Now YOU Can Choose the Best Veterinary Lighting for Your Surgery Room

When it comes to surgeries, good lighting is crucial.

Without good quality light, it can be hard to see all the details of what you’re working on, whether that’s a spay, a wound repair, and abdominal exploratory, or anything else.

Dim or subpar lighting can make you strain your eyes while trying to place or tie your sutures. And, adequate lighting is important to accurately note the color, texture, and general appearance of tissues for your medical record—that way, nothing gets missed.

Not to mention, good visualization of your field of work keeps you from craning your neck to see better—which can be helpful for your posture and for preventing aches and pains from hunching over. 

Maybe you already understand the importance of good surgical lighting—but did you realize how affordable it is?

In the past, LED lights have been very expensive compared to halogen bulbs—and maybe that seemed cost-prohibitive.

However, new lights are available at 30-40% less (and that includes a better warranty, too).

So, considering the energy efficiency and performance of LED lights, there’s really no competition—affordable, high-quality LEDs are a great investment for your practice.

Plus, many cities, counties, states, and even electric power companies offer rebates for upgrading to LED lights, due to the decrease in power used.

Specific requirements for rebates vary by location—so be sure to check with your local municipality and utility providers to see what’s available in your area. Because it’s always great to get a cash rebate that can help cover the cost of your upgrades!

So, how do you choose the right surgical light?

When it comes to selecting the best surgical light, there are many things to consider…

• Affordability. LED lights are much more affordable now than they used to be, so shop around and be sure you’re getting a good deal (be sure to compare all the other factors on this list, too).

• Quality. Look for dependability, durability, and a good-value warranty to back up your investment.

• Range of lighting brightness, including high-intensity light, and dimming options to use as needed.

• Adjustable. The light pattern can be adjusted from a smaller, focused pattern, to a larger area of coverage, depending on your needs.

• Precision positioning. You should be able to adjust the entire head and arm of the light, and know it will stay precisely where you put it (we recommend limitless arm rotation and a drift-free design that moves easily when you adjust it, but then stays put where you want it).

• Easy to clean (and sterilizable handles are a plus).

• User-friendly, with dimming and focusing controls on or near the handle.

• Shadow-free illumination—or at least a design that minimizes shadows as much as possible.

• Mounting options that match the layout of your surgery room or suite.

What’s our recommendation?

We recommend the new Burton veterinary LED surgery light.

Why? Because this light checks all the criteria above. Plus, it has a dependable LED, is assembled in the USA, and is backed by an industry-leading 5-year warranty.

At a competitive price point that optimizes design, performance, and value, it’s pretty hard to pass up!

Is a Burton light right for you?

When it comes to investing in new equipment for your practice, maybe the lighting isn’t always the first thing on your mind…

However, surgical lighting is something you use many times every week—maybe even several times per day, depending on the nature of your practice.

That’s probably more often than you use some of the other equipment in your hospital.

So, be sure not to overlook this crucial piece of equipment. You may be surprised how better lighting can make your time in the surgery suite more comfortable and efficient.

How a Nomad Pro 2 Dental X-Ray Generator Can Benefit Your Practice

Dental radiographs are an important part of your patients’ dental care. These images allow you to diagnose dental or periodontal pathology, form the best treatment plan, and confirm the successful removal of any extracted teeth.

When it comes to dental x-rays, you have a lot of options in terms of finding a unit that suits your needs and your practice style.

If you’re looking for flexible use and high quality—especially if you’re a mobile practitioner, a practice where space is at a premium, or just like the convenience of a handheld unit—a Nomad Pro 2 dental x-ray generator from Aribex may be right for you.

How Can a Nomad Pro 2 Dental X-ray Generator Help Your Practice?

Every practice has different needs. For example, maybe your practice space or setup dictates the type of equipment that’s best for you. Or maybe the right payment plan, equipment capabilities, or required training for use may help you make your decision.

The following benefits of the Nomad Pro 2 Veterinary dental x-ray generator can meet the needs of many different practice styles and setups…

• Simple and convenient operation. The generator is light to hold and easy to operate. Rather than being attached to a cart, a wall, or any other fixed structure, the generator is handheld, weighing merely 5 ½ pounds (2.5kg). 

An ergonomic grip and an intuitive, simple display for the settings also allow for ease of use.

• Easy setup. There’s no installation or re-wiring required—and no need to renovate your clinic to set up for dental radiographs. With a small, portable unit, you can make any table or space into an effective x-ray station.

• Move the unit, not the patient. You can capture images from any angle, even difficult or oblique angles, without excessive repositioning of the patient. 

• Flexibility for your practice. Capture images anywhere! The cordless, battery-operated unit is suitable for dental, small animal, exotic, and equine use, and for use with film, phosphor plates, and digital sensors.

• Location independence. Choose the best spot in your clinic for dental radiographs, without being limited by tight spaces. Handheld units are also ideal for mobile practitioner needs, and the generator may be used outdoors.

• Safety for staff and patients. The unit operates with low radiation exposure. 

Compare the annual, whole-body radiation exposure between the Nomad Pro 2 dental x-ray generator and other common exposure scenarios:



Internal shielding (which prevents leakage from the x-ray source) and external shielding (to block backscatter radiation) also contribute to safety, protecting your team from unnecessary radiation exposure.

This also means your team member can stay with the patient while taking x-rays.

• Consistently sharp, clear images. Specifications include a 0.4mm focal spot, 60kV DC x-ray generation, and an mA of 2.5. The generator allows your team to quickly capture high-quality images.

• Affordability. The easy setup, without major installation, makes it easy to get started. And simple monthly payments mean the generator can pay for itself each month—so you can start making a profit and return on investment right away.

Tips for Getting Started

• Use the best financing option for your practice. Low monthly payments mean you can make a profit right away just by using your new generator a couple of times per month. 

And if you need an intraoral sensor and software to go with your generator, ask us about an affordable bundle that includes all three.

• Protect your investment. Ask about a warranty for your machine. 

• Invest time informal training. You probably know that new equipment is best utilized if your team feels comfortable using it. By training your team to take all the dental views you need, they’ll be able to comfortably and effectively capture images in a matter of minutes.

• Work the cost of dental x-rays into your estimates. Client education can help your clients understand why dental x-rays are so important with any dental procedure. And by including the cost together with your dental procedures (rather than as an “add-on” service), it helps convey that dental radiographs are a necessary part of your patient care plan.

Envision what it would be like to have a quick and easy dental x-ray system in your practice, to help improve patient care and improve your bottom line.

Any questions about how a Nomad Pro 2 dental x-ray generator from Aribex can fit into your practice space, workflow, or budget? Just give us a call or contact us here!

Mental Health and Work-Life Balance for Veterinary Practice Owners

Veterinary medicine can mean a busy schedule and emotional ups and downs. 

Unfortunately, recent data suggest that this, along with other factors of daily practice, can take a toll mentally and emotionally.

Plus, as a practice owner, there’s the additional pressure of running a business.

You got into this profession because you love pets and want to help them—and that can make for a very rewarding career.

The trick is finding ways to care for yourself. 

This may look a little different for everyone, but here are some popular suggestions that have helped many veterinarians find more energy, wellbeing, and balance…

Set Boundaries

When you love animals, it’s natural to want to help every pet who needs care. But failing to set boundaries can lead to burnout.

In addition to the turmoil it causes in a person’s life, burnout can also interfere with the ability to help pets over the long-term.

Setting boundaries can mean a number of different things, depending on your personal preferences and what your work rules allow. Here are a few suggestions…

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• Put breaks into your schedule

Giving yourself 5-20 minutes to recharge in the morning and afternoon (in addition to your lunch break) can be immensely helpful during a busy day.

• Have clear cut rules for scheduling

For example, is double booking allowed? Can you go to lunch rather than seeing the patient that walks in at lunchtime (assuming it’s not a life-threatening emergency)? 

To accommodate these and other scheduling surprises, it helps to leave a few appointment slots open each day—that way, you have enough time for all patients rather than running yourself to exhaustion trying to fit everyone in.

• Set boundaries with clients

For example, if you give your phone number out to pet owners, be sure they know when and under what circumstances they can call you. 

Or if a client is acting really outrageous and causing stress for all employees, it may be in your team’s best interest to “fire” that client to protect everyone’s time, energy, and morale.

• Say “no” sometimes

This might mean coordinating with another doctor at your practice to take over care of your patients on your day off, so that your team isn’t calling you at home unless absolutely necessary. 

You deserve to enjoy some days off!

Focus On the Positive

Despite your intelligence, knowledge, and passion, some things are out of your control. 

Even with your best efforts, sometimes pets don’t get better—due to the nature of their medical condition, or due to owners not agreeing to the type of care you’d like to provide.

This happens to everyone. And while it’s hard to accept, it may help to focus on all the good memories—all the times you’ve helped pets, all the thank you cards from clients, etc.

Sometimes negative thoughts—whether it’s a client who said something rude or the loss of a patient you care about—dominate our minds. It’s human nature.

But usually, the good days outweigh the bad. It’s just a matter of training our brains to refocus on the positive.

Figure Out What Brings You the Most Fulfillment

Find ways to make your daily work life as enjoyable as possible.

This could mean cultivating relationships with clients. 

