Good evening everyone and welcome to tonight's webinar titled How best to get your Clients Engaged about fleas, ticks and worms, a very important topic. This webinar is free for everyone to view thanks to the very kind sponsorship of MSD Animal Health. We do actually have Hannah Newbury from MSD on the line with us.

Who's just gonna say a few words, about the big flea project. Thank you very much. So yes, just following on from the first webinar in the series at the beginning of April where I introduced the big flea projects to you all.

Registrations are now closed, as of Friday last week, so that the flea collection can now actually properly start and the ana analysis can take place. We have had a massive, 1,576 practises register, and fleas are starting to come in. So a huge, huge thank you to all of those that have registered.

. We've had so far 228 responses actually submitted online on our online questionnaire. And interestingly, I thought you'd like to know that 49% of the questionnaires have been completed from cat owners and 51% from dogs, which is fantastic. So we've got a really nice even split, and I hope that will continue.

And so far, although it's very early days, we've got fleas present in 28% of the pets that have been, inspected. So once again, before I hand over, a huge, huge thank you. Please keep examining those dogs and cats.

We need 5 dogs and cats at random examined a week for 4 weeks from each of your practises. Do fill in the questionnaires online at big fleaprojects.co.uk.

And if you have any questions at all, then contact your MSD account manager, or you can email us at info [email protected]. I'm sure we can put those links into the chat box during the the webinar.

So thank you very much. Once again, it's been really greatly appreciated and I'm really excited to see what the results bring. And I will now hand over.

Thank you. Yeah, thank you very much, Hannah. It's a great take up and we really do look forward to hearing the results from that project.

Just a bit of housekeeping for everyone, before we get going. If you do have any, questions, if you think of any questions during the talk, please do submit them into the Q&A box, which you'll find the little icon at the bottom of your screen. We'll be collating these questions as we go, and we'll get to ask, both Ian and Jamie at the end of the presentation.

And if you have any questions for Hannah about MSD as well with the, big flea project, Hannah will be saying online as well. So we're delighted to have Ian Wright and Jamie Crittle with us today on this webinar. So Jamie's a 2nd generation vet qualifying from Bristol University, and he owns a 145 year old multi-branch clinic and is joint owner and a 7 year old startup, as well as the global healthcare compliance software company Virtual Recall.

As was created as a result of Jamie's passion for delivering outstanding customer experiences to drive loyalty and to maximise compliance with a desire to enhance workflow. He and co-founder and fellow vet Charlie Barton, currently have their IRecall software installed in over 1200 clinics spread across three continents. Jamie has an all-encompassing knowledge and love for the media, being vet on set for film, TV and commercials for 20 plus years, and a 5 year sabbatical in British television.

He appeared regularly as a vet on The Big Breakfast, Sky News, BBC One's the really useful show, and latterly co-presenting Pet Rescue's spin-off series, Pet Rescuers and Pet Rescue Roadshow. He has radio broadcasts around the country and is a regular speaker at UK Veterinary Business, Technology and marketing seminars and conferences and events. Jamie is also a trustee of the Pet Plan Charitable Trust.

A marriage with 3 children and a menagerie of pets, and you can often be found mountain biking around the Surrey Hills. We also have Ian Wright with us, who many of you will, recognise from the previous webinar. Ian's a practising veterinary surgeon and co-owner of the Mount Veterinary practise in Fleetwood.

He has a master's degree in veterinary parasitology, is head of the European Scientific Council of Companion Animal Parasites, SSCAP, UK and Ireland, and guideline director for SSCAP Europe. Ian's regularly published in peer reviewed journals, an editorial board member for the Companion Animal Journal, as well as peer reviewing for journals such as JSAP, Companion Animal, and Veterinary Parasitology. He continues to carry out research and practise, including work on intestinal nematodes and tick-borne diseases.

So without further ado, I shall pass over to Jamie and Ian. Thank you very much and well thank you to Provecto for for sponsoring this and also for everyone tuning in for what is the next step of the four stages of effective parasite control. So for those of you who tuned in to the first webinar.

You'll remember that we covered the parasites that are major threats in the UK, the ones that will affect cats and dogs, and also may have zoonotic risks, so may affect pet owners and the wider public at large, and. What we want to do as vets and as parasitologists is to take good research, so to have good research, whether that's in the lab or whether that's in veterinary practises such as the Big flea project, which hopefully is gonna give us great flea data as the big big tick project did for ticks. But you know, it's great, it's great to get research and data like that, but then we have to get that across to, to vets and nurses and veterinary practises and make that accessible for them, which is what the, the first webinar.

Was about to try and get that information across to try and impress the sort of vets and nurses and practises, which parasites are important, where they are in the UK and what types of, of threat they pose. And that information allows us to then formulate a parasite control plans to focus on which parasites are important. But then of course we need to move on to the next step, which is what this webinar's about.

So veterinary practises, having been convinced of parasite risk and the parasites that we face, the need to control them. Us having been convinced, we then need to convince clients of the need for parasite control. And that involves risk assessment, that involves, putting together parasite control plans for clients, but also practises speaking as one voice, and getting that message across.

And so. To help me, in this sort of, it, it to sort of, summarise all of this in this webinar tonight, is Jamie, who, you know, I have my monthly slot on Radio Lancashire, but it would seem that, you know, he's vastly more qualified than me, to talk about most of these subjects. So with without further ado, I'll pass over to Jamie.

Thank, thank you, everybody, thank you, Ian, and absolutely thank you to the webinar vet, Hannah at MSD for doing this. And as Ian says, it, it is, we're gonna be a tag team this evening, because what we want to sort of get over to you is the importance of it being a complete team approach throughout the practise. And just to give you some idea of how sort of virtual recall came to be, I am a vet, I have some veterinary practises, and we just needed to find a way of being able to communicate with clients, all of the important, issues, in order to help educate them.

And we're now in 3 continents and we're seeing the same significant consistent results. But the idea behind it is absolutely to make every single client as proactive and real partners in your practise to help them look after their, their pets, become active sort of stakeholders. And for a lot of things, what are, what are those key issues that we want pet owners to buy into?

And not surprisingly, it is these preventives and we're gonna be talking about flea, and worms and ticks, but there's a raft of other things, and a lot of the time, particularly those preventives will be incorporated into pet health plans, but that's going to be more of a feature for the third, webinar in this series, the end of the summer in. September. But all of the idea behind this is to make sure that clients become more compliant.

And as a, as a term, compliance is pretty complex. But effectively, if you need them to do something, you've got to get them on that journey and help them to understand it and actually keep to it. And we ended up deciding, try to, to being, objective and come up with this phrase, pet compliance 365.

So whatever a pet needs to have in a 365 day year. Whatever they need to actually make sure that they have that. And unfortunately, all of us are sort of a long way short of that.

And to give you some statistics about this, these came from what became the Vet Futures, but it was called the 2020 vision, and 34% of pets were given a flea treatment. But actually looking into that data, unfortunately that was 34% of pets receiving a free pack, and we understand that flea pets need to be treated each month throughout the year. So equating to a 12% pet compliance 365.

For worming, it's not that much better. That was 41%. Really being wormed once a year, and as Ian explained on the first webinar, at the very least they should be being wormed 4 times a year, and there's a good argument for roundworms, toxicoriasis, we should be doing that on a monthly basis.

That equates to 15% of our pet compliance 365. So as you can see, it's woeful, all of the red means that these clients are not compliant in giving those important er parasiticides to their pets. When we go over to the US it's no different, except for if there's really deemed to be a serious disease of which heartworm kills dogs, 51% of them are given heartworm, but unfortunately they're only given it for 9 months of the year and they need to be given it throughout the year.

So it's slightly better. But why is that? Why aren't clients compliant?

And over the, the 7 years that we've been running Virtual Recall, we've got a lot of data and for those clients that actually are doing things. They often, and one of the the human elements that we all share is that we forget. But 2/3 of people don't do anything.

