Getting to the veterinarian during coronavirus

When Christy Mitchell’s mini-Aussiedoddle puppies, Ellie and Bosun, began sneezing and having diarrhea, she knew she had to take them to the vet. She couldn’t let her fragile 10-year-old labradoodle Jake, already in poor health, catch a virus or parasite.

It was early March, well before full-fledged social distancing due to Covid-19 was the norm, and Mitchell was concerned. Living precariously with pulmonary arterial hypertension, a severe lung condition that requires 24-7 IV infusions via a port in her chest, she knew exposure to the disease caused by the novel coronavirus could easily be a death sentence.

Mitchell called first and found her vet already had safety precautions in place.

“When I went they were only letting one person at a time into the clinic and making sure that everything was very clean,” she said. “And they keep us in the loop on any new precautions with emails. Now if I need to go, a person in full protective garb will pick up the dogs from the car.”

While each vet will have his or her own procedures, the American Veterinary Medical Association provides frequently updated guidance to its members on minimizing possible exposure to Covid-19 while providing quality care for pets.

Veterinarians Dr. Will Draper and Dr. Francoise Tyler, who own a number of veterinary clinics in metro Atlanta, immediately implemented virtual telemedicine visits for their clients.

A husband-and-wife team who starred in the NatGeo Wild series “Love and Vets,” Draper and Tyler have experience with video production and have produced helpful (and funny) explainers on what to expect during a curbside or telemedicine visit at their facilities.

For telemedicine, the couple uses a downloadable app that allows text, audio and video communication between a vet and a client to determine if the concern is worth the risk of a visit.

Draper often works into the night to triage pets into such medical categories as “don’t worry about it” or “let’s try this and see how your pet is tomorrow” or “we need to do an examination, so you’ll need to bring your pet to the clinic.”

A dog’s life

A lot of the non-emergency calls are from dog owners who never realized how much their pet scratched or licked a body part until they were home with them all day, every day, Draper said.

“Dogs typically lick their rear ends or feet or scratch their ears a few times a day,” Draper said. “But now owners are seeing it and think their dog has fleas or an allergy. I also see a lot of limping dogs who’ve pulled a muscle playing Frisbee and need to rest for 24 hours.”

If the pet needs to come in — and many do — the clinics have elaborate safety plans in place to protect both the clients and the vets and their teams, Draper said.

“We’ve numbered the parking lots at all the hospitals and we’ll tell clients to pull in space one, space two, space three. When they’ve done that, they call us and one of the technicians goes out with gloves and a mask and brings the pet into the clinic,” Draper said.

“Then we will either video conference with them while they’re in the car or just call them on the phone and discuss what we’ve found and our recommendations for their pet.”

The various procedures are working well, the couple said, so it’s likely their clinics will continue to offer a telemedicine option after the coronavirus pandemic has passed.

“I do miss interacting with my clients directly,” Tyler said, “which is why I often ask to do a video conference call with them, so I can see and talk to them. Plus it helps when I’m giving them advice to see their reactions and their facial expressions to be sure they understand what I’m saying and are not concerned.”

So how can you have the most successful “virtual” visit to the vet during the age of coronavirus?

State regulations, including telemedicine

First, know the regulations in your state, which your vet can tell you when you call. While veterinary practices across the United States are typically considered “essential” and can remain open, many states have suspended various “elective” procedures such as spaying, neutering and dental cleanings.

A listing of state restrictions during the pandemic can be found on the American Veterinary Medical Association website.

States may differ on who is allowed to use telemedicine, according to Dr. Dana Varble, who is chief veterinary officer for the North American Veterinary Community.

“Most states still require a physical exam to establish a valid VCPR [veterinarian-client-patient-relationship],” Varble said.

In Georgia, where Draper and Tyler practice, telemedicine consults are restricted to pets who are current clients.

“We have to have a veterinary client-patient relationship with the owner and have seen the pet within the last 12 months in order to be able to do a medical consult,” Draper said. “The US Food and Drug Administration recently relaxed the rules on that requirement, but the state of Georgia did not adopt that change.”