It could also mean community involvement, such as charity efforts, puppy/kitten classes, or informational talks on pet nutrition or other topics.

Fulfillment may also mean specializing, or being the “go-to” doctor in your practice for specific procedures or medical conditions that you enjoy working with.

Cultivate Joy 

In addition to professional fulfillment, it’s important to cultivate joy in your personal life.

This means some type of human connection—whether that’s a partner, friends, or family. 

If you’re working long hours, it’s easy to feel isolated. By doing your best to schedule time with people you care about—even just a quick phone call—you may find that your mood lifts.

Additionally, physical activities, hobbies, learning new things, and other pursuits outside of work can remind you that “there’s more to life.” 

This makes it easier to reframe a bad day as something that, while hurtful, is probably small in the scheme of things.

Schedule Time to Slow Down

If you need to sleep or binge-watch a show after a tiring week, go for it! 

Or find time to read a book, take a bath, or meditate.

In addition to activities that bring you joy, scheduling “slow time” may help you feel centered, recharged, and in control of your schedule.

Seek Out Support

It’s helpful to find caring people who can listen.

Depending on your needs and circumstances, this may include…

• Friends and family.

• Colleagues you trust.

• Veterinary support groups such as… 

  • Vets4Vets®

A confidential support group for veterinarians associated with the VIN Foundation, which includes everything from weekly group discussions to one-on-one support.

• Not One More Vet 

An online support network of over 20,000 veterinarians with additional resources, including support in finding temporary relief workers for vets who need a few days off.

• A therapist or counselor. Nowadays, there are convenient and reasonably priced online services such as Talkspace and BetterHelp. 

Sometimes, just venting to someone in a safe, confidential setting can really lift the weight off of a person’s shoulders.

• The National Suicide Prevention Lifeline: 1-800-273-TALK (8255), or text 741 741 to speak to a trained crisis counselor.

The Truth About Balance…

The thing about balance is, it’s dynamic, not static. 

That means that as you go through different stages of life, your schedule, priorities, and tricks for recharging yourself may change. The key is to be aware and to adjust as needed.

The better you care for yourself, the better you’ll be able to care for pets—and the more joy you’ll get out of your daily work and personal life.

Resources:

• Vets4Vets: https://vinfoundation.org/resources/vets4vets/

• Not One More Vet: https://www.nomv.org/

• Talkspace: https://www.talkspace.com/

• BetterHelp: https://www.betterhelp.com/ 

• The National Suicide Prevention Lifeline: 1-800-273-TALK (8255), or text 741 741 to speak to a trained crisis counselor. 

Written by: Dr. Tammy Powell, DVM

7 Tips for Managing Money in Your New Veterinary Practice

Learning to manage money—including balancing your budget, planning your taxes, and tracking all expenses—is a daunting task for any new business owner. And veterinary practices are no exception.

However, healthy finances are necessary for your practice to grow and thrive.

Think of Accounting as Part of Your Strategy

With all the work that goes into opening a veterinary practice—not to mention your busy schedule seeing patients—it’s understandable you might want to ignore your practice’s balance sheets or just assume you’re doing okay if you’re not out of money at the end of the month.

However, much like a personal budget, keeping track of your business revenue and expenses can help you make the most of your money.

It allows you to focus on your goals—like investing in better equipment or hiring new team members, all for better patient care. 

It can even help you maximize your practice’s valuation, for that far-off day in the future when you may want to sell.

Importantly, knowing where you stand also helps you feel in control—so you can confidently “steer your ship” through good and bad economic times alike.

Here are some tips for taking on your practice’s financial duties…

1. Learn Basic Bookkeeping and Financial Terms

Do you know what it means to set up a profit and loss statement?

What about cash versus accrual style accounting? And how is cashflow different from profits?

If these terms sound like a foreign language to you, you’re not alone. There’s a lot to learn when you’re just starting out managing finances for a business.

Like any field, it helps to start with the basics. 

This will allow you to understand more complex financial concepts in the future, and to properly categorize all your expenses and revenue for accurate records.

2. Ensure You Have All the Proper Legal Paperwork

If you’ve formed a corporation, there is always paperwork involved. This may include not only your paperwork to create a corporation, but also certain forms regarding your tax classification (for example, LLCs have the option to file taxes as S corporations).

You’ll also need the correct forms required by your state, county, or city to operate your business. At the very least, in addition to veterinary licenses, this probably includes a local business license and forms that authorize you to collect taxes from your clients on taxable goods or services.

All of this may vary a lot between states or cities, so it’s important to research what is required for your location. Failing to do so, and to renew when needed, could result in financial penalties.

3. Keep Business and Personal Finances Separate

Mingling personal and business finances make it impossible to really see how your business is doing.

Also, it may carry financial risks. You could lose tax benefits such as deducting business expenses. 

Depending on which type of business you’ve set up, you could even face personal liability (rather than having liability protection through your corporation) if you are sued. 

To avoid these issues, it’s crucial to keep your personal and business finances separate.

The easiest way to do this is by having entirely different bank accounts for yourself and your veterinary practice. And if you need to use a credit card, have separate business and personal cards.

By maintaining this separation, you’ll never accidentally mix your personal and business transactions.

There are ways to withdraw money from your business to use for yourself, such as when you pay yourself a salary. But it’s important to check that you’re following all of the legal rules and tax considerations for this.

4. Track Everything in Real-Time

Don’t be the person who shows up at their accountant’s office two weeks before April 15th with a giant box of unsorted receipts…

Rushing at the last minute is inefficient. It prevents you from setting goals, seeing where you stand throughout the whole year, and planning for certain tax benefits.

So stay on top of your bookkeeping year-round.

5. Find a System That Works for You

You may have heard of common accounting software like QuickBooks. You may also have some accounting capabilities in your veterinary practice’s software.

Do some research and see what works best for you. 

Try to automate whenever possible—i.e., use a system that automatically syncs with your expenses and revenue, so you don’t have to enter numbers manually.

6. Consider Working With a Professional

Many business owners outsource their financial tracking to a CPA or other qualified professional. 

This makes sense. It saves you time and allows you to focus on what you really want to do—care for animals—rather than spending hours on tedious number crunching. 

Plus, you have the security of a knowledgeable professional who can ensure everything is done correctly (some even offer guarantees to defend you if you’re audited), and offer additional tax and financial planning strategies you might not have thought of on your own.

Also, a financial professional may be more likely to spot mistakes or missing money—whether accidental or due to something like an employee pocketing cash or merchandise.

Nowadays, there are even CPAs who specialize in the veterinary industry and understand your needs as a practice owner. 

7. Track Your Goals

One of the biggest benefits of managing your finances is that it allows you to accomplish your goals.

Rather than leaking cash here and there, you know exactly where every dollar is going—so you can use your money the way you want to use it to grow your practice.

Even if you’ve outsourced to an accountant, check in with them on a regular basis. Explain your goals so they can work with you to make it happen.

Knowledge is power. When you take control of your practice’s finances, you’ve taken a powerful step toward success and realizing your dreams as a practice owner.

Written by: Dr. Tammy Powell, DVM

Location and Real Estate Considerations When Opening a Veterinary Practice

When starting your own veterinary practice, location is one of the most important decisions you make.

Here are some considerations to help you pick the perfect place…

Where Do You Want to Be?

If you’re firmly rooted in your current location—due to family or a strong tie to the community—then go ahead and explore the options in your town or nearby within a reasonable driving distance.

But, if you’re more flexible, looking outside your city may present more options to choose from.

If you’re staying close to home, remember to look at the non-compete clauses of all the practices you’ve worked for recently. 

What Do You Need to Consider About Your Desired Location?

So, you have an idea of where you’d like your future practice to be. But, how do you know that location will be sustainable for your new business?

Evaluate your potential location(s) for…

• Visibility/prime location in the community. 

A high-traffic area may help new clients find you. But, a prime location can also be more expensive.

• Ease of access. 

Is it convenient to reach your practice from the road? Is there plenty of parking? Is there a spot for dogs to go to the bathroom?

• Is there enough space? 

Consider anything you might want to add in the future (such as a boarding facility)—will there be enough room on the property for this?

• What’s the veterinary community like? 

Is the area already saturated with the competition? Or, is there room for one more? 

What will differentiate your new practice from other veterinary businesses in the area?

• What’s the clientele like? 

Is the average income in the area consistent with the prices you’re planning to charge for your services?

• Which businesses are your neighbors? 

A dog grooming salon could be a perfect neighbor to form a mutually beneficial relationship with. On the other hand, sharing a wall with a club that plays loud music might not be good for keeping pets calm.

• Is the population growing or declining?

For many of these considerations, it’s best to work with a veterinary or start-up consultant. 

Do You Want an Existing Practice, Or Something Totally New?

Many experts report that existing practice is favored by lenders since there will already be an existing, provable business structure and cash flow. 

But, the disadvantage of this option is that it may be harder to make changes and create a practice that’s truly your own. Existing staff and clientele may be expecting things to be done the same way they’ve always been done.

Here are some important questions if you’re thinking about buying an existing practice…

• How was the asking price calculated? 

You’ll also have the chance to get your own valuation with a consultant, to be sure the price is appropriate.

• What’s included with the sale, and what isn’t? 

Don’t assume the x-ray machine and other equipment are included (and in good working order), only to find out they’re not.