And whether that's they just genuinely don't believe that they need to do it, or they just haven't been convinced. And as vets, a lot of the time, we think it's to do with cost, . But it's not, certainly not in the first instance.

There may be elements of cost in it if you're charging too much for what your clients can actually afford. But how many of us are pet owners? I have 7 pets in my house at the moment, 3 cats, 3 dogs, and a tortoise.

And I want to do exactly what's right for all of them, sometimes. I just forget. But a lot of the times I've already convinced myself because of the education and particularly, Ian, I've got to take my hat off to you on that first webinar.

You taught me things that I didn't know and has reaffirmed my sort of belief in being able to get that opinion over to clients. And if we were to look at it from a decision funnel, it's, we want to bring them down that decision funnel. And the first bit is that awareness, making somebody go, oh, I didn't know that, as Ian managed to do that.

For me, and I've been qualified nearly 25 years, getting them interested. I'm now a lot more interested in fleas, thinking, oh no, fleas are just a a sort of a pesky parasite. There are more, or not exciting, that's probably the wrong term, but more risky parasite parasites.

But fleas have real problems. Then, I understand that they're gonna help if I do something about it for my pet. Then I want to do it, I become committed and finally, the most important part of all of this is becoming adherent, i.e.

I continue to do things, I stick with it. Now the challenge that we all share is this limited time in front of a client. My practise is we practise 15 minute consults, but a lot of you may be doing 10 minute consults.

Some of you may be doing longer, but that's quite a lot to achieve. That you've got to take a history, you've got to examine the pet, and then you've got to get over your rationale to er get somebody on board and do it. So first we've got to get the buy in and then finally the sticking with it.

And what I'm gonna be talking to you tonight is that buy in element. The sticking with it is September's webinar. But if we look at our area of influence.

It really is this iceberg. The top of the er iceberg is in practise, but the vast majority of a pet's life is at home. And remarkably, I did some statistics.

99.99% of a pet's life is spent at home without us being able to help influence them. But there are things that we can do to help influence them at home.

Now, every single one of your practises is unique. I feel that my practises are unique and we all have slightly different issues or challenges, but there are a lot of challenges that we all share. Absolutely, I would say, very limited, face to face time.

Doctor Google can create challenges for us, the internet. Big box retailers. Almost that element, can we compete?

Well, absolutely, yes we can, and one of the things, we also ask for feedback from our clients and we do it for other practises as well, and our clients, in general, really love us. So the most important thing that we need to do is decide on the practise parasiticide plan that works for us. And as Ian absolutely rightfully says, and as I say, this is gonna be a a tag team, a lot of it is gonna be down to the risk factors that you actually have in your areas that affect your clients and affect their pets.

But for me, in my experience, it really needs to be as simple as possible. Therefore, it's easier to recommend, it's easier for clients to take on board and stick with it. I also think it's pretty important that in an ideal world you have the same protocol for dogs and cats.

It may have to be a different protocol for, for rabbits, but it needs to be safe, absolutely. If a, if an owner picks up the wrong product to give to the wrong pet, and that can cause a real issue, ideally, don't even go there. The manufacturers are all producing brilliant, effective, safe products.

Make use of them, they're there to help you. But it's really important to help communicate to your team, help them understand how to communicate it to the clients so they understand all of the facts about it. And also, everybody needs to be.

Absolutely on board that you need to be doing this year round. It's not just a case of, when you see a, a pet for an annual vaccination to sell them a 3 pack or a, a product that does 3 months' worth and think that's good enough. Because how.

Many of you then see them, well, chances are it won't be in 12 months' time, it may be in 14 or 15 months' time for their next vaccination, you say, oh, would you like some more flea product? And they say, oh no, I've still got some sitting in my cupboard, just sat on the shelf. They've bought it, but they haven't actually applied it to their pets, so it's not helping anybody.

And then most importantly, it's sticking with that plan. So I'm gonna hand over to Ian because now it's that risk element. How do we assess that?

Over to you, Ian. Thanks, so this, yes, this is the parasitey bit, so, yes, no, I mean very much so. Clients are gonna come into the practise and all, I think there have been all sorts of studies done now that show that clients really are seeking a recommendation, that they're seeking a recommendation from you.

They want your advice and they want. To be told something firm to do. And, you know, for many practises, that will be a very simple protocol, maybe fitting in to practise plans, there may be just sort of two or three options.

Some practises may have fallen in love with parasitology, having listened to my last webinar and think, no, I, I want to do something very bespoke and, you know, I want to have sort of very detailed questionnaires. But the thing is, whatever you decide to do, it's first of all, very important that everybody in the practise is on the same page and sort of following the same protocols, but also that that advice is risk assessed. And that risk assessment can be very, very simple.

But it can be, much more involved, depending how far you want to go into it. But the clients appreciate that time, they, they appreciate having, their own sort of circumstances, the history, . Lifestyle taken into account, and that's really what separates us from clients just going out and and getting a product.

So I, I have a parasitology colleague who once told me, oh sorry, last last slide, last slide. Oh, thank you, yeah, I had a parasitology colleague who once told me er that parasite treatment is easy, er, and parasite control is easy. You just treat everything for everything all of the time, and then everything dies, practises make lots of money, health goes up.

It's all that straightforward. But that sort of sledgehammer approach endangers sort of alienating the client and the client thinking, well, the advice is the same all of the time, but also it does risk overtreatment. So, you know, practise advice does need to be tailored.

And that information, there's lots of information that needs to be, needs to be acquired. It can be acquired across the whole practise, so it can be acquired in your 1015 minute consults, but also it can be acquired through questionnaires, and prompters in reception. You can use patient history.

Much of the information you need may already be there in the records. But also, you know, you can use nurse consults. This is a nurse awareness month, so I'm gonna take this moment to thank nurses all over the country.

But you know, do all these, you know, fantastically varied roles in, in practises, but often now have their own dedicated nurse consults where information about parasite control plans can be asked. And also just never underestimate the power of the practise reception. So the receptionist, a well trained receptionist will be chatting to the clients, information will be being exchanged, and that is all very, very useful for parasite control.

So next slide please. Timed it better this time, thank you. So this is just an example of SAP UK and Ireland material that you can use in, in reception, so they're just prompters really.

I mean these are. Sort of aren't sort of bespoke for individual practises, but they just ask questions that perhaps owners might want to consider and they can tick the boxes and they think, oh, actually, yeah, I've ticked these boxes. I, I might be, my pet might be at risk from ticks, or my pet might be at risk from tapeworms, and then they can take that information into nurse consults or into vet consults, and have that fleshed out, and recommendations can be made.

Next slide please. So how do we assess risk? Well, really it, it falls under into three different categories.

So we assess risk in terms of lifestyle. We assess risk in terms of geography, in terms of where parasites are across the country. And having done all of that, we also need to consider compliance factors, and factors, about sort of day to day living, that may affect efficacy of products.

So initially you can get this information, whether it's from questionnaires or asking questions or the client's history. There are a few things that we need to assess and when we start off down this road, often people think, oh this is gonna be desperately complicated. But you can get a lot of information from very few questions and from very little history.

So the basis on which you're gonna build any parasite control plan is 4 times a year minimum for Toxicara. I hope I convinced everyone of that last time. Jane is convinced, I hope everyone else is convinced.

And also that all cats and dogs may be exposed to fleas. Flea infestation in houses is a very bad thing, and therefore, you know, everybody, or all cats and dogs should be on routine preventative flea treatment. So then what you're doing is you're asking questions to see whether tick, lung worm, tapeworm prevention also needs.

Needs to be bolted on and whether we might need monthly treatment for Toxicar. So we need to know, does the pet have access to offal products, raw offal, carcasses on pasture, and of course now unprocessed raw food diets. So are people, are people cooking up there or not cooking up just putting together, raw food diets at home.

And does the pet hunt? This is my neighbour's cat who constantly lives the dream, reducing local vole and rodent populations. This cat is going to be picking up toxicara for a pastime and also tapeworms, so hunting is a very, very important factor.

