How to Evaluate the Urinary Bladder Effectively on Ultrasound

An ultrasound of the urinary bladder can be recommended for a number of reasons, including suspected uroliths, cystitis, and neoplasia—to name a few.

Often, the evaluation includes the entire abdomen and any other parts of the urinary tract that can be visualized.

Given all the conditions that can affect the bladder, as well as important information from an ultrasound study to help guide the treatment plan, it’s beneficial to gain proficiency in evaluating the bladder via ultrasound.

Use a Systemic Approach to Evaluating the Bladder

A systemic approach to the whole abdomen is good, and a bladder evaluation is usually just one part of an abdominal ultrasound study. So while it may be tempting to jump to the bladder right away if the patient is having urinary symptoms, it’s best to complete your abdominal ultrasound study in the same order that you usually do it.

Once you reach the urinary bladder, a systemic approach is again useful, to ensure nothing is missed. Here is one method for a stepwise evaluation…

• Is the overall bladder shape normal and as expected? Through practice, a veterinarian can get a good feel for what shape is normal for canine and feline patients, and how it may change if the bladder is full versus empty or nearly empty.

• How does the lumen of the bladder look? If urine is present, is the urine is anechoic? Is there sludge, sediment, crystalline material, a polyp, or anything else that is abnormal?

• If there are uroliths present, they generally appear as hyperechoic structures inside the lumen of the bladder. There may be acoustic shadowing, and the calculi may move freely depending on how large they are. 

• Is the bladder wall smooth, a normal thickness, and well-defined? Be sure to evaluate the entire bladder. If cystitis is present the wall may be focally or generally thickened or have irregularities in the mucosa, depending on the severity and duration of the cystitis. Keep an eye out for polyps or masses/tumors, too. Also, look for deviations in the wall that could indicate a urinary bladder diverticulum.

• If a mass is present, make note of the size, appearance, and location. Transitional cell carcinoma, the most common neoplasia of the bladder, tends to occur in the bladder wall near the neck and trigone. Commonly, these masses are hyperechoic or mixed echoic and have been compared to cauliflower in appearance. Evaluate nearby blood vessels and regional lymph nodes, too. Avoid cystocentesis or aspiration for samples, because of the risk of seeding the neoplasia into the abdominal cavity when the needle is withdrawn. Sometimes, it’s easy to confuse blood clots with masses, so keep this in mind and re-evaluate as needed.

• Be sure to evaluate other urogenital structures, including the kidneys and ureters (the latter are often not visible unless there’s an abnormality), as well as blood vessels and lymph nodes in the region. Remember to look for the uterus/ovaries in intact females and the prostate in males, although it might not be possible to visualize these structures in all patients, especially if they are normal.

Whenever abnormalities are noticed, describe them in detail and take measurements. Include all of this in the notes. Even if things look normal, it’s still a good idea to take some measurements (such as bladder wall thickness) and describe what you’re seeing, as a baseline for comparison in case anything changes in the future.

A Few Tips

A full bladder can help with visualizing certain lesions (such as hyperechoic uroliths) by providing “contrast” or a backdrop to help make abnormalities stand out. Also, a full bladder smooths out the bladder wall, whereas an empty bladder may lead to false readings of wall thickening or masses. Additionally, a large bladder allows for an easier ultrasound-guided cystocentesis. So whenever possible, try to ultrasound with a full, or at least partly full, bladder. In some cases, it may be appropriate to give the patient water or IV/SQ fluids and wait for the bladder to fill prior to the study.

Pressure from the transducer can alter the bladder’s shape.

So be sure to practice with various pressures and become familiar with how the appearance of the bladder might change.

Repositioning the patient can also be helpful.

This may give you a better viewing angle and position for certain structures. Having the patient stand up may put gravity in your favor by decreasing the distance between the bladder and the probe. Also, patient movement may cause sludge/sediment to move around or disperse so that it’s not mistaken for a urolith.

Have appropriately sized needles, syringes, and collection materials available.

In case an aspiration/cystocentesis is needed, it’s best to have supplies ready to go.

Ultrasound of the urinary bladder is a very valuable skill, and it works well in conjunction with information gained from x-ray studies. Training and practice in ultrasound of the urinary bladder are often well worth it for patient care and for additional income from ultrasound studies. 

Written by: Dr. Tammy Powell, DVM

Adrenal Ultrasound in Big Dogs: Step-by-Step Techniques

A thorough abdominal ultrasound includes evaluating the adrenal glands.

Common reasons to look at the adrenals include searching for signs of neoplasia, Cushing’s, or Addison’s disease. And even in animals where adrenal disease isn’t suspected, sometimes growths or other changes to the gland(s) are discovered incidentally.

Unfortunately, sometimes adrenals can play “hide and seek” and be tough to find. That’s true for any dog—but especially for large dogs with deep abdomens, since the abdomen may be too thick for the ultrasound waves to penetrate well. 

Having a repeatable system for where to look can help. Here are some steps for finding those tiny glands inside of a big dog…

Perform an Abdominal Ultrasound in the Same Order Every Time

Just like reading an x-ray or performing a physical exam, a systemic approach helps ensure that nothing is missed. 

Each veterinarian may have their own preference for how to go through a scan in a stepwise fashion. For example, some may scan cranially to caudally. Others may scan clockwise, or have some other system. Any system is fine, so long as it covers everything you need to see and is easy to repeat on each patient. So choose what works best for you.

In addition to revealing unexpected abnormalities of the adrenal gland(s) sometimes, systemically examining the entire abdomen will also help a veterinarian gain experience. Then, when it’s time to locate the glands on a patient with suspected adrenal disease, you’ll have plenty of practice to fall back on and may feel less pressure.

Where to Find the LEFT Adrenal Gland

• To narrow the search, first, find the left kidney by scanning the left dorsal mid-abdomen.

• Next, narrow the search even further by finding the vascular landmarks: the aorta (in long view) and the left renal artery. 

• Look for the spot where the left renal artery branches off from the aorta. The left adrenal gland should be just cranial to this junction.

Where to Find the RIGHT Adrenal Gland

• First, locate the right kidney by scanning the right cranial abdomen.

• Next, locate the vascular landmarks: the caudal vena cava (in long view) and the cranial mesenteric artery.

• Apply some pressure, which will cause compression of the caudal vena cava and allow better visualization of the adrenal gland. The gland is dorsolateral to the vena cava and just cranial to the cranial mesenteric artery.

A Few Tips

It may be tempting to use the kidneys as a primary landmark since the adrenal glands are located near each kidney. However, the kidneys may overshadow the small glands. So while the kidneys are a good starting point, it’s also important to use vascular landmarks.

Color Doppler can be a big help, too. It often makes it easier to find and view vascular landmarks.

Minimize the distance between the probe and the adrenal glands as much as possible. This can be done by moving the probe as needed, and by applying gentle pressure if the patient allows.

What to Include In the Medical Record

Be sure to describe any abnormalities. Additionally, rather than just noting ‘normal’ or ‘abnormal’, it’s good to provide specific details in case a comparison is needed in the future. Here are some things to note, even if the glands look normal…

• Measure and record the size of each gland. Measurements are typically taken from the cranial to caudal pole, as well as a measurement of the thickness of each pole.

• Note if the glands are hypoechoic to surrounding fat or if their appearance is different than expected.

• Classic adrenal gland shape has been compared to a ‘peanut’, or sometimes an ‘arrowhead’ for the right adrenal. Note if the shape is as expected or if it’s abnormal.

• If any abnormalities are noted, list the most likely rule-outs and a recommendation for follow-up/monitoring or further diagnostics if indicated.

With practice, locating the adrenal glands will become second nature. It may still be challenging on some patients, but having a repeatable system and gaining experience will help.

