Say yes to annual wellness diagnostics and oral microbiome tests

As a cat practitioner, I have seen many sick cats. The most difficult cases always involve cats whose owners say they haven’t been to the vet in years and have recently stopped eating. Congratulations. Your pet has stage 4 renal failure and needs dental care. How do you know which disease came first? Which is the bigger problem? Knowing that if they had just brought the cat in for regular physicals and annual checkups, they could have caught chronic kidney disease (CKD) sooner. It is difficult to confirm.

We all understand the benefits of annual diagnostic testing. It helps establish a healthy baseline, monitor trends in organ function, and detect disease early.¹ But how do you convince owners of its importance? What if there was another kind of screening test that didn’t involve a venipuncture that could increase compliance?

When our clinic first conducted the Annual Wellness Blood Test, the concept was simple. Owners had to understand the benefits of early detection of the disease and it had to be affordable. The conversation started with the receptionist. On the day of the appointment, the technician will explain: Dr. Saffire explains the recommended diagnosis based on Fluffy’s age and test results. “

It’s my turn next. It sounds like Fluffy needs a vaccine, but I’d also like to talk to you about running a wellness lab. He’s already a year older and a lot can change in a year. I would like to be able to run a senior wellness panel to collect information about his overall health, including information about his red blood cells, white blood cells, blood sugar, kidneys, liver, and thyroid. A urine sample is also taken. Are you sure about this? ” If the owner agrees, the lab will run. Follow up with a detailed summary of results for each visit so owners understand the value of what they have done.

The latest statistic for wellness lab compliance in the annual exam was 86%. The remaining 14% of him declined because the cat had a recent experiment or the owner was not prepared to incur the additional cost. my reaction? “That’s fine; I understand we weren’t prepared for the extra cost today. Fluffy is otherwise doing well, so I wouldn’t mind skipping the lab this year, but we’ll do it next year.” Create reminders so you can.” The next year, those owners will usually say yes.

CKD and periodontal disease are common in feline medicine, and the two often coexist.² Conventional renal biomarkers for CKD in cats are important but may have limitations.³ Other risk assessment tests for CKD and periodontal disease have been developed, including noninvasive oral swab-based screening tools that assess genetic predisposition, health markers, and oral microbiome.^4-6

The importance of physical examinations in veterinary medicine cannot be underestimated. Early detection of disease is possible, leading to earlier treatment and hopefully longer life expectancy. To confirm the importance of annual monitoring for clients, wouldn’t it also be helpful to have information that patients are at increased risk of developing certain diseases? In the meantime, please train your staff to discuss annual health checks with clients at all contacts.

Ashlie Saffire, DVM, DABVP (Cat), is an expert in feline medicine and serves on the board of the American Association of Feline Practitioners. She is a tutor for the University of Sydney’s Feline distance learning course and at Cats Her Only Veterinary Clinic in Columbus, Ohio where she is her Advisor for her ABVP Feline Residency.

References

1. Ray M, Carney HC, Boynton B, et al. 2021 AAFP Cat Senior Care Guidelines. J Feline Med Surg2021;23(7):613-638. Doi:10.1177/1098612X211021538
2. Trevejo RT, Lefebvre SL, Jan M, Rose C, Goldstein G, Lund EM. Survival analysis to assess the association between periodontal disease and risk of developing chronic azotoemic renal disease in cats assessed in primary care veterinary clinics. J Am Vet Med Assoc2018;252(6):710-720.doi:10.2460/javma.252.6.710
3. Kongtasai, T, Paepe, D, Meyer, E, et al. Kidney biomarkers in cats: a review of the current state of chronic kidney disease. J Veterinary Intern Medicine2022;36(2):379-396.doi:10.1111/jvim.16377
4. Thomas S, Lappin DF, Nile CJ, et al Microbiome analysis of feline dental crushing resorptive lesions (FORL) and feline oral health. J Med microbes2021;70(4):001353.doi:10.1099/jmm.0.001353
5. Baker JL, Edlund A. Harnessing the Oral Microbiome to Prevent Caries: Has Evolution Already Provided the Best Tools? front microorganisms2019;9:3323. doi:10.3389/fmicb.2018.03323
6. Davis EM. Gene sequence analysis of healthy oral microbiomes of humans and companion animals: a comparative review. J. Vet Dent2016;33(2):97-107. Doi:10.1177/0898756416657239