Implementing the CAPC Guidelines: Making a Difference in Your Practice
This article was the tenth installment of a 10-part series and was written by:
Gary Holfinger, DVM, East Suburban Animal Clinic, Northwood, Ohio
Jeanne Eisenhour, DVM, South Suburban Animal Clinic, Perrysburg, Ohio
Over the past several years, we have had the honor of working with other members of the Companion Animal Parasite Council (CAPC) to develop and launch the “CAPC Guidelines for Controlling Internal and External Parasites in U.S. Dogs and Cats.” The initial set of guidelines was announced in January 2004 at the North American Veterinary Conference in Orlando, Fla.
Since early this year, we’ve had the opportunity to discuss implementation of these guidelines in settings ranging from large-scale meetings with veterinarians and veterinary organizations to in-clinic training sessions with our own staff members. While the basic principles of the guidelines are simple, in some practices they can require significant changes—from revamping protocols to retraining staff members to revising client education programs and recommendations.
Focus on prevention
CAPC principles include:
Treating pets year-round with broad-spectrum heartworm anthelmintics that act against parasites with zoonotic potential
Placing dogs and cats on preventive flea and/or tick products as soon after birth as possible and continuing for the life of the pet
Conducting fecal examinations two to four times during the first year of life and one to two times per year in adult pets, using at least one gram of feces and centrifugal flotation technique
Revamping procedures and programs
Implementing these and other changes advocated by the CAPC guidelines has produced important and positive changes in our own practices. For example, we have revamped fecal examination procedures to comply with the CAPC guidelines. While we once performed fecals using simple flotation and sodium nitrate solution, we now use centrifugal flotation and Sheather’s sugar (sucrose) solution. As a result, we’re getting more positive test results now (we obviously were getting false negatives before). In addition, we’re finding our technicians now realize the significance of the “lowly” fecal examination as the most important laboratory test for the health of the entire family, not just the pet.
Client education also is paying off. Since training staff members to discuss the implications of parasite management, we have seen a significant increase in clients— especially those who have children— who are concerned about parasite prevention.
This is not to say change is always easy. What is easy is to assume that proper fecal examination technique takes too long or is sloppy—or that it’s difficult to justify year-round use of what is perceived to be “heartworm medicine” when mosquitoes aren’t present yearround. However, we have found the results of our efforts to be more than worth the time, training and money invested. Only by evolving our standard of care can we truly improve the health status of pets—and reduce risk to the people who care for them.
Where do we go from here?
The initial CAPC guidelines have been in place for nearly a year, and the council will continue to refine and develop them. We urge practitioners to visit the CAPC Web site at http://www.capcvet.org for the latest guidelines and recommendations. A number of resources are available on the site, including detailed guidelines on parasite diagnostic procedures, parasite visuals and a staff instruction presentation on fecal examinations.
In July 2004—just six months after launching the CAPC guidelines— we conducted a quantitative survey of veterinarians to gauge how effective we had been in our communications efforts. At that point, a majority of veterinarians were aware of the guidelines, while even more of them supported the guidelines’ basic tenet of broadspectrum, year-round parasite prevention.
The greatest obstacle that remains, however, is client compliance. We already know from several studies, including the 2003 AAHA Compliance Study, that the level of client compliance with administration of parasite preventives is highly unsatisfactory. We must address this problem by making a long-term commitment toward client education and by upgrading our own diagnostic and prevention protocols.
As they say, information is power, and we all have the power to change.