Today's Veterinary Business

FEB 2018

Today’s Veterinary Business provides information and resources designed to help veterinarians and office management improve the financial performance of their practices, allowing them to increase the level of patient care and client service.

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61 February/March 2018 • TODAYSVETERINARYBUSINESS.COM round. We might advise a client to hold off administering the first dose, but gaining client acceptance must happen during their visit no matter the time of year. This may be our only chance to ensure proper coverage before the next visit. I guarantee that the client will be on Google and inside a grocery store many times before the next visit. Narrow the Choices Next, research and select a flea and tick product that you and your staff are going to be passion- ate and excited about. Take time to do your due diligence. Meet with the manufacturing representatives and discover all the information needed to make an informed decision. You may think you did this several years ago, but you may be pleasantly surprised by some of the advancements revealed over the past 12 to 18 months. Also know that oral dos- ing has become increasingly pop- ular among clients. The ease and simplicity of chewables contribute to this satisfaction. With ease, we find that compliance follows. Once you have your research in place, take time to meet with your associate veterinarians and ask about any major objections to the preferred product. Stocking three or four products that offer similar benefits is not an effective strategy for gaining client compliance. Once your product is selected, reinforce the decision with the rest of the staff. Now is the time to bring in the account manager to deliver a product overview. Keep the education simple and client friendly. This means educate your staff about what the client needs and wants to know. Why are you recommending the prod- uct? How does it work and for how long? What are the benefits? How often does the client administer it? Is it safe? I suggest scheduling a continuing education kickoff each year to refo- cus the efforts, remind the staff of the benefits and needs, and refresh them about how we educate our clients to say "yes." This is also the time to evaluate pricing and promote the fact that your clinic's pricing is competitive within your region and relatively competitive to online offers. Don't misunder- stand me: I am not advocating that we need to match online pricing, but we do need to be competitive. We can do this through our mar- gins and by making sure that we maximize any and all manufacturer loyalty programs, rebates, instant savings and free-product deals. (For example, buy three, get a free dose.) Offer a Guarantee The groundwork has been laid for success. You have created a medical protocol for your geo- graphical area that states when and why you recommend flea and tick protection for the pets you serve. You have completed the due diligence and researched the latest technology. Not only have you found the right product fit for your practice, but at this point you should be ec- static and enthusiastic about being able to offer the new technology to clients each day. When you reach the point that you are excit- ed about a product, the feeling becomes conta- gious. The client question "Where do I purchase this product?" ceases to be asked. The last but maybe most important por- tion of our plan is continued feedback and follow-up. We need to assure ourselves that the client is using the products we provide. More important, we need to make sure that the prod- ucts are working as promised. I suggest that we consider a product guarantee. If we feel strongly enough to recommend the product, then we have to be in a position to strongly guarantee it. Work with your manufacturing representative to make this happen. Flea and tick products are not new to our industry, but the advancements are. What's mindboggling is how we administer the prod- ucts, their efficacy, the near-immediate protec- tion, the safety indications and the overall client satisfaction. Clients need to hear from you about these incredible developments and hear why they should purchase a flea and tick product from you. Hearing the confident undertones of your recommendation will go a long way, as will the education you provide. If this all goes missing, clients might say to themselves, "I might as well just take my $6 and purchase a three-pack online." After all, where is the harm in that? Selling Points columnist Brian Conrad is practice manager at Meadow Hills Veterinary Centers in Kennewick, Washington, and immediate past president of the Veterinary Hospital Managers Association. Clients need to hear from you about these incredible developments and hear why they should purchase a flea and tick product from you. Hearing the confident undertones of your recommendation will go a long way, as will the education you provide. ANADA 200-550, approved by FDA. *Please read entire package insert before use. Meloxidyl ® (meloxicam) 1.5 mg/mL Oral Suspension Non-steroidal anti-inflammatory drug for oral use in dogs only Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. Indications: Meloxidyl Oral Suspension is indicated for the control of pain and inflammation associated with osteoarthritis in dogs. Contraindications: Dogs with known hypersensitivity to meloxicam should not receive Meloxidyl Oral Suspension. Do not use