Thursday, May 28, 2015

More things I learned from the AVA conference

Laser goggles for dogs and cats. To protect them from therapeutic lasers. Spotted at the dlc stand.

Conference world is a weird parallel universe. At the 2015 AVA/NZVA Pan Pacific Veterinary Conference this week, lectures begin at 6.45am and carry right through to 6pm. Sure, one is fed three times a day, but it is a totally immersive experience and I can’t blog as fast as I am learning new information. 

Today is the final day of lectures, and tomorrow we break for workshops which are a bit more interactive/hands on.

There are eight concurrent streams, so one can’t attend everything at once as much as one would like to.

For me yesterday’s highlights included a talk by Professor David Mellor on promoting positive welfare states. For years our thinking at welfare has been dominated by the “five freedoms” model – animals should be free from hunger, pain, fear and distress etc. But Professor Mellor is one scientists who has pushed for a model of welfare and measures of quality of life that incorporate positive welfare states. He has worked on the “five domains” model which is discussed elsewhere.

Dr Magdoline Awad from the RSPCA chaired the session with Professor David Mellor.
He put forward a five-tier system for assessing quality of life in animals.
  1. Animals that have a life not worth living – these animals should be euthanased in the interests of their welfare.
  2. Animals that have a life worth avoiding – these animals may have their quality of life improved by veterinary or husbandry interventions, at least to ensure the negative experiences are alleviated so they live a theoretically neutral level
  3. The theoretical point of balance – where the negative and positive welfare states produce a neutral quality of life.
  4. A life worth living – meeting all minimum standards of codes of welfare.
  5. A good life – meeting all of the best practice recommendations in codes of welfare. Animals that have an overall positive existence.

The behaviour stream produced some heated discussion yesterday when US veterinary behaviourist Meghan Herron discussed the “top ten behaviour tips”. One of these was the myth that dogs that behave aggressively are dominant.

There was some colourful discussion when Dr Herron stated that “The idea that there is a dominance hierarchy between humans and dogs is no longer scientifically accepted. Social ranks do not cross species lines. Most human directed aggression is based in fear (perception of threat) or protection of resources.”

Wherever you sit on the fence (and the fence keeps moving if you look at the literature), our beliefs about the motivation of canine behaviour do change the way we approach and treat dogs and they have massive welfare implications.

Veterinarian and coach Dr Natasha Wilks gave a great talk on “understanding clients to increase compliance.”

Veterinarians and doctors often use the term “compliance”. But a lot of non-medicos find the term offensive and I get it. I did an arts degree before I studied vet science so the term “compliance” to me was about following a rule, or doing something that some authority tells you because they said so. I remember once reading a letter to an editor from a veterinary client saying “I heard my vet talking about my compliance. How dare they!”.

In a medical context, we mean how closely the patient or client stuck to the treatment recommendations.

But the above example really does speak to one reason why clients don’t always follow our recommendations. It’s that “us vs them” type thinking which is rapidly becoming old school. We’ve not yet found a better word for compliance but we need to find something that reflects shared decision making (happy to take suggestions).

What happens “out the back?” Dr Wilks described how veterinarians are rapidly desensitised – we tend not to notice the noise or smells in our clinic (a poor sense of smell is a definite career attribute in this field, I have to say). But we don’t see the same things clients do.

She stressed the need to SHOW clients what the problem is – point it out, demonstrate it (if possible), take a photo, show the x-rays, show them the blood results. Use models, give a handout, draw a picture, use videos, refer to a blog or website.

The important thing is to then inform the client HOW this affects their pet. Does it cause pain and if so, is it mild, moderate or severe? Is it likely to worsen? What are short and long term effects? What do they need to look for and what do they need to do?

Yesterday at lunch when I was feeling a bit fatigued along came Dr Ilana Mendels from VetPrac who managed to eat lunch, set up her personal boom box (she funked it up with Shake Your Booty) and trialing a canine massage bed (she's sitting on it) at the same time. 
There have also been oodles of meetings, the Australian Veterinary Orchestra's second ever concert, university reunions and free health checks for vets.