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Category: Opinion

Social media, pt 4 – content creation

Goals, targeting and platform are really important, but the most important aspect is, of course, content – what will you actually say and will your audience see it?

Generating content can be really time-consuming, but one thing I’ve learned is I tend to overthink it – a simple image or short video can really speak to people; it doesn’t always have to be profound or polished.

However, a plan needs to be in place to make it work. Think about who will create your posts – internal staff or external, and if external, how well do they know your business? Most posts should have an action you want people to take, so make it really clear if it’s a click, sign-up or watch. Plus, think about who will schedule it and who will monitor it.

Mix it up

At our hospital, we try to be consistent and post three times a week on the same days and times – although when we started, we did experiment with different days and times to see where we got the most engagement from our audience.

We find what works best is cute, informative and surgical (or gory) posts. However, no winning formula exists – expecting something to go viral is almost a guarantee it will not. The best advice is you have to mix it up, try new things and see what works best, but don’t stop experimenting and learning.

Permission to post

The most important aspect in a veterinary practice, if you are showcasing pets, is consent – always ask permission before posting. It is one of our key policies and we have a robust process, using consent forms and telephone calls, to ensure clients are happy with us telling their story.

For us, in emergency, this is essential as we deal with some of the sickest of sick pets. With this in mind, we tend to wait until they have been discharged from our care for a number of weeks and follow up with a call to see how the patient is before we consider releasing videos or case studies.

Make sure they also know the posts are for the purpose of education and prevention.

Make sure you are prepared to respond to questions and comments.

Back and forth

Always remember, too, that social media is a two-way street. When you open yourself up on social media, be prepared for questions, comments and reviews that come your way.

Set aside time – and have a policy in place – for answering and responding. This is especially true for the negative ones, which, inevitably, despite best intentions, every practice will get.

Done well, and with the right time, team and money invested, social media in the veterinary industry is a brilliant way to showcase the fascinating, inspiring, sometimes strange and utterly rewarding work we do each and every day.

April 27, 2022
Social media, pt3 – choosing the right platform
Understanding which social media platform will work for your practice really depends on your key audience and the type of content you want to share.

Loads of social media platforms exist and I sometimes find I’ve just got the hang of one, only to be encouraged to try a new one. It’s easy to get caught up in the next big thing, but considering we also need to do our demanding jobs, it is important we get it right and don’t waste our time.

Each channel is different, so should be used in different ways. My advice is keep it simple and master a few channels, rather than doing most of them.

Choosing and using the right platform

To help find the best social media platform for you, start by asking yourself these four simple questions:

Why?

It is important to ask what the overall motivation is. Each platform has its preferred type of audience and style; therefore, look at what you want to achieve and go with the platform that can offer the best return.

Do you want to increase traffic to your website, increase search engine optimisation (SEO), create a community with clients, or reach new people? Once you know your social media goals, the platform you should be using will become obvious.

Also, give each platform time. They take time to grow – especially organically.

Which?

“Facebook is by far the largest social media platform and is great for reaching the pet and veterinary communities,” says Gerardo.

Research each platform to identify which one offers the biggest audience reach, how easy is it to reach them and what style – photos, text, video or blogs, for example – works best.

Facebook is by far the largest and great for reaching the pet and veterinary communities. Plus, content remains on there – like a mini website – for years. Other channels such as Instagram, Google+ and Twitter have a quicker and more visual approach, but content gets old very quick. Google+ and Twitter are also good for improving SEO, so they are worth considering for your strategy.

LinkedIn is tailored more to business-to-business, Tumblr for blogging and Reddit as a discussion forum. If you want to engage with a younger demographic then Snapchat and Instagram are best, while Pinterest has more female users.

We have found it is better to focus on a couple of platforms with equal benefits on engaging with our audience, reaching local pet owners, and increasing web traffic and enquiries.

When?

Think about when you will be posting. Look at each platform to see when people are online – before work? After work? At lunch?

If you find your audience is online outside of work hours then, to take the stress out of it, go for platforms with a simple scheduling tool, such as Facebook, so you can schedule posts in advance – saving you having to think about things each day.

Only commit to what you can – a post every day may sound good, but in reality, it may be a stretch too far. Do two or three posts a week to begin with and alternate days on each channel. That way, you will have content live on most days of the week.

Also, it is important to think about how many users will have access to each platform, how will you monitor who is responsible for what, and who will be responding to comments and messages.

How?

Focus your time. It is worth investing a little time to understand what the platform can really offer – if you can, watch tutorials, read blogs or ask an expert.

With Facebook, once I really looked at what it could do versus what we were doing, I found we were not taking advantage of its full potential.

Most social platforms are constantly updating and evolving what they offer, so keep up to date and make sure you get the most out of them.

Also, if you find one platform isn’t working out, don’t be afraid to close the account.
- Next week, we will be looking at the all-important content and how to get it right.
April 25, 2022
Social media, pt 2 – targeting your audience
Last week, we discussed core goals for social media within a veterinary practice. This time, I want to look at target audience – how to define them, how to reach them and how to keep them engaged.

Getting the audience right is essential. Otherwise, you are just wasting your time and money – and who wants that?

You need to put yourself in their mindset – sometimes, we want to share something from the practice; however, is it really of interest to the pet-loving public?