Has there been a previous history of tick exposure? If there's previous history of tick exposure, lifestyle is going to expose them again. And does the pet have outdoor access?

So if cats are spending a lot of time outdoors, if dogs are out sort of skipping across ruminant pasture, tall bracken and grass, their risk of exposure to parasites is going to be increased. Next slide please. In terms of compliance and efficacy, does the owner shampoo their pets?

Because this is going to affect the efficacy of some flea treatments and tick treatments. Similarly, does the pet frequently swim? In terms of shampooing, I mean this is quite a common practise in dogs, less common in cats, but you can always look for the scars on owners to try and ascertain that information.

There's a preference for tablets, spot on, collar, and this is often sort of, you know, maybe overlooked or or even looked down on a little bit. But, client preference is extremely important. If you know, clients aren't on board with what you recommend, if you recommend, say a spot on, and they think, well, actually I, I think I'd rather just use something else or I really struggle with applying spot-ons or vice versa, then compliance is going to be reduced, so don't be afraid to ask the client what they would actually prefer.

Previous reactions or even just perceived reactions, to sort of spot-ons or collars in the past or whether they vomited on specific tablets in the past, all of these can affect compliance, and just getting, getting the owner on board with what you're suggesting. Next slide, please. Si Your overall recommendation, it has to consider sort of high risk parasites, sort of, you know, geographically, which we'll talk about in a moment, but also the ones that lifestyle are are going to expose you to.

So, you know, questions as well like are dogs cereal grass consumers or do they eat slugs and snails that might expose them to lung worm? We need to consider compliance, we need to make sure that the client is really pleased with what you're going to give them, and that they're not going to struggle, maybe lose appendages, wrestling with cats, or be worried about adverse reactions. We may want to make sure that whatever we're recommending is applied frequently enough and the client really understands that.

And it is where we have comparable options, very important to consider licencing and above all to make sure that what we're recommending is safe in any individual pet. So next slide please. So geographically, there is lots and lots of information that's now available to us.

So there are there are different types of geographical map and information that we can fall back on. So the first example is nationally reported clinical cases. And a good example of this is lung worms.

So there are a variety of lung worm maps available where people just report, cases that they've diagnosed and. This is, this sort of strategy is, is quite unscientific in in that none of these cases are confirmed. Very little extra information about how the conclusion was drawn is reached.

And yet, if you get a sufficient number. You start to get a very representative map, and by looking at these maps, you can start to get a feel on a national level as to whether you're in a sort of high density, high risk, high incidence lung worm area. Next slide, please.

Another way of looking at things is real-time data. So if we look at ticks and when ticks are active and when ticks are feeding, there's lots of real-time data, so ticks that are submitted with information about when they're submitted, and where on the body they've been found. And I mean this information is available from SASnet, the University of Salford, Richard Birtles study group, and also the ever wonderful .

Tick surveillance scheme that this data comes from. So you can look at it and say, well, yes, ticks feed all year round. So there isn't a time of year when we're completely safe from ticks, but there are times of year when ticks are much more active, their feeding is much more prolonged.

There are much higher numbers of ticks on cats and dogs. So then, you know, at those points in time, we really need to be emphasising. That tick prevention is very, very important.

Next slide, please. Oh, I think this is back to you, Jamie. Well, I think that's one of the fascinating things.

Not surprisingly, manufacturers, last year, the big tick project that, Hannah mentioned, got amazing data. And all of this is readily available and, and I find clients love it. And it, but it's.

Really, really important as we become more able to sort of segment and and target specific owners to almost have this individual pet health, that we can do it for individual pets. And there's lots of it. The Bristol University's tick ID which came from the big tick project, as Ian says, Savsnet, IEX.

The manufacturers, all want to try and help you, but what I think's really, really important is to use the risk that is specific to you and your clients. So the, if I go back to the the previous page where you think, OK, well that's fascinating, really pretty colours around the, the UK, but if your practise is in one small defined location. Your owners may not be interested in what's happening 150 miles away, but what's on their doorstep, and this is one of my practises, Hirsham, and we're in a high medium risk.

So therefore I take that into consideration as to. What we should be doing to recommend to our ticks, ticks, apologise to our clients about ticks, but if they're finding ticks on their pets, as Ian says, then we need to start adding that in, to their parasite prevention plan, . Now you might want to talk about this I, one of the things, making it as simple as possible is how should you do that?

What do you reckon? Well, yeah, and it's very interesting because there's been a lot of debates, backwards and forwards about whether monthly or quarterly or even, you know, sort of less frequent than quarterly is the way to go in terms of treatment frequency. And you can pick your data really, as to, you know, you, you go to sort of any individual study and often depending who's funded them, but in independent studies as well, some of them will fall out on the side of monthly, some of them will fall out on the side of, of less frequently, sort of quarterly or, you know, sort of less frequently than that.

I think the reality of the situation is that client preferences do vary, but also interestingly, that there are geographic differences and socioeconomic differences, between, sort of whether people want monthly or whether people want less frequently. So, . Geographic examples, you know, if you've got lots of, dogs that are on monthly, sort of preventative treatments, say for lung worm, they may want to, to sort of fit in with that, with a monthly treatments, but equally so, they may not want to be sort of using two treatments every month.

They may be wanting less frequently. If we consider socioeconomic, you know, there are some parts of the country where people very much want to just pay a sort of chunk of money and have a product that's gonna last a long length of time. In other areas, and people may want to try and sort of spread that cost, that can be done via practise plans, or it may be that people just want to, to get very small amounts of treatment in any one go.

But the point is, it's a case of knowing your clientele, and you know, you may want to go very bespoke and give people options of treatment treatment frequency, but it may be that there is a real sort of client drive in your practise, to go for either monthly or quarterly or less frequent. And this again is where it's sort of talking to clients. About their preferences, and really sort of getting them on board with with whatever you recommend is very, very important.

I mean, there's, there's no, as far as we know, there's no efficacy difference in terms of how often you're treating these pets if your instructions are carried out and compliance is good. So whatever decision you make, whether it's a short term or a long term problem. It's a case of really making sure that your client is on board with it and also that they understand, how long it's going to last, and just what, what you're doing and what the aims of your recommendation is.

And, I mean, we're very, very lucky that now, you know, we have such a wide range of choice, open to us, which has really opened up in, in recent years. Next slide. And, and of course, you know, we have the, the, the wonderful array of sort of multi-formulation and broad spectrum products.

So I don't think, I think Jamie and I can both remember the days where products were very narrow spectrum. So if you had a number of parasites to deal with, the number of things that you had to be giving to cats and dogs was going up and up. And up.

And also the compliance options in terms of sort of spot ons, choose, were very, very limited. It was much more like human medicine. It was like, well, this is what you've got, and, you know, you're just gonna have to give it or, or die trying, you know, which, I mean, now, we're very, very lucky in that we can reduce the number of products that we have to give.

Because we have broad spectrum products, but also we have a variety of formulations to choose from. So we can really target sort of clients' lifestyles, and their sort of wishes and preferences, and in doing that, we can maximise compliance with the minimum number of products necessary. Well, next slide.

So just again to, to summarise for your overall parasite control recommendations. You believe that your clients want a recommendation. They've come to you, they may want to be involved in the discussion, but at the end, they want you to say, this is what you need.

I've considered your lifestyle, compliance. Factors have considered geographical factors, and this is what I recommend for you. Not how well, you know, you could have this or you could have that.

Having considered all of the options, most clients want to be told what to do. And they appreciate those recommendations being based on need rather than just saying, well, frankly, we could give you this stuff every time and it'll just kill everything. They appreciate having their own lifestyles and risks taken into account, .

And then a plan being formulated as a result. And that plan that we formulate is gonna be based on geography, on lifestyle, and owner compliance. And to help us put this into practise, it's back over to Jamie.

Fantastic, thanks, Ian. Yeah, so the, the next stage of this, you've made your decision on everything about that. I would also just sort of add in, of course, there's going to be an economic element, almost who's the, the company that you have the best relationship with that can help.

