Heartworm prevention: Clients can’t comply if they don’t know they should

While we may feel like we’ve talked about heartworm disease over and over again, we must keep educating clients about how to protect their pet

But it is a heartworm preventative, isn’t it?

Images courtesy Ceva Animal Health
Images courtesy Ceva Animal Health

Another of the study’s results showed owners in the confused non-user category were certain their brand of choice protected against heartworm disease, too. Even when asked to get the package and read the indications, they still said it prevented heartworm disease.

If their product of choice didn’t come from your hospital and you didn’t write a prescription, your client is likely in the confused non-user group.

To be certain you know what their pet is receiving—and what it isn’t—ask clients to bring all their pet’s medications to their appointment. That allows you to see with your own eyes where the gaps are. If they forget, ask for the brand name of what they are using, and find out when they last administered it and how. These answers will help you get the information you need.

Other prevention difficulties

The survey identified three additional usage barriers that get in the way of dog owners purchasing and using preventatives on a consistent basis. They are:

1) Perception of risk (i.e. a perceived low risk of heartworm disease because of where they live, or a perceived high risk of drug side effects)

2) Ease of use, meaning the requirement of a prescription and other perceived hassles with obtaining medication

3) Cost, which was by far the biggest barrier for the active non-user segment

Interestingly, other factors (e.g. forgetting to buy or give the heartworm preventative or apathy) did not emerge as strong impediments to address. Consistent users received or recalled starkly different information from their veterinarians than did the other groups of users and non-users. Let’s look at each barrier more closely:

Making the risk real: A lack of perceived risk is a key reason why owners don’t administer heartworm preventatives. Maybe you’re in a region of the country that has not had significant issues in the past. Perhaps the owner thinks that because their dog is an indoor dog, it’s not at risk. Or maybe the owner knows mosquitoes carry the disease, but they think there isn’t a risk of transmission during the winter. Don’t all mosquitoes die during winter months? No mosquitoes means no problem, right? (Don’t we wish!)

Owners who fear side effects more than the disease need support, too. While we know the risks are low for an adverse event, those concerns are very real and scary for your client. It’s important to take the time to determine where the fear is coming from to help make them understand heartworm preventatives are safe.

Where do you start? Help pet owners see the risk in their community,
at their park, and in their own backyard.

  • Ensure clients know that if there is a heartworm-positive dog within a mile and a half, their pet is at risk because mosquitoes can travel that far.
  • Rather than ask if the dog is an indoor or an outdoor pet, ask how much time it spends outside to help discuss the risk.
  • And let them know it’s a myth they don’t need to use a preventative in the winter. In parts of Canada, mosquitoes may not die off during the winter. Due to microclimates and warmer temperatures in general, it’s easier than ever for them to survive in colder months. It’s critical owners understand a monthly preventative isn’t about the mosquito. It’s about preventing the worms from growing in the circulatory system (and, of course, year-round protection against intestinal parasites, as well).
  • Many clients aren’t aware infected mosquitoes are found in more places than ever before. This is due in part to more dogs travelling with owners. Plus, natural disasters can lead to the relocation of many heartworm-positive dogs.

For practitioners, it is easy to fall into a trap of believing the risk is low. So, we drop the conversation when we get pushback from the client. However, that is a mistake. Low prevalence doesn’t equal no prevalence. If there has been even a single heartworm-positive dog visiting your community, your canine population is at risk.

Make it hassle-free: The second challenge centres on ensuring heartworm prevention is easy and hassle-free for your clients, and especially for those inconsistent users and non-users.

Spend time training your staff what to do when they receive outside prescription requests. Ask if clients are shopping those other outlets due to cost or convenience. If it’s cost-related, offer a price match or a generic. If it’s a matter of convenience, offer to mail it to them at no charge or encourage them to order it through your online store.

And set up protocols so the pet owner doesn’t even need to think about it. Reminder calls, postcards, and an auto-ship program to deliver the medication just in time are a few ways to make giving preventatives routine.

