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Meet our EDITORIAL ADVISORY BOARD!
DVM, DACVS-SA
Jenifer Chatfield
DVM, Dipl. ACZM, Dipl. ACVPM
CVT
DVM, DACVECC
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Barkleigh Productions, Inc. - President
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Britany Smith
DVM, CVPM
-Tamara Grubb,
President of International Veterinary Academy of Pain Management (IVAPM)
s veterinarians, the health of our patients is paramount, and one way to maintain their health and wellbeing is understanding and utilizing BEAM (Behavior, Energy, Appetite, Mood) scores. BEAM scores can greatly enhance our ability to detect early signs of disease in pets, leading to more successful treatment outcomes and, ultimately, happier and healthier animals. The following aims to provide a comprehensive overview of how veterinarians can use BEAM scores to detect disease, monitor pet health and optimize veterinary visits.
1. Behavior: Changes in a pet’s behavior can be a significant indicator of their health. For example, a dog that once greeted the client with barks and a wagging tail but now greets them with a low whimper or shows reluctance in getting up may be signaling discomfort or distress. Similarly, a cat that used to enjoy cuddles but now prefers solitude might be experiencing pain or illness.
Monitoring BEAM scores is a helpful and easy-to-implement part of veterinary assessments. Early detection of subtle changes can lead to timely diagnostic and therapeutic interventions. Here are some steps to integrate BEAM scoring effectively into veterinary practice:
- Establish Baselines. Determine normal BEAM scores for each pet during regular check-ups to identify any deviations during future visits.
- Educate Pet Owners. Inform pet owners about the importance of BEAM scores and how they can monitor these at home, empowering them to journal the scores and note any changes that will prompt them to seek veterinary care.
- Encourage Regular Updates. Encourage pet owners to provide updates on their pets’ BEAM scores during routine visits or via digital communication tools.
- Integrate with Physical Examinations. Combine BEAM score assessments with physical exams to provide a comprehensive overview of a pet’s health.
- Use Technology. Leverage technology such as pet health apps or validated activity trackers to continuously monitor changes in pets’ behavior and energy levels, facilitating early intervention.
- Present Case Studies. Presenting detailed case studies can help illustrate how changes in BEAM scores have led to the identification and management of early-stage diseases, encouraging owners to follow through with them.
By David Ranney
lanning for retirement is very personal. Some people prefer to manage their own investments and plans, whereas others would much rather hand over this incredibly important task to a trusted professional. Regardless of which side you are on, there are a number of common mistakes often made by individuals and small business owners, which have a profound impact. The key aspects to help you avoid these mistakes are keeping costs low, avoiding risk and understanding the importance of working with a fiduciary.
Keeping Costs Low
The largest U.S. firms enjoy total 401(k) fees or costs of under 1%; however, small businesses, like many veterinary practices, have historically found it difficult to compete with this—until recently. Thankfully, fundamental changes to the small business 401(k) market have brought in better, more modern approaches to retirement planning.
It is essential that any business owner review their plan and ask their provider if current fees are in line with the market. For example, if you are paying 3% of your assets under management every year in fees and it is reduced to 1% or lower, this directly translates to higher balances for you and your valued employees. With compound interest taken into account, this seemingly small change can have a dramatic impact on your financial future. And, these lower fees tend to lead to increased staff retention and satisfaction, as they see less of their retirement savings being withdrawn as fees on an annual basis.
Veterinarians with individual retirement plans should consider reassessing their fees as well. If you are paying fees 2.5%+ of assets under management while seeing poor returns, this may leave your savings stagnating rather than growing. There are many options for individuals in the market that sit under 1% of assets under management.
“By periodically investing in an index fund, the know-nothing investors can actually outperform moost investment professionals.”
– Warren Buffett
“By periodically investing in an index fund, the know-nothing investors can actually outperform moost investment professionals.”
– Warren Buffett
Avoiding Risk
Even Warren Buffett, one of the greatest investing minds in history, encourages investors large and small to focus on low-cost index funds. He famously declared, “By periodically investing in an index fund, the know-nothing investors can actually outperform most investment professionals.”
Being a financial advisor does not make someone a fiduciary, so make sure that you can confirm—preferably in writing—before deciding to work with a firm. This is especially important for veterinary practice owners that have a 401(k) plan for staff. If your plan provider is not a fiduciary, then it is you, the veterinary practice owner, not the 401(k) plan provider, who is liable for any breach of fiduciary responsibilities.
