How can pet owners get the most out of low and no-contact veterinary visits

 

Social distancing in veterinary settings is critical to ensure ongoing veterinary care.

New South Wales, the state from which this blog comes to you, is in hard lockdown. That means hardship for many people, but it also means the return of low and no-contact veterinary visits.

Low and no-contact veterinary visits are designed to maximise social distancing between all humans involved to minimise the risk of COVID-19 transmission.

You can still take your companion animal to the vet.

But the experience may be different to the vet visits you are used to.

At the advent of the COVID-19 pandemic I undertook research on ethically challengingsituations encountered by veterinary teams. One of the major issues that emerged was being able to attend to animals (our core work) while also keeping ourselves and our families safe. Low and no-contact consultations, and confusion associated these, was one cause of stress.

So, how can companion animal owners access necessary care for their animals while also ensuring the safety of veterinary team members?

1.     Let the vet team know you are coming.

Book ahead for an appointment or, if a genuine emergency, phone and let the team know that you are coming.

Different clinics may have different protocols, for example some may require you to wait with your animal while others may allow you to drop off animals.

2.     Prepare in advance.

Veterinarians usually take a history when they see a companion animal. This isn’t just chit-chat – it includes vital information which directs assessment of the patient and further investigations.

Broadly, a history can be divided into two parts:

General history.

This includes general information about a companion animal including what they are normally fed (meals, snacks AND treats); their normal activity levels and exercise routines; and lifestyle factors, for example whether they are indoors or outdoors, have contact with other animals or have a history of travel. This also includes medication (including complementary and alternative medicines) and supplements taken. Where possible it helps to provide the name of the medication, the dose and how often it is given (e.g. ½ of a 50mg tablet morning and night). Finally, if your pet has any allergies (for example to medication) or intolerances (for example to food) it helps to know this in advance.

Specific history.

This relates to the reason for coming in. What is the problem or problems? When did it begin? What are the symptoms you have noticed and how have they progressed? Were there any changes in the lead up to the onset of symptoms? (For example, I saw a dog with a three-day history of vomiting. The day before that, she was fed a leg of lamb).

Our research revealed that communication between veterinary team members and clients is more challenging during the time of COVID. For example, some veterinary team members reported that it was hard to hear or be heard clearly while wearing masks; others struggled in non-contact consultations because neither they nor the client could point to an area on the animal’s body.

If you have multiple concerns that you want addressed, write it down. This helps reduce miscommunication.

If symptoms are intermittent, infrequent or episodic (like coughing or limping that comes and goes) it can be useful to take a video to share with your veterinary team. If there is a concern relating to a site on the patient’s body (for example, a wound or a lump) it can be helpful to take photos – both from a distance and also close up.

3.     Be proactive.

If your pet is typically very fearful or shows signs of reactivity (e.g. barking, growling, lunging, licking lips or muzzle) or aggression in a veterinary setting, let the team know so they can work with you to plan the best strategy.

4.     Follow the Government advice.

If you are sick, awaiting the results of a COVID test or isolating, have someone else bring your animal to the vet, or contact your veterinary team for advice.

Just like anywhere else, if you do enter a veterinary facility, wear a mask, sanitise your hands and check in using the QR code provided.

It is important that your mask stays on even when you are talking. Often people want to remove their mask when they are speaking to ensure they speak clearly – but you need to avoid doing so.

Wherever possible, only ONE person should accompany the animal to the vet.

5.     Please be patient.

Right now, veterinary clinics may be very busy. This is due to a number of factors including: staff shortages; increased staff absenteeism (for example, due to COVID testing and isolation); a large number of animal adoptions during the pandemic and the need to minimise foot traffic in veterinary hospitals.

While you wait, please practice social distancing, i.e. don’t gather with other waiting clients.

You may need to wait outside of the building – please ensure all pets are contained (cats in carriers, dogs on leads); and bring a book.

Make sure your phone is charged and switched on.

Paintadog!

This is a somewhat Sydney-centric post, but it is a beautiful idea shared by a friend. It encourages artists, it supports bushfire recovery, and it celebrates dogs. So I am posting it here.

Paintadog

Paint and help us make history! Enter the first ever Blackheath village dog art competition in Springtime 2020

Do you have a dog? Enjoy painting? Then be part of a history-making event and enter a painting of your dog, or someone else’s dog in the inaugural

Blackheath PAINTADOG competition.

The competition is open to everyone across New South Wales and will be judged in two categories: Children up to 15 years and adults.

Submissions can be drawn or painted, and must be mounted, but unframed. Initially copies of works must be submitted through our website www.paintadog.com.au with your entry form. As our space is limited we can only accept the first one hundred works from each category.

Entry to the exhibition is free and opens 11 am on Saturday October 3^rd  2020.  Judging will be by a well-known local artist

A non refundable entry fee to the competition, adults $20 children $5. All profits from Paintadog will be donated to The Blackheath Rhododendrum Park, which was badly affected by the 2019-2020 bush fires.