Tackle the cost issue: Finally, for many dog owners, and especially those in the inconsistent users and active non-users segments, cost is a key barrier; a significant percentage of those dog owners report they would give a preventative every month if it cost less. In today’s competitive environment, there are great generic options at your disposal. Make sure you carry a low-cost option for clients in need of them.

Heartworm prevention starts in the clinic

There are many ways clients talk themselves out of giving these products to their pets. Believe it or not, these same factors can sway even veterinarians and hospital staff from recommending these products.

While we may feel like we’ve talked about heartworm disease over and over again, we must keep educating clients about how to protect their pet. And even after you have presented a compelling and influential case, don’t be discouraged if a client says no. You will likely get this response many times before he or she agrees to your recommendation for heartworm prevention. Don’t get discouraged.

No veterinarian wants to tell a pet owner, “Well, there was something we could have done to prevent this from happening, but I didn’t want to push the conversation.” Our clients trust us to help them provide the best care possible so their pets can live a long, happy, and pain-free life. Nobody wants to part with a beloved pet before its time. The needless suffering that accompanies heartworm disease can be prevented.  

Asking open-ended questions takes practice, but working to make that skill second nature will help draw out better information from your client. Here are a few to consider:

  • What do you know about how heartworm disease is spread?
  • Where do you think heartworm is found in the U.S?
  • How are you working to prevent your dog from getting heartworm disease?
  • What do you know about products for your dog that kill and repel mosquitoes?
  • How would your dog’s quality of life decline if he contracted heartworm disease?
  • What are the activities you would miss doing with your dog if he had decreased heart or lung capacity?
  • It seems like you’re not concerned about heartworm disease. Can you tell me more?

If a client says they are giving a preventative, but didn’t get the product or a prescription from you, ask the following:

  • How do you get your heartworm medication?
  • How is it working for you?
  • When and how did you administer it to your dog?
  • How many doses of the preventative did you give this year and when was it given?


1 Ceva partnered with Unfenced Animal Health and True North Market Insight for this research project and found very enlightening facts along the way. The study’s goal was to understand pet owners’ knowledge about heartworm prevention. By analyzing reasons why preventatives were or were not given, Ceva hoped to gain insight veterinarians could use in-hospital to increase the number of dogs receiving a preventative. To learn more, visit bit.ly/2WzdLvB.

2 Consistent users are those who receive a great deal of communication and support from their veterinarian and the hospital staff. Through frequent and clear communication, the team at the veterinary hospital has reinforced adherence to a prevention plan. For inconsistent users and non-users, there is a clear lack of engagement with the veterinarian and a failure in communication or a total absence of a discussion about the disease and how it can be prevented.

3 For consistency, the research counted ProHeart 6 injections as six doses.

Charles (Chuck) Johnson, DVM, MBA, is senior director of U.S. veterinary services and pharmacovigilance at Ceva Animal Health. He has more than 30 years’ veterinary practice experience. Dr. Johnson earned his bachelor of science degrees (animal and poultry science) and DVM from the University of Florida. He earned an MBA from University of Wisconsin-Madison. Johnson has been active in business education for the veterinary industry, and is a member of the executive board of the University of Florida, College of Veterinary Medicine. He can be contacted at charles.johnson@ceva.com.

Karen Padgett, DVM, is a graduate of the University of Georgia College of Veterinary Medicine and practiced small animal medicine in Charlotte, N.C. She’s since held leadership and executive positions in the animal health industry, including numerous roles at Hill’s Pet Nutrition, followed by Ceva Animal Health, where she served as chief operating officer of the U.S. companion animal group and then as president of Unfenced Animal Health marketing. Padgett currently heads an animal health consulting company offering market research, technical writing, business planning, and branding to help national and global animal health companies better serve the veterinary profession and improve pet health. She can be contacted at kdvm@kdvmconsulting.com.

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