Obesity is a huge welfare problem that is rapidly increasing. We all know this.
That owners with obese animals are guilty of neglect is obvious[1.yes, rarely there can be endocrine or metabolic problems], as is the state of their animals, and they don’t need a vet to bring this up in a consult – all they need to do is look at their animal.
The solution for each patient is very usually the same – neatly summarised: eat less, move more.
Unfortunately, this means a lifestyle change for the patient, and this inevitably means a lifestyle change for the owner too – regardless of whether he or she needs (or wants) it.
This was neatly illustrated by a case one of my nurse colleagues saw. She came into the prep room where I was wrestling with a python (if I remember correctly) and sat on a table, quite red-faced. One of her obesity patients was putting on weight on a calorie-controlled diet. The owners swore blind they were feeding the diet and nothing more, yet the dog was still putting on weight.
So we agreed to cut them a deal – we’d keep the dog in hospital, feed him the calculated amount of food, give him half an hour of exercise twice a day (the most we could manage with our exercise yard being needed for other patients), and see what happened. And we’d agree to do it all for a set amount. They agreed.
The dog lost the expected amount of weight and our VN had some facts and figures to work with, as well as something to back up her suspicion there were extra calories sneaking in somewhere.
All of this is well-worn and regularly repeated whenever you go to CPD meetings on the subject. Much, much harder is our end of the deal. For example, bring the topic up in a health check or booster consult and you, more often than not, hear the usual excuses.
What is far harder is talking about it convincingly, empathetically and sympathetically and trying to get the owners “on side” – all in a 10 minute consult where you need to cover other issues, offer advice and administer the booster, if it’s needed. And don’t get me started on trying to do all this when the patient’s teeth need a clean-up, it hasn’t been wormed in ages and you’ve got “bonus” appointments coming in. Quite a few places now allow 15 to 20 minutes for health checks, and it’s still a challenge.
The solution for many practices is to employ a VN who is an expert in this field (which isn’t just juggling calories and diets – such a person needs to be such an expert in psychology they would give Derren Brown the creeps).
But what completely stuffs the exercise is having to make a separate appointment with that nurse, often at a later time or date. In a way it’s a filter; only the more dedicated owners will make or turn up to that appointment. Far better would be the ability to get those owners seen then and there.
I worked for a long time at a practice that took exotic pets very seriously. Each consult was 20 minutes long, and usually had another 20-minute consult with a nurse booked immediately after to allow him or her to go over husbandry advice and tutor the owner in drug administration. It might well be worth seeing if we could do this with so-called “booster/health check” appointments, rather than making an appointment days or weeks hence or getting the usual “I’ll need to look in my diary” response.
Something else that’s been brilliant to work with is a “service history-type” book where the vet ticks, comments, and/or grades each aspect of a patient’s health, going through a checklist (even better with a “squashed dog” or “flat cat” map to mark things on). It gives both the client and the vet something to talk about and can depersonalise the whole situation, as well as providing the client with a record of this year’s exam and the ability to compare it with previous years’ entries.
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