Everybody get on board, you now need to get it sold to the practise team. They need to understand the risks, they need to understand that we're aiming for a 100% pet compliance, 365, giving that same consistent message. Making sure that every pet, owning, sort of team member who has a pet also is using it on their pets.

That becomes a really powerful, sort of message for them, coaching them in all of the information and trying to find sort of handy tips and, ways to convince that client. And this is where I do really think the manufacturers are are brilliant with the lunch and learns and the support that they can provide. But it's really, really important that everybody in the, the practise doesn't get sort of hung up if a client says no.

That doesn't mean not ever, that they haven't really. Sort of been taken through that funnel to decide to sort of go for it. So, repeat, repeat, repeat, we're not doing this to make money, we're doing this for the wellbeing and the health of each of our clients' pets, and that's what's really important.

So educate your team. Do they know all of the facts? So one of the things from last the last seminar from Ian, 21% of cats, so 1.6 million have fleas.

7% of dogs. Just under 600,000 has fleas. The big flea project will give us even more information by the end of this year to determine that.

And that's really useful information. And if you've got more pets in the household, don't forget, they all need to be treated because they're gonna be at at risk of it. I've already said, involve everybody in the team, so here's me with part of my team.

You need to sing from the same song sheet. You don't see me here because I can't sing. But you need to get that message across to client.

Every client, every time, no exceptions, no excuses. I think one of the things that's really useful about that. Is, as I say, it's what I use on my pets, so if you've got this protocol, every member of the team needs to be doing it.

And remember, it's not, it's at every touch point on the phone, face to face, newsletters, every single sort of communication to reinforce that strong message. And as I say, here's one of my beautiful cats, Cosmo, and. On the 19th of each month, I treat all of my pets.

I know exactly what I need to do. And as I say, every pet in the household, well, within reason. I don't know, do we need to do goldfish, Ian?

No, well, not, not to my knowledge so far, but you know I have an open mind. And I think it's really one of the things that's really fascinating is establish that parasiticide status of every pet at least once a year. Everybody in my practise has to do this every time they examine a, a pet, particularly for an annual health check or vaccination, that this is one of the key things, and we book it, zero priced.

code in the system, and that means that we also then have a protocol as to when we can, redispense that product. And it's really, really useful. You need to also keep track of the purchase history.

I do genuinely do this. Here are, my six pets. On the 19th.

I know when I need to do it, but I still want to, remember how to do it. Online reminders are really helpful and therefore really capture digital contact details or encourage clients to do that. But one of the things, your clients have the relationship with you rather than a third party.

They're very useful and, and this is one way to help compliance, but if you can do it and do it in different ways, multi-channel, text, email, post from you. And do it automatically, clients genuinely appreciate it. And that's how we got into this and and why we get the same well, market leading sort of response levels.

And as I say, capture those details. It's really, really important. And from the 25th of May with the onset of GDPR you need to continuously do that.

We need to make sure our data is really good. And it gives us that opportunity to extend care beyond the practise door, as I say. We're seeing our clients infrequently, and we want to extend that area of influence beyond the practise into the home.

To give you a better perspective, if a pet was in your hospital for 2 whole days and you got that pet better. They've only been in that practise, in your practise for just over 0.5% of their time.

But we need to really demonstrate to our clients that we care about them and understand the well-being and care about the well-being of their pets all year round. So if I go back into that decision funnel, the compliance and the adherence, the first bit. The compliance, getting the, the education and their their buy in and reminders help with the adherence.

So I recall, don't mean this to be a plug, but everything that we're passionate about is to increase this compliance. So how do we get the, the clients bought in? Can we do that when they're away from the practise?

Can we help get their conviction? And yes, we can, but it's really, really important to make it personal to them and really specific. So it's as if you're talking to them face to face, but when they're at home, making it really relevant to them.

Timing is important. And the consistency of that message, as I've said, every single time in order to help bring them down that that funnel is really important. And again, just like the, the, the products themselves ask the client for their preferences.

How do. They want to be communicated with, make use of their data in an appropriate way, and if you personalise and it, it's coming from you, they genuinely appreciate it and they do more of it. So you can get more clients on board.

Now, it's really, really important to understand our pets are part of the family. But just as this little girl is, she's not aware. Of the risks that are involved in that, and it's really, really important.

One of the things that Ian talked about the last webinar and why for me, toxicoriasis. We've just got an absolute responsibility to stop something like 40 people go blind from larval migraines for something that can be eradicated. And our owners don't want that, and if you give them the.

The information and help to educate them, they will be really pleased with that strong firm recommendation to worm them. And it's exactly the same for fleas and ticks, depending on that risk. So if you were to sort of segment your clients, they've never bought.

Now in some ways, that's quite a hard sort of task to get them completely on board unless you've got a lot of time, effort. So it's. Giving them the right information, talking to them just as Ian has said, and bring them down that funnel, helping them understand the risks that are common and real but making it individual to them.

Then, there are a second, sort of group of clients who may have been compliant in the past or the example that I gave that they came in for their vaccination, and you gave them a 3 pack. And then the next year you say, oh, do you want some more? And they say oh no it's still sitting on the on the shelf.

They just, they may have forgotten. They may have gone over the counter, they may have gone into the supermarket, they may have gone online. Or, for a lot of the case, they may just not have seen any of the problems and just think that they don't need to do it.

So by giving them that information, you can get them back on board. And then finally, the people who are convinced and generally compliant, you want to help sort of reinforce them. Help them remember the pet health plan, but the more of this in September's webinar.

Now helping with that. Almost having strategic months in which you focus in and we all try to do that in practise, but get everybody on board with lovely posters and letting clients know. So there are ways making use of manufacturer campaigns that you may see things on billboards or adverts or in magazines, but actually if it's coming from you rather than the manufacturer, that helps reinforce it.

So we can help with that and it makes it much more powerful. So here, tick awareness. Just as looking at that seasonal map that er Ian showed us, now ticks are starting to become more prevalent.

And as a result, if we look back to last year with the big tick project. Combining all of that fantastic information and marketing that MSD did, combining that from getting the same message across to your clients, we ended up having a significantly more powerful and more successful campaign, and we helped pets have fewer ticks. This year, flea awareness, the, the big flea project, it's really important.

If you can get a campaign going to your clients who are not doing anything. With really good interesting facts, here are links through to SAP, asking them to come in to have a potentially a free parasite parasite MOT to be able to do that risk assessment, your clients will really get on board. And from that, sort of general campaign, you can look at it and almost target all of those areas that.

Getting it across to the whole practise and a an awareness campaign, those that are compliant continue with them, and those that aren't, you just want to look at them, as I've said, they've never done it, help them on that journey. If they've lapsed, try and re-engage with them. And the, the beauty of it, you end up delivering what we call a virtuous value circle.

The manufacturers make the best products. We already know that they're safe and effective, and they help pets live a healthier, longer, happier life, which, as a pet owner myself, so I am a client of my practises, that makes me pleased. Therefore, I become more loyal, more bonded to the practise.

I end up visiting more, I tell more friends about it, and that ends up being a real success story for the practise. And as a result, because of MSD in this instance being help helping me to do that, my relationship with them increases. I do more with them, and as a result, this circle continues and we get more healthy, happier pets, happier, healthier pets, happier clients.

And it just continues, it becomes self-perpetuating, and the, and the team love it. So, how do I summarise that? Know the risks.

Absolutely. I do think a simple, what I say a pan practise, if you can come up with a simple protocol that works for the vast majority of your clients, understanding those risks, it becomes an easier message to get across to clients, and they're hearing it more regularly. Work with the manufacturers, work with MSD on the the big flea project.

Because you end up having a much more valuable, relationship. Consistency, every pet, every time, not just face to face in all of your communications. What I mean by removing polypharmacy, and it is interesting, .