In the case of “legacy” 401(k) plans, it is unlikely that the provider will act as the fiduciary automatically, despite charging higher fees. This is almost certainly the case if your 401(k) provider is a payroll company or a large bank. The result of this could be that the veterinary practice owner is held responsible for restoring plan losses and costs associated with any inappropriate actions committed, even if these issues were caused by a stockbroker. Moving to a fiduciary structure will reduce your risk, ensure that the advisor is working in your best interest and should lower fees dramatically.
Self-Management
Make sure that you have a financial plan and stick to it, cut your fees, and make sure that you are getting a good rate of return. If you commit yourself to planning for retirement today, your future self will surely thank you.
Photos provided by Advanced Care Veterinary Services
find that too many people think ‘my dog is just getting older’ or ‘my dog is more tired the older it gets’ and do not realize their pet is in pain. Older dogs should still remain active and not have a considerable ‘slow down,’” shares Douglas Stramel, DVM.
“So my passion is to treat painful pets like that and then hear the owner say ‘my dog is acting like a puppy again,’” he continues. “I love to be able to take on cases where other veterinarians say there is nothing more they can do and then be able to help the pet live a less painful life, and for the pet to still be around for the owner to enjoy longer.”
“We see dogs that are partially paralyzed and utilize acupuncture, photobiostimulation, and shockwave, among other therapies, to help them regain the ability to walk,” he shares. “We also see a lot of pets with cruciate ligament injuries that are not ideal surgical candidates and we help them regain function and use of the affected knee. We have even been known to treat a bunny or a chicken with acupuncture to help it with mobility issues.”
“By working with Zoetis and Elanco, I have provided continuing education presentations and wet labs on the topics of anesthesia and pain management to practitioners in north Texas and Oklahoma,” he adds.
“A brand new product was just released called Rimadyl,” Dr. Stramel continues. “It was the first FDA-approved NSAID for dogs to treat pain and inflammation. After doing my exam, I thought I could help the dog with the use of this product. The dog, Molly, responded very well and I was able to keep Molly comfortable for the next two years. This was my first and most important step in getting into the pain management field.”
“There are a lot of brilliant minds involved with both IVAPM and many universities that are continuously looking at new ways of treating pain,” Dr. Stramel says. “The newest product we have is not even a drug per se; it is a monoclonal antibody that targets the pain associated with osteoarthritis. I look forward to what all will be released in the next few years, as there is quite a bit in the works.”
Even with his many accomplishments and specialized training, Dr. Stramel has proved that the sector of veterinary pain management is complex and always changing. However, he goes on to say that there are additional measures that general practice vets can take to identify and treat pain in their patients.
“It starts with thoroughly palpating the pets for a good musculoskeletal examination,” Dr. Stramel advises. “There have been numerous times, after I examine a pet, the owner states that no one has ever touched their pet so much during an examination. Without thorough palpation it is quite easy to miss important details about the pet’s pain.
While his days in practice are dedicated to managing pain in pets, Dr. Stramel still finds time to enjoy his home life with his family on their Texas ranch.
“Most of my free time is used by my eight-year-old daughter and her barrel horse, Jackpot,” he says. “My wife runs an amazing boutique horse hotel and Airbnb so I have plenty of chores to do around the ranch. Lastly, I make time for my daughter and I to go fishing, explore the woods, and ride the four-wheeler.”
The specialty sector of pet pain management is oftentimes one that is taken for granted; to treat a pet for its symptoms—which often include pain—is veterinary care. However, identifying the source of pain and choosing the proper method of treatment are areas that require skill and a depth of knowledge, and this is certainly a specialty that Dr. Douglas Stramel has mastered, relieving his patients from pain and putting their owners at ease knowing their pets are no longer suffering.
To learn more about the International Veterinary Academy of Pain Management, visit www.IVAPM.org
Photo provided by PetPace
n the ever-evolving field of veterinary research, staying ahead means embracing innovation. That’s why advancements in wearable and mobile health technologies have sparked a revolution in how animal health is monitored for research.
With advancements in miniaturized sensors, modern smart collars can house several measurement devices within a single device that can be worn as a normal pet collar. Due to this streamlined design, smart collars can now collect real-time data across a variety of vital signs and biometrics, including temperature, pulse, HRV, respiration rate, posture, activity levels and more.