• Why is the current owner selling? What are their plans for their own career after the sale?

• Are there any special terms or conditions?

Other buying options include:

• an existing non-veterinary structure

• or building your own practice from the ground up.

Each of these options has its own pros and cons.

When purchasing an existing non-veterinary building or unit, look into what sorts of renovations are needed to create space for major equipment, a surgery suite, exam rooms, etc.

This may be a good in-between option that allows you to build your own practice culture, and that’s less expensive than starting from scratch with a new structure—assuming the renovations aren’t price prohibitive. 

If you decide to build your own practice, you’ll have the most freedom in terms of seeing your own dream practice come to life.

But, this option can be very expensive, and it will take time to build a clientele. You’ll need a solid business growth plan to show lenders they can take a chance on you.

Should You Rent Or Buy?

Here are some things to consider about renting…

• A leased space may be less expensive than buying (according to some consultants, your loan will be half or even just a quarter as much as buying a practice).

• You may be limited in renovations and expansion potential.

• How and when will the rent go up?

• Are repairs (such as a plumbing leak) covered by you or the landlord?

When buying, think about these factors…

• Is the higher loan amount realistic for your immediate income needs?

• Will the current owner cover repairs that are needed right away? You certainly don’t want to buy a practice only to discover an expensive foundation or roof repair is needed!

How Do You Figure All of This Out?

If you’re working and have your hands full with a packed appointment schedule, you may be wondering how you’ll find the time to do all this research and make an informed decision.

That’s where the right consultant (or team of consultants) comes in. Experts you work with may include a: veterinary consultant, start-up consultant, veterinary practice appraiser/valuator, accountant, banker, architect, real estate agent, attorney.

Every situation is unique, so your list of consultants may look different than this. In general, try to find professionals who have experience with veterinary practices and understand the nuances of your industry.

All of this may take time, but it’s important to have patience. Rather than rushing into something that isn’t quite what you wanted, you’ll be excited the day you open the doors to your dream practice!

Written by: Dr. Tammy Powell, DVM

Five Essential Veterinary Practice Financing Questions

When it comes to opening your own veterinary practice, financing may be one of the most important—and most daunting—hurdles to overcome.

Since most practice-owners-to-be don’t have a large cash reserve saved up or an angel investor waiting in the wings, chances are you’ll need to look for financing.

Every situation is different, and working with financial experts and veterinary consultants can help you make the best decision for your future.

Here are a few good questions to ask yourself along the way…

What Do I Need Financing For?

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Evaluating the following factors can help you figure out how much you’ll need to borrow…

The Practice Space

The most obvious thing you’ll need to finance is the space in which you intend to practice.

This could mean acquiring an existing practice, leasing a new space, or breaking ground and building your own practice from the ground up.

Less commonly, this could also mean a buy-in option at a practice where you currently work as an associate, or even a franchise opportunity.

Major Equipment

Your veterinary practice can’t operate without equipment like an x-ray machine, exam room tables, surgery lighting, a dentistry unit, computers, and more…

Fortunately, you have options

Financing may be available directly from the equipment seller, or from a bank (often called a “capital lease”), so you can pay as you go and start making a return on your investment right away. 

Also, consider purchasing used equipment. Sites such as usedvetequipment.com offer high-quality used equipment you can score at a great bargain.

Daily Supplies

All those little costs add up, including needles, syringes, pharmaceuticals, cleaning supplies, surgical scrub, gloves, and anything else you need for your practice’s daily operation.

Other Operating Costs

When making a business plan, don’t forget to factor in costs such as wages, insurance, utilities, landscaping, licenses, and more.

How Much Can I Afford to Live On?

Most new businesses don’t make a profit for the first 1-3 years… and unfortunately, veterinary practices are no exception.

It takes time to grow a business to the point where the money coming in each month is more than your expenses. And until that happens, you might not be taking home a salary.

This doesn’t impact everyone in the same way, though. For example…

• Purchasing an established practice may mean you have more clients initially than if you start up a brand-new practice.

• Some new practice owners have a spouse whose income can cover all of their household expenses in the meantime, while others do not.

• You may have other life factors that limit you from taking risks with a new business, such as dependents or health considerations.

If owning a practice is your dream but you’re concerned about limited income while your practice gets up and running, talk to a veterinary consultant to figure out if practice ownership is right for you, and see what’s the safest path for you to realize your dream.

How Do My Student Loans Factor In?

According to an article in Today’s Veterinary Business, veterinary lenders don’t typically expect you to have your student loans paid off before you start a practice of your own. 

That makes sense because with today’s growing costs of veterinary education, paying off student debt quickly isn’t always a realistic expectation.

However, be sure your student loan and other debts are in good standing. Very few lenders are going to trust you with a practice loan if your student debt is in default.

And, of course, you’ll have to factor your student loan payments into your own income needs and overall financial picture.

When in doubt, it never hurts to find out more, rather than assuming student loan debt would prevent you from starting the veterinary practice of your dreams. You’ll never know for sure if you don’t do the research.

Where Do I Find a Good Lender?

There are some veterinary-specific lenders out there. These businesses can be a good option because they understand your industry and may have realistic expectations in terms of starting costs and a repayment timeline.

Small Business Administration loans (government-backed lending funded and serviced by banks) may be another good option, with flexible terms and conditions.

And, local banks or lenders may offer great customer service and community knowledge. 

So, explore your options and see which lender works best for you. 

Ask a lot of questions to see what your lender’s customer service and communication style are like, and to find out important information such as…

• The required down payment.

• The term of the loan.

• The interest rate.

• Fees associated with the loan.

• Penalties for late payments or pre-payment.

• Any available special arrangements, such as graduated repayments (loan payments that start small when your business is new, then gradually increase over time as your business becomes more established and successful).

In general, many lenders require a business plan and financial projections to fund your new practice. 

How Do I Figure All of This Out?

While there are never any guarantees when you start a new business, doing your due diligence before you finance will help you make the best possible investment.

This will likely involve a CPA or financial advisor, a veterinary management consultant, and experts in demographics and feasibility for new practices—to name a few.

These experts can offer invaluable advice, and also help you with the business plan and financial projections you’ll need.

Be sure to put in the time to research. And, invest in expert advice to help you make the best decisions for yourself and your future.

If you need help with financing, Call me - I can help you - 530-722-4977 Brad Haven, Jr.

Written by: Dr. Tammy Powell, DVM

Starting a Veterinary Practice: The Importance of Your Online Presence

You might have the best veterinary clinic in the world, with stellar medical care, an amazing team, and great customer service…

But, for clients to bring their pets to you, those clients must be able to easily find your practice and learn how great it is.

So, when you open a new veterinary practice, how will your clients find you?

The First Place Your Potential Clients Will “See” You

In modern times, many pet owners locate and research their next veterinarian via an online search.

That’s even more true during the 2020 pandemic, when physically “stopping by” a veterinary practice to meet you is difficult.

Even if you have a prime hospital location with a lot of foot traffic and nearby businesses, pet parents who see your hospital in passing will probably Google your practice before bringing their pets to you. So, it’s still important to have a strong online presence.

For that reason, we’re talking about websites and social media in today’s article. 

Because even though you’ll have a lot of important decisions to make before you open your practice—such as financing, equipment, staffing, and more—it’s never too early to start thinking about messaging and marketing strategies for your clinic’s success.

Your Veterinary Practice’s Website

Think of your practice’s website as an online hub where clients can come to learn more about you, your staff, your services, and your facility.

But, creating an effective website can be tricky. There’s a lot to think about, including searchability. 

And, it’s crucial to make sure your website paints a clear picture of who you are and all the wonderful things you do to help pets.

Here are a few tips to help make your practice’s website effective…

• Use warm, inviting photos and images. 

For example, images of your caring team members—smiling, in action, and holding cute pets—is much more effective than a picture of the outside of your hospital. 

This creates the right mood for your website and also helps potential clients know what to expect when they bring their dog or cat to see you. 

Just remember: If using pictures of client-owned pets on your website, get the client’s permission in writing first.

• Focus on your clients’ needs and wants. 

When writing about your practice, be sure to include your experience, expertise, and services offered… But, don’t forget to tell clients HOW these things benefit them. 

For example, instead of saying, “We have 40 years of combined experience,” say, “Our 40 years of combined experience means your pet will receive excellent care from experienced veterinarians.”

• Make all key information easy to find. 

Place your practice’s physical address and contact information right at the top of the page, where it’s easy for a potential client to find it.

• Pay attention to SEO. 

SEO stands for search engine optimization, and it’s what makes your practice’s website show up higher in Google’s search results (which makes it easier for clients to find you!). 

Don’t worry, you don’t have to be an expert in SEO… Actually, it’s a pretty broad field that can take some time and dedication to truly master. And, it’s constantly evolving.

But it’s important, so consider hiring a consultant—or, if you’re creating your own website content, at least be familiar with SEO basics. 

We’ll have an article with more details on SEO basics later in this series, so keep an eye out for that.

Do You Need Social Media?

Social media is an excellent way to extend the reach of your website.

By posting on Facebook, Instagram, or other social media platforms, your posts can make pet parents smile and prompt them to learn more about you by following a link back to your website.

