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Nurse-led clinics important for treating ectoparasites

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01 March 2016, at 12:00a.m.

VETERINARY practices should be running dedicated nurse-led preventive medicine clinics to reduce the burden of chronic skin disease in the UK’s dog and cat population, delegates at VetsSouth 2016 were told.

David Grant, former director of the RSPCA Harmsworth hospital and a diplomate in veterinary dermatology, spoke on the identification and treatment of ectoparasites in companion animals in the nursing stream at the event in Exeter on 11th February.

He argued that poor compliance with treatment by clients was the main reason for the high prevalence of skin disorders in pet animals and that nurses held the key to tackling the problem.

Pet owners fail to make use of the effective treatments available against fleas and other arthropod parasites because they don’t fully understand what is expected of them.

“In the consulting room you will often have a young vet explaining all about this incredibly exciting condition without noticing that the client is staring out of the window. Then the owner will go back to reception and ask the nurse: ‘What did the vet say?’ So it is up to you to tell them.”

While Mr Grant felt that veterinary colleagues were often very bad at explaining what clients need to know, he acknowledged that it was very difficult to achieve this within the constraints of a normal veterinary consultation. Clients need to understand the flea life-cycle and the role of the pet’s immunological response in causing the disease, as well as being told about the product being recommended and shown how to use it – and there simply isn’t enough time to do all that in 10 minutes, he said.

In a nurse consultation it would be possible to give all that information and to show exactly how the recommended product should be applied. This would address one of the most common reasons why the treatment might be less successful than expected.

Mr Grant believed that on many occasions clients will apply a spot-on insecticidal product to the animal’s fur rather than directly onto the skin.

He acknowledged that it might sometimes be difficult for an able- bodied person to treat a cat that has learned to avoid the feel of the liquid on its skin. So there is little chance of someone with, say, arthritis or poor eyesight, being able to successfully carry out the task on their own. At a preventive care clinic, nurses would also be able to apply the product for their client.

In some cases, chronic pruritus caused by the parasite may be the reason why the owner may experience difficulties in handling the animal. If that condition is brought under control, the pet may well become more biddable and the owner may then be able to apply the product without a struggle, he suggested.

Responsibilities

Diagnosis and prescribing remain the responsibility of the supervising veterinary surgeon, but a VN will normally be given responsibility for administering the treatment, he said.

It is not essential for the nurse to know everything about all the many different products available for use in treating external parasites but they should know about the specific products stocked in their practice.

It is also helpful for nurses to be familiar with the main parasite species and to have learned the basic diagnostic techniques such as hair plucks, skin scraping and microscopy. Mr Grant noted that pet owners may be reluctant to accept that their animal has fleas, lice or mites and so it is vital for ensuring good owner compliance that the VN is able to demonstrate their presence on the animal, especially when the parasite numbers are small.

If clients could be persuaded to attend these clinics more regularly then the numbers of pets being treated for internal parasites would also increase and reduce the zoonotic threat posed by organisms like Toxocara canis.

“This has to be the way forward – as it would be good for the health and welfare of our patients, it is good for human health and it would help the bottom line of your practice as well.”