As with any use case, AI models become more powerful when provided with more data to learn from. Therefore, when data is collected from an animal over a longer period, AI can better identify baselines unique to the animal and can help discover potential diseases before they would otherwise be noticed. By leveraging advanced machine learning technology, researchers can identify anomalies and learnings like never before.
Another area that’s a growing trend is TeleVet Medicine. In the U.S., the TeleVet Medicine market is $137M annually and projected to reach $900M in just a few years. Wearable smart collars can help triage the pet while on a virtual visit, allowing the vet to make decisions based on objective data rather than subjective information from the pet owner. This elevates the TeleVet experience for better outcomes.
Wearable technology is reshaping the landscape of pet health research. By providing researchers with the tools they need to gather real-time data from animals in their natural environments, this technology is unlocking new possibilities for understanding and improving pet health.
he day starts like any other. You check the weather report, you check your watch for your fitness stats, and you check your texts and emails. You check the numbers, note the trends and plan your day. You go to work and most likely hear your colleagues talking about their “numbers” and what they need to do. Most of us have trained ourselves to look at the numbers and adjust accordingly. Can the same apply to the veterinary team and business numbers?
Imagine if the veterinary healthcare team participated in looking at some business numbers. If you gave the team specific stats, would they be interested? If they saw a negative trend, would they talk about how to change the numbers? Probably. All it would take is explaining why and what to do. So how do you make this happen? Enter Open Book Management…
Open Book Management (OBM) involves sharing data (i.e., business performance and financial information) with the team and training the team to use the information in their daily work. It encourages team members to take responsibility for the business’s success and think as if they own the business and are investing their resources into it. It promotes the feeling of having a part in the business’s growth, success and reputation.
OBM is more than just numbers tossed out to the masses. It is about the numbers that are important to the operational success of the business of treating pets. It is about interpreting those numbers and developing plans for changing them. It is about the team seeing how their actions and decisions affect the business, patient care and their paycheck. Ultimately, it is about strengthening the circle of care and not permitting the circle to be broken.
The basis of using OBM is to give team members information that helps them do their tasks effectively and efficiently, focusing on things they are directly involved in. In the book The Great Game of Business, Jack Stack lists some basic rules for OBM: Teach team members the metrics, keep score to monitor improvements, and provide a stake in the outcome.
With all the talk about employee satisfaction and employee engagement, why not have a system that actively involves your team members in monitoring and changing metrics that they have direct contact with? Establish critical numbers and encourage creative thinking, teamwork, and a sense of partnership to engage your employees and promote the success of the business, world-class patient care and excellent client service.
- Brings every team member to the decision-making table
- Shows how everyday decisions impact patient care, client service and business performance
- Answers the age-old question of why we must cut costs or why we need to be more productive
- Opens the door to ideas, initiatives and insights from others
- Builds trust through the transparency of data sharing
- Improves team member engagement
Once the “why” is addressed, the next step is forming scorecards and assigning teams. Remember, this is about your strategic plan for the year, so focus on what is essential to your practice goals as you build the scorecards. Teach the team about OBM and how to use their assigned scorecard to improve patient care, client service and business performance.
Here are some steps to follow to set up a team to use OBM:
- Create a scorecard with Key Practice Indicators with that team.
- Assign roles of “information gatherers” to team members who will be responsible for gathering data (this may be asking the manager for specific numbers from Quickbooks or having access to a PIMS report).
- Gather information and present to the team at a monthly meeting.
- Discuss trends with the entire team and allow them to give ideas and feedback.
- For numbers that are doing well, use Appreciative Inquiry and see if techniques can be applied to other KPIs that are not doing as well.
- For numbers that are not doing well, discuss ways to make changes.
- Be sure to celebrate successes (catered lunches, bonus pay, etc.).
Here is an example of how the above steps could work:
A strategic goal is to improve the care of the older pet population. Metrics to put on the scorecard are the number of older pets, the percentage of those pets receiving eye exams, senior wellness tests and other vital services beneficial to an older pet. Put that team in charge of tracking the trends and talking to the rest of the team about what works well and what doesn’t when making a recommendation. Now for the spark of innovation—the “old pet” team will see areas of strengths and weaknesses in the program, think of solutions, and be responsible for discussing ideas with management and implementing change.