With virtual recall, not surprisingly, I speak with lots of practises and we send a lot of, parasiticide reminders all around the world. And there are some practises that have so many different products that they're, they're recommending, it almost just sort of beggars belief for me thinking that from a vet's perspective, or particularly a locum, that they go into the dispensary and see this whole array of products and think, oh, what shall I pick now? And that inconsistency can provide real problems that there is no consistent message.

But I do think it's absolutely as Ian has said, you've got to be tolerant of edge cases that if a client can't tablet er a dog or a cat and. Then a spot on. Or similarly, if they've got really valuable furniture or sofas and they hate spot-ons, go for tablets.

But even better if you've got a formulation or multi-formulation of the same product that comes in different formulations, that that doesn't change anything. Repeat, repeat, repeat. That would be my big, big mantra.

And remember everybody in the practise, I go back to the, the locums. I hope all of this becomes ingrained and written down into your practise protocols or your practise handbook when somebody comes into the practise, they understand what your message needs to be for them to each of your clients that they see. Now, if I was to go for my pesky parasite prevention plan, I always start with trying to make it smart.

It needs to be specific. Ian's already said it and I totally agree. Give a firm recommendation.

Don't be woolly about it, don't give too many options, your firm recommendations about what a client needs, but listen to them, understand their needs and actually what's going to work best for them. Measurable, really important. What are your sales?

Your manufacturers can help, your wholesaler can help, but even better if you can look at your data that of the sales going out to clients, but also apply that to the number of pets you have. That every single pet needs to be having this, we've already agreed that, so that becomes a sort of key performance indicator for the whole team to understand what those compliance figures are. Make use of our pet compliance 365.

That's what I do. I want to improve it. I'm still woeful.

I've got 2/3 of pets not doing anything. But I do have over 30% doing 12 months' worth. Do more.

It needs to be achievable. If you've got really low figures at the moment, don't suddenly think, right, I'm gonna get 100%. But start, get everybody on board and be realistic about it.

Where are they in that decision funnel if they've come in and they say, I've never seen fleas or ticks, my pet live lives inside, I don't even need to worm them. Well, by taking little, each bit in turn to help an a client understand that they may still have risks. They may not need to to worm every month, but they may need to do something.

And remember, every client interaction, that's not just face to face but also at home. And timely. This I think is one of the most important thing.

Make use of your communication at the right time. But from a vaccination point of view, you should have a healthy pet. So trying to encourage an owner to keep your pets healthy.

Is a really, really powerful time, so from my sort of practise protocol, it is always the annual health check that is the most important one that we really focus on, parasites. Of course, this summer with the, the big flea project. As Hannah said, 28% of pets so far have fleas.

That is remarkable. So here is a timely, occasion, making use of a national campaign, which a client may see that. One of the things which I'm sure MSD will be doing lots of is lots of PR.

They certainly achieved that with the the Big Tick project. And it may be your clients coming in, they may see the fleas at home. Nobody likes fleas.

One of the reasons why I got on board and as a, an anecdote for you, I forgot to give the flea treatment to my first two cats. Sadly, I lost the second one, at the beginning of the, sorry, at the end of last year, aged 19.5.

She didn't quite get to 20. But I missed my flea treatment and suddenly on our bed, riddled with fleas, my cats lived on, on our bed, and I was shocked. And from that moment on, I ended up using a flea spray around the house.

They were on programme every month and at the time, it was Ian sort of talking about back in the good old days, Nan Top and Staykill. As soon as Frontline came on board, that made a, a big difference. But now products are even better, more productive, more effective, that you don't want to have that.

And it's almost those anecdotes that really work to get your clients on board. Remember that beautiful, picture of Cosmo I showed you? It's what I do in my pets.

And exactly the same for the rest of the team. And remember, it is your aim, helping your clients be proactive partners in their pets healthcare, not reactive. If it is reactive.

Ian will be able to assure you it's quite hard to get eradicate fleas once they've got there. Prevention is so much better, but if you do have fleas, and so far, as I say, 28% of pets have fleas, you need to get a really good flea treatment, a flea prevention plan in place. So thank you from me.

I'm sure we're probably gonna go to er some questions, and a big thank you to Ian as well. Oh my pleasure and thank you Jamie, yeah. Just before I'd, I'd just like to, to add, I mean, I can completely, agree with that.

I I think that, you know, it's, it's good. Almost all major drug companies now have a very wide parasiticide portfolios, so whatever your own preferences and your client's preferences and parasite protocols, you can work, with sort of one or two, drug companies. And, and build those sort of great close relationships.

And I think that, you know, once you have those relationships going, we're all working towards the same aims and the same goals. You know, there's a lot of great work that that can be done. So, and you know, don't, don't be afraid to use zoonotic messages, to get sort of compliance across.

So, you know, some vets, some veterinary practises and Nervous about, approaching, say, toxicorosis, because they're worried that people will be scared, perhaps to the point that the animal, human animal bond will be reduced, or perhaps even that people, you know, will want to rehome their pets. But I think that we can put that message across as long as we then give a solution. So we say, look, you know, there are these sort of terrible zoonosis like toxicosis.

This, you know, can do you a lot of harm, but with very simple preventative measures. So, you know, if the client comes in with children, you say, look, you've got children, you know, that that risk is is there for those children, but these very simple preventative measures with good hand hygiene, monthly deworming, you know, we can more or less eliminate that risk for you and then you can have a happier relationship with your pet. Yeah, I absolutely agree with that, Ian.

And that's what owners really, really want. Yeah, yeah, absolutely. We want them to be fit and healthy, and we don't want to see these pesky parasites.

And I agree. I don't think. You're, you'd be doing them a disservice without, giving them the facts.

It's not trying to scare them, it's trying to educate them and, and making them aware of those risks, and as a result, you help them down that, that funnel, and it ends up being a, a significantly healthier relationship that you have with your clients. Yeah. Absolutely.

Yeah, that's been an excellent webinar. Thank you very much both for that some really useful and practical information there for for everyone. We do have, both speakers are happy to stay online for some questions now, and Hannah from MSD is also staying online.

So if you do have any questions for the all star panel, now is the time to get them in. We have had some questions in already. I will answer the first couple because, Alanda is asking if there's any way to get a recording of this presentation, and Sharon asked how she can access the last webinar.

So all of our webinars are recorded, and then edited and uploaded to our website, typically within, a day or two. So the recording of this webinar should be up in the next couple of days. The first webinar, if you go to the webinar vets.com, and then go to, the webinars tab, you should be able to find it.

It's in chronological order. And that was from, about a month ago, I believe. So it should be quite easy to find.

Now then, a couple of, interesting questions here. Greg's asking, So I understand that shampooing dogs more than 4 times a month, reduces the effectiveness of spot-ons. But does this also apply to, say oral symparica where the effect of the drug is at skin level?

Well, that, that is a very good question. I mean it it all boils down to the, the C bum layer, essentially, that's what you're sort of stripping out with with the shampooing. And you know, there are, there are some spot on products, not all, because some are systemically absorbed, so once they're absorbed into the body, then you're fairly immune to the, the effects of of the shampoo.

It's the ones that rely on distribution through the, the sort of sebum layer of the coat and the skin. If you're sort of stripping that layer away through frequent shampooing, or potentially through through frequent swimming, then you have the potential to lose some activity, with that product. I don't know on the technical side if if you have anything to add, Hannah to that.

No, absolutely. I mean, from a, you know, from obviously the provete kind of side of things, we don't have, any contraindications when it comes to, the certainly the or the or two would . In no effects with swimming or exposure to with shampoos and and frequent washing.

With the topical side on data sheet, it is 3 days, and that's purely based on the the study work that was done during the licencing process. That was the earliest time that the efficacy was, was measured. We do.

Have data, and a and a published paper looking at, dogs are being exposed to water before that three day time period. And again, we wouldn't deem there to be a reduction in efficacy purely based on the way that it is rapidly absorbed and then a systemically distributed. OK, great.