However, the world of business-related social media may seem nebulous and confusing if you’re new to it…

So, we’ll have a more in-depth article on social media further into this series. But for now, here are a few things to keep in mind…

• Start with one platform at a time. 

If you try to master Facebook, Twitter, Instagram, LinkedIn, and more all at the same time, you’ll probably feel overwhelmed—and then give up. So, just start with one platform. When you feel comfortable, consider expanding. 

On that same note, set a realistic schedule for how often you are going to post.

• Where do your potential clients spend the most time? 

Facebook is a very common and effective platform. But, if you have a younger clientele, maybe they spend more time on Instagram and would be more likely to see your posts there? 

A veterinary consultant or marketing expert could help you determine factors like this.

• Use photos or images as much as possible. 

Images are more likely to catch attention than posts that contain just text. 

As with your website, obtain a client’s permission if you post their pet’s picture.

• Try to engage your followers. 

Ask them questions, ask them to post pictures of their pets, and so on—anything that encourages them to interact with you in a positive way.

While you’re planning the veterinary practice of your dreams and working out the more material aspects of financing, equipment, and so on, go ahead and start thinking about how you want potential clients to see your practice.

Think about your practice’s philosophy and culture, as well as the impact you would like it to have on pets and pet owners in the community.

Then, think of how to express that message in everything you do online—on your practice’s website and all of your social media posts.

That way, new clients who find you online can get to know you and feel happy about scheduling their pet’s first visit.

Written by: Dr. Tammy Powell, DVM

Tips for Starting a New Veterinary Hospital or Clinic

If you’re looking to start your own veterinary practice, congratulations!

You’ll have a lot to think about and plan. But, there’s nothing like being able to run your practice exactly the way you want to—to make your dream come to life.

This article is the first in a 10-part series discussing the different aspects of practice ownership—everything from location, to staffing, to equipment, to marketing.

This will help you think through some of the key decisions that come with opening a practice of your own.

Veterinary Practice Location

Of course, one of the very first questions you might ask yourself is where your new business should be located.

In some cases—such as if you have a spouse with a long-term local job commitment—you may not be able to relocate.

But, even then, you could look at nearby cities within an hour’s drive (or, however long of a commute you are willing to make).

Whether staying in place or relocating, when looking at your desired location, here are some things to ask yourself…

• What’s my ideal clientele? 

When looking at local socioeconomic factors, does this line up with the level of care and pricing strategy you intend to offer? Also, is your clientele younger and more likely to want things like telehealth and online appointment scheduling?

• What’s my competition? 

Knowing whether your ideal location is already saturated with veterinary hospitals can help determine whether it’s wise to open a new practice there—or, at least help you think of some way to differentiate your practice from the crowd.

• Which logistics do I need to consider? 

For example, what’s the parking situation like? Are you conveniently located near major roads or shopping areas? And, where on the property can dogs go to the bathroom?

Services Offered

Are you a general practitioner? A specialist? 

Knowing EXACTLY what you offer will help determine where you fit within the local community.

For example, a neurologist or ophthalmologist may fit in nicely even if the area is already filled with GPs.

And, if you are a GP, maybe there’s some other way to distinguish your practice and provide something new and unique to the community. For example…

• Emergency hours.

• Urgent care hours.

• Care for exotic pets.

• House calls.

• Hospice care.

• Acupuncture or holistic care.

• Large animal care and farm calls.

Will You Be On Call?

Depending on your state’s practice license requirements, you may need to provide access to 24-hour pet care—whether at your hospital alone or by recommending a local 24-hour facility to your clients.

So, if you don’t intend to be on call for emergencies, research what’s available in your area to fill this need for round the clock emergency services.

To Build or Not To Build?

Do you want to build an entirely new facility, tailored to your specific vision? 

This may be to your benefit, especially if you want to integrate some of the Fear Free standards for lighting, insulation, separate entrances, and more.

On the other hand, you may have found a practice for sale at a location that’s hard to beat, with an established clientele.

While less common, franchising may also be an option.

In any case, you’ll also have to decide whether to buy or lease the property.

The Legal Stuff

If you don’t have the right business permits and licenses, that could result in severe financial or disciplinary penalties.

You’ll need to research what’s required in your area, but examples include…

• Veterinary licenses for yourself and all associates.

• A veterinary practice permit.

• Local business licenses for your city or state.

• Registration for taxes.

• Forming an LLC, corporation, or other legal entity.

• A DEA license for controlled substances.

And in addition to licenses and permits, you’ll also need to plan for…

• A CPA or other professional for bookkeeping, financial planning, and filing your taxes.

• Liability insurance.

• Occupational health and safety requirements (OSHA).

• Hazardous waste and EPA requirements.

• Employment contracts.

• Developing a business plan.

Considerations for Modern Times

Modern times have resulted in the need for changes to the way most veterinarians practice.

At the time of this writing, curbside service is the norm because of the coronavirus pandemic. And, telemedicine is being added to many practices.

Because of the convenience of telemedicine in your clients’ busy schedules, many pet owners may expect this service to continue even after social distancing precautions are lifted.

So, what modern services and conveniences do you think your potential clients will want? How can you stay competitive?

It’s Best to Work With A Consultant

Before you make a big investment, it’s a good idea to work with a consultant—or, more likely, a team of several experts and advisers.

These specialists can walk you through legal, financial, demographic/feasibility information for start-ups, valuation for the sale of established practices, HR management and compliance, real estate, equipment and supplies, and various other aspects of practice ownership.

This will not only save you time but also ensure you’ve considered all angles and have the best chance of finding success as a veterinarian and business owner.

One helpful resource is Vet Partners, where you can search for experts and consultants by location and specialty.

Look for veterinary consultants, and for businesses (such as banks and real estate agents) who are used to working with veterinary practices and understand the nuances of your business.

Also, consider talking to other veterinarians who have been in your shoes and purchased a practice recently, who can share the wisdom of their experience. 

How Will Your Clients Find You?

Once you establish your dream practice, you need to ensure new clients know you exist, and that they want to bring their pets to you.

In this day and age, your online presence (your website and social media) will play a large role in helping new clients find you.

So, in the next article, we’ll have some tips for making sure your online presence truly conveys how great your practice is.

Stay tuned!

Written by: Dr. Tammy Powell, DVM

Fear Free Certification® for Your Veterinary Practice

As a veterinarian, you go out of your way to make your patients comfortable. 

So, if you can do something to help dogs and cats have a better, less stressful doctor visit—while also giving your practice a competitive advantage—it’s a win-win!

Fear Free Helps Patients and Clients

Fear Free is a voluntary set of standards that can be implemented to the benefit of your patients’ mental and emotional health. It helps dogs and cats feel more at ease while visiting your practice.

As the Fear Free motto says, you’ll be “taking the ‘pet’ out of ‘petrified’.”

This improves your patients’ wellbeing. It can also make it easier for clients to bring their pets to see you since clients are more comfortable when their pets are at ease during a visit.

Also, Fear Free principles involve client education and empowerment. There are even online resources you can recommend to clients at Fear Free Happy Homes.

What Does It Mean to Be Fear Free?

Fear Free involves alleviating fear, anxiety, and stress in pets. To do this, it’s important to think about the visit from a pet’s perspective.

Along these lines, there are a few different aspects to think about for your practice, including…

• A pet’s physical and emotional comfort. To improve their experience, you could…

  • Have a calm, quiet place for treatments and procedures, with nonslip surfaces on floors and tables.

  • Use treats to distract pets during any unpleasant procedures such as vaccines or blood draws.

  • Make all needles single use only (i.e. change to a new needle to administer a vaccine after drawing it up).

  • Offer elevated platforms and hiding places for cats.

  • If possible, use separate entrances and waiting rooms for dogs and cats.

• Consideration for a pet’s sensitive nose. 

  • Clean with products that don’t have irritating, residual odors or cause “nose blindness” (this is where a strong odor causes temporary loss of a pet’s ability to explore the environment via smell, and this can create fear or nervousness).

  • Use pheromone products.

  • Consider air sterilizers to reduce odors that may be distressing to a dog or cat, such as odors of other pets, cleaning supplies, etc.

• Consideration for other senses such as hearing.

  • Instruct all staff to use calm behavior and “inside voices.”

  • If possible, integrate insulated walls to block noises from barking, or background noise from medical equipment.

• Client education.

  • Schedule appointments in a way that not only gives enough time for pets to acclimate to the environment but also allows for non-rushed appointments and adequate client education.

  • Make take-home Fear Free resources available to clients.

• Medical records.

  • Add standardized measures of the patient’s emotional health, physical pain, and level of stress during each visit to the medical record.

  • Use this information to improve a patient’s experience and emotional health.

• Team culture and training.

  • Educate all team members on Fear Free principles, and use standard operating procedures.

  • Recognize and celebrate successes.

• Maintaining a high standard of Fear Free care.

  • Teach staff to observe a pet’s body language so improvements can be made if a pet shows signs of fear, anxiety, or stress.

  • Include pre-visit preparation to help clients bring their pet in as calm a state as possible.

How to Seek Fear Free Certification®

If you decide to implement Fear Free principles, you can seek certification. 

This certification is something you can display so clients understand the measures you’ve taken to set yourself apart as a practice, and how it all makes for a better experience for their pets.

