Why Veterinary Team Education is Necessary to Maximize the Value of Kidney Biomarkers

Communicating the importance of kidney testing to your team and providing team education so that they are properly trained on kidney testing will help ensure patients get the care they need, and pet owners understand why this care is necessary. Here is an overview of what they need to know and the best ways to deliver it.

What Veterinary Teams Need to Know

Kidney health is vital to patient longevity and quality of life, and veterinarians have become accustomed to using kidney markers to screen and diagnose kidney function in dogs and cats. Kidney markers help with assessing kidney function, detecting kidney injury, and managing kidney disease. The following is a breakdown of the biomakers and their roles that your veterinary team should know.

Assessing kidney function

• Creatinine, SDMA, and BUN are utilized to assess glomerular filtration rate (GFR)
• SDMA concentrations increase with as little as 25% loss of function, compared to creatinine and BUN, which increase only after approximately 75% of functional kidney loss.^2-3
• All three should be included in every chemistry panel to provide veterinarians with the most comprehensive picture of kidney function at any life stage.

Detecting kidney injury

• Cystatin B is a small intracellular protein released into the urine when there is insult or destruction to renal tubular epithelial cells.
• There is now a diagnostic test available for this kidney marker which is indicated for use in unwell patients.
• Testing for cystatin B can reflect injury to the kidney that may not show up as a change in the functional markers SDMA, creatinine, or BUN.^{24, 43, 44}

Managing kidney disease

• FGF-23 is a hormone that controls phosphorous homeostasis.
• FGF-23 is a kidney marker that helps veterinarians with the management and treatment decisions of cats with CKD.

Since kidney biomarker testing has such an important role in patient health, veterinary teams need to understand this and be able to communicate the importance of this testing to clients.

Training for Different Roles

Once the practice is aligned on why kidney biomarker testing is essential, the other critical step is training. This may seem daunting with today's stresses and time limitations, so it's important team members feel supported throughout their education on kidney testing.

First, it's critical to tailor team education for the different roles within the veterinary team. For example, veterinarians can receive information on how to better understand kidney biomarkers, interpretation, and treatment options through webinars and reviews of the SDMA algorithm. This helps veterinarians understand case selection and how to identify cases like acute kidney injury in dogs that were previously undetectable.

For veterinary technicians, training can shift focus to the practical application of biomarker monitoring, sample collection, and client communication. Technicians are also called upon to translate the veterinarian's diagnosis and recommendation to the pet owner in a language that's easy to understand.

Finally, the other veterinary professionals in your practice, like customer service representatives, must be armed with basic knowledge to effectively communicate with clients, schedule appointments, and maintain patient records. This continuity of care strengthens the bond between the client and the practice.

Tailoring Education Style to Your Team

Keep in mind that humans are diverse learners. Creating different types of learning situations is essential to engage team members differently. The goal is effective learning, and the formats that deliver this vary from written articles, videos, recorded webinars, lunch meetings, and case rounds. Often, small meetings incorporating relevant case studies are relatable to the veterinary clinical team and create logical thinking patterns easily applied to current cases to develop habits.

Sometimes, the best learning happens during hands-on training. Working with the veterinary technician team and other team members involved in sample collection and analysis helps to create a more efficient and effective procedure. This includes the logistics of what tubes are required for lab processing, how to process in-hospital and reference lab samples, and low-stress handling techniques to create the least emotional stress for the patient and team.

As with any practice-wide team initiative, encourage open communication and collaboration. Clients feel most supported when they hear consistent messaging from all team members reinforcing the veterinary recommendation and compassionately answering questions and concerns. And, when the whole team has a firm grasp on kidney testing and its importance, they can effectively communicate with clients why this testing is necessary and what the benefits include.

References: https://www.thevetiverse.com/en/latest/sdma-references/