Thank you very much both. Very interesting question here and rather topical. So should we be concerned about resistance to parasiticides developing when we recommend more frequent treatments?

This has been seen in farm animals where it's now recommended that farmers get faeces checked prior to treatment from Helen. OK, well, well first of all, if we take the worm side of things, so first of all with worms, companion animal worms are very different. The, the epidemiology of them is very different to sort of horses and cows.

So horses and cows, almost all the worms that you're treating are inside those populations of horses and cows, so they're all exposed to the wormer, and there's a lot of selection pressure. A lot of wormers used in horses and cows even kill arrested stages in the muscles, which is, is very important, but that increases selection pressure. So what happens is then as a result, you have resistance that develops and can develop quite quickly.

And to avoid that resistance, what you need is something called refugia. You need to let some worms live, and those worms occupy the pasture and you reduce. Resistance as a result, and you can do that through, worm testing to sort of, you know, pick out the sort of wormy horses and cows and sheep, or you can do it through strategic, sort of worming at just certain times of year or spacing your worming out.

In in cats and dogs, there are a number of factors that naturally limit resistance. So the first is that there are lots and lots of wildlife reservoirs. So we have foxes, slugs, snails, intermediate hosts, paratenic hosts like birds and rodents, that aren't being touched by worms.

So we have a sort of natural reservoir there. If you take parasites like Toxoara, they're arrested in the tissues of many cats and dogs, er and those won't be affected by worm treatment products. So we have another natural reservoir there.

And, and finally, it, it would be wonderful if, if everyone in the whole country was worming their pets, every month, or, or even 4 times a year, with similar base group products, and if everybody was doing that, then you would have significant selection pressure potentially being exerted. But the reality is that all sorts of different worms and products are being used. At relatively infrequently and there would need to be a massive increase in usage before you got any sort of significant selection pressure applied.

But you, you don't limit resistance by not worming uninfected cats and dogs, you would only limit resistance by allowing shedding into the environment and. Another big difference between cats and dogs and horses and cows is that with cats and dogs we're dealing with zoonotic parasites. So what you would have to say is that you were prepared to let zoonotic toxicara eggs or echinococcus eggs into the environment.

And potentially expose people to limit resistance and that is a very, very difficult argument to make. So I think that, you know, it needs to be a risk assessment, we don't want to over worm for its own sake. Not all cats and dogs need monthly worming.

But, you know, we need to ensure that human health is, is paramount and the health of the pets, and that we, if we have at risk groups that they are adequately wormed, that has to be the primary concern. So, you know, we mustn't be complacent about resistance, but those health factors and zoonotic factors, they need to be considered first, very much so. And we need to stop.

Children, people going blind from toxicar or larval migraines, I would say. Yes, I would say that that was the priority. I think that we can all agree.

But you know, you do need so. You know, for instance, you know, if you have someone who has a cat and dog, they don't have children in the household, if they worm 4 times a year, they'll reduce egg output, which is good, but there is limited risk to that individual household, particularly if that cat and dog doesn't hunt, and therefore 4 times a year, fine. If you have children in the household and you're worming 4 times a year, those resistant eggs, as in environmentally resistant eggs, are gonna build up in the environment over the time, there's still gonna be very significant zoonotic risk.

So, you know, you have to, in those situations have to recommend monthly worming to to limit that zoonotic risk, that is the absolute sort of paramount, sort of priority. Excellent, very interesting, thank you both and you've also just answered someone else's question there, Ian, so well done on your psychic powers. Asian was asking, can garden birds be parainic hosts?

Can, can what, sorry? Can garden birds be? Oh yes, yes they can, yeah, absolutely, for things like toxoplasma as well, you know, cats love eating them, and you know, birds love to peck around and eat other paraic hosts like earthworms, and beetles potentially.

So yes, you know, parasites can very easily be cycled through the bird route, as well as the small furry rodent route. Great. I've got an interesting question here from Alander again.

So, thinking about the, the raw diets, so how would you get around clients that are so set on feeding a raw diet, and are against, vaxes and worming, etc. Because they believe that feeding raw with fur attached helps act as a natural wormer, and the acidic nature of a raw diet makes it inhospitable, environment for internal parasites. Well, well, in terms of the latter part, they're, they're deluded, so it's important to point that out, you know, but, perhaps slightly more diplomatically than that.

The, the raw diet question though is a very good one, because although you, I believe from a parasite prevention point of view, you should recommend a cooked diet, the people on either side of the fence for all sorts of different reasons. If clients are determined to feed a raw diet, then it should be a processed completely. Raw diets.

So, you know, the bags of of like like look like regular sort of dry dog food, but raw processed diets, cos they will have undergone meat inspection, but they'll also have been frozen for a week. The ingredients will have been frozen for a week at least, before being used in the diets. And this will kill, parasitic cysts like tapeworm cysts, sarcosyssis, Neosporra, toxoplasma.

So there's still, you know, potential bacterial issues there, which, again, there's a lot of debate around. I'm not gonna sort of engage there, but from the parasite point of view, that freezing process is very helpful. So if clients are determined, I'd much rather that they were feeding a sort of processed raw diet rather than getting off or, or sort of, you know, chunky bones off the back of a van, you know, that's, that's, that's the sort of direction that we definitely want to be heading in.

And I, I, I'd go on further, Alanda, that here's a client that is almost fallen out of that, funnel, that your, the likelihood of you being able to get them onto a health plan, straight away is obviously almost nonexistent. But taking them as an individual and Ian's just giving you some amazing facts to go back to them to say, go and look into this. My recommendation is that you should worm, with regards to vaccinate.

You, you take that in turn as well and, and you give them the evidence, and if they still don't believe you, at least you tried. But you're giving them the truth and scientific evidence, but they're just outside the funnel, but you may well be able to bring them down into it. So persevere.

Absolutely, and you know, engage with them, say, you know, look what I'm telling you is is evidence based, and you can sort of give them some references and discuss that evidence. I mean you can invite them to do the same, and you know, when they come back with their, you know, Doctor Google forum, you can say, well, you know. If we, if we really deep, deep down into this, it's not a lot of peer reviewed evidence at the bottom, you know, and in that way, you know, I, I don't think you should be afraid to sort of debate these things with clients.

They're often very firmly held beliefs by by those clients. But you know, you have to use evidence. You know, the power of persuasion, the, the wonderful receptionist, power of persuasion, often, to, to try and, you know, to, to sort of bring them round, but Jane is absolutely right, it can be a long process, it's not necessarily a battle you're gonna win by one route or at the first attempt.

And often I find that they, they genuinely feel that you're, you're making, making a recommendation in order to make some money. So I would probably say this is the product that I would recommend. You can go and buy it from wherever, or I can give you a prescription, but actually there's a, there's a question earlier on.

Paul, about how do you sort of take on internet pharmacies. Part of the thing that I would make a sort of a really strong recommendation and it would be part of, what I tell you in, in September, trying to be as competitive, but because you're going to be able to make more recommendations and have more of your pets compliant. That the, the almost the profitable side, the amount of revenue that you make will be more than the few sort of parasiticide sales that you may be making at at the moment.

And if they genuinely then think, oh God, actually you, this is your firm recommendation and you've given evidence about it and you've even sort of quashed the idea that you're ripping me off because you're just wanting to sell me a a wormer. You may be able to bring them down that funnel and get them on board. And interestingly, those are, in my experience, the characters that almost become your most loyal clients because you've been able to win them over.

You've given them all of the evidence that they needed to take your recommendation, and you've been firm with it, and they will stick with it. Absolutely, yeah. Yeah, that's great.

Thinking about, a lifetime value of a customer as well. Yeah. Yeah.

And it, it is difficult with the, the conversations, particularly around things like, raw foods, as you were mentioning there, because human nature does tend to make us become entrenched in our views and almost put up defences, doesn't it? So, I think what I, you mentioned about. Making sure it's a nice conversation and that you're, you'll keep going with it and trying to make sure that they understand the risks, that's, that's what's important there.