Entries will open Monday 24^th August 2020 and close on Friday 24^th September 2020 Please fill out the entry form on our website and scan with your painting.

Prizes: $750 for the adult winner, $250 for The People's Choice, four $100  for the children's category. Information about other prizes from local businesses and councils, will be available closer to the date on our website.

There will be a dog parade, weather permitting.

We recommend you book your accommodation early, to avoid disappointment. There are many pet friendly Airbnb's, Stayz etc.. in and around Blackheath. A list of these will be posted on our website: www.paintadog.com.au closer to the time.

With thanks to The Blue Mountains Bush Fire Recovery Program

The RSL Blackheath

The RFS Blackheath

Jenny ward Communications Director

Henry Collins

More sponsors will be .published closer to the date

Up to date information on Covid-19 for veterinary teams

Social distancing means that I cannot visit my family, including Bosca. 

Last night I gave a webinar for the Centre for Veterinary Education on ethical challenges for veterinary teams that have arisen from the Covid-19 pandemic. A recording will be available soon (more info here https://www.cve.edu.au/web/ethical-challenges-veterinary-teams-covid-19-era). 

In the meantime a common question was where to go for reliable information.

For reliable it needs to be up to date, as – to repeat an oft-repeated phrase – this is a rapidly evolving situation.

There is quite a lot out there and it can be hard to sort the wheat from the chaff, but this is an area where our professional organisations play a vital role. For example, the Australian Veterinary Association (of which I am a member) has established a Covid-19 working group which has already produced some very useful resources and answered practical questions.

The Australian Veterinary Association have set up an online Coronavirus Information Hub which includes FAQs about PPE, telemedicine, protocols and procedures: https://www.ava.com.au/coronavirus/

The Royal College of Veterinary Surgeons (RCVS Knowledge) has established a coronavirus information page: https://knowledge.rcvs.org.uk/covid-19/

The American Veterinary Medical Association also has a page here: https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19

The World Small Animal Veterinary Association have provided information, available in a number of languages: https://wsava.org/news/highlighted-news/the-new-coronavirus-and-companion-animals-advice-for-wsava-members/

Dr Scott Weese's Worms and Germs blog is extremely useful and very current. I am not sure when he sleeps, but if there's a new pre-print about Covid-19 with a veterinary angle, he covers it: https://www.wormsandgermsblog.com/

For general information of the non-veterinary kind, the World Health Organisation provides situation reports, rolling updates and online courses: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

For veterinarians based in Australia, Judy Gillespie from Vet Answers has been compiling a Covid-19 resource hub for the veterinary industry: http://www.vetanswers.com.au/covid-19-the-veterinary-industry

Clarification on media reports

I’ve learned this morning that I’ve been quoted by some media outlets – including publications that have never made any attempt to contact me – urgently warning dog owners not to let other people pat their dogs.

I want to be very clear.

Right now, there is no evidence that you can catch Covid-19 from companion animals.

The very small number of animals that have tested positive have had contact with infected humans.

We know that the virus can live on surfaces like plastic, steel and cardboard for variable periods.

We do not know if SARS-COV-2 can survive on the coats of animals, and if so, for how long. If it does survive, there is a chance that a person could have contact with the virus on the animal’s coat, then touch their own face. Current information suggests that this presents a very low risk.

Therefore, out of an abundance of caution, the current advice is to treat animals as a potential surface. i.e. wash your hands before and after touching them and try to avoid handling other people’s animals (but if you do, wash your hands before and after).

Additional Covid-19 resources

One of my colleagues sent me this image of her cats socially distancing. Something that comes a bit more naturally to this species.

This week we’ve been working from home, teaching and doing research-based writing online, attending Zoom meetings (a highlight was being ZoomBombed by a prominent specialist’s cat’s bottom), and trying to attend webinars on Covid-19. I write We because everything I do, I am doing with a cat who appears to be mildly annoyed that I am working from home. We're a smidge "behind" in my webinars, but also trying not to turn into square-eyed blobs!

We're also making an effort to have virtual cups of tea with colleagues and friends where we can, and learning that many of my colleagues are struggling with home schooling their children, on top of completely changing the way they practice, and fielding animal welfare issues. Others are struggling with isolation, especially those living alone, which social distancing guidelines seem to overlook.

Last night we watched the Covid-19 episode of Playschool, and it was like watching something from a science fiction movie. Only it wasn’t. (If you’re looking for something lighter, Sammy J’s Corona Yoga is worth a peak).

RCVS knowledge has put together a comprehensive coronavirus resource page which can be accessed here. It provides information from both medical and veterinary sources, and includes links to journal articles and webinars. You can find it here. 

This week I am hearing a lot about animal welfare implications of the pandemic from colleagues in Australia and overseas. It can be very challenging to get accurate information, but I am working on compiling this. The big concern is animal care during lockdowns and/or absolute shortage of personnel and funds.