Written by: Dr. Tammy Powell, DVM

Essential Technologies to Transform Your Vet Practice

In part one, we explored some popular new technologies being adopted by many veterinary practices, such as cloud systems, telemedicine, and mobile apps.

Today, we’d like to take it a step further and discuss some new and evolving tech that may help you provide great patient care and customer service in totally new ways.

Here are some technologies to think about…

Pet Wearables

There are now devices available for pets that can monitor body temperature, heart rate, respiration, and more.

Often, this would be something pet owners purchase and use at home, similar to a FitBit. This technology may help pets with medical issues (such as tracking a resolving fever or monitoring exercise in overweight pets). Or it may help with something as simple as seeing true TPR values when a pet is at home and relaxed versus at the clinic and stressed.

Another thing to consider is the possibility of having these devices at your clinic, for a low-stress way to get a TPR during a pet’s visit.

You’ll have to decide for yourself the practicality and dependability of this relatively new pet trend—but the possibilities are certainly exciting!

Live or Visual Information Sharing

Times have changed from the days of placing x-ray films on viewers in your exam rooms for clients to look at (and reserving the room with the “best” x-ray viewer for that specific client!).

Don’t get us wrong—this traditional technology can still get the job done. But how much more convenient and interactive would it be to share digital info and images on large, flat-screen monitors that you have in each of your exam rooms? 

This digital, high-depth technology looks impressive to clients. And even when you’re not using a monitor to present patient information, you may want to have informational pet care videos playing to keep clients entertained while they wait (and also promote some of your services).

Plus, there’s an opportunity for live sharing when clients can’t be in the room with their pets.

One example would be cameras mounted on the ceiling for live and convenient sharing of patient updates, bloodwork, ultrasound findings, etc. Even some microscopes can connect to Wi-Fi.

This type of visual, real-time sharing maybe even more relevant until pandemic restrictions are lifted… 

Since clients can’t always accompany their pets into the clinic, this can help them feel like they’re still connected. Instead of worrying about the “unknown” (i.e. what happens when their pet is taken to “the back”), clients can see some of what’s happening during an exam or other procedures. This may provide mental comfort, confidence, and trust.

3D Printing

According to the University of Illinois College of Veterinary Medicine, 3D printing can help surgeons plan and practice a surgery ahead of time, via models of bone that are created based on CT scan images. Printers can also replicate muscles, blood vessels, and other organs for this purpose.

In addition to a veterinarian’s use for surgical planning, 3D printers can create models for client education purposes.

Encourage Clients to Use the Tech in Their Phones

While not considered new or ground-breaking anymore (since most of us have had smartphones for some time now), simple features on a phone like a camera or voice memo can be immensely helpful during a visit.

For example, if you’re going over bloodwork results, encourage a client to record what you say—that makes it less likely their spouse (who wasn’t at the visit) will call and want you to go over all the results a second time.

Or if your team is demonstrating how to clean a dog’s ears, have the client record it so they can replicate the process at home.

Choose What’s Right for You

If you’re just opening your own veterinary practice, it might be worth it to invest in new technology right from the start—to help set your clinic apart from the competition, and to customize your practice so it suits your workflow, communication style, and the type of medicine you’d like to practice.

It may also be practical to start with just a couple of new technologies at a time—to save some expenses when first opening a practice, and to wait and see what other new technologies are developed in the meantime until you’re ready to invest again.

Either way, it’s certainly valuable (not to mention fun) to start “dreaming” about how you want your veterinary practice to look and function. 

Dreaming is the first stage of planning—and imagining what sorts of tech you’ll use in your veterinary practice can help you bring your dream to life. 

Written by: Dr. Tammy Powell, DVM

Client Communication and Customer Service Training

Veterinarians and veterinary team members sometimes say they got into veterinary medicine because they like animals more than they like people.

But the truth is, no matter how much you and your awesome team love animals, a large part of your job will consist of dealing with the human beings attached to those animals.

Why Invest Time in Communications and Customer Experience Training?

You’ll probably have some clients you love, others you feel neutral about, and others that you find difficult to work with.

Sometimes, the art of “communications” is presented primarily as a way to become skilled at conflict resolution, for those times you’re dealing with people who are rude or argumentative. 

But the truth is, communications can help ALL of your clients (everyone from difficult to A-list) better understand your services and the value you provide.

It can help them feel comfortable coming to you with their questions and concerns and have a better perception of you and your veterinary practice.

All of this can potentially lead to more income, as well as more flattering online reviews and word of mouth referrals.

Communications and customer experience are fields where there’s always more to learn, and these skills can continue to improve with practice over time.

But, here are a few good places to start…

Communicating for Clarity

One of the most important things to do is ensure your clients understand the information you’re telling them about their pet—and, that they’ll retain that information.

Here are some ways to do that…

• Clearly state what is happening. 

For example, we’ve probably all heard stories about clients who thought a neuter was the same thing as a vasectomy—until they got home and realized their pet’s testicles had been removed! 

Clear communication at the beginning (and not just assuming a client already knows what the word “neuter” means), could prevent such misunderstandings.

• Offer ways for a client to easily recall the information or learn more. 

For example, give the client a handout with more detailed information to refer to, or allow them to videotape your talk.

This can also help when they go home and relay the information to their spouse—so you won’t get a request to repeat your entire speech for their spouse!

• Use distraction-free communication. 

Make your exam rooms cell phone-free zones. 

Have something available to occupy rambunctious kids (for example, a movie or toys).

And wait to bring the pet back into the room until you and the client are done talking.

Prioritize Time With the People Who Truly Value Their Time With You

It may be tempting to spend extra time in the room and debate with the client who wants to listen to their breeder or Dr. Google instead of you…

And sometimes that’s worth it. But, if you’re pretty sure that person is never going to change their mind, your time may be better spent with a client who WANTS to hear what you have to say.

So instead, spend that extra time with the sweet client who is a little chatty but always seems to say thank you and really appreciate (and follow) your advice.

Keeping All Your Communications Consistent

If you and your technician both give a client the same advice about heartworm prevention—but then your receptionist tells the client, “Nah, I don’t use it for my own dog…”—what would be the end result?

Probably confusion and doubt in the client’s mind. And maybe suspicion that you are selling products that aren’t really necessary for their pet.

This could happen with a variety of products and services, including parasite preventions, good quality pet foods, dental procedures, and more.

It’s important to be sure your whole team is on the same page, sending a consistent message to your clients.

The Little Things You Can Do to Improve Client Perception and Experience

Often, small little things you do to brighten a client’s day can make a BIG, positive impression—and bond that client to your practice for the long-term.

A few examples include…

• Helping elderly clients by going out to their car when you see them arrive, and offering to carry their pet’s carrier for them.

• Sending a card after a pet is euthanized, or during the holiday season.

• Allowing clients to go out the back door after euthanasia, for privacy when they’re crying.

• Telling clients how you change to a fresh needle after drawing up a vaccine, so the injection is more comfortable for their pet (remember, if you don’t tell them, they won’t know!).

Avoiding Client Shaming

While still somewhat controversial, this topic is drawing more attention in the veterinary community…

Client shaming means unintentionally (or, sometimes intentionally) making a client feel guilty when they’re behind on care for their pet or did something they shouldn’t have done (like giving a human medication that’s toxic for pets)—especially if it’s led to their pet becoming ill.

The thing is, most clients already feel very bad about it without veterinary team members making them feel worse. 

If you can make your practice a safe space for clients to come without judgment, you may find that some of those very same clients appreciate it so much that they’ll be bonded to your clinic long-term. 

They may even start to bring their pet to you more frequently for routine care and preventive diagnostics!

