Creating a need for the VetLyte

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Creating a need for the VetLyte

• Electrolyte testing and Fluid Therapy
• Electrolyte testing and Emergencies
• Electrolyte testing and Pre-Anesthetics

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Why are electrolytes so important ?

• They help maintain normal cell activity
• They help maintain normal body fluid balance
• They are part of the diagnostic puzzle
• diagnosis of underlying disease
• level of hydration
• Monitoring patient care

Most importantly, monitoring the electrolyte
balance increases the level of patient care.
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Electrolytes In Review

• Na Sodium
• associated with water balance
• regulated by the kidney
• all mammals need salt in their diet in order to
  maintain proper fluid balances

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What causes high Sodium Levels?

• Increased intake
• highly salted diet
• Fluid replacement containing sodium
• Excessive loss
• fluid loss which exceeds sodium loss
• vomiting and/or diarrhea
• dehydration
• evaporation due to heatstroke, panting,
  hyperventilation
• Inadequate intake
• water unavailable (anesthetic recovery)
• insufficient amounts provided

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Medical conditions that can cause high sodium
levels

• Increased loss
• vomiting and/or diarrhea leading to severe
  dehydration w/o sodium replacement
• end-stage kidney failure
• Addisons disease
• diuretic therapy
• Diabetes
• Over hydration
• excessive administration of fluid replacement
• administration of Na free or low fluids-types

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Why Doctors should test for sodium levels

• Senior pets on heart medication
• Addisons disease
• Fluid therapy
• Pre-anesthetics

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Senior pets on heart medication
Feature Monitor Sodium values while dog owner waits
Benefit Insures that there are no adverse reactions when a senior pet is receiving heart medications such as Furosimide. This medication can cause electrolyte imbalances and dehydration.
OEQ What is your current protocol when maintaining a patient on Furosemide?
High Yield How would the ability to immediately identify adverse reactions to medications such as this benefit you?
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Furosimide
PROOF SOURCE From the IDEXX Medication
Monitoring Chart
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Diagnosing Addisons Disease
Feature Diagnose Addisons Disease
Benefit Having the ability to immediately identify if the patient has Addisons disease. Because signs and symptoms of Addisons often wax and wane, the ability to run a test while the patient is symptomatic is crucial.
OEQ What is your current protocol when confirming if a patient has Addisons disease?
High Yield How would the ability to run electrolytes in less than a minute benefit you and the pet owner in a suspected Addisonian case?
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Sodium (Potassium) and Addisons Disease

• ELECTROLTYES
• Hyponatremia (low sodium)
• Hyperkalemia (elevated potassium)

CONFIRMATION TEST ACTH test (cortisol readings)
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Sodium and Fluid Therapy
Feature Monitoring Patients on Fluid Therapy
Benefit VetLyte offers doctor ability to have immediate electrolyte results which will allow doctor to choose and monitor patients on fluid therapy. This will allow for faster and better recovery.
OEQ What is your current protocol when choosing what types of fluid therapy you use?
High Yield How would the ability to identify if a patient had an electrolyte imbalance effect what type of fluid therapy you choose?
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Sodium and Fluid Therapy
From the VetLyte Sell Sheet
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Sodium and Pre-Anesthetics
Feature Check sodium levels before a senior patient on heart medication is anesthetized for surgery
Benefit Reduces risk that patients will not have an adverse reaction to surgery or anesthesia due to medications/electrolyte imbalances. Senior patients are already in a high risk category for anesthetic risk, especially those on medications.
OEQ What is your current protocol when preparing a senior pet, especially on medications such as Furosimide?
High Yield How would the ability to immediately reduce the risk of complications due to age or medications benefit you or the pet owner?
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Important facts to remember when combating the
my clients wont pay objection!

• If a pet owner is willing to spend the money and
  take the time to medicate their pet daily, then
  they most likely will be willing to spend the
  extra money to run additional tests before a
  surgical/anesthetic event.
• Senior pets are an established part of the
  family, and the human-animal bond is strongest
  because the pet has been part of the family for
  years. Pet owners want to avoid added risks
  because of this bond.

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Cl Chloride

• Least important electrolyte
• Mimics sodium changes

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Potassium

• Carries the most clinical significance
• Regulated by the kidney

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High potassium -Hyperkalemia

• Potassium containing drugs
• potassium chloride
• some antibiotics
• reduced excretion
• urethral obstruction
• bladder rupture
• Addisons disease
• acute renal failure
• ethylene glycol

Addisons disease is one of the most obvious
reasons for elevated potassium levels
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Low potassium - Hypokalemia

• Causes of hypokalemia
• chronic vomiting
• pancreatitis
• intestinal obstruction
• chronic diarrhea
• relief of urethral obstruction
• kidney failure
• long-term administration of K free fluids
• prolonged anorexia

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Potassium significance in the cat

• Hypokalemia relatively common
• especially in early stage renal disease
• Condition/symptoms non-specific
• Mimicked by other disorders
• many associated with aging

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Facts about Hypokalemia

• In A study performed by Dr. Irwin 19 out of 67
  cats (28) that were clinically normal were
  HYPOKALEMIC. Most were diagnosed with
  pre-dental/pre-surgery lab work. He recognized
  this as a probably cause for the short-term
  anorexia these cats experienced post
  anesthesia/surgery. Electrolytes in Veterinary
  Practice, Dr. Irwin

