ABSTRACT: Nurse clinics are a fundamental part of a first-opinion practice for advising clients on all manner of things from flea and worm treatments to neutering and diet. This article highlights the importance of veterinary nurses having the knowledge and confidence to help those clients wanting to breed from their pets; including knowing which tests are recommended for which breeds and setting up genetic health testing clinics in practice. These clinics can be set up to obtain blood samples or cheek swabs from patients to be sent off to the relevant laboratory and tested for genetic diseases. Advice can also be given to clients who are unsure as to what they should be testing for in their particular breed.
Nurse clinics take up a substantial part of the time of many veterinary nurses working in first-opinion practice. Dealing with all manner of topics from weight management to preventive programmes to control parasites, physiotherapy sessions and senior clinics, nurses are an essential part of the client education process.
What can nurses do to further promote animal welfare and increase their clients’ knowledge? Neutering of pets is one major issue that should be discussed during a puppy or kitten check; but what advice can the nurse give when the client mentions he or she intends to breed from the animal?
Whilst it is not the duty of a veterinary nurse to advise against breeding, it is however, his or her responsibility to advise of the pros and cons of breeding; as well as how to make the process as safe as possible for the dam and ensure that the litter born is as healthy as possible.
Genetic health clinics
There are already several external schemes in place that are run with the help of the Kennel Club (KC) and the British Veterinary Association (BVA).
These schemes concentrate on hip and elbow dysplasia, hereditary eye disease and, more recently, the Chiari Malformation/Syringomyelia Scheme.
The Kennel Club also has its own programme to try to encourage healthy and responsible breeding – The Assured Breeders Scheme – which insists that breeders test their dogs against a range of breed-specific genetic diseases. Even if owners are not members of this initiative, it is still important to encourage them to undertake these tests in order to reduce the number of puppies born with genetic problems that could otherwise have been avoided.
The most popular breeds registered with the Kennel Club in 2010 and 2011 were the Labrador Retriever and the English Cocker Spaniel (Table 1). Since the start of 2009 there have been 132,317 Labrador puppies and 73,744 Cocker Spaniel puppies registered with the organisation.
If the breeder is a member of the Assured Breeder Scheme, it is mandated that these breeds are screened for progressive retinal atrophy (prcd-PRA) and hip scoring (this is not insisted upon but recommended for Cocker Spaniels). However, in spite of this, since the BVA/KC Hip Dysplasia Scheme started in the 1960s, only 74,094 Labrador Retrievers and a mere 1,100 Cocker Spaniels have been tested.
The number of these breeds that have undergone prcd-PRA testing is even more disappointing as only 1,897 Cocker Spaniels and 2,166 Labradors have been tested. This data includes ‘clear, ‘carrier’ and ‘affected’ dogs (Table 2).
The popularity of these breeds has resulted in a subsequent increase in the number of litters being bred. As such, the veterinary profession has a responsibility to help owners understand the importance of ensuring that litters are bred from healthy parents and the risk of genetic health problems is reduced to an acceptable level.
What test and where?
Currently owners may need to wait weeks – or'even months – for a local clinic to be run by a breed club or organisation to enable them to have their dog’s blood sampled or a cheek swab taken and sent for testing. Clients will also travel many miles to go to a vet who is experienced and charges a reasonable price for hip and elbow scoring.
However, setting up genetic health clinics in practice is more convenient and, in the majority of cases, actually cheaper than waiting for these clinics to be scheduled by the breed club.
There are many laboratories in Europe that run DNA tests – OptiGen, Laboklin and VetGen are three examples. In the author’s experience, forming a good business relationship with these laboratories may result in favourable rates which can either be passed to the client or retained as profit for the surgery. For example, the larger UK commercial laboratories will also run the tests – either ‘in house’ or via the specialist laboratories – at rates that are potentially a fraction of the price compared to the owner sending it to them directly.
Many clients think that health testing is an additional expense and is unnecessary, others are ignorant about the fact it should be performed. However, awareness of the actual costs that are involved and advice about the appropriate tests will increase the likelihood that they will seek advice when the time comes and put the advice to good use.
