomes. As such, it may be time to consider adding it to all annual wellness visits, along with vaccines, heartworm and tick borne disease testing, and fecal analyses.
As it can be difficult to get our clients and team members on board with new policies and processes, it's wise to re-emphasize the many benefits of including this important screening tool for every patient.
All About the Baselines
By incorporating a chemistry panel that includes electrolytes in every wellness visit, you will amass a good deal of "normal" results for most patients—but "normal" doesn't mean the data is not valuable. Knowing that a pet's potassium is always slightly above normal each year on their preventive care blood work, for example, helps you interpret any changes you find when they are sick.
Tools such as the trend graphs can help show the value of monitoring chemistry analyte and electrolyte concentration over time. Use them to educate your clients about subtle changes in their pet's health that should be closely monitored. Also, make sure to point out that preventive care blood work is most helpful when we get values each year.
Monitoring the SDMA
In the past four years that our practice has been offering preventive care blood work, the single most helpful value I want to know about each patient is their SDMA, especially for cats. Measuring SDMA—a methylated arginine amino acid excreted by the kidneys—in my "healthy" feline patients has completely changed the way I practice feline medicine.
All cats in our practice with an SDMA of even just one unit above normal will return for a blood pressure check and urinalysis. Many will manifest a markedly elevated blood pressure, and getting them on medication early can prevent the progression of kidney damage. Even if their blood pressure and urinalysis are normal, we will continue to monitor their kidney values on a regular basis as they are at risk for further progression of renal disease. Most cats will return one month after the intial elevated values are found and then at least every 6 months after that.
Although kidney disease is thankfully not as commonly recognized in our canine patients, catching the mild increase in SDMA in breeds that are predisposed to renal disease, such as west highland white terriers, also warrant getting a blood pressure measurement and urinalysis.
Getting the Team on Board
Getting buy-in from your team members is the first step in adding chemistry panels to your wellness appointments. Start with an educational campaign for your team about the benefits of getting baselines and monitoring values like SDMA.
Each time you have a case that highlights the benefits of preventive care, talk about it with your team. Sometimes, the most powerful lessons are those that did not have a panel as part of the wellness plan and end-stage disease is found when it's too late for meaningful intervention. Talking with team members about what could have been done to keep the pet from progressing to where they are now can help reinforce the importance of getting baselines, catching changes early and saving time all around.
Offer free annual panels for your team members' pets so they can see the benefits for themselves. Have a resident practice cat? Check their panel each year and talk as a team about the results and the benefit to our furry team members.
Once you have your team on board, they'll be able to recommend chemistry panels and send out reminder texts for preventive care more confidently to your clients. This, in turn, leads to more success in early intervention and overall patient treatment.