Adoptions from shelters seem to have increased in general, but they need to maintain funds to care for animals even when they are closed, and they also have a duty to protect staff. There is some interesting info about local shelters, including the RSPCA and the Cat Protection Society, in this article (it also stresses that pets are for life, not just for quarantine). 

Finally, if you’re around this morning, Mighty Vet in the US are streaming an update on Covid-19 on Facebook. To register click here.

Veterinary clinics remain open, but need to be vigilant

Frankie is helping Jane work from home, but has demanded a new feeding schedule.

On Friday night, the Federal Government announced that veterinarians are an essential service and remain open:

The Federal Government considers the role of veterinarians essential to the agricultural sector and therefore to our nation’s food security but also in protecting companion animals and our nation’s wildlife. 

The Federal Government has not put any restrictions on veterinarians other than the practice of social distancing and hygiene practices during the COVID-19 crisis. While confusion has arisen due to the closing of some state borders, those state governments have assured us that veterinarians are able to continue to operate across borders.

Most veterinary clinics are changing the way they practice, and globally there has been a tendency to implement low and no-contact consultations to minimise human to human contact and thus reduce the risk of SARS-CoV-2 transmission.

This is the best way to protect both our human clients and our veterinary team members, though it does make everything feel different. We ask screening questions about the health of the owner, i.e. have they traveled within the last 14 days, do they have Covid-19, are they in quarantine?  Its strange to be a vet routinely asking questions about human health but here we are.

We are discouraging walk-ins and encouraging people to phone ahead, to avoid crowding or congregation in the waiting room. We are encouraging only one person to bring an animal in where possible (as opposed to the whole family or a group of friends).

Instead of spending time in a consultation room with a client and their animal, the client now leaves the animal for me to examine, I perform an examination and take a history from the client on the phone, and then we discuss whether any further tests or treatment are required. The animal is then discharged to the client, whom I might wave to at a distance.

I conduct my examinations in PPE – a full gown and mask. I thought this might freak my patients out but they seem to get it. And on the whole they are coping well without their owners in the room (some appear to be less stressed, occasionally they appear more stressed). They still get treats (unless contraindicated), and a nurse helps hold them. Some owners are very anxious so in some cases I've examined animals in front of them, through the windows of the building. It would be nice not to have to do this but people do understand.

The new normal? Ready to consult in PPE.

There are going to be issues when demand for PPE exceeds supply. The AVMA have provided some information about this here: https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/guidelines-ppe-covid-19-pandemic-demand-exceeds

To me the biggest challenge is socially distancing BETWEEN veterinary team members. This is critical as anyone can contract the virus and may be asymptomatic. While we are reducing the risk of transmission between clients and veterinary teams, we have to be equally conscious of reducing the risk of transmission between colleagues. Infectious disease guru Scott Weese has provided some guidelines here: https://www.wormsandgermsblog.com/2020/03/articles/animals/dogs/social-distancing-within-veterinary-clinics/

The other issue is stress. Like everyone, veterinary team members are vulnerable to anxiety, depression and work-related stress. For many people, Covid-19 – the challenges it presents, including its associated restrictions on personal freedoms – has ramped that up. Cathy Waburton, founder of Making Headway, us running a free webinar on coping in the Covid-19 crisis. You can sign up here: https://www.vet-webinar.com/en/webinar-live/webinare/coping-in-the-covid-19-crisis/

Readers are welcome to send photos of their animal family members working from home. Today’s post features Frankie, who is keeping Jane company as she works from home. Frankie has insisted on a new feeding routine, so now has half of her dinner at 3.30pm and the other half at 6pm (as opposed to dining at 7).

Jane is doing a brilliant job increasing the frequency of meals but not the daily ration. One thing I noted consulting during Covid-19 is weight gain in companion animals. Don’t cave in to those demands for more food!

How do we continue to minimise stress in companion animal patients during the Covid-19 pandemic?

Since I've been doing a lot more work from home, Hero is demanding meals at very specific times. 

Companion animal vets work hard to minimise fear, anxiety and stress in our patients. While the Covid-19 pandemic necessitates some dramatic changes to the way we practice in order to protect veterinary team members and clients, there are still steps we can take to make the veterinary experience easier on companion animals. The Fear Free team have a host of webinars on topics from euthanasia in the time of Covid-19 to infection control: https://fearfreepets.com/resources/webinars/

For a non-companion animal specific activity, a researcher at the University of Texas, Austin (USA) is conducting The Pandemic Project, a social psychology initiative that is studying how our everyday lives are affected by the coronavirus outbreak.

The survey, which took me about 15 minutes to complete, provides some feedback on how your reactions to the outbreak compare with others. You will get personal feedback about your coping methods with information about what may work best for you (I thought this was very helpful).

http://utpsyc.org/covid19/index.html

If you want to share an image of animals in this very unusual era of quarantine, please feel free to email me a JPEG.