Eight Strategies to Improve Management of Skin Cases

August 22, 2023

By Wendy S. Myers, CVJ – A Paid Consultant for Covetrus® 

You see the dog’s discomfort when you walk into the exam room. Sammy has reddish-brown stains on his fur from excessive licking, bald spots, and a red belly. The client pleads, “Sammy is scratching 24/7. Can you give him a shot to make it go away?” Successful treatment of skin diseases may require long-term or lifelong management and are frequently a matter of effective control rather than cure, according the Merck Veterinary Manual.1

You may educate clients about many factors to manage skin diseases, including progress exams, recurring diagnostic tests, long-term drugs, diets, supplements, and/or shampoos. Use eight strategies to set client expectations and ensure ongoing treatments:

Set expectations on the day of diagnosis
When explaining skin diagnoses, tell clients the next steps in ongoing treatments.

For example, Dr. Melissa Eisenschenk, DACVD, of Pet Dermatology Clinic in Maple Grove, Minn., follows a protocol for Apoquel® monitoring in dogs that are on once daily dosing. She checks a CBC/Chem6 before staring Apoquel, in three months, and then annually.2

Explain the need for recurring tests
To avoid complaints of “No one told me,” discuss future drug-monitoring tests with written and verbal communication. Share the “why” behind recurring tests when giving medication instructions.

SAY THIS: “To monitor how your dog reacts to this drug throughout treatment, we need to perform a blood test today before starting the medication, in three months, and then annually. This test will identify any changes and let us adjust dosages or medications if needed. Recurring tests let us assess correct dosages over the course of treatment. I’m also giving you a client information sheet with more information. What questions can I answer about this medication?”

Use confident, clear words such as “need” instead of the wiggle word of “recommend.” The open-ended question of “What questions can I answer?” invites a discussion compared to the yes-or-no response to “Do you have questions?”

Never say you want to “recheck” blood work because pet owners won’t see value or comply. Explain that this medication requires recurring drug-monitoring tests, which communicates testing is medically necessary. Remind clients that even if pets are responding well to treatments, they need future exams and lab tests for reassessment and continued treatment. 

Provide take-home information
One client may be in the exam room and need to repeat the diagnosis and treatment to family members at home. A client information sheet explains how the drug works, potential side effects, and symptoms to watch.

Get client information sheets from pharmaceutical companies and the U.S. Food & Drug Administration. The U.S. Food & Drug Administration advises giving a client information sheet every time you dispense a drug that has a sheet available, whether it’s the first or 15th refill.3 Lab companies also provide client brochures that advise recurring drug-monitoring tests. Handouts will help clients identify side effects early and know when to contact your hospital.

Create scripts and history questions for consistent messages
Whether staff members have worked at your hospital for 10 days or 10 years, you want them to give clients the right information every visit. Scripts let your team be confident communicators, using the same buzzwords to increase client compliance. Here are my favorite word makeovers: 

DON’T SAY   DO SAY
 Recheck  Progress exam
 Recommend  Needs
 Drop-off  Day admission appointment
 Estimate   Treatment plan 

During follow-up exams, create templates of history questions that let you track treatment results.

Zoetis offers a Cytopoint® certification program for licensed technicians. In the introductory training video, Amanda Friedeck, BS, LVT, VTS (Dermatology), of Texas A&M University shares history questions to ask pet owners during technician appointments for Cytopoint injections:

  • Was the response to the last Cytopoint injection as you expected?
  • What other treatments are you giving your dog for its skin?
  • Has there been any significant breakthrough of allergic itching, licking, chewing, or biting since the last injection? (If yes, consult a veterinarian.)
  • Does your dog have any sores, hair loss, head shaking, or ear discharge/odor today? (If yes, consult a veterinarian.)

Leverage technicians
Schedule technician appointments for recurring lab tests and administering certain medications and treatments. Set a hospital protocol on the frequency of veterinary exams, especially for patients with chronic conditions. Your state practice act may mandate annual exams to assess pets’ health and prescribe prescriptions.4 If concerns are identified during technician appointments, let clients know you will consult with a veterinarian and/or schedule a veterinary exam when applicable.