Of course, it won’t go that way every time. And clients do need to be informed when they’ve made mistakes, so they can avoid repeating those mistakes.

So, use your judgment to figure out the best way to communicate in each unique client situation. 

Who Can Benefit From Learning More About Communication and Customer Service?

In short—everyone! The whole team, from the medical director to kennel assistant, could benefit. 

Even if someone is naturally a good communicator, there’s no harm in that person learning more and adding additional communication tools to their toolbelt.

To get started, you can look for formal communication and customer experience training. You can also do in-house training, with role-playing.

Progress checks from time to time may help, too, so everyone can continue to learn and grow.

The time you invest can be well worth it. It can make everyone’s daily interactions (for team members and clients alike) as smooth and pleasant as possible. 

And, nurturing happy clients can certainly help to improve your bottom line.

Written by: Dr. Tammy Powell, DVM

How to Explain Halitosis Risks to Concerned Pet Owners

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 apparent terrible dental disease, you can probably assume the smell (or at least, a large portion of the scent) is coming directly from their mouth.

If a dental procedure is indicated, you’ll likely do pre-op bloodwork, which will help confirm that 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

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!

The Value of Newsletters for Your Veterinary Practice

You don’t want to just see pets once and then not see them again for years…

Instead, you want to develop long-term relationships with your clients. You want to get to know dogs and cats when they’re first adopted, and keep caring for them well into their senior years.

There are many ways to develop this ongoing bond and trust with your clients. One simple but effective strategy is to stay in touch between appointments, through newsletters.

Why Should Your Veterinary Practice Have a Newsletter?

There are many ways newsletters are beneficial to veterinarians, including…

• Staying front of mind.

Clients are busy, and after their pet’s checkup, they might not think about their veterinarian at all until the next time their pet needs something. 

But informative or entertaining newsletters will help clients remember your practice and how helpful you are—so they’ll never have a reason to look elsewhere.

• Developing trust. 

They say people buy from those they trust. Newsletters help you in this regard.

By providing informative articles or other content, you can help dedicated pet owners learn more about their dog or cat’s health. Newsletters can reinforce what you teach clients during their visit, and also present new and valuable information on a variety of pet health topics.

Additionally, newsletters can show off a bit of your practice’s personality and culture. That’s especially valuable during curbside service when clients can’t always come in to “see” your practice for themselves the way they used to.

• Sharing important announcements.

If you’re running a special promotion (such as dental month discounts or discounted vaccines on certain days of the week), newsletters are a great place to inform your clients.

• Marketing and social engagement that isn’t subject to algorithms.

Last week, we shared information on social media for veterinary practices. And while social media is great, most platforms are subject to one potential disadvantage—algorithms.

In short, algorithms mean that social media platforms have a formula they use to determine which posts your followers actually see.

Newsletters, on the other hand, are delivered to EVERYONE on your email list, with no interference from finicky and unpredictable algorithms.

How Do You Set Up and Write a Newsletter?

Here are some tips for getting started…

• Decide on a frequency. 

Are you going to send your newsletter weekly? Every month? Every quarter?

This depends on your clients’ preferences, and your strategy may change over time. 

If you’re not sure, one newsletter per month is usually a good place to start. 

• Create a template. 

A template is a backdrop for your newsletter—the formatting, colors, and graphics that make it look visually appealing.

If you use a mail service provider like MailChimp, they generally have pre-made, professional-looking templates you can use.

If you want something more unique, you can look into formatting and designing your own template if you’re the creative type, or consider working with a professional graphic designer.

• Brainstorm a list of ideas.

That way, you’ll never get “writer’s block.” See the section below for inspiration.

• Share your articles. 

Don’t just email your content. Also, post it on your website and share it on social media.

What Do You Write About?

• Seasonal or timely content. This could include holiday hazards, fireworks safety, warm or cold weather advisories, and fun holidays like Love Your Pet Day or National Dog Biscuit Day. 

• Important announcements. Tell your clients about changes to the hospital (like closures or new staff members and new services offered), pet food recalls, local pet events, etc. 

• Veterinarian Q&A. Encourage people to send in general pet health and wellbeing questions, which may be answered by one of your veterinarians in a future issue.

• Discounts and special offers.

• Interesting or important pet health topics.

• How-to articles, such as how to administer pills or brush a pet’s teeth.

Some Helpful Tips…

Keep the writing simple. Sometimes less is more, meaning shorter articles and shorter paragraphs are more likely to be read than larger chunks of text.

Include pictures, since they can make a newsletter more entertaining. Look for stock photos, including some of your own authentic photos from your practice, or work with an artist on Fiverr who can create infographics (such as a picture illustrating 10 plants that are toxic to pets) for a very reasonable price.

Also, create enticing subject lines that will make clients want to open and read your newsletters. For example, instead of a subject line that says “Pet Dental Health,” write “Dental Disease Affects a Pet’s Whole Body - Here’s Why…”

To save time and maximize your results, consider working with a professional marketer or copywriter who is familiar with the veterinary industry.

How Do You Know If Your Newsletter Is Effective?

If you put time into your newsletter, you want to know it’s accomplishing its purpose. Here are some ways to tell…

• Look at statistics (such as how many people opened your email, and whether they clicked on any links you included) from your email service provider.

• Take note of any engagement, such as people sending you questions, leaving comments, or even mentioning the newsletter during an appointment.

If you’re not getting a big response in the beginning, don’t worry—this is a marathon, not a sprint. Your goal is to build relationships over time, not get a huge wave of business with each article you send out.

All in all, newsletters are a good investment. They’re a great way to stay in touch and deepen those relationships that make caring for pets so rewarding.

Written by: Dr. Tammy Powell, DVM

What Does a Portable/Equine Veterinary X-Ray Machine Cost?

Portable x-ray equipment can be valuable to equine practitioners, mobile veterinarians, veterinary practices with limited space for equipment, or anyone else who could benefit from equipment that is compact and easy to transport.

Radiology equipment is an important investment. Here are some tips to make sure you get the best value and make a return on your portable X-ray system purchase.

How Much Do Portable Veterinary X-Ray Systems Cost?

Here, we’ll focus on digital x-ray equipment. An average price range is about $25,000-60,000. Of course, this depends on whether you are buying new or used, as well as on what’s included in the system. 

For example, you’ll need a generator and a plate or sensor. Not all systems include a generator in the price, so be sure to check exactly what’s included. And if using CR rather than DR technology, a plate reader is needed. 

Additionally, many systems include software and a laptop for capturing and storing images. Some software has extra perks that could come in handy, such as the ability to make measurements right on the images.

When deciding which x-ray equipment to purchase, consider how it will be used at your practice. 

For example, if you have a mobile small animal practice, how much room do you have for equipment storage? 

If you’re in a barn with limited electrical outlet access, would it be better to purchase a cordless unit? What about WiFi or Bluetooth access for wireless sensors or a protective cover for the equipment?

Consider getting opinions from other vets that use a portable system, to see what they recommend. 

Could These Factors Help with the Purchase Price?

Some things to consider when it comes to finding the best deal include…

• Ask around for different quotes once you know which system you are interested in. Ask vendors for any special deals they may offer, and see if they can beat an offer you already have.

• Consider different financing options. Does it make sense to pay upfront or to do a monthly payment plan at a reasonable interest rate? And will you finance through the equipment seller, a bank, or another option?

• What are the tax implications (and potential savings) on your equipment purchase? In some cases, tax savings could make up for the expense of buying new equipment.

Look at Long-term Expenses in Addition to the Purchase Price

Of course, the purchase price is important. But long-term costs are also crucial to consider since expensive maintenance could end up canceling out the initial savings on a cheaper but lower-quality equipment purchase.