Fear Free Certification® can be sought by individual veterinarians, by pet professionals (trainers, groomers, etc.) and by animal shelters.

You can also seek certification as a veterinary practice.

Individual certification is great. But, certification of your entire practice promotes Fear Free culture as a part of everything your team does.

To seek certification, check out the Fear Free website, where you can do a self-assessment, and when you’re ready to schedule an onsite visit with a Practice Certification Veterinarian to get your Fear Free Certification®.

Certification even includes marketing materials, to help you show off your amazing achievement to clients so they understand the value you deliver.

Written by: Dr. Tammy Powell, DVM

Ultrasound Techniques: Visualizing the Adrenal Glands

The adrenal glands, those tiny but very important glands, can be tricky to find and evaluate during an ultrasound exam.

However, having a system and knowing where to look can make your job much easier.

There are many reasons you want to visualize the adrenal glands on every scan, including checking for neoplasia and other masses and looking for any changes that could be associated with Cushing’s or Addison’s disease.

Here are some tips to help save you time and allow for a clearer view of these small glands…

Have a repeatable system

When you perform an abdominal ultrasound, it’s important to have a systematic approach to look at everything. And that includes keeping small structures like the adrenal glands and abdominal lymph nodes on your list, so they don’t get overlooked.

Do your scan in the same order every time—whether that’s cranial to caudal, clockwise, or some other system that works for you—and it’s much less likely that anything will be missed or any abnormalities overlooked.

Adrenal gland landmarks

The right and left adrenal glands are respectively located near the right and left kidneys. However, the kidneys are relatively large, whereas the adrenal glands are small. So, the kidneys can overshadow these small glands.

The kidneys are the first things you’ll locate because they’ll point you in the right general direction. After that…

Vascular landmarks are most helpful when it comes to locating the adrenals.

Specifically, the aorta, caudal vena cava, renal vessels, and mesenteric artery are what you’re going to be looking for.

Color Doppler can help you visualize the vessels.

Also note, if the patient allows you to apply gradual pressure, it helps to minimize the distance between your probe and the glands as much as possible.

Finding the LEFT adrenal gland

The left adrenal gland is located ventrolateral to the aorta and cranial to the left renal artery. 

Start by scanning the left dorsal mid-abdomen and visualizing the aorta in a long view. 

Find the spot where the left renal artery branches off from the aorta, and just cranial to that you’ll see the left adrenal gland.

Finding the RIGHT adrenal gland

The right adrenal gland is dorsolateral to the caudal vena cava, and just cranial to the cranial mesenteric artery. It’s also more cranial and dorsal compared to the left adrenal gland.

Scan the right cranial abdomen, with the caudal vena cava in long view.

Apply some pressure with the transducer which will cause compression of the caudal vena cava and help you visualize the right adrenal gland. The gland is right next to the vessel, slightly oblique to it.

Are the adrenal glands normal?

Evaluate the qualitative properties of the gland, and then measure the glands from their cranial pole to caudal pole. Also, measure the thickness of each pole.

Normal adrenal glands are hypoechoic to surrounding fat, and have a characteristic “peanut” shape (although the right adrenal may have more of an “arrowhead” appearance). Typically, adrenals are 4-7mm thick in dogs and 3-4mm thick in cats. 

Abnormalities may include…

• Evidence of hyperadrenocorticism. 

  • If pituitary-dependent, the adrenal glands may be normal in appearance, or they may be “plump” (symmetrically enlarged). An ultrasound exam alone is not enough to diagnose Cushing’s, but may be helpful in context with additional diagnostic tests.

  • If adrenal-tumor related, you may be able to visualize a mass. 

• Evidence of Addison’s disease or hypoadrenocorticism.

  • You may notice smaller or thinner adrenal glands. As with Cushing’s, you’ll want to use this information in conjunction with clinical symptoms and other diagnostic tests.

• Adrenal masses.

  • Many are incidental findings only.

  • Pheochromocytoma is a possibility.

  • Malignancies are possible and may lead to invasion of adjacent tissues, especially blood vessels. 

  • You’ll use your clinical judgment and the patient’s clinical signs to help you determine whether more diagnostics are needed, or to start by monitoring the growth with repeat ultrasound exams over time.

• Age-related changes.

  • Nodular changes and remodeling may be normal in old adrenal glands. Practice will help to develop clinical judgment of what’s normal and what’s not.

The ability to find the adrenal glands quickly will come with experience, and knowing the right tips and techniques will make it easier to get the information you need even when you’re first learning.

Written by: Dr. Tammy Powell, DVM

Patient Injury & Complications In Veterinary Dentistry

The nature of anesthesia brings risk in general. In veterinary medicine, during dental procedures, pets are often placed in vulnerable positions which can lead to increased risk of injury and medical complications.

These risks can be minimized or entirely avoided with careful consideration, and proper training and continuing education of staff. Listed are a few of the more common injuries that can occur during a dental procedure.

Aspiration Pneumonia

Aspiration pneumonia in pet patients occurs when the patient inhales a foreign substance and develops lung inflammation and infection as a result.

The most common occurrence during dentistry is water and debris entering an unprotected airway, hence allowing fluid and debris to enter the lungs. This can occur from an underinflated tracheal tube, or repositioning during the procedure that allows fluid to enter the airway.

Aspiration pneumonia can also occur if the patient vomits or regurgitates during anesthetic recovery.. To reduce the incidence of dental-related aspiration pneumonia, maintaining the patient on their back during the procedure, and avoiding repositioning has proven to not only lessen the risk of aspiration but also lessens the amount of anesthesia needed during the procedure.

In addition, antiemetic medications given during the premedication phase can help reduce the incidence of post-anesthetic nausea and vomiting. Caution should be taken during the recovery phase to wait until the patient is alert and responsive enough to deflate the cuff and remove the tracheal tube.

Tracheal rupture

Tracheal rupture in dogs and cats are more frequent during dental procedures than any other medical procedure. Seventy-five percent of tracheal ruptures are thought to be associated with oral surgical procedures with the incidence more common in cats than dogs.

Tracheal injury can cause symptoms such as mild dyspnea, and even death. The most likely cause of tracheal rupture is thought to be due to an overinflated tracheal cuff, as well as failing to detach the tracheal tube from the anesthesia hose during repositioning, which can cause a torque on the inflated cuff resulting in a tear of the dorsal membrane of the trachea.

Another common cause of tracheal rupture is a patient that is not adequately anesthetized and coughs or lunges upward during intubation, tearing the trachea.

Pressure from an overinflated cuff can cause pressure necrosis of the trachea, showing delayed symptoms of inflammation and scarring.

Avoiding over-inflation of the cuff, using new tracheal tubes, testing the cuff to ensure proper inflation prior to use, avoiding repositioning as much as possible, and ensuring a level plane of anesthesia prior to intubation can help minimize the risk of tracheal rupture.

Artery Damage during Tooth Extractions

Arterial damage to arteries such as the palatine artery which runs the length of the mandible can accidentally occur during routine tooth extractions where the instrument can slip from the practitioner’s hand.

These injuries can be mild to more severe requiring surgical intervention.

The most effective way to avoid this type of injury is to implement extraction techniques involving gingival flaps where the roots are exposed, and more easily undermined, and extracted. 

Written by: Dr. Tammy Powell, DVM

Take The Frustration Out Of FORLs

To extract or not to extract that tooth root?

Is a crown amputation all that’s needed?

When it comes to feline odontoclastic resorptive lesions (FORLs), these may be the questions you’re asking yourself.

FORLs can cause loss of the protective surfaces (enamel, cementum, and dentin) of both the crown and the root(s) of a tooth, resulting in pain.

These lesions come in two varieties:

• Type 1: Where the root appears radiographically normal.

• Type 2: Where the root is radiographically hard to distinguish from the surrounding bone, with loss of visibility of the periodontal ligament space.

As you know, the treatment for these lesions is different—full extraction of the root(s) for Type 1, versus just a crown amputation for Type 2.

Performing a crown amputation and leaving a root in place for Type 1 could result in problems or complications, not to mention continued pain for the patient.

On the other hand, trying to extract the root of a true Type 2 lesion could be a monumental task and a big headache.

So, it’s very important to determine what type of lesion you’re dealing with. Here’s how…

Diagnosing FORLs

Patient presentation

A client brings their pet to you because of halitosis, food dropping, and occasional jaw chattering. 

During the physical exam, you notice bright red, inflamed gums and gingival hyperplasia near one of the mandibular premolars. 

You suspect a FORL—and given that FORLs are one of the most common dental problems in cats, you’re probably right.

You suggest a dental procedure, including dental radiographs, a full cleaning, oral exam, and possible extraction. The client agrees with the plan.

The day of the procedure

After the patient is anesthetized, your technician obtains radiographic images of the entire mouth, which takes just a few minutes to perform.

Then, you look at the radiographs in conjunction with your oral exam.

While probing the tooth in question, you feel a rough patch under the gingival hyperplasia, consistent with a resorptive lesion.

The x-ray confirms your diagnosis. 

Determining the best treatment plan

In this case, the patient’s tooth is clearly Type 1, with a periodontal ligament space still visible. So, you perform a full extraction.

While evaluating the dental rads, you also notice the premolar on the opposite side is starting to show radiographic evidence of a lesion.