Lead clients to forward book appointments
Do this for both technician and veterinarian appointments. You will ensure timely exams, treatments, and tests. Let’s say a veterinarian examines the pet today, and it will need a drug-monitoring test in three months. Schedule the technician appointment during checkout.

SAY THIS: “<Pet name> needs a drug-monitoring test in three months. During this 15-minute technician appointment, a technician will ask how your pet is doing on the medication, get vital signs, collect blood/urine samples, and update your pet’s medical record. Let’s schedule the technician appointment now so you get your first choice of time and date. I have <date 1, time> or <date 2, time> available. Which do you prefer?”

The benefit statement of “get your first choice of time and date” will encourage forward booking. Use the yes-or-yes approach to guide the client to an appointment that works well for your schedule’s flow, improves compliance for recurring tests and refills, and ensures future hospital revenue. Never ask, “Do you want to make your next appointment?” You’ll set yourself up for failure.

Send diagnostic reminders
Send the first reminder 30 days ahead so the client has ample time to schedule an appointment before the next drug-monitoring test and refill will be due. Send texts because they have a 98 percent open rate and 45 percent response rate.5 Most clients will see your messages and nearly half will book right away. Your text should include data fields with the pet’s name and test due date. Having a deadline will prompt clients to schedule drug-monitoring tests before medication runs out. Reminders should include links to book appointments online or through your hospital’s app. Covetrus® offers Rapport Client Communications, which includes reminders, messaging, and online scheduling tools.

TEXT THIS: <Pet name> is due for a drug-monitoring test, which is required before the next <drug name> refill on <date>. We will collect a blood sample during a technician appointment. Book online, download our app, or call 555-555-5555. 

Send medication refill reminders
Medication adherence is a critical factor for successful management of dermatologic conditions. Reminders should include the drug name, purpose of the medication, preferred pickup method, rebates, and link to your online pharmacy. Covetrus’s prescription management solution provides automated refill reminder emails and AutoShip, helping to ensure clients don’t run out of medications for their pets. To encourage pet owner compliance and help your practice generate more online sales, Covetrus provides discounts on pet products—funded by Covetrus and manufacturers—which don’t impact your margins.

TEXT THIS: <Pet name> needs a refill of <drug name> for <health condition>. Get a refill through our online pharmacy with home delivery OR reply Y for curbside pickup at our hospital. Get $XX instant rebate when you buy XX doses.

Create a standard operating procedure (SOP) for skin conditions that defines how your hospital will address progress exams, client education, diagnostic reminders, and medication refill reminders. Write scripts, history questions, and reminder templates. As a result, you will ensure patients’ comfort and grow lab and pharmacy revenue.

Please see full Prescribing Information for the products mentioned in this article. Trademarks are the property of their respective owners. This article is not sponsored by Zoetis.

About the author As founder of Communication Solutions for Veterinarians, Wendy S. Myers, CVJ, has taught communication and client service skills for 23 years through online courses, onsite coaching, and conferences. She was a partner in a specialty and emergency practice. Visit Csvets.com for more. Wendy is a paid consultant for Covetrus.

1. Shipstone, M. Drugs Used to Treat Skin Disorders. Merck Veterinary Manual. Available at: https://www.merckvetmanual.com/special-pet-topics/drugs-and-vaccines/drugs-used-to-treat-skin-disorders. Accessed July 6, 2023.

2. Eisenschenk M. My Clinical Experience With Apoquel® (Oclacitinib). Available at: https://www.petdermatologyclinic.com/apoquel-information. Accessed July 6, 2023.

3. Client Information Sheets: Take-Home Safety Knowledge. U.S. Food & Drug Administration. Available at: https://www.fda.gov/animal-veterinary/animal-health-literacy/client-information-sheets-take-home-safety-knowledge. Accessed July 6, 2023.

4. The Veterinarian-Client-Patient Relationship (VCPR). American Veterinary Medical Association. Available at: https://www.avma.org/resources-tools/pet-owners/petcare/veterinarian-client-patient-relationship-vcpr. Accessed July 6, 2023.

5. CoteS. The Future of Sales Follow-Ups: Text Messages. Gartner. Available at: https://www.gartner.com/en/digital-markets/insights/the-future-of-sales-follow-ups-text-messages. Accessed July 6, 2022.

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