So, look at the warranty for starters. When does it expire? What does it cover? Can the warranty be renewed, and how much will it cost to renew? Is there an expected charge for routine maintenance? And for older technology, are replacement parts still being manufactured?

And speaking of maintenance, how durable is the equipment? This could make a huge difference, depending on when and where you plan to use the equipment. 

For example, if you do farm calls, can the generator and sensor stand up to the elements (dust, humidity, etc.)? Can it function well after being transported in the car during hot or cold weather? If equipment gets damaged easily, that could really add to long-term expenses, and that must be considered in your purchasing decision.

What about software? How often does it need to be upgraded, and are upgrades included in your costs?

Crunch the Numbers 

All of the above factors will be part of your financial considerations. Additionally, it helps to plan ahead for how much income the new equipment is expected to bring in—to ensure the purchase makes financial sense for your practice.

For example, how much would the practice charge for various types of x-ray studies? 

How many x-ray studies are expected per week or per month—and does this cover the monthly payment on the equipment while also bringing in a profit?

Before investing in new equipment for your practice, it’s helpful to consult a financial advisor or veterinary business consultant.

Make Sure Your Equipment Gets Used Safely and Efficiently

Radiation safety is always important. For mobile units, there may not be a dedicated x-ray suite available, so it’s necessary to ensure that everyone is present (the vet team operating the equipment, as well as any pet owners who are present during the visit) and follow all safety recommendations.

Additionally, training the vet team on the new equipment will ensure they can use the equipment quickly and effectively. This could potentially mean saving time and scheduling more procedures—which could help with the ROI on your equipment purchase.

The right portable veterinary x-ray system purchase will vary from practice to practice, depending on the circumstances under which the machine will be used (in a clinic or out in the field), how busy the practice is, finances, and other factors. 

But by carefully considering all these things ahead of time, it will be easier to determine which system suits your practice’s needs and to find the best possible deal to ensure your investment pays off.

Written by: Dr. Tammy Powell, DVM

The Veterinarian’s Guide to Diagnosing Heart Tumors in Pets

Cancers of the heart are uncommon in dogs and cats. When they do occur, it’s important to differentiate a tumor from other conditions that could cause generalized or focal enlargement of the heart and cardiovascular symptoms.

Which Cancers Occur In Cardiac Tissues?

A cancerous lesion based at the heart could be a primary tumor, or due to metastasis. 

Primary tumors that occur at the heart include:

• Hemangiosarcomas—the most common heart cancer in dogs, usually occurring at the right atrium. These occur most frequently in larger dogs with longer noses, such as Golder Retrievers, Doberman Pinschers, and German Shepherds.

• Chemodectomas, also known as aortic body tumors or heart base tumors. Generally thought to be slow-growing, these tumors occur most commonly in brachycephalic breeds like Boxers, Bulldogs, and Boston Terriers.

• Myxomas.

• Sarcomas.

• Ectopic thyroid tumors.

• Lymphoma/lymphosarcoma—the most common heart cancer in cats.

Other cancers are possible, but these are the most commonly diagnosed types. Breeds may vary as noted above, but most pets with tumors of the heart are middle-aged or older. 

How Are Heart Tumors Diagnosed?

If slow-growing, tumors near the heart base are often an incidental finding, seen on thoracic radiographs that are taken for another reason.

Other times, diagnostics are pursued because of clinical symptoms—which are often sudden in onset.

Once a mass is large enough to push on the heart and major blood vessels, many cardiovascular symptoms are possible, such as:

• Coughing

• Ascites

• Lethargy

• Weakness

• Vomiting

• Loss of appetite

• Difficulty breathing

• Collapse

• Sudden death

Note: If a dog presents with some of these symptoms, especially sudden weakness and collapse, a quick ultrasound scan may help to identify pericardial effusion and aid in guiding a needle for emergency pericardiocentesis.

Finding Heart Masses Early

As with most cancers and disease processes, discovering a problem earlier rather than later can allow for more treatment options.

General screening radiographs or ultrasound checks—such as with a senior wellness health check—can be a good opportunity to discover heart base tumors before they cause cardiovascular dysfunction and symptoms.

An echocardiogram performed via ultrasound can help to provide more information on the location, size, and invasiveness of the mass. 

In some cases, a presumptive diagnosis may be made based on the appearance and location of the mass on an ultrasound study, along with the patient’s signalment. If possible to perform without undue risk, an ultrasound-guided aspirate of the mass can provide more information about which type of tumor is present.

Treatment Options For Cancers Of The Heart

Treatment will be based on the type of neoplasia, how fast the mass is growing, whether metastasis is present, and whether or not the pet is symptomatic.

When a tumor of the heart is diagnosed, a good next step is to screen for metastasis and concurrent conditions via chest x-rays (if not already done), bloodwork, lymph node evaluation, and abdominal ultrasound.

Once a diagnosis is made, treatment options may include:

• Periodic monitoring with a cardiologist (especially for slow-growing chemodectomas/heart base tumors) prior to pursuing more invasive treatments.

• Surgery to remove the tumor.

• Pericardiectomy to remove the pericardium and prevent life-threatening cardiac tamponade or pericardial effusion. 

(A pericardiocentesis may be necessary on an emergency basis prior to diagnostics in a pet who presents with acute symptoms. After that, a planned pericardiectomy can help to prevent further emergency episodes of fluid buildup around the heart.)

• Chemotherapy, often in conjunction with surgery.

• Radiation therapy—either conventional, or via Cyberknife therapy.

Even though cancers of the heart are uncommon in pets, they can be scary to pet owners because of the possibility of sudden onset of serious clinical symptoms (especially with hemangiosarcomas).

By performing diagnostics, referring to specialists as needed, and giving your clients as much information as possible, you can help them make an informed decision for their pet.

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

Top Strategies for Hiring and Retaining Veterinary Staff

Your team members are a crucial part of your veterinary practice’s success.

Therefore, it’s worth it to invest time in hiring, developing effective team communication, and figuring out how to nurture team members so they stay with you long-term.

But, if you’re new to hiring and team motivation, where do you begin?

It All Starts With Your Foundation

To hire and retain the right staff members for your new veterinary practice, you first need to know what you really want your practice to be like.

What’s your practice philosophy? How big should your team be? What style of communication would you like to be the norm? Will your staff be cross-trained, or will each team member have a clearly defined role? 

Spend some time thinking about these things. Make notes, and put as many details into your vision as you can.

The more you can convey your vision in your job postings and during interviews, the more you’ll be able to find people who are a good fit for your practice environment.

Finding the Best Candidates

Here are some basics to think about when it comes to attracting high-quality candidates…

• Where will you find candidates? Think about posting your job listing on sites like Indeed, LinkedIn, the AVMA, Facebook job boards, and asking vet schools to post at the school for you. In addition to posting a job description, think about local and online networking.

• Does your job listing stand out? Think of a catchy title. Use bullet points rather than long paragraphs—that makes it easier to scan the text. Also, focus not just on technical information about your practice, but also on the perks and benefits for potential employees and why it’s great to work there.

• Be specific and accurate. Be honest about the job and responsibilities, in as much detail as possible. That way, potential candidates will know exactly what to expect.

• Why should candidates choose you? Once you find a good candidate, it’s important to remember they may be interviewing at several places and have several good offers. So, it’s best to make your offer as attractive as possible, if you really want to hire the best.

Benefits could include things like health insurance, scheduled raises or bonuses, incentive programs, paid time off, a relocation bonus, student debt repayment help, or a CE allowance. It could also include a structured mentorship program for new graduates. Get creative, see what others in your region offer, and figure out how to make an offer that would be difficult to refuse.