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Facts about Hypokalemia

• Hypokalemia occurs in 30 of cats and 10 of dogs
  with chronic renal failure.
• Pg 98, Small Animal Clinical Diagnosis by
  Laboratory Methods

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Facts about Hypokalemia

• By adding electrolytes to routine blood panels,
  we fine-tune diagnostic and treatment
  capabilities. Knowing electrolyte values has
  great significance in diagnosis and treatment.
  Because values change quickly, however, this
  information is significant only if it can be
  obtained immediately. Electrolyte Values Remain
  Underdog of Diagnostic Testing, DVM Newsmagazine,
  May 1998, Dr. Irwin

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Facts about Hypokalemia

• A JAVMA study found that one in every three cats
  examined for a variety of illnesses were
  hypokalemic. Hypokalemia in Cats 186 cases
  (1984-1987) Dow, S.W. JAVMA Vol. 194, no. 11,
  June 1, 1989.
• JAVMA Journal of the American Veterinary
  Medical Association

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Facts about Hypokalemia

• In the beginning stages of hypokalemia, signs
  of potassium loss are very subtle and often are
  attributed to old age or other diseases. In
  severe cases of hypokalemia, cats will often
  exhibit weight loss, muscle weakness, stiff gait,
  poor hair coat and listlessness however, the
  majority of potassium depleted cats will not
  manifest these signs until the condition becomes
  acute and possibly life threatening. Potassium
  Depletion in Cats Causes and consequences,
  Steven W. Dow, DVM, PhD.

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Potassium and Pre-Anesthetics
Feature Screening patients, especially cats, before surgery/anesthesia
Benefit VetLyte offers the doctor the ability to have immediate electrolyte results, which allows the doctor to identify the number one abnormality in pre-anesthetics, hypokalemia. This abnormality can be an early indicator of serious conditions such kidney failure. Since signs are non-specific and mimic other conditions, this condition often is misdiagnosed.
OEQ What is your current protocol to identify cats which might be in a high risk category for anesthesia.
High Yield When a patient does not recover from anesthesia as expected, how does this effect you and your staff? How does it affect the pet owner?
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Potassium and senior patients
Feature Adding electrolytes to senior testing
Benefit Hypokalemia is an early indicator of kidney disease and is commonly seen in senior cats. It is treatable and cats recover quickly from this problem with minimal treatment. Since hypokalemia signs are non specific and often mimic other diseases and conditions, the VetLyte is essential to rule in/out hypokalemia as the cause
OEQ When a client says their older cat aint doing right, what conditions and/or diseases do you consider as a cause of this?
High Yield How would being able to identify the cause of a cats non-specific signs immediately help you and the pet owner?
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Electrolytes are similar to pain management

• Except for Addisons disease, electrolytes are a
  piece of the diagnostic puzzle used in
  conjunction with other tests to aid in a
  diagnosis. They are not usually a life or death
  test, so how do you justify the use with your
  doctors?
• Electrolyte monitoring is like pain management.
  The patient would most likely survive without it,
  but the level of patient care and time to recover
  is increased when used.
• Pain Management
• Animal feels less pain
• Recovers quicker

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Electrolytes and Pain Management
Feature Electrolytes increase patient care
Benefit Animals with electrolyte imbalances identified by the VetLyte receive proper treatment, which includes fluid therapy, supplements and further testing. All increase the patients recovery time and help them to feel better.
OEQ Doctor, do you currently use pain management medications in your practice? How do they help you and the patient?
High Yield How would the ability to offer that same quality of care in other areas in your practice benefit you? How about the pet owner?
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Cost justifying the VetLyte

• VetLyte is perceived as expensive!
• How do you overcome this objection?

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Cost Justifying the VetLyte

• OBJECTION The VetLyte costs too much to run!
• During the sales call you have asked open-ended
  and high yield questions that help to identify
  areas the doctor would benefit from electrolytes
• Now you must identify the opportunities!

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Identifying Opportunities

• How many pre-anesthetic opportunities?
• How many fluid therapy opportunities?
• How many medication monitoring opportunities?
• How many sick patient opportunities?
• How many senior patient opportunities?

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Cost Justifying the VetLyte

• This spread sheet is the US example of cost per
  test. It takes into consideration the cost of
  reagents, electrodes and parts. It bases the
  cost analysis on the assumption that the doctor
  will replace EVERY electrode yearly. It does not
  include the cost of instrument

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Cost Justifying the VetLyte

• This spreadsheet illustrates that the VetLyte is
  not expensive. It is just the opposite! The
  more you use the instrument, the more cost
  effective it becomes.

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I get electrolyte results from the reference lab!

• Electrolyte results are as time sensitive as
  hematology (but for different reasons)
• Electrolytes are affected by
• Fluids going in the body
• Fluids leaving the body
• Intake of salt and potassium

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I get electrolyte results from the reference lab!

• Clients expect a high level of care
• Technology to provide this service is available
• Fine tune diagnosis and treatment
• Values change quickly!
• significance is greater when obtained immediately

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In Summary

• It is important to create the need for
  electrolytes first.
• This can be done using Sodium and Potassium
• Senior patients on heart medications
• Pre-Anesthetics
• Fluid Therapy
• High incidence of Hypokalemia in cats
• Client satisfaction
• Once you create a need, you need to cost justify
  the VetLyte
• How many times would the doctor average using the
  VetLyte a day?