Even though it’s mild, you call the owner and inform them of the likelihood of progression. 

To prevent a painful lesion from developing between dentals, the owner decides to go forward with a pre-emptive extraction of that tooth as well.

Documenting the extraction

In addition to being an integral part of your treatment plan decisions, dental radiographs can also help you document that extraction was performed successfully.

A post-procedure x-ray image is a great way to document that there are no root tips left behind.

And, in cases where a crown amputation was indicated, dental rads provide visual proof that this was an appropriate treatment course.

In this way, dental radiographs not only help you to plan and implement a very high quality of medicine—but they also give you peace of mind and are a valuable part of your medical records.

Talking to clients about dental radiographs

Maybe you already know the benefits of dental radiography—but you’re concerned about discussing the additional cost with clients. 

Often, it helps to include the x-rays as part of the dental procedure package. List them on the estimate so the client understands the value they are receiving—just don’t itemize the cost of the radiographs separately. 

Be sure to adjust the estimate of the dental package accordingly, to cover your costs. And remember, with a monthly payment plan for your dental radiography system, just a couple of dental procedures per month can cover your investment.

Client education also helps. Explain how the results of the radiographs allow you to provide the best possible treatment and reduce the likelihood of future complications.

With clients who want the best for their pets, it’s a win-win for both of you.

Written by: Dr. Tammy Powell, DVM

5 Tips for Radiation Safety During Uncertain Times

Your x-ray unit is something you use frequently—probably every day, or multiple times per day—in your practice.

You know radiation safety is important. But recently, if you’ve had to reduce the number of team members in the building at any given time, maybe it feels like there aren’t enough hands on deck for patient restraint and positioning.

The good news is, some of the same principles that reduce radiation exposure can also help your team operate more efficiently.

Here are some tips to maintain safety, even when you’re shorthanded…

A.L.A.R.A.: A Brief Reminder

A.L.A.R.A. stands for “As Low As Reasonably Achievable,” and it’s the guiding set of principles that help you reduce radiation exposure to yourself, your staff, and your patients.

This is important because ionizing radiation from x-rays can damage cells, and cumulative exposure can lead to health risks such as cancer and genetic damage to reproductive cells.

To minimize exposure, there are 3 principles to keep in mind:

• Time

• Distance

• Shielding

Decreasing exposure times, increasing the distance between your team and the x-ray source, and using PPE, all can help to decrease radiation exposure.

Tips for Radiography Safety and Efficiency

Hands-Free Restraint

Increasing the distance between your team members and the x-ray source is one of the most effective ways to decrease x-ray exposure.

Think of the inverse square law, which states that doubling your distance away from the x-ray source results in ¼ of the dose of x-ray radiation.

That’s a significant decrease!

Also, scatter radiation comes from the patient—so by not touching the patient, you’re reducing your exposure.

This can be accomplished by using:

• Chemical restraint.

• Positioning aids such as sandbags and tape.

• A combination of both.

In addition to contributing to safety, hands-free restraint also increases staffing efficiency.

Especially for large or wiggly patients, it takes fewer staff members to position the patient when hands-free restraint is used.

Patient Comfort

A patient who wiggles at the last moment can lead to a crooked radiographic image—and thus, the need to retake that view.

The more shots you take, the higher the x-ray exposure to your team members.

Keeping a dog or cat’s comfort in mind can help you get the shot you need the first time—and decrease the need for retakes.

Here’s how you can do this…

• Minimize fear and pain (for example, pain from stretching a sore leg to get the right position) by using chemical restraint. 

• Use a trough or other aid for comfort. Lying with their back on a cold, hard table can cause even the most cooperative of pets to squirm. Giving them a cozy place to settle into can really help.

• Play white noise or background music. This helps make the big buzzing and beeping sounds from the x-ray machine less startling to a dog or cat.

In addition to a better patient experience and less x-ray exposure, these methods help save your staff time by getting your views more quickly.

Getting Things Right the First Time

The fewer images you take, the less radiation exposure there will be.

In addition to the measures listed above, here are some ideas for taking the fewest views possible…

• Good planning. Be sure to know exactly which views you need ahead of time and what position the patient needs to be in for those views. Communicate these expectations clearly with your staff.

• Proper measurement. Measure the patient in the position they will be in during the shot (lying down rather than standing).

• Have a technique chart, or use appropriate settings in your digital unit. Teach team members how to make quick and accurate adjustments in settings, too.

• Use collimation. In addition to producing a higher-quality image, collimation decreases scatter radiation.

A thorough understanding of x-ray positioning and machine settings will save your staff time and headaches—in addition to minimizing radiation exposure.

Who Should Be in the X-Ray Suite?

Only the team members taking the radiographs should be near the machine. Clients shouldn’t be in the x-ray suite, and other team members should be fulfilling other duties—especially when you’re shorthanded.

Rotating the staff you have on x-ray duty can also help minimize their cumulative exposures. 

So, it’s smart to invest in training multiple team members. That way, you’ll also avoid delays if your “go-to” x-ray staff member ever needs to call out sick or otherwise miss a day.

PPE Care and Use

Even though the nature of your daily practice may have changed, it’s still important to keep up with x-ray safety measures, such as making sure your PPE is in good condition.

Experts recommend checking PPE every six months, and this includes radiographing your aprons, gloves, and thyroid shields to check for cracks. Of course, check and replace sooner if there are any notable defects.

Uncertain times may be stressful, but you and your team can continue to help the patients who need you while keeping yourselves safe.

Written by: Dr. Tammy Powell, DVM

Good Exam Room and Dental Lighting: Why It Matters

When it comes to upgrading your veterinary practice, maybe the first things that come to mind are new exam tables, high-tech anesthesia monitoring equipment, or an in-house chemistry analyzer.

Was a new LED exam room light also on your list? If not, it should be. Here’s why…

While lighting is often overlooked, just think about how many times per day a good, strong light could make your life easier.

Times, when a high-quality LED light could come in handy in your exam room, include the evaluation of…

• Lesions and wounds.

• Dental disease or oral lesions.

• Ocular health (you’ll use your ophthalmoscope and other equipment for a more detailed exam, but good room lighting can help you pick up subtle lesions during a routine checkup).

• Paw pads and the spaces between the paw pads.

• External ear structures.

• Dander, fleas, and other skin and coat issues.

These are a few good examples—but really, good lighting can help with much of the physical exam by making it easier for you to accurately document tissue colors, textures, lesions, and other notable abnormalities in your medical record.

Good lighting is essential for dental procedures and surgeries

In our last blog post, we gave some advice on how to pick a good surgical light.

And along those same lines, don’t forget about dental procedures!

The mouth is like a dark cave, making it difficult for you and your staff to see what you’re working on if you don’t have good lighting.

Some things a good light will help you visualize include…

• Calculus that needs to be cleaned—and verifying that all calculus was removed.

• Enamel defects and small chips or fractures. 

• Staining, or other color changes such as pulpitis.

• Subtle bleeding or mild gingivitis.

• Oral abnormalities such as masses or inflammation.

• Pharyngeal or tonsillar abnormalities.

• Extraction sites—before, during, and after the extraction.

• Placement and manipulation of small sutures.

Not to mention, a good overhead light can aid your laryngoscope light during intubation. 

How affordable are good LED lights?

In the past, LED lights were very expensive compared to halogen bulbs—so it’s understandable if you’ve not purchased one before.

However, some brands are now 30-40% less than previous LED prices.

So, LEDs don’t have to be expensive anymore. And considering their performance and efficiency, a good LED light can be a great addition to your practice.

Plus, many cities, counties, states, and even electric power companies offer rebates for upgrading to LED lights, due to the decrease in power used.

Specific requirements for rebates vary by location—so be sure to check with your local municipality and utility providers to see what’s available in your area. Because it’s always great to get a cash rebate that can help cover the cost of your upgrades!

How do you choose a good exam room or dental light?

When it comes to selecting the best lighting, there are many things to consider…

• Affordability. LED lights are much more affordable now than they used to be, so shop around and be sure you’re getting a good deal (to be sure you’re comparing apples to apples, check for the other factors on this list, too).

• Quality and dependability. Plus, a good-value warranty helps to back up your investment.

• Lighting adjustability in terms of intensity and dimming options, as well as area of focus.

• Precise positioning. The light head and arm should be easy to move and manipulate—but then, stay right where you put it without drifting. 

• Easy to clean.

• User-friendly, with simple controls on or near the handle.

• Shadow-free illumination—or at least a design that minimizes shadows as much as possible.

• Mounting options that match the layout of your rooms.

• Comfortable and safe for pets, with adjustable settings you can change as needed, and low heat output.

Here’s what we recommend…

We recommend the new Burton veterinary LED exam light because it checks all the boxes listed above.

Plus, it has a high-quality LED (virtually heat-free and with a 75% energy savings compared to halogen), is assembled in the USA, and is backed by an industry-leading 5-year warranty.

At a competitive price point that optimizes design, performance, and value, it’s pretty hard to pass up!

Why invest in new lighting?

As we said, lighting is often overlooked in terms of equipment upgrades…

But, just think of how many times per day you’ll use a good-quality light in your exam rooms or dental area.

In terms of cost per use, that can make new lighting a great investment—something you’ll benefit from using many times per day.