• Talk to colleagues. It’s possible someone you went to vet school with may have a stellar employee who’s moving to your area, and your classmate can recommend your clinic.

• Keep your website up to date. Potential candidates may research you via your website and social media presence. Keeping these online platforms up to date, with great content and fun pictures, can create a positive first impression. In addition to potential employees, it also helps with potential clients.

• Consider hiring a veterinary recruiter. Sometimes, it’s best to let the experts do the legwork so you can balance your daily responsibilities as a practice owner. 

Your reputation is also important.

If your employees rave about how much they love working at your practice, word of mouth can help to attract wonderful new employees.

On the other hand, employees who’ve had a negative experience may have the opposite effect. 

Hiring Tips

Once you have candidates to interview, you’ll need to design a process that works well for you in terms of interviewing.

This may take some trial and error. But start with these tips…

• Focus not only on technical skills and qualifications, but also on attitude, and on soft skills such as communication.

• Verify degrees, licenses, references, etc.

• Ask the same set of questions to all applicants. And consider using behavior-based interview questions, which tell you more about how a person may act in a given situation.

• Ask about availability and flexibility, especially if you need to fill specific shifts.

• Don’t make the process too difficult. For example, multiple days of interviews may not be possible for someone currently employed elsewhere.

• Try to do a working interview, and consider bringing other key staff members into the decision process.

• Always communicate clearly, and try to give a timeframe for when you’ll make your decision.

During social distancing, it may also be valuable to do your initial conversation via Zoom. Become familiar with this platform, and treat it just like you would an in-person interview by sending personalized messages and introducing everyone who joins the call.

Staff Retention

Once you find team members who are a good fit and contribute to the growth of your practice—of course, you’ll want to keep them around!

Here are a few ideas to help with staff retention…

• Deliver on what you promised, in terms of the new hire’s job responsibilities, your practice culture, etc.

• Have a clear, comfortable onboarding and training process for new team members.

• Have check-ins at specified times after hiring, to see how the new team member is adjusting and if they need anything.

• Ask your team members about their goals. Some may want to increase their pay. Others may want a flexible schedule based on their kids’ school and activities. Still, others may be interested in professional growth and the ability to rise to management. For veterinary associates, this may mean adding a new skill set to offer to clients, such as acupuncture.

Whatever your employees’ goals, professional fulfillment can help with retention.

• Encourage open communication. By making it safe for your staff to have any complaints heard and addressed, you can resolve issues before they become a big problem.

By nurturing your team and creating a supportive environment, you’ll not only make your own workdays more pleasant—you’ll also be contributing to the success of your new veterinary practice.

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

Vomiting in Cats: Common Causes and Diagnostic Steps

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

Choosing the Best X-Ray System for Animal Shelters & Non-Profits

X-ray equipment is an important purchasing decision for animal rescues, state and county-run shelters, and 501(c)(3) organizations. 

Animal shelters and non-profits have a mission to help as many pets as possible, including those pets who have nowhere else to turn.

As a veterinarian working for a non-profit or rescue organization, you know that every dollar counts. The more you can save on expenses, the more money can be used to care for pets. 

With that in mind, here are some considerations for purchasing x-ray equipment…

What Radiographic Equipment Does Your Shelter or Non-Profit Need?

Here are some questions to ask to help evaluate your organization’s radiographic needs…

• Which services will you offer that require radiographs? For example, limited-service operations like vaccine or spay/neuter clinics may not have a strong need for radiography. Some rescue organizations will use x-ray equipment moderately—say, for diagnosing bone fractures and creating a plan for stabilization, or for counting the number of puppies in a pregnant dog. And some well-funded non-profits may offer full-service diagnostics and treatment, including dental imaging. Your clinic’s needs will determine which type of equipment is a practical investment.

• Do you need an entirely new system—or do you already own some components such as a table, generator, software, etc. that are still in working order?

• Are you looking for film or digital x-rays—and if digital, CR, or DR technology? Digital offers many advantages such as the speed of obtaining images, while film may be more affordable. Although, by the time the cost of a processor (and maintenance), as well as physical film purchases and disposal, are taken into consideration, the savings might not be as much as expected. So it’s important to factor in all associated costs over the expected lifespan of your equipment.

Where to Obtain X-Ray Equipment for Shelters or Non-Profits

Here are a few options…

• Purchase new equipment. This may be the most expensive option upfront. Although if a warranty for service is offered, it’s possible this may be a cost-effective option for some organizations.

• Purchase used equipment. This option may provide a lower upfront investment for equipment that’s still in pretty good shape. Of course, it’s important to do your research. Ask the seller about the condition of the equipment and whether there is still a warranty in place (and if that warranty can be transferred to a new owner). Figure out what legal rights you have to recoup your money if the equipment doesn’t work as advertised. If it’s from a nearby practice, ask about coming to try out the equipment in person.

• Ask for donations. Sometimes, veterinary practices may be willing to donate their used equipment to a good cause when they want to upgrade. This can be an exciting opportunity that’s difficult to pass up, especially for new rescue and non-profit organizations that don’t have a lot of cash flow yet. Just check the condition of the equipment, and see if excessive maintenance and repairs are expected.

Conclusion

Shelters, rescues, and non-profit organizations can benefit from minimizing expenses whenever possible.

The x-ray equipment needs of each operation are unique.

Factoring in your organization’s services, budget, and available supplies will help with the decision of which equipment is the best fit for your clinic.

Written by: Dr. Tammy Powell, DVM

Editor’s Note:

Our Complete DirectVet X-Ray System is available for $29,995, which includes the table, generator, DR plate, software, and acquisition computer, as well as a 5-year warranty.

Convenient, affordable monthly payments are also available. Learn more and contact us with any questions, Click Here

Looking for used equipment? Be sure to also check out usedvetequipment.com.

Investing in Staff Specialization for Vet Practice Growth

A well-trained team can make your life easier and improve your practice’s bottom line. 

Instead of trying to do everything yourself, you can delegate to someone your trust—so you can do more. 

Delegating is all about balance. There’s always a tug-of-war between giving someone enough responsibility that they feel valued, trusted, and professionally stimulated, while also not overburdening that person with more than they can reasonably handle.

It helps to communicate with your team, keeping in mind that their needs may change over time. It’s also important to make sure your highly qualified team members are fairly compensated, so they won’t need to seek out a better-paying position after they’re trained.

However, done well, there is definitely value in investing in your wonderful team members. 

Here are just a few ways to do that…

Formal Training and Certifications

The NAVTA (National Association of Veterinary Technicians in America) offers several official certifications through their Committee on Veterinary Technician Specialties. Some of the specialties include…

• Emergency and Critical Care Technicians.

• Dental Technicians.

• Internal Medicine Technicians.

• Technicians in Anesthesia and Analgesia.

• Zoological Medicine Technicians.

What does certification mean, exactly?

To take an example, there could be a lot of value in hiring a dental RVT. This is a tech or nurse who specialized in the field of veterinary dentistry.

According to the Academy of Veterinary Dental Technicians (AVDT), their members have immense knowledge of pet dental diseases and can help to educate clients on the importance of oral health, as well as on procedures the doctor may need to perform during a dental. 

This knowledge comes from a minimum of 3,000 hours of veterinary dentistry training, training under a mentor from the AVDT program, and a 2-phase (written and practical skills) exam. 

So, having a dental RVT could save you a lot of time in client communication, while also instilling trust in clients that the whole team is knowledgeable and cares about their pet.

You also know a dental RVT is a person you can trust to help you perform dental procedures efficiently.

So far as this program and other formal training programs go, you could look to hire someone who already has this certification.

Or, if possible for your practice, it may be worth it to help invest in the process for a team member whom you know will be staying with you long-term.