Setting up genetic health clinics
Setting up these clinics need not be stressful or even time-consuming. A small notice board in the waiting room with bold information, some pictures and details is the first step.
A good idea is to use bright colours and images of radiographs (with the relevant owners’ permission).
Figure 1 shows an example of a waiting room display board advertising the genetic health clinics. It has images of actual radiographs that were submitted to the BVA/KC Hip and Elbow Dysplasia Scheme, examples of the forms used and information as to where and when the clinic runs, as well as some of the tests offered.
Figure 1: Waiting room display
It is vital to have this positioned in the waiting room where clients will see it when they are waiting or popping in for food or flea treatments. If the display is in a nurses’ room or other consulting room, it limits the number of clients who will see it.
The Kennel Club has published an excellent guide that lists all the registered breeds in the UK and states what tests are essential or recommended. It is available in paper form or on a CD-ROM and will provide a quick and easy reference guide to staff when owners ask, “What tests does my dog need then?”
A mail shot or mass e-mail to all the local breed clubs, ring craft societies and breeders registered at the practice will reach hundreds of people and it’s surprising how much interest will be generated from this activity.
Also consider contacting those people who have booked their dog in for hip and elbow scoring to offer other relevant blood tests for their breed, this can easily be done by e-mail. Some of these people may have either been paying a
lot more for the service than your practice is offering, or are unaware that these tests are available, so it should come as welcome correspondence.
Choose which laboratories to use and establish any discounts to which you may be entitled – if the practice is involved with a buying group, it may give you even more discount at certain laboratories.
Then sit back and wait for the clients to make an appointment. It really is that simple.
All that needs to be done in the practice is to brief all staff with the protocol for making appointments – having a typed list of required information in several places can be a useful tool. For example, this will ensure that KC registration documents are brought to the clinic and that the dog is already micro¬chipped, or that it will be done as part of the consultation.
You may or may not choose to provide the KC with the results when they return. If you do want to provide this service for the owner, ask them (when they arrive for the blood sample) to sign a consent form authorising that the results can to be passed to the KC and noted on the dog’s public record.
And our feline friends?
Although this article has focused primarily on health testing in dogs, with the numbers of pedigree cats being bred it is worth bearing in mind that these clients should not be forgotten. If owners of queens or toms express an interest in breeding from their pets, advising them on relevant health tests for their breed is certainly worthwhile.
Examples of conditions that can be screened for include: polycystic kidney disease in Persian cats and hypertrophic cardiomyopathy in Maine Coons. There is no list for feline tests similar to that which the KC has produced, so making your own in practice will help as a reference guide.
The veterinary professions are at the forefront of animal health and welfare. It is our responsibility, not only to treat health issues, but also to prevent them arising where possible. The best way to minimise the impact of genetic disease in the cat and dog is to educate owners, breeders and ourselves on the problems that can arise in certain breeds.
Author
Johanna Page RVN
Johanna Page RVN is the head nurse at Orchard Veterinary Group in Glastonbury, Somerset. She has a keen interest in radiography and genetic health and in her spare time enjoys training and competing with her Cocker Spaniel in field trials and working tests, and working her dog on various estates during the shooting season.
To cite this article use either
DOI: 10.1111/j.2045-0648.2012.00204.x or Veterinary Nursing Journal Vol 27 pp 310-312
Useful references
BRITISH VETERINARY ASSOCIATION. Canine Health Schemes. [Online]. Available from: http://www.bva.co.uk/canine_health_schemes/Canine_Health_Schemes.aspx [accessed June 16th 2012]
BRITISH VETERINARY ASSOCIATION. Breed Specific Statistics [Online] Available from: http://www.bva.co.uk/public/documents/Breed_Specific_Statistics_2012.pdf [accessed June 14th 2012]
THE KENNEL CLUB. PRA Screened English Cocker Spaniels. [Online] Available from: http://www.thekennelclub.org.uk/item/1969 [accessed June 16th 2012]
THE KENNEL CLUB, PRA Screened Labradors. [Online] Available from: http://www.thekennelclub.org.uk/item/1490 [accessed June 16th 2012]
• VOL 27 • August 2012 • Veterinary Nursing Journal