Perhaps don't use delusional in your opening sense after all. Yeah. So we have, nice comments here.

Thank you very much for the excellent webinar, which is always nice to see. Thank you. .

So a couple more questions here. So, there's There is a study by Otrantotal in 2013 that investigates the efficacy of a combination of 10% amidochloropride and 4.5% flamethrin on canine leishmaniasis prevention on endemic areas.

What do you recommend for that purpose? Right, OK, well that's I, I'm gonna hand that over to you, Ian, because I don't see, Leishmaniasis very often. No, no, certainly, no, no, well, we're not, we're not endemic yet, no, but you know, .

I mean, fly repellency very, very important in endemic countries, whether your pet lives in them or whether you're visiting them. So for dogs, there's a number of, of licenced options. I, I'll have to go UK here, I'm not 100% certain what's licenced in mainland Europe, but in the UK you've got the choice of permephrin spot ons.

So off the top of my head, currently I'd say, advanced. 6 Vetra 3D and I'm not 100% sure if Actavi Plus has a fly repellency licence, but you get the idea that permephririn and other flea product spot-ons. They often have to be applied every 2 or 3 weeks, but every 2 or 3 weeks they are, quite efficacious, round about sort of 85 to 90%, fly repellency.

Scalibur is another excellent option, which is a collar, that gives good, fly repellency, very similar levels of efficacy and can last up to 5 months, but this is a good example tying you into the webinar of life. Style and compliance and because it is affected by by frequent swimming. So, you know, if you are gonna go on holiday and your German shepherd wants to chuck himself in the canal or you know in the in the sea, then scalior may not be the best option.

So you have to sort of take those, you know, into account. I mean, you know, if your pet doesn't swim, and you know, you're gonna be out there for a long time, Scallior may be the better option. So it does depend on lifestyle, but you're using a pyrethroid repellent.

Cerreto currently has something of a grey area in terms of its licence. Have a, a sort of bayer person to comment. But, certainly in cats, where there's no other licenced options, then Cerresto has been demonstrated to have sort of, you know, good, good fly repellency off licence and is safe in cats.

So for cats, it is, it's a good option at the moment. But that's it. Bottom line is Very regular pyrehoid repellency, but it's not, it's not 100%, which is why over time, so many dogs living in endemic countries, do become PCR positive for leishmania.

Can't, can't really go into, I don't really got time for me to go into that into too much depth, but, that's, that's it in a nutshell. Great, thank you very much. An interesting question here, do you have any links to a questionnaire that you can use with clients?

I agree with what you said about them wanting a recommendation based on lifestyle, and I think that this may help. I don't, I don't have a questionnaire, but that, slide that I put up, that download with sort of prompters for clients, you can download from the SAP UK and Ireland websites. So that goes through the same process.

It basically says to clients, 4 times a year minimum for toxicara, year round for fleas, and then, you know, have you considered, you know, and, and. Some of the sort of lifestyle factors we've discussed, to then prompt them to discuss, monthly worming for toxicara, treatment for ticks, treatment for tapeworm, and treatment for lung worms. So it's not a straight questionnaire per se, but they're points, lifestyle points for them to consider that they can then discuss with nurses, receptionists, and, and vets.

There have been all sorts of articles published as well. I published one in Companion Animal about risk factors. There have been others, that have been published that sort of, you know, go through the same sort of reasoning and sort of questions that you might ask clients or for them to fill in in questionnaire form, that you then base your your parasite control recommendation on.

Absolutely. And one of the things that we often do, through our recall is a pre-consult questionnaire that can be absolutely linked to a parasitic ide, or getting the risk profile. So, you can make use of process, so your client can even do that before they come into the, the, the practise and make use of that time at home.

Yeah, absolutely. So, you know, potentially something that they can download from, the sort of practise websites, or they can be filling in in the waiting room while they're waiting on one of those crazy, you know, Monday or Friday evenings. You can go, well, actually, you know, why not fill out this questionnaire?

And, you know, it just sort of saves time that there's all sorts of sort of time that you can utilise in practise that isn't necessarily in a consulting room. That's great, thank you very much. One question just going back to resistance issues.

So if a dog is on monthly heartworm prevention, in this case, Heart guard, do you recommend using any additional products or changing between products in order to avoid resistance after some time on the same product? Shall I shall I take that one? It's, it's basically, there is resistance to heartworm that's developing, and it is a concern.

It's quite localised at the moment, and it's thought, that to a certain extent, sort of dog densities, but also the use of sort of slow kill regimes, for heartworm treatment may be sort of driving this resistance rather than fact, rather than the fact that just one. Type of macrocyclic lactones being used. I mean, in reality, you know, many, many different types of macrocyclic lactone are being used across the whole of, of the United States and, and even with individual areas.

So I would say that, you know, compliance is still the most important factor really, in terms of sort of what you're using and it fitting in to your overall parasite control programme. What is perhaps useful though is to consider using, a fly repellent, a mosquito fly repellent, as well as your sort of monthly macrocyclic lactone or or whatever product that you're using. Because in that way, you've got a double level of protection if you were unlucky and you've got a sort of resist.

Microfilaria on board. So, you know, doable level of protection is quite useful, but I think for you as an individual using a preventative product, if you've got one that's working well for you and you've got good compliance with and that you're remembering to use, then, you know, I mean, those are still overwhelmingly the most important factors. And one of the other things that I, I would say about that, if by adding in other products you, you lessen your your message, your compliance may go down, that in the states at the moment, and where it's endemic, in the US, even there, you're not getting a hun sort of.

12 months compliance. So, I would be wary, stick to your guns and encourage your clients to be doing it on a monthly basis. Go for that 12-month, heart guard treatment, and be, PET compliant 365, and I think your clients will end up.

Being much more grateful to you. Yeah, absolutely. I mean, I think the sort of take, take home heartworm message is that most of the resistance has gone through, has, has occurred through sort of perhaps inappropriate use, rather than using the same thing over and over again in an appropriate way.

So yes, no, I'd agree, absolutely. Sort of stick, stick to your plan. Definitely.

Yeah, that's great. And just touching on this as well, we have, someone asking, when Frontline first appeared, it was the product for fleas. But now, especially with many other brands using F Fipronil, it doesn't seem to work as well.

Is this perceived resistance to fipronil real, or is it due to, different carriers the various brands use? Well, yes, well it was wonderful, wasn't it, when it first came in. I, I too have fond memories of chasing cats around with new Van Top, you know, slowly intoxicating myself with organophosphate.

So you know, we've come on a a long way. But you know, the, the thing is that there are, drug resistant fleas. So, you know, these are in labs and, you know, they, they predate, those lab resistant fleas predate, fipronil, but the resistance that they carry dates back to crop insecticides.

So, you know, it has nothing to do with flea treatments having been around for a long time, or the fact that we've used them for a long time. That resistance was always there. And it's only partial resistance.

So even if you use fipronil on these fleas, you know, if you use it every 2 to 3 weeks, it will still get the job done. So the, the question is, you know, these, these drug resistance genes are in are in fleas in, in the field under natural conditions, but are they making any difference? You know, is there selection pressure taking place for them?

And as far as we know today, worldwide, the answer to that question is no. I mean there there hasn't been a single case of flea resistance causing flea control breakdown confirmed worldwide and. Often where flea sort of control breakdown is studied worldwide, it's found that other causes are responsible.

And they're sort of many varied, many and varied as as I discussed in the first webinar, you know, that perhaps you wouldn't immediately think of, or it may be that it is just taking a long time, you know, which it does take a long time to get existing infensations under control, so. You know, again, we shouldn't be complacent about sort of flea resistance being a possible cause of flea control breakdown, but it's just almost infinitely more likely that there's going to be another reason that you have to find. And if you don't find that reason, if you just change products and you go, well, it might be resistance, let's change products.

You know, you're still going to have flea control breakdown if you don't get to the bottom of the of the actual reason why flea control breakdown has occurred. So the, the simple answer is in the field to date, there's no evidence that flea drug resistance is at play. So it's teipronil or or any other product.

