Stephen Jones, DVM
Partner, Lakeside Animal Hospital, Moncks Corner, S.C.
For Jones, the challenge with his clientele is getting owners to understand the importance of a parasite they can't see.
"Outward signs that a dog or cat is infected are not apparent until the disease is advanced, which can take years," he says.
"Unfortunately, at that point clinical signs such as cough, exercise intolerance and heart failure may mistakenly be attributed
to old age."
Recognized or not, though, heartworms damage and obstruct pulmonary arteries, often lead to pneumonitis and can permanently
alter the heart.
Meanwhile, veterinarians themselves sometimes need convincing. While Jones understood the risk and consequences of canine
heartworm disease, at one time he himself believed that feline heartworm disease was so rare it wasn't worth discussing with
cat owners. That changed when a feline patient died and heartworms were discovered during necropsy.
The team at Lakeside Animal Hospital now uses visual aids to communicate the compliance message. They find that setting a
jar containing a heartworm-infected heart in the exam room tells a greater story than any brochure or handout can.
But Jones's staff doesn't rely on a single touchpoint to achieve better compliance. Like Dr. Buzhardt's team, they employ
a three-pronged approach during each visit.
1. Ask. The technician asks the client about compliance.
2. Comment. The veterinarian either commends the pet owner for good compliance or discusses the dangers of failing to protect a pet.
3. Refill. The receptionist makes sure the client either has a supply of heartworm preventive or makes a purchase before leaving the
Because heartworm prevention is such an important part of pet health, Jones doesn't let cost become an obstacle to compliance.
"I make it a point to carry an array of heartworm products," he says. "I also do my best to price-match online pharmacies.
Once a pet owner purchases elsewhere, you have no way of tracking compliance."
Sheldon Rubin, DVM
Emeritus director, Blum Animal Hospital, Chicago Past president, American Heartworm Society
The Midwest with its frigid winters may seem like a region where the risk of heartworm disease is reduced. The real risk,
says Rubin, a long-time Chicago resident, is that owners will try to guess when their pets are "safe" from heartworm transmission.
The incidence of heartworm disease has been on the rise in Illinois, thanks to warmer winters, a large reservoir of wildlife
vectors, the transfer of homeless pets from the South for adoption and urban microclimates that allow mosquitoes to survive
Rubin is happy to share a few of the tips he developed over the years.
1. Use visuals. Pull out that dusty jar of heartworms and place it on the reception desk to stimulate questions.
2. Talk and listen. Have staff place a "not current on heartworm medication" note in a patient's record so the veterinarian can have a discussion
with the client. This is also a good time to remind pet owners that most heartworm preventives also protect pets against intestinal
3. Don't be shy. Don't hesitate to discuss cost as part of your "prevention is important" message. Let clients know that your prices are competitive
with online pharmacies.
4. Send reminders. Program your practice management software to automatically remind clients to repurchase heartworm preventives when needed,
based on the type and quantity they were originally dispensed.
5. Keep it simple. The easier it is for pet owners to purchase the medication, the better (e.g., provide online ordering and mail items at no
charge). And have clients sign up for an online reminder service to help them remember to give preventives year round.