Continuing Education Events

In addition to CE for veterinarians and veterinary students, large conferences such as VMX also offer a wealth of choices for technicians/nurses, practice managers, and other support staff.

Topics covered often include…

• Various skills for vet techs, ranging from daily procedures to emergency and critical care.

• Hiring and employee evaluation best practices for managers.

• Social media and marketing tips.

• Communication skills.

• And more…

Supporting your team members in learning these new skills could help to add more technical capabilities to your practice, ease team communications, and make your practice’s daily operations smoother.

If sending team members to a big conference isn’t an option yet (which may very well be the case until your new practice gets established), look for local events. 

Sometimes, emergency vet hospitals or local veterinary specialists offer CE events for community veterinary practices in topics such as pet CPR.

In-House Training

Having an in-house training program for your new hires is a very common method of bringing new team members up to speed. Done well, it can be very efficient and help new employees bond to their team members.

However, it’s important to go about it the right way. Here are a few tips…

• Have a comprehensive resource—such as a staff training manual covering client communication, dress code, fecal interpretation, etc.—in a place that’s easy to access, such as a physical binder or computer file.

• Ask your new hire about their previous experience, and what questions they have for you.

• Set up a timeline, so the new employee knows exactly what they need to learn and by when.

• Decide who is doing the training. Make sure that person is up for the job—rather than viewing it as a burden, they should be someone who enjoys teaching others.

• Have check-ins during the training process—both to see if the new hire is doing their part to learn, and to be sure they’re not overwhelmed.

Learning to “Let Go”—So You Can Thrive

As a veterinary practice owner, delegating your tasks can be hard at first. 

After all, you’ve just built the practice you dreamed of, and you might feel a strong desire to have a hand in every aspect of your daily operations.

It can be challenging to let go of that need to oversee everything.

Also, delegation is not necessarily something to be taken lightly. You must be sure you have team members you trust to take on important responsibilities. 

However, once you allow your talented team to take on the responsibilities they’re trained to do, that can mean better professional satisfaction for them, and less “overwhelm” for you.

It can allow you to do more with your time each day while expanding your reach in terms of both patient care and income potential.

Written by: Dr. Tammy Powell, DVM

Social Media Tips to Grow Your Veterinary Practice Today

Which Platforms Matter Can Work for your Hospital?

You spend all day running your practice and seeing patients. So maybe social media seems like an unwelcome burden on top of your already-busy days.

However, it’s best to think of social media as an advantage rather than a burden… 

Done well, social media can bring in new clients, help current clients bond to your practice, and boost your practice’s reputation.

This can make social media well worth your time.

How to Use Social Media to Your Advantage

Here are some of the advantages of developing your social media presence…

• Building your practice’s reputation.

Social media gives a “window” or “sneak peek” into what your veterinary practice is like, which is part of your branding and also helps establish trust.

• Finding new clients.

Many potential clients choose a veterinarian not only by looking at websites and online reviews but also by looking at social media.

• SEO/Searchability.

Social media isn’t a replacement for an optimized, searchable website. However, it can aid your other efforts to show up higher in online search results.

• Nurturing existing clients.

Social media is a great way to keep in touch and nurture your relationship with current clients—so they would never dream of taking their pets anywhere else.

• Building trust during social distancing and curbside service.

During the last year, your online presence may be more important than ever…

Because of the pandemic and curbside service, clients can’t observe your clinic firsthand or see the caring way you work with their pets.

Social media can give clients an idea of what’s happening behind the scenes—which may promote a sense of trust and confidence while they wait in the car for their pet to return.

• Free marketing!

Some social media advertising is paid. However, you can post plenty of content and pictures for free!

Which Platforms Matter?

Maybe you’re convinced of the benefits—but, you have no idea where to start…

That’s normal. Keep in mind that social media management can be a full-time job and profession—so don’t expect to be an expert overnight.

Instead, ease your way in with 1-2 of the following platforms…

• Facebook is tried and true, and a great place to start.

• Instagram is another popular, growing platform, especially for Millennials (the US’s largest pet-owning population).

• YouTube. If you’re comfortable posting videos (which can be simple, short videos you record on your phone), YouTube is a great option. 

• Twitter and other platforms. Feel free to start these if you’re interested. But the three platforms listed above are usually the best bets for veterinary practices.

What Should You Post?

The key is authenticity, and visual posts (i.e. pictures and videos do better than just text).

Rather than stock photos, people want to see pictures of you and your team in action. Try to capture the times when your team is smiling and enjoying caring for pets.

Also, try your hand at simple, inexpensive tools to create infographics, such as Canva.

With that in mind, here are a few post ideas…

• Timely information and events, like holiday safety for pets in December, toxic plants to be aware of in springtime, local animal shelter fundraisers, or sharing information about your team members during National Vet Tech Week.

• Anything that encourages engagement (response to your post). For example, ask your followers which pet topics they’d like to learn about. Or put out a request for people to post pictures of their own pets. 

• Contests. For example, if you request pet photos, select one of the photos to receive a small prize like a bag of treats.

• Discounts or special offers, such as discounts during the dental month. 

• Special announcements. Share a picture and some information on any new team members you hire. Or announce closures during inclement weather.

• Cute animals! Cute animal photos and videos are hugely popular on the internet—giving you an advantage as a pet professional. Share pictures of your team members’ pets, or pics of your patients (with the client’s written consent, of course, since confidentiality rules still apply—but many clients are happy to have their pet’s picture posted!). 

• Educational content. Explain to pet owners what sorts of parasites live in your area, what are the signs of a sick pet, how to read cat body language or anything else that may be of interest. 

• Videos. Record instructional videos on how to properly clean a dog’s ears or how to administer a pill, for example. 

How to Find the Time

Here are some tips for fitting social media into your schedule…

• Decide who will be posting on social media, whether that’s you or a team member.

Don’t assume that a team member who spends a lot of time on their own social media profile will be able to manage your pages—because personal and business social media management are two different animals. 

If delegating, provide guidance on goals, strategy, and what is/isn’t an appropriate post.

• Set realistic goals.

Initially, this could be as simple as posting once per week. This is less than social media gurus say you should post—but it’s better than setting a lofty goal and then abandoning it and never posting at all.

Once you’re more comfortable, allow your strategy to evolve over time.

• Create a “cheat sheet.” 

Write down ideas of what to post, which may include some of the examples listed above. Then, you won’t be out of ideas when it’s time to post—you’ll have a reserve of ideas to draw from.

• Put social media time into your calendar, just as you would a patient’s appointment. That way, you won’t miss it.

This should include checking your platforms daily and responding to any questions and comments—in the beginning, this shouldn’t take longer than 5-10 minutes per day. 

• Watch which posts get the most engagement.

“Likes” are good, but comments on a post are even better. Try to produce more of the types of posts that get engagement.

• When you’re ready, it may be worth it to invest in a professional marketer or social media expert who is familiar with the veterinary industry.

Consistency pays off over time. So keep it up—you’ll be happy you did!

Written by: Dr. Tammy Powell, DVM

Why Fear Free Certification® Gives Your Practice an Edge

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

Navigating the World of Mobile Veterinary Home Services

The Future of Pet Healthcare: Mobile Veterinary Services Explored

In the ever-evolving landscape of veterinary medicine, the emergence of mobile veterinary home services has become a transformative force, ushering in a new era of convenience, comfort, and personalized care for both pet owners and their cherished companions.

For veterinarians contemplating this exciting venture, our comprehensive guide is designed to equip you with the knowledge and strategies needed to establish a thriving mobile veterinary practice, complete with tips on sourcing quality used equipment.

Unwrapping the Charms of Mobile Veterinary Home Services

The allure of mobile veterinary home services extends its embrace to both pet owners and veterinarians, reshaping the pet care experience in unprecedented ways.