And if your new light makes your life easier in terms of visualizing the patient and making accurate medical notes… that’s an investment that could save you time and headaches, and be well worth it!

Vomiting in Cats: Finding the Cause

Cats are good at hiding illness and pain. So, for some feline patients, it’s hard to tell what’s behind a bout of vomiting. 

A few of the many possible causes include:

• Hairballs.

• Food sensitivities.

• Dietary indiscretion.

• Infections or parasites.

• Stress.

• Pain.

• GI foreign bodies.

• Inflammatory conditions.

• Internal issues such as kidney disease or hyperthyroidism.

• Cancer.

Is it serious?

Often, it’s obvious whether the patient needs aggressive treatment right away or just needs a little bit of supportive care and observation at home.

However, other times it’s more difficult to know for sure. Those are the cases that may stay on your mind, making you wonder if the vomiting will continue or even become more severe.

It’s especially nerve-wracking if the patient went home for observation, but you’re concerned they may get worse overnight.

Reaching a diagnosis

Depending on the patient’s signalment, history, and physical exam findings, you’ll recommend the appropriate diagnostic tests.

Bloodwork

Bloodwork is a key factor in determining overall health status, and in establishing a baseline to monitor the patient for improvement or worsening of their condition.

These labs may be especially valuable in senior cats who have lost weight, when kidney disease, hyperthyroidism, or other internal medicine issues may be what comes to mind as the most likely diagnosis.

Imaging with x-rays and ultrasound

For some patients—especially if the vomiting is severe, or if you feel something abnormal on abdominal palpation—imaging may be needed right away. For patients with milder signs, you may decide to hold off on imaging at the first visit, but recommend the client bring their cat back if symptoms don’t improve.

And even if an obvious abnormality is noted on bloodwork (such as elevated thyroid hormone), imaging is still a good idea to rule out concurrent conditions, and to establish a baseline to compare any changes that show up on future imaging tests.

Either way, when it comes to imaging, radiographs are a good place to start. 

Radiographs give you a good overview of what’s going on inside the abdomen. You can look for masses, abnormal-looking organs, constipation, bladder issues, pyometra, signs of a GI obstruction, and much more.

However, sometimes more information is needed. Often, x-rays and ultrasound work well together to give you the full picture.

Ultrasound gives you additional clues about soft tissue structures, including:

• Differentiating a mass (size, what the borders look like, texture, thickness, etc.) from surrounding normal soft tissues. Silhouetting may make this interpretation challenging on x-ray images.

• Viewing bladder stones that aren’t radiopaque.

• Looking at small structures that are hard to see on x-rays, such as the adrenal glands.

• Inflammation of the GI tract or other internal organs.

• Finding evidence of a GI obstruction when it’s not obvious on radiographs (or, ruling out an obstruction—which may help you worry less if you decide to send the patient home for monitoring).

The list goes on, but the point is, x-rays and ultrasound can complement each other to give you the information you need, which can help you confidently diagnosis the mysterious vomiting cat.

Additional tests

Sometimes additional tests—for example, biopsies and infectious disease testing—may be needed to reach a diagnosis.

However, bloodwork, x-rays, and ultrasound are a great place to start. And often, these modalities will need to be completed prior to other modalities such as surgically obtained biopsies.

Lifestyle changes and monitoring

If the vomiting is due to a factor such as stress or hairballs, this may require a simple lifestyle change like providing Feliway diffusers and adding mental enrichment at home, or changing to a special diet.

But even in these cases, it’s good to rule out other, treatable medical causes—so a medical workup with diagnostic tests may still be recommended.

Keeping the vomiting at bay

If you have a patient with a chronic condition, you may recommend repeating the bloodwork, x-rays, and ultrasound at regular intervals.

A wellness checkup package that includes testing may be a good option for many patients—especially seniors. The wellness tests can be offered at checkups before the patient ever becomes ill, which gives you a great baseline for comparison with future test results.

Even though cats may not like to show symptoms of illness until a disease has progressed, wellness bloodwork and imaging (x-rays and ultrasound) can help to catch abnormalities early on, when the chances for treatment are better.

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Written by: Dr. Tammy Powell, DVM

Bad Breath Can Mean Trouble

Bad breath, or halitosis, is one of those health problems that’s easy for pet parents to overlook.

Sure, it’s inconvenient. Stinky breath can certainly put a damper on a pet owner’s cuddle time or other interactions with their dog or cat.

However, many pet owners don’t realize that halitosis can mean something much worse… such as periodontal disease, or even an internal problem.

As a veterinarian, you know this very well—but it can be a challenge to communicate the dangers lying “under the surface” when it comes to bad breath.

Explaining halitosis to pet parents

The first step is figuring out where the bad breath is coming from, and explaining the potential risks to clients.

Dental problems such as periodontal disease are the most common cause of bad breath in pets. But sometimes, halitosis begins somewhere in the body other than the mouth.

Possible sources of halitosis include…

• Periodontal disease and other dental issues.

• A health condition such as kidney disease (an ammonia-like or unpleasant smell) or diabetic ketoacidosis (more of a sweet smell).

• Respiratory diseases.

• Digestive issues or dietary indiscretions.

• Objects (like branches or chicken bones) stuck somewhere in the mouth.

• Oral neoplasias.

• Certain toxins.

Based on your patient’s history and physical exam, you’ll determine the most likely cause of the bad breath, and decide if diagnostic testing is needed. 

If the patient in front of you seems otherwise healthy but has obvious terrible dental disease, you can probably assume the smell (or at least, a large portion of the smell) is coming directly from their mouth.

And if a dental procedure is indicated, you’ll likely do pre-op bloodwork, which will help to confirm the patient is otherwise healthy. 

A recap of periodontal disease

It all starts with plaque, that thin film that forms on teeth due to food and saliva. We get plaque as humans, too, but fortunately, plaque can be removed by tooth brushing.

If not brushed away, plaque hardens into calculus (tartar) within as little as 24-36 hours. Then, it accumulates more and more over time and harbors bacteria. Calculus can’t be removed by toothbrushing alone.

Soon, this calculus (and its resident bacteria) become very irritating to the gums—and they like to grow below the gum line, where it’s harder to observe the process visually. This results in gingivitis, an early stage of periodontal disease (a disease process affecting the structures that hold teeth in place) where the gums become red and inflamed and may bleed.

From here, as the periodontal disease worsens, it creates pockets in the gumline, destruction of the periodontal ligament, and even bone loss in the maxilla and mandible. In severe cases, this bone loss can cause jaw fractures.

This all leads to pain and tooth loss. And, opportunistic bacteria may enter the bloodstream via inflamed gums, traveling to and causing problems in organs such as the heart or kidneys.

Reminding clients of the dangers of periodontal disease can help them understand their pet’s bad breath is true health and quality of life problem—not just an inconvenience.

Evaluating and treating dental and periodontal disease

Your initial pre-op exam will be done while the patient is awake—ideally with the owner present so you can show them what you’re seeing.

However, awake exams don’t allow for a full oral assessment. And, dogs or cats who are painful might not let you get a good look.

So you’ll make a dental cleaning estimate based on your initial exam but explain to the client that the full assessment will be done during the procedure.

This assessment should include dental radiographs. Since much of the disease process starts below the gumline, x-rays are the only way to see the full extent of damage from periodontal disease.

Some patients will just need routine cleaning, while others may need significant dental extractions. And, you can talk to your clients about continuing dental care at home through tooth brushing and dental treats.

By providing this valuable service, you’ll be not only keeping your canine and feline patients in great health—but also increasing the human-animal bond by preventing halitosis from interfering with the quality time between a pet and their owner.

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Written by: Dr. Tammy Powell, DVM

How and Where To Buy Used Veterinary Equipment

During the economic fallout of this unprecedented global pandemic, it’s more important than ever for businesses to stretch their dollars as far as they will go. 

Buying used equipment is a budget-friendly way to purchase high-quality machines and supplies—so you can operate and upgrade your practice the way you want to. 

More importantly, you can buy on a friendly, community-based platform that removes all headaches about negotiating, shipping, and payments—so you can securely get the equipment you need without taking time away from your busy schedule.

In case you’re not already familiar with it, we recommend you visit: usedvetequipment.com. 

This website was started because veterinarians needed a marketplace just for their industry—somewhere to easily buy and sell quality used veterinary equipment from trusted colleagues. 

Here’s what one happy buyer had to say:

“I purchased a digital x-ray system through usedvetequipment.com. The transaction was smooth. I would not have taken the chance without the third party mediator. Brad did a great job and the sellers were great to work with. I would not hesitate to use this service again.”

—Mark Robinson, DVM Montana

Here are a few advantages that usedvetequipment.com offers to you as a veterinarian buyer…

• Quality. On the site, you’ll find products from top manufacturers such as Abaxis, Shoreline, Heska, SurgiVet, Cardell, Welch Allen, Idexx, and much more.

• Choices. Whether you’re looking to invest in something as large as a full radiology unit, or something as small as a laryngoscope or warming pad, you can find it on usedvetequipment.com. 

There are far too many examples to list here, but other items recently sold include endoscopes, Dopplers, stem cell therapy equipment, surgical tools, cages and floor grates, exam lift tables, and much more.

• Easy Payment Options. You’ll be emailed an invoice for convenient online payment.