Because few vets in the Atlanta area are offering telemedicine, new client business has grown, Draper said, but all new clients must first be examined in the office before a virtual re-check can be scheduled.

“I log into our system and see that they’re not a patient of ours, and I have to say, ‘Unfortunately I can’t provide a diagnosis or prescribe medication for your pet,'” Draper said. “I can give you advice as I would to a client who calls in for the first time at the hospital, but that’s all unless they come in.”

Essential services

Surgery for injuries and other emergency procedures are typically allowed, and many vets are providing other “essential” services such as important vaccinations.

Rabies vaccination. “By law, you cannot put off your rabies shots,” Draper said. “If your dog needs a kennel cough vaccine or something like that, we just tell them you should wait because you’re not going to be boarding them or going to a groomer right now anyway.

“However, if a dog is due for a rabies vaccine on May 1 and he bites somebody on May 3, he has to be quarantined. So we have to make sure that they’re current on rabies.”

Your puppy or kitten’s vaccine series. Just like with human babies, young kittens and puppies need protective shots at specific times within a 16-week period. This may also apply to the many rescue dogs and cats that people are adopting or fostering during the pandemic.

Emergency services. Try to call first, even in an emergency. If it’s after-hours, vets who provide 24-7 urgent care will still have new procedures in place on where to park, which entrance to use, and how to properly wear protective clothing such as a mask and gloves.

How to optimize your drop-off visit

When you do visit your vet for a consult, please consider abiding by the following etiquette to protect both you, your pet and your vet.

Call first. It’s different from the days when you could just show up with your pet. You need to know the parking, billing and drop-off procedure.

You should also be prepared to answer questions on your health status and that of your family. If you’ve been exposed to Covid-19 or work in a profession that puts you at risk, you might be asked to have a different member of the family bring the pet.

Be patient. When you arrive, please be patient. Visits could take much longer these days, mostly due to the extra precautions.

“With the time it takes to call from the car, find the records, ask the tech to sanitize and put on gloves and mask and go out to the car, It just will take a little bit more time,” Draper said. “The team is trying to work with you and remember, they’re scared of Covid-19, too.”

Stay in your car. “In spite of telling clients when they make the appointment, in spite of the signs in the parking lot saying stay in your car, in spite of the tech telling them as they walk out, you would not believe how many people just have to get out of their car,” Tyler said. “Please, for everyone’s safety, stay in your car.”

Don’t expect to pay in cash. Most vets are trying to eliminate the need to touch cash or interact with people to give change, so most are going to ask for a credit card number when the appointment is made, Tyler said.

Clean the carrier in advance. Here’s a pet peeve: Don’t pull your cat or dog carrier out of the garage where you’ve stored it for the year and expect your vet tech to be thrilled when you deliver your pet in it.

“The carrier is full of cobwebs and dust, and they just throw the poor cat or small dog in there,” Draper said. “It’s not good for the pet, we don’t have time to clean it, and it just sends a message that maybe you’re not doing all you can to be careful about coronavirus.”

Always call if you’re worried. Recent studies have shown some people are not going to the doctor when they feel chest pains or have high blood sugars due to fear of catching coronavirus from the doctor’s office or hospital.

Please don’t do that to yourself OR your pets, experts said. Elderly dogs may need immediate attention if they begin vomiting or have diarrhea due to a fast loss of fluids. Because cats often try to hide an illness, they are often extremely sick by the time their person even realizes something is wrong. Waiting one or two days could possibly be dangerous, even deadly.

“I’ve had people who call and say their dog is squinting, there’s discharge from his eye,” Draper said. “And I say, ‘Look, you just need to go in. If I just try to give you some ointment, and it’s the wrong medication and it costs your dog his eye, that’s not going to make you or me happy.’

“Or our dogs are outside more often with us now, and one gets a bee sting. They need to come into the office because you need something that’s going to get in their system quickly to resolve the allergic reaction, because they can die,” he said. “So don’t skimp on care.”