Jessie Merritt, CVPM, SPHR, Oswego Veterinary Hospital, Portland, Oregon
Patients with CKD are often very high maintenance, both in the practice and at home, and frequently require more than an average amount of time for quality care. Providing consistent and efficient information and treatment can be invaluable for case management. To prepare your team, define what should be standard for your practice:
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- Are all CKD cats receiving a blood pressure reading during the visit?
- If so, is this after the patient has relaxed and calmed down from transport?
- Is the blood pressure reading performed with the client holding the pet?
- Is a body temperature reading done after the blood pressure reading?
- Depending on equipment, what size cuff is used, and what is the placement protocol?
- Is cuff size noted and adjusted depending on weight gain and loss?
- Are readings completed consistently by select, trained team members?
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- Is the team knowledgeable about what diets are carried at the practice and why?
- Does the practice allow for time between examinations to sell the prescription diet?
- Is the practice using reminders for food purchases?
- Is the team well versed in diet transition strategies?
- Does a standard client handout discuss how to transition diets?
- Is the team familiar with why fluid therapy is frequently warranted in CKD cases?
- Does the practice have a relaxed, competent team member who can demonstrate how smoothly and comfortably SC fluids can be administered (and earn clients’ confidence and trust)?
- Does the practice have an assigned quiet, relaxed area for fluid therapy demonstrations and training?
- What is the protocol for warming the fluids?
- How frequently are needles and lines changed?
Clients and patients facing CKD often visit a practice frequently over many years, and team members can become fond of both client and patient during this time. Nurture this bond as part of your practice culture.