• Good for Animals and the Environment. Reusing and repurposing equipment is not only a great way for the veterinary community to share resources to improve animal care everywhere—it can also help keep materials out of landfills.

• Safety and Security. We’ve found the veterinary community to be honest in their descriptions of the equipment they are selling—and the standard buying process lets you inspect the equipment upon arrival before your payment is processed.

• Stellar Service. Just check the site, and you’ll find reviews from tons of happy buyers and sellers!

If you’re ready to get started, head over to usedvetequipment.com. 

Here are some things to keep in mind as you shop…

• Compare your options. If there’s more than one listing for the equipment you need (a common scenario), search around and make obligation-free offers. And if you’re not in a big hurry, search over time to see what else pops up.

• Ask Questions. This isn’t a big, faceless online store—instead, it’s all about community! You’re free to reach out to sellers with any questions you may have and to ask us about the details of shipping and payments. 

• Expect the Best Experience. The goal is for you to feel comfortable (and very happy!) with your purchase.

More interested in SELLING equipment rather than buying? Check out our next article, which will have detailed suggestions for how to successfully sell on usedvetequipment.com.

Until then, take a look around the site to browse what’s available, and be sure to bookmark usedvetequipment.com in case you need to come back to it to make a purchase in the future.

Wishing you good luck in your search—we’re sure you’ll find just the right equipment you need for all the services you’d like to offer at your practice. 

A community marketplace like this is the perfect place to buy and sell with colleagues as you build the practice of your dreams.

“… 10,000 times better than any eBay / Amazon kind of purchase! We will definitely look here 1st for future purchases.”

—Sandy Pamplin, Manager Pleasanton Road Animal Hospital San Antonio, Texas

“I recently purchased a film processor through Used Vet Equipment. I was very impressed with the website- pics and descriptions. I received a quick response to my questions. Brad was very professional and thorough in handling the transaction through delivery and tracking info. He made sure I was completely satisfied with the product. I would definitely do business here again! 5-star rating!”

—D Davis, Colorado

Written by: Dr. Tammy Powell, DVM

Find Those Urinary Bladder Stones

Sometimes, diagnosing urinary bladder stones in dogs and cats is simple: one set of x-rays and the mineral-dense uroliths glow bright white on your viewing screen.

Other times, it’s not so straightforward… especially for small or radiolucent stones.

Here’s how radiographs and ultrasound can be used to help you find pesky, hard-to-view bladder stones.

Are bladder stones on your differential diagnosis list?

Bladder stones may be at the forefront of your mind if you see a dog or cat who’s…

• Having blood in their urine.

• Urinating more frequently, and in short streams.

• Having urinary accidents in the home.

• Straining or experiencing pain during urination.

• Excessively grooming around their genitals.

Usually, a client will bring their pet into you for these concerns, and your physical exam will help to determine that there’s no urinary obstruction.

With urinary bladder stones, you may notice some discomfort on palpation of the caudal abdomen. On a cat or small dog, you may even feel stones or crepitus in the area of the bladder. 

Some patients, on the other hand, may exhibit minimal symptoms and their physical exam may be normal (sometimes bladder stones are an incidental finding).

Either way, most pets will need some type of imaging to confirm that bladder stones are there. Radiographs are a great place to start…

Finding uroliths via radiographs

In addition to any other needed tests—such as a urine analysis or bloodwork—radiographs are often recommended for pets with urinary symptoms, in order to look for uroliths or other abnormalities.

Typically, you’ll start with two simple views of the abdomen—a lateral and a VD. 

Take a close look at the urinary bladder to look for radiopaque stones, which should show up as a white opacity relative to soft tissues thanks to their mineral composition.

Stones can range in size from small sand-like grains to more than two inches across. There may be just one or two stones present… or a small group… or even more than 100.

Remember to check the urethra for small stones that could be stuck—especially if the patient is straining or in pain during urination.

For better visualization of the entire urethra in male dogs, consider taking another lateral view with the hindlimbs pulled forward.

Also, check the kidneys and the areas of the ureters. While much less common in pets than in people, occasionally uroliths may be seen higher up in the urinary tract.

If you see stones now—you have your answer.

If you suspect urinary bladder stones but still don’t see them, a contrast study may allow better visualization.

For finding bladder stones, a double-contrast study is ideal.

This includes using both a positive contrast agent (soluble iodinated contrast medium) and a negative contrast agent (room air, or ideally carbon dioxide to reduce the risk of an air embolus) in the bladder together.

Anesthesia or sedation may be needed for the patient’s safety and comfort since the contrast agents are administered via a urinary catheter.

In addition to radiographs, an ultrasound is a useful tool…

Finding uroliths via ultrasound

An ultrasound study is another great option for finding bladder stones, especially radiolucent ones.

The fluid-filled bladder provides contrast for the ultrasound waves so that stones can be found (and often emphasized by acoustic shadowing). 

Besides radiolucent stones, you may also see…

• Bladder stones (radiopaque or radiolucent) that were too small to visualize radiographically (smaller than 1-3mm).

• Other problematic issues in the bladder, such as ‘sludge’ buildup in cats with crystalluria.

• Damage to the urinary bladder itself, such as inflammation.

• The condition of the upper urinary tract—the kidneys and ureters.

• Unexpected findings, such as tumors or anatomical abnormalities of the bladder.

Because of this, ultrasound imaging is a valuable tool for helping you diagnose and treat problems of the bladder, including urinary stones.

Follow-up

Depending on your findings, you may recommend a diet change for dissolvable stones, or a cystotomy to remove the stones.

For dissolution, follow-up imaging can help to track the patient’s progress and see whether or not the stone is dissolving.

When a cystotomy is recommended, remember to use imaging on the day of surgery…

Take pre-op radiographs to confirm the stones are still there, and that your urinary catheter is in place.

Include post-op views to confirm and document that all stones were successfully removed.

Since most stones are radiopaque, standard radiographs are a good option for follow-ups—and typically the imaging choice on the day of surgery.

But ultrasound can also be used in conjunction with other diagnostic tests to monitor the health of the urinary system long-term and to look for early signs of a problem such as a reoccurrence of stones.

Catching stones early, when they’re small, may allow less invasive treatment options such as voiding urohydropropulsion.

With the right combination of imaging modalities, you can help your clients stay on top of treating, monitoring, and preventing urinary bladder stones in their pets.

Written by: Dr. Tammy Powell, DVM

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Radiographs for CCL Injuries and TPLO Surgery

When it comes to cranial cruciate ligament (CCL) injuries in your patients, x-rays play a key role in your diagnosis, treatment, and follow-up.

So whether you’re the surgeon performing the procedure or a GP referring your patient to a specialist, having a good understanding of what to look for on your radiographic images can help you provide great patient care.

It all starts when the patient first comes in to see you…

The initial visit

More than likely, you’ll be seeing a middle-aged, medium or large breed dog who suddenly started limping on one of their hind limbs.

During the exam, you determine that the pain is in the stifle. Then, using sedation, you perform more thorough palpation, followed by radiographs.

Your detailed exam of the knee reveals some swelling and a positive drawer sign, and you take x-rays to confirm your suspicion of a CCL tear.

Considering this is one of the most common orthopedic injuries in dogs, you’re probably correct. However, occasionally there may be a surprise—such as a fracture near the stifle, or even an osteosarcoma lesion for older patients.

Radiographs will help you correctly diagnose and document the problem, and rule out concurrent conditions.

With a recent CCL injury, you might not see a lot of obvious evidence on your views—that’s because it can take more time for radiographic evidence of a CCL problem to show up.

However, you will likely see compression of the infrapatellar fat pad—which indicates joint effusion.

If the condition is chronic, you may notice arthritis and other signs of long-term inflammation.

Planning for a TPLO surgery

If your patient is a good candidate for surgery, then it’s time to discuss options with the owner. A tibial plateau leveling osteotomy is a good option for many otherwise-healthy dogs, but of course, the recommendation may vary for each individual pet.

Now’s the time when pre-op radiographs come in, by helping you to measure the tibial plateau angle and determine the saw blade size and position of the bone plate and screws.

The importance of post-op radiographs

After a surgery such as a TPLO, it’s important to document that everything went well—that all implants are in place, the tibial plateau has been repositioned as planned, and that there were no complications such as bone splintering.

This will be very reassuring to a worried pet parent, and will also be a valuable part of your medical record.

These post-op radiographs can also provide more information if a problem or complication comes up later, by using these initial images as a frame of reference for comparison.

Radiographs are useful if complications arise

More than likely, your patient is doing great. In that case, follow-up x-rays will help you confirm and document that the bone has healed as expected.

However, if they do run into any problems—such as an infection or a fracture—an additional set of radiographs can help you diagnose the issue and treat it ASAP. And follow-up rads will allow you to monitor the patient’s healing progress and their response to treatment.

Basically, radiographs give you an “inside view” throughout the whole process of diagnosing and treating a CCL injury, and are useful for common surgical options such as a TPLO.

Digital radiographs are especially helpful in terms of sensitivity for soft tissues such as a joint space, and also for providing rapid results within seconds.

But no matter which radiology equipment you choose, your X-ray images will provide valuable information for diagnosis and treatment of CCL—for happy patients and clients.

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Written by: Dr. Tammy Powell, DVM