For Pet Owners:

• Convenience Redefined: Bid farewell to the stress of transporting pets to traditional veterinary clinics, as mobile services eliminate this hassle for both pets and owners.

• Home Sweet Home: Embrace in-home care, allowing pets to undergo examinations and treatments in their familiar and cozy environments, potentially reducing stress-induced behavioral issues.

• Tailored Scheduling: Extend flexibility in appointment scheduling, accommodating the bustling lifestyles of pet owners and the unique needs of their furry companions.

For Veterinarians:

• Personalized Connections: Forge personalized relationships with pet owners and their companions, offering a unique level of attention and care.

• Breaking Clinic Boundaries: Escape the traditional clinic setting, enjoying a distinctive work environment.

• Autonomy and Control: Revel in a sense of autonomy and control over your practice, steering it in the direction you envision.

Must-Have Equipment for Your Mobile Veterinary Clinic

Ensuring the delivery of comprehensive veterinary care at your clients' doorsteps requires the right equipment.

Consider sourcing quality used equipment from platforms like [usedvetequipment. com](https://www.usedvetequipment.com/):

• Portable Examination Table

• Basic Diagnostic Tools: Stethoscope, otoscope, and ophthalmoscope.

• Essential Medications and Supplies: Be prepared for common pet ailments.

• Waste Disposal System

• Portable Laboratory Equipment: Facilitate in-house blood and urine tests.

• Reliable Transportation: A vehicle to ferry your equipment and supplies.

Crafting a Dynamic Marketing Strategy

Effective marketing is the linchpin for success. Consider these strategies to raise awareness and attract clients:

• Forge a Robust Online Presence: Develop a professional website, engage on social media, and showcase testimonials for credibility.

• Community Collaboration: Partner with local businesses, shelters, and groomers to cross-promote your services. Attend community events and pet fairs to flaunt your expertise.

• Competitive Pricing and Packages: Lure in new clients with introductory packages or discounts, tailoring your pricing to cater to specific needs.

• Emphasize Convenience and Personalization: Highlight the unique advantages of mobile veterinary services, focusing on convenience, stress reduction, and personalized attention.

Navigating the Regulatory Maze

Before setting sail with your mobile veterinary practice, acquaint yourself with the regulatory landscape in your jurisdiction:

• Obtain Necessary Licenses and Permits: Secure a mobile veterinary license or permit.

• Vehicle Standards: Ensure your vehicle adheres to safety and sanitation standards.

• Meticulous Record-Keeping: Maintain thorough records of patient care, staying in line with veterinary practice standards.

Why Mobile Veterinary Home Services Are The Savvy Choice

Opting for mobile veterinary home services isn't just a trend; it's a smart choice with numerous advantages:

Cost Efficiency: Bid farewell to hefty overhead costs associated with traditional clinics.

Flexibility in Schedule: Design your work hours for an optimal work-life balance.

Broadened Clientele: Reach a diverse clientele, including those with mobility challenges or multiple pets.

Job Satisfaction: Experience the joy of providing personalized care in a relaxed and stress-free environment.

In Conclusion

Embarking on the path of mobile veterinary home services promises a fulfilling and rewarding career. By adhering to these comprehensive guidelines and considering the option of sourcing quality used equipment, (or even new equipment) you can successfully build a thriving business that caters to the unique needs of both pet owners and their cherished companions.

Mobile Veterinary Home Services: A Comprehensive Guide

The Convenience Revolution: A Deep Dive into Mobile Veterinary Home Services

In the ever-evolving realm of veterinary medicine, mobile veterinary home services have emerged as a game-changer, offering convenience, comfort, and personalized care to pet owners and their furry companions.

If you're a veterinarian contemplating this exciting venture, this comprehensive guide will equip you with the knowledge and strategies to establish a thriving mobile veterinary practice.

The Allure of Mobile Veterinary Home Services

Mobile veterinary home services present a plethora of benefits for both pet owners and veterinarians.

Convenience for Pet Owners:

• Eliminates the hassle of transporting pets to traditional veterinary clinics, reducing stress and anxiety for both pets and owners.

• Offers in-home care, allowing pets to be examined and treated in their familiar and comfortable environment, potentially reducing stress-induced behavioral issues.

• Provides flexibility in scheduling appointments, catering to busy lifestyles, and accommodating pets with special needs.

Advantages for Veterinarians:

Enables personalized attention and relationship building with pet owners and their furry companions.

Offers a unique work environment, breaking away from the traditional clinical setting.

Provides a sense of autonomy and control over one's practice.

Essential Equipment for Your Mobile Veterinary Clinic

To ensure you can provide comprehensive veterinary care at your client's homes, you'll need to invest in the following equipment:

• Portable examination table

• Basic diagnostic tools, such as a stethoscope, otoscope, and ophthalmoscope.

• Essential medications and supplies for common pet ailments.

• Waste disposal system.

• Portable laboratory equipment for in-house blood and urine tests.

• A reliable vehicle to transport your equipment and supplies.

• Shop for used equipment. https://www.usedvetequipment.com/

Crafting a Winning Marketing Strategy

Effective marketing is crucial for raising awareness about your mobile veterinary services and attracting clients. Here are some key strategies to consider:

• Establish a Strong Online Presence: Create a professional and informative website that clearly outlines your services, location, and contact information. Utilize social media platforms to engage with potential clients, share educational content, and showcase testimonials from satisfied customers.

• Target Local Communities: Partner with local pet stores, animal shelters, and groomers to cross-promote your services. Engage in community events and pet fairs to showcase your expertise and connect with potential clients.

• Offer Competitive Pricing and Packages: Consider offering introductory packages or discounts to attract new clients. Tailor your pricing to the specific needs of your target audience.

• Emphasize Convenience and Personalized Care: Highlight the unique advantages of mobile veterinary services, emphasizing convenience, reduced stress, and personalized attention for both pets and owners.

Navigating the Regulatory Landscape

Before launching your mobile veterinary practice, it's essential to familiarize yourself with the applicable regulations and licensing requirements in your jurisdiction. These may include:
Obtaining a mobile veterinary license or permit.

• Ensuring your vehicle meets safety and sanitation standards.

• Maintaining proper records of patient care and adhering to veterinary practice standards.

Why Mobile Veterinary Home Services Are a Smart Choice

Mobile veterinary home services offer a compelling alternative to traditional brick-and-mortar clinics, providing several distinct advantages:

• Reduced Overhead Costs: Eliminates the need for expensive clinic facilities, rent, and utilities.

• Flexible Work Schedule: Set your own hours and work-life balance.

• Expanding Client Base: Reach a wider clientele, including those with mobility challenges or multiple pets.

• Enhanced Job Satisfaction: Experience the satisfaction of providing personalized care in a relaxed and stress-free environment.

Conclusion

Mobile veterinary home services present a rewarding and fulfilling career path for veterinarians seeking a unique blend of entrepreneurship, clinical expertise, and compassionate care.

By following these comprehensive guidelines and embracing the inherent advantages of mobile veterinary practice, you can successfully establish a thriving business that caters to the needs of pet owners and their furry companions.

How to Select the Best Veterinary Portable X-Ray System

There are many possible reasons why a veterinarian might need a portable x-ray machine. This is especially true for mobile or farm call practices, which must perform diagnostic procedures on-site.

Even a brick-and-mortar practice might occasionally need portable x-ray capabilities, for example, to perform horizontal beam shots.