I have a, a slightly different view on that. I, from the science and the evidence, I totally agree with you, Ian. I think, I genuinely think Pom Ve products are better because we're making that recommendation in practise, and I'm, I'm almost heading, hedging, we, we, we don't mean to miss SQPs SQPs within the practise having that extra training, of course, are really, really vital.

And I think as fitpreil has gone off licence, and can be bought more widely available, those clients and those pet owners are not making the benefit of the veterinary practise. Recommendation, and I think they become less compliant and therefore they start to see fleas because they may have bought the product, they may not be given it, applying it at the, in the recommended way. And as a result, fleas break through and then we see them in practise and we think, oh it's fitronil.

I think it is genuinely down to client compliance and that's why I would always make that recommendation, come into the. Veterinary practise, speak to the vet, the receptionist, the nurses, the SQPs in order to get the evidence and be helped through that risk assessment about what is the best product and overcome the flea burden, and then stick with it and become a really adherent pet owner. And I think that really makes a big difference.

Yeah, no, absolutely, and you know, I mean this this is exactly what I mean, you know, I mean that there are, you know, compliance, you know, sort of products not being applied effectively or not being applied often enough, or being applied and then being shampooed off, you know, many, many different reasons that might look like flea resistance, but are actually sort of compliance essentially breaking, breaking down. Yeah, and I've just seen Georgiana's sort of question, sorry, Paul, about pet age. Ian, do pets, I would have thought, become more prone to problems.

Particularly worms. I was, yeah. I mean, certainly, you know, it's for if we take reactivation of toxicara for instance, it's thought that immunity is a factor, you know, sort of, you know, dropping in immunity and sort of stress factors, physiological stress factors, and you know, there's no doubt as we get older, we're probably prone to more of those.

There's been less studies on. This than you might think. But I would say intuitively, sort of older dogs probably are going to be more prone because of concurrent disease, really, to having worm burdens.

Certainly no evidence that that's true of ectop parasites. Ectop parasites just love feeding on pretty much anything that's going. You know, but, and there are all sorts of environmental factors that feed into that, and lifestyle factors.

But no, for the end of parasites, age does play a part, that the very young and the very old, for, for all sorts of reasons, are gonna be more susceptible to infection. But of course, pets of any age might be. So Georgina, I would absolutely then reaffirm within the whole team, age is not.

A defining factor to reduce your parasiticide, and same with vaccinations, it's even more important and educate those clients better, bring them down the funnel, and actually, particularly as they get older. You want them to be as healthy as possible, and again the owners will appreciate that, and you can help them become more compliant. You just need to give them the right information and advice.

And then help them stick with it. Yeah, but you're so right, but clients love to or some clients love to, to give up, yeah, just give up, vaccinating, worming, you know, as as dogs get older, and yet, you know, we, we don't, you know, decide to to just stop vaccinating our elderly people, you know, for flu, for instance, or, you know, when you actually consider. Read in human terms, it's sort of counterintuitive, isn't it, really?

And yet, you know, many clients will just think, wow, you know, they're old now, we'll just stop, you know, with the preventative treatments. You know, often when I imagine they're at their most vulnerable. So, you know, I think that, you know, we do really need to emphasise preventative healthcare in, in the geriatric patient, absolutely.

And Jamie, do you have any any data, surrounding that in regards to drop off with, with age? No, not specifically. I think, what Georgiana was asking is that those clients just don't think they need to do it.

So they're not even becoming, going down that funnel and becoming compliant. What we do have evidence with that it makes absolutely sort of no difference, once you've got them purchasing a product, helping them stick with it. Ends up being almost those sort of nudges, the reminders about when to apply it.

And if you've sort of had a really consistent message that it's not just for, if you, if you sell them a 3 pack, and that's one of my big bugbears of the veterinary, profession or a product that does 3 months, Brevecto, but you only sell 1 tablet. You need to get the clients to understand this needs to be a year-round, sort of treatment plan. And then you help remind them when to, when to apply, when to give those, and make it as convenient as possible to get, to get more.

And I think then it doesn't make any difference about age. One of the other people was asking. Going back to this sort of how do you sort of stop in internet, sort of sales.

Interestingly, in Australia, there are no, prescription only medicines. All of the products that we have as prescription only medicines here in the UK are over the counter, and, a. A lot of our Australian customers saying, oh well, we've almost given up selling parasiticides, we can't compete with the big box retailers.

And we've absolutely demonstrated to them in exactly the same way, if you give a good firm recommendation, you stick with it and you help an owner, remember, remind them when to apply it, that client becomes really appreciative and they come back and repurchase it and you get this value, sort of. Virtuous value circle continuing. So it is really, really important that you're there helping the client and the client appreciates that, but you do need to be consistent, and therefore it ends up working.

Yeah, couldn't agree more, absolutely. That's great. Thank you very much both.

I think we've slightly gone over on our, specified one hour webinar. So just, a few, few last comments. Thank you very much for, an excellent webinar, very interesting lecturing Q&A session, brilliant webinar.

So thank you very much both. Just finally, Yvette saying, don't forget us SQPs as we also, one of the main people to speak to clients. And Jamie, that sort of ties back to what you were saying about everyone needing to sing the same message, I guess.

Yeah, very much so. I, again, Paul, I'm just gonna quickly ask, cos I think one of the things that Ian and I can answer, it must be an an American attendee, how often do we recommend faecal analysis in dogs and cats. Here in the UK it is less common, certainly from a horse point of view it's very, very common.

Less so for dogs and and cats, whereas in the states, clients very much educated almost for their annual exam, to bring in a faecal sample. Ian, do you think we will get to that stage in the UK? It'd be wonderful if we did.

You, you've just stumbled across right at the end, one of my bugbears, you see, and that is the belief that these two are mutually exclusive. That you know, you either test or you treat, but, you know, if you're routinely treating, testing is still very important to check that that treatment's working, but also to get a handle on what parasites those pets might be being exposed to. So there was a study in Holland, that showed that 25% of dogs are responsible for 75% of Toxoara egg out.

So knowing which those dogs are is naturally, you know, very useful, and very important. It doesn't necessarily impact on your overall recommendations. It's more of a monitoring thing, and particularly now, IEX have brought out a very effective monitoring tests.

So you've got angio detect, you've got, faecal antigen for intestinal parasites. So it's getting easier and easier to monitor. That the problem with using them as a replacement for routine treatment is that shedding of parasites is often intermittent, and faecal flotation is far from 100% sensitive.

So, you know, if you're going to use it as a replacement, you'd need to be testing very, very frequently, but that doesn't mean that we shouldn't be encouraging, owners to regularly sort of. Test faecal samples, and to do sort of regular testing for parasites, because again, this, helps to improve our knowledge, it helps to show that our practise plans are working, and it's a very justified additional source of revenue. So, you know, please don't think of the two as separate things.

You know, they actually work very, very well together. But Ian, if I was to ask you, if a client had a certain amount of money and they could afford to have a faecal test or a a an effective wormer. Which would you recommend?

Well, the thing is, well, first of all, should always recommend best practise. So, you know, best practise is to do both. If the client then can't, if the client then can't afford both, then the preventative treatment in the absence of knowledge is the most important.

There's, there's no, there's nothing to be gained in having the knowledge and then the owner not being able to. For the treatment. You know, it has to be the other way round, but, you know, building in, say, building into your practise plan, building into your booster cost, having a faecal test, you know, is getting cheaper and cheaper, and it's sort of very useful information.

So, you know, bring, bring it all on. That's, that's what I say. Definitely.

Excellent. Thank you very much both. That's been a fantastic webinar.

So thank you, Ian. Thank you, Jamie, and thank you also, Hannah for joining us. The webinar will be up on our website in the next couple of days.

You can also find the, the first webinar, by Ian on the website, and stay tuned for the September webinar, with Jamie. Thanks all. Have a good evening.

Thanks, thanks so much. Bye-bye.