In addition to pet care, business performance can benefit from OBM. For example, everyone always hears that inventory is the second largest expense after wages. Since the team has its hands all over inventory, why not create a scorecard and assign some “eyes” to it? Income-to-expense ratios (especially lab, food, pharmacy and designer drugs) are valuable metrics for identifying possible problem areas.
OBM enables you to strive for a partnership with your team, which means that there is value in the efforts and ideas of each person. The team sees the scorecard and how their action contributes to the practice’s mission and the business’s success.
It is hard to keep your finger on the pulse of the business. We are inundated with information regarding client numbers, the number of visits, cat versus dog visits, repeat visits, new visits, etc. After hearing all these studies and reports, do you have the time to look at your numbers? Do you have time to track trends in the past quarter, the past year or the past three years? With OBM, you can have teams involved in the tracking. Set up a scorecard, be clear about the target to aim for and let the team start to monitor.
Using OBM, your team can see the changes—rather than just hearing you complain about client or pet numbers. Now you have something to talk about, to get ideas about and to try to change with the help of the entire team. Ideas tried can be monitored and results evaluated; keep with the idea or tweak it and see if it affects the numbers.
Remember, you can’t lead the band and play all the instruments. So while OBM is sometimes thought of as sharing financial information with the team, it is really about leadership, team development, communication, client service, performance improvement and profitability improvement. With Open Book Management, the attention to practice performance is made available to those team members who can make a difference and affect the numbers. Responsibility for the success of the practice is now a team effort.
Understanding the Chiropractic Connection to the Nervous System
By William Ormston, DVM
bove-Down, Inside-Out” is a statement of chiropractic philosophy. It means that the brain is the control center of the body; the “Above.” The control of the body then travels “Down” the entire body on the “Inside” and finally flows “Out.” It is a very simple phrase born at the turn of the 20th century to express a very complex process. It refers to the functioning of the nervous system and all its manifestations.
The more you know about the nervous system, the more you can appreciate the phrase. If we remember that healing comes from “Above-Down, Inside-Out,” then the importance of the spine becomes clear. The body was designed from day one for the brain to be in control of everything—from regulating movement to healing.
All but two nerves exit the brain at the back of the skull, and most of these go through the foramen magnum. Lack of motion causes “SHaRP,” a phenomenon every student studying to become a doctor learns. SHaRP is an acronym that stands for Swelling, Heat, Redness, and Pain. If this occurs at the base of the skull because of a subluxation at the level of the atlas, every nerve will be affected in some way.
When a spinal segment doesn’t move properly, it appears to influence how the brain perceives and responds to all other sensory information. Spinal function seems to be one factor the brain uses as part of its processing and integration of all information. This may cause some animals to be afraid of shadows, lights and noises that a subluxation-free animal would ignore.
Spinal adjustments can restore normal movement patterns in these spinal segments, which will restore a more natural pattern of input from the spine to the central nervous system. In turn, this will allow the spinal cord, brainstem, and brain to process incoming information in a more coherent and meaningful way. Therefore, seemingly unrelated events are corrected by the animal that is under chiropractic care.
This function is very important in our athletic animals. It has been shown that the number of muscle sensors are remarkably high in the deep, small upper-neck muscles (those around the atlas and base of the skull). These deep upper-neck muscles seem to act primarily as proprioceptive sensors in the body, rather than playing any significant role in actual movement of the head and neck.
White noise is a constant background noise or processes in the brain. With over three trillion bits of information reaching the brain every second and the conscious mind only handling about 50 bits per second, that leaves a lot of stuff going on in the background; things like breathing, cellular metabolism, blood circulation and immune system function. The subluxation of the atlas affects every function in an animal’s body.
The four key functions of the vagus nerve are: 1) sensory, 2) taste, 3) motor function for the muscles in the neck responsible for swallowing and speech, and 4) parasympathetic functions that control the digestive tract, respiration and heart rate.
The nervous system can be divided into two areas: sympathetic and parasympathetic. The sympathetic side increases alertness, energy, blood pressure, heart rate and breathing rate. The parasympathetic side (where the vagus nerve is heavily involved) decreases alertness, blood pressure and heart rate. It helps with calmness, relaxation and digestion. As a result, the vagus nerve also helps with defecation, urination and sexual arousal.