How much to invest, which features to look for, and other purchasing requirements vary from practice to practice. Here are 10 factors to help a busy practice decide which veterinary portable DR machine or system might best suit their needs…

1. Cashflow/return on investment plan. An equine specialist who takes frequent, detailed images of the limbs and hooves might want a top-of-the-line machine. On the other hand, a small animal house call practice that specializes in hospice and end-of-life care might not perform nearly as many x-rays.

Think about how often your practice performs radiographs, and whether this number is expected to increase due to demand. Do clients in your area expect radiographs, and what is the going rate for x-ray studies?

Once expected income from the equipment is known, that can help determine how much a practice should spend on its new system.

1. Imaging requirements. Which patients will your practice see and take radiographs on? Which types of studies will be performed? 

Look at imaging capabilities and technical specifications to determine which portable x-ray machines can get the job done. Ask to take the machine on a trial run for different size patients (or body versus extremity shots, etc.) to make sure it provides the level of detail required on different types of studies.

1. Durability. Conditions outside the clinic are not nearly as controlled in terms of temperature, movement/transport in a truck or van, accidental drops, and elements like dust, dirt, humidity, or precipitation. This is especially true for farm calls or remote destinations in hot or cold climates. 

If this sounds like your practice, it’s important to make sure your x-ray system stands up to all these conditions, lasts long enough to make your investment worthwhile, and still delivers results without malfunction or loss of diagnostic quality. Protective cases and screens, especially waterproof ones, can also be a necessity.

1. Warranties. Even with a durable machine and good protective measures, accidents happen. Ask about warranties—is one in place, what it covers, how long it last, and how much it costs to extend? 

2. Support and maintenance. Ask about routine maintenance, what’s included, and any additional costs. Even brand-new machines need proper maintenance to keep running at their best.

Also, is there a 24/7 tech support line available?

Finally, many veterinarians inquire if a loaner x-ray system is available should their equipment need to be sent back to the manufacturer for time-consuming repairs. That way, a practice can stay up and running in the meantime.

1. Cords or cordless/wireless. Unlike large machines that must be installed in a standing facility, some veterinary portable DR systems are wireless. 

This could mean “cordless,” in terms of having a rechargeable battery so the generator doesn’t need to be plugged in. This is advantageous at locations where there’s not a convenient electrical hookup inside a barn. On the other hand, some vets note a battery might not last the whole day if they have a lot of appointments or drive long distances.

It could also mean “wireless” in terms of sending images from the sensor to a digital reader/storage software through a wireless internet connection. This can be convenient because there are less wires that could be tripped over or damaged. On the other hand, it could be a disadvantage in places with reception issues.

1. Ease of use. Although there’s a learning curve for any new veterinary equipment, some machines are much easier than others to learn. 

Look for intuitive interfaces that will be easy for the team to start using right away. Presets for different types of species and x-ray studies are also very helpful, potentially reducing errors and saving time.

Additionally, something that is lightweight, compact, ergonomic, and easy to hold and operate will help reduce the risk of drops or other accidents.

1. Digital veterinary software compatibility. It’s common to integrate DR images directly into practice management, image viewing and sharing, or electronic medical record software. To avoid headaches and extra work, make sure the portable veterinary x-ray system you are purchasing is compatible with your practice’s software. 

To avoid future expenses as much as possible, ask if software upgrades are included and if tech support or a guarantee is provided in case of any malfunctions. 

Finally, ask about the privacy/security of the software.

1. Where to purchase. Consider speaking to vendors you know and like. It might make sense to bundle purchases (such as an x-ray system and laboratory equipment) together for a discount. Just check the fine print, as some of these deals tie a veterinarian to a contract for minimum ongoing purchase requirements (for example, a minimum number of lab tests per month).

Other sellers, including used equipment sellers, can also offer some great deals. Look for reviews, reputability, and specifications of the equipment. Ask colleagues for their recommendations, too.

1. Financing and money considerations. Is purchasing the equipment outright an option? Or does financing make more sense in terms of cash flow? Remember to check on tax benefits as well. 

Research and discuss everything with decision-makers at the practice.

Consider including team members who would be using the portable veterinary x-ray system—they might have very valuable input for what would improve efficiency.

Consult business, tax, or financial professionals as needed.

Although a large equipment purchase is a significant investment, it can also be a way to bring new income to the practice—not to mention boost patient care and improve workflow and efficiency. 

Written by: Dr. Tammy Powell, DVM

How to Deliver Difficult News to Pet Parents with Empathy

One of the most challenging parts of our job is preparing to deliver life-altering news to our pet parents.

Delivering a poor prognosis or having an end-of-life talk with pet parents is always a tough conversation, and no conversation is precisely the same.

 Each discussion needs to be approached with empathy, sensitivity, and clarity.

Having a framework that both you and your team can use when delivering tough news to pet parents can be helpful.

SPIKES – Six-Step Protocol for Delivering Bad News

When delivering news that may be shocking or upsetting to our clients, we want to be sure we can share in a clear, honest, and compassionate manner.

Baile and Buckman developed a framework to help health professionals convey the major talking points that should be addressed during these conversations.

SPIKES is a six-step framework that you and your team can use when having difficult conversations with your clients.

So, what does it mean?

SPIKES is a simple acronym to help you remember the framework:

• S- Setup

• P- Perception

• I- Invitation

• K- Knowledge

• E- Emotions

• S- Strategy and summary

Let’s dig in a little deeper…

Step 1: Setup

Setup the discussion in a private and comfortable location. Try to ensure it’s a space that will avoid interruption. If there’re more than one staff member who will be present, be sure you’re both clear on who will deliver the news.

Step 2: Perception

 First, try to understand the pet parent’s perception of their pet’s condition. It can be helpful to understand how serious things are from their perspective and can tell if perhaps they’re in denial.

To help start the conversation, you may ask something simple like, “What have you made of Charlie’s illness so far?”

During this part of the discussion, you can pick up on verbal and non-verbal cues to help you gauge their feelings about the situation. 

Step 3: Invitation 

During this step, we want to respect what our clients are emotionally ready to hear. This step can help you form your delivery.

You might ask, “At what level do you want to know about Charlie’s prognosis.”

This is by no means a way to withhold facts about a patient’s condition or illness, but rather, it may help you understand whether the client is looking for a “straight to the point” answer or if they’d like more detail to better understand the situation.

Step 4: Knowledge

Consider this the “meat and potatoes” of the conversation.

During this step, we want to share:

• Diagnosis

• Treatment Plan (if applicable)

• Prognosis

• How we can support

When possible, share client handouts or written details about the diagnosis, treatment plan, and prognosis. This can help the client digest what’s being shared and make a more informed decision about the next steps.

Step 5: Emotions

 These conversations are always challenging. Try to assess your client’s emotions during your discussion.

• Acknowledge any shock and ask them how they’re feeling.

• Their response may range from silence, distress, denial, or anger.

• If you’re unsure how to respond, try to respond empathetically. Allow some silence to let things sink in.

• Avoid arguing or getting defensive. Do your best to create a space that allows the pet parent to express their emotions without criticism.

Step 6: Strategy and Summary

To wrap things up, summarize what’s been discussed so far and clarify the next steps.  

• Pet parents will likely look to you to help make sense of the news.

• Explain what will happen next and what they can expect.

After the Conversation

After the conversation and your client has left, would you like a moment to yourself before seeing your next patient?

If taking a break at that moment doesn't work, you should plan for when you can find some breathing space within the next hour.

Suppose you’ve been following along with our recent series of articles. In that case, you know the demanding nature of the veterinary field can lead to high-stress levels and burnout among veterinary teams.

Be sure to prioritize your needs and well-being during high stress.

Take breaks, practice mindfulness, and engage in activities outside of work that make you feel recharged and refocused.

Remember, you’re not alone. Lean on your team for support and contact a professional who can offer tailored and personalized support.