Meloxidyl Oral Suspension in cats. Acute renal failure and death have been associated with the use of meloxicam in cats. Warning: Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information. Warnings: Not for use in humans. Keep this and all medications out of reach of children. Consult a physician in case of accidental ingestion by humans. For oral use in dogs only. As with any NSAID, all dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy. Appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to and periodically during administration. Owner should be advised to observe their dog for signs of potential drug toxicity and be given a client information sheet about Meloxidyl Oral Suspension. Precautions: The safe use of Meloxidyl Oral Suspension in dogs younger than 6 months of age, dogs used for breeding, or in pregnant or lactating dogs has not been evaluated. Meloxicam Oral Suspension is not recommended for use in dogs with bleeding disorders, as safety has not been established in dogs with these disorders. As a class, cyclo-oxygenase inhibitory NSAIDs may be associated with gastrointestinal, renal and hepatic toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest risk for renal toxicity are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such antiprostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Since NSAIDs possess the potential to induce gastrointestinal ulcerations and/or perforations, concomitant use with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. If additional pain medication is needed after administration of the total daily dose of Meloxidyl Oral Suspension, a non-NSAID or non-corticosteroid class of analgesia should be considered. The use of another NSAID is not recommended. Consider appropriate washout times when switching from corticosteroid use or from one NSAID to another in dogs. The use of concomitantly protein-bound drugs with Meloxidyl Oral Suspension has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant and behavioral medications. The influence of concomitant drugs that may inhibit metabolism of Meloxidyl Oral Suspension has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy. Adverse Reactions: Field safety was evaluated in 306 dogs. Based on the results of two studies, GI abnormalities (vomiting, soft stools, diarrhea, and inappetance) were the most common adverse reactions associated with the administration of meloxicam. The following table lists adverse reactions and the numbers of dogs that experienced them during the studies. Dogs may have experienced more than one episode of the adverse reaction during the study. In foreign suspected adverse drug reaction (SADR) reporting over a 9 year period, incidences of adverse reactions related to meloxicam administration included: auto-immune hemolytic anemia (1 dog), thrombocytopenia (1 dog), polyarthritis (1 dog), nursing puppy lethargy (1 dog), and pyoderma (1 dog). Post-Approval Experience: (Rev 2010) The following adverse events are based on post-approval adverse drug expe- rience reporting. Not all adverse reactions are reported to FDA/CVM. It is not always possible to reliably estimate the adverse event frequency or establish a causal relationship to product exposure using these data. The following adverse events are listed in decreasing order of frequency by body system. Gastrointestinal: vomiting, anorexia, diarrhea, melena, gastrointestinal ulceration Urinary: azotemia, elevated creatinine, renal failure Neurological/Behavioral: lethargy, depression Hepatic: elevated liver enzymes Dermatologic: pruritus Death has been reported as an outcome of the adverse events listed above. Acute renal failure and death have been associated with use of meloxicam in cats. Effectiveness: The effectiveness of meloxicam was demonstrated in two field studies involving a total of 277 dogs representing various breeds, betweens six months and sixteen years of age, all diagnosed with osteoarthritis. Both of the placebo-controlled, masked studies were conducted for 14 days. All dogs received 0.2 mg/kg on day 1. All dogs were maintained on 0.1 mg/kg oral meloxicam from days 2 through 14 of both studies. Parameters evaluated by veterinarians included lameness, weight-bearing, pain on palpation, and overall improvement. Parameters assessed by owners included mobility, ability to rise, limping, and overall improvement. In the first field study (n= 109), dogs showed clinical improvement with statistical significance after 14 days of meloxicam treatment for all parameters. In the second field study (n = 48), dogs receiving meloxicam showed a clinical improvement after 14 days of therapy for all parameters; however, statistical significance was demonstrated only for the overall investigator evaluation on day 7, and for the owner evaluation on day 14. How Supplied: Meloxidyl® 1.5 mg/mL Oral Suspension: 10, 32, 100 and 200 mL bottles with small and large dosing syringes. Storage: Store at controlled room temperature 68-77° F (20-25° C). Manufactured for: Ceva Santé Animale, S.A. Marketed by: Ceva Animal Health, LLC, Lenexa, KS 66215 Meloxidyl ® is a registered trademark of Ceva Santé Animale, S.A. Adverse Reactions Observed During Two Field Studies Clinical Observation Meloxicam (n+157) Placebo (n+149) Vomiting 40 23 Diarrhea/Soft Stool 19 11 Bloody Stool 1 0 Inappetence 5 1 Bleeding Gums After Dental Procedure 1 0 Lethargy/Swollen Carpus 1 0 Epiphora 1 0

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