The vagus nerve communicates with the diaphragm. With deep breaths, an animal feels more relaxed. The vagus nerve sends an anti-inflammatory signal to other parts of the body. If the vagus nerve is overactive it can lead to the heart being unable to pump enough blood around the body. In some cases, excessive vagus nerve activity can cause loss of consciousness and organ damage. Proper vagal tone is important in lowering the heart rate and blood pressure.
The vagus nerve also sends information from the gut to the brain. This information is linked to dealing with stress, anxiety and fear. Heart rate variability (the evenness of the heart rate) has been shown to decrease with chiropractic adjustments. Lower heart rate variability indicates a more relaxed individual or animal.
Most animals are being brought to the clinic because they are having difficulty with some organ controlled by the vagus nerve. Therefore, it’s important to check the movement at the base of the skull to see if a chiropractic adjustment would benefit them.
Following the Above-Down, Inside-Out concept, chiropractic care may be just what is needed for patients in your veterinary practice.
- Haavik, H. (2016). The Reality Check: The Quest To Understand Chiropractic From The Inside Out. Haavik Publishing.
eing a veterinary professional is a labor-intensive job. You’re on your feet for long hours and often in odd positions drawing blood, performing surgery or restraining an animal. When it comes to your body, aches and pains tend to come with the profession—but it doesn’t have to be so bad. Here I will share with you some of the things I’ve found to be helpful in reducing inflammation and managing chronic pain.
Simple yoga poses can be done throughout the day instead of adding it on to your already full schedule. These poses help you notice and correct things that might later manifest into stronger pains or require medical interventions. They will also help you feel refreshed after hours on your feet with the weight of gravity pulling you down. Here are two simple poses to try:
- Mountain Pose: Stand with your feet hip distance apart. Lift and spread your toes, then lower them back down and connect with the ground.
- Forward Fold: Stretch your arms forward away from your shoulders and hinge at your hips to bow forward with your torso.
The following are three of the top anti-inflammatory foods and some simple ways to incorporate them into your diet.
Turmeric also comes in health “shots” found at the supermarket. Paired with other herbs and spices, these can boost your immune system. Turmeric and immune-boosting supplement combinations are also available in a capsule form, which can be easier for busy professionals—and you don’t taste the strong flavors. You can also travel with these, which is a game changer for recovering.
If you are new to the land of tea, steer away from floral flavors, sticking with fruitier flavors. For existing tea drinkers who are ready to up your game, aim for green tea or matcha tea for the best health benefits.
For example, if you make coffee in the morning, put the blender right beside it. If you prep your coffee the night before, do the same with your supplements or smoothie supplies. Or, when you reach for the door handle to examine a patient, do a mental check and readjust your body into mountain pose.
Before you know it, these small changes will become second nature. And if you stray from a previous health commitment, gently remind yourself to move toward that direction once again. For the most part, you can’t see or feel the benefits of incorporating these new practices straight away, but your cells will thank you as they recover from daily stress.
In her book, author Erika Sinner beautifully captures the profound impact of pets who have a permanent residence in our hearts. The exploration of grief, resilience, unconditional love, and companionship reminds readers that we are not alone in experiencing the loss of a beloved pet.
Pétillant naturel—or pet nat—is a traditionally made semi-sparkling wine that’s bottled while it’s still fermenting. Hazy, fruity, and generally low in alcohol, pet nats bring a year-round taste of summer to your table.
Ready, Vet, Go provides veterinary practices and new vets a successful path to a collaborative and long-term relationship, ensuring the future and wellbeing of the veterinary profession. readyvetgo.co
Rucking (walking with a weighted pack) is said to build endurance, improve heart health, burn calories, and strengthen bones. Rucking is now more accessible and mainstream with companies designing weighted packs for different body types and with lower, more manageable weights.
Ready, Vet, Go provides veterinary practices and new vets a successful path to a collaborative and long-term relationship, ensuring the future and wellbeing of the veterinary profession. readyvetgo.co
Hosted by Stacy LeBaron, each episode explores inspiring stories and voices driving the spay/neuter movement, all while keeping focus on the bigger picture. www.unitedspayalliance.org/podcast/
Get your continuing education with some southern hospitality in Fort Worth, TX, including exhibits, interactive labs, and social activities. swvs.org
2 leading trade magazines for the pet professional in your life with all the content to assist them in keeping your pet healthy, happy and beautiful.
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