“Keep it simple” is the best advice I was given. Social media posts tend to have a short shelf life – blink and you miss them, so make your point quickly and make sure the intended audience knows to pay attention.

What? When? How?

You always have to think about what your audience wants to know, how it wants to know it and when it will be online to see it. By profiling your main audiences, you can then create images, video, wording and tone that is going to engage them.

As with most things, having a strategy in place for each audience group is important. When you start, you want to experiment with timings of posts, style, and content and creative, but after a while, you will see a clear outline of who, what and when works for you.

Hashtags are a type of metadata tag used on social network and microblogging services that make it easier for users to find messages with a specific theme or content.

It is important to use the insights on your chosen platform – from that, you can learn which posts are the most liked, most shared, the demographics of your audience and the times that seem to get the most engagement.

Reaching the right people

Make sure you have researched hashtags, locations, interest groups, ages and keywords. Also, when you add an image, video or blog, make sure your tagging and keywords are accurate and up to date.

Many social platforms and networks reward a page for relevance and authentic content. This is even more important for paid content – it may be tempting to get likes and follows from the cheapest targeting; however, it is better to build an audience of those who may need your service and are relevant.

Also, regularly profiling your audience may show a potential audience group you are missing – such as, perhaps, a younger demographic, a location that doesn’t engage or an industry angle.

Striking the right balance

My book The MiniVet Guide is aimed at helping students through their studies and in clinical practice – so a key audience for me is veterinary students. I love sharing tips, tutorials and surgical videos to help them in their journey as they become a vet – and their response has been incredible.

I quickly discovered what engaged them and what didn’t – even if I sometimes want to post something different, you have to find the right balance between what you enjoy sharing and what the audience wants to see.
- Next week, I will look at what platforms to use and how to get the most out of them.
April 18, 2022
Social media – getting your practice online
For the next month, I want to move away from the clinical and medical aspects, and focus on some other demands and challenges part of everyday veterinary life. So, over the next four weeks, I will look at the main considerations when planning social media campaigns for your veterinary practice.

As a director of a number of emergency animal hospitals, it is also part of my role to produce content, develop a strategy and oversee our social media presence.

Of course, I am not solely responsible. I am lucky to have a great team surrounding me, which is crucial in making social media work in your practice – it has to be a team effort with everyone understanding, and sticking to, the agreed rules, strategy and objectives.

If I am honest, I was unsure about our hospitals – and me, personally – venturing out on social media; however, after a couple of years, it had proved both rewarding and essential in raising awareness of our work and profession, and in connecting with our clients and pet-loving public.

In this four-part series, I will look at four key aspects in making social media work for your practice. The first aspect is goals, or motivation for getting your practice online socially.

Goals and objectives

Firstly, the whole practice must agree and commit to a set of shared goals and objectives, and all be on the same page when it comes to what they want to achieve and how to go about it.

Without a plan or strategy in place, no direction, teamwork or accountability exists. Plus, it is hard to know you have been successful, if the practice hasn’t agreed what successful means to them.

Secondly, for the most part – although it is nice to get a little fame and recognition – the main motivation for any vet practice when sharing what they do socially is that it comes from a place of training and education. We all want to educate pet owners in preventive measures and help them keep their pets safe and healthy.

I also find in the veterinary industry, misinformation and misconceptions can exist about the work vets actually do, so this is our chance to show and educate people what it is really like behind the scenes, by showing real life stories and cases – even the tough ones. This has been a favourite aspect of mine – I love being able to share what we do behind the scenes, and the reaction has been incredible.

Thirdly, in a veterinary practice, social media offers a unique opportunity to strengthen and enhance the client bond, and be a constant source of accurate and important pet health information. Being able to have that two-way street with our clients is also essential for us to continually improve and learn.

Public awareness

Emergency practices don’t have clients as such; they only need us when their pet is in a critical state. So, what we want is for the public to know our name, what we do and, most importantly, where we are in case, one day, they need us.

Social media has been integral in allowing us to reach and engage with people before they actually need us.
- Next week, Gerardo will be looking at targeting and its importance in creating return on investment on your social media efforts.
April 11, 2022
Catharsis, enemas and colonic irrigation for acute oral poisoning
Great news for those who hate enemas: you may not have to do any of these ever again. This is the consensus by both the American Academy of Clinical Toxicology, and the European Association of Poisons Centres and Clinical Toxicologists.

The theory behind these procedures is legitimate – reducing systemic exposure of a toxicant by accelerating gastrointestinal tract (GIT) expulsion. But this is assuming the toxicant is absorbed very slowly, undergoes substantial enterohepatic cycling, or undergoes slow reabsorption in the lower GIT – all of which are uncommon characteristics of the types of toxicants veterinary patients are exposed to.

In fact, most toxicants of veterinary interests are generally rapidly absorbed in the upper GIT and absorption are not affected by catharsis.

Lack of evidence

No clinical evidence exists to support the use of a cathartic alone, or in combination with activated charcoal, to reduce the bioavailability of drugs or to improve the clinical outcome of poisoned patients. In fact, some evidence shows systemic exposure is increased following oral dosing of sorbitol, with activated charcoal, in canine paracetamol poisoning cases.

Similarly, no evidence exists that enemas and/or colonic irrigation improve clinical outcome in the treatment of oral poisoning.

The risks can be quite high with these procedures, with patients at risk of:
- haemorrhage (in the case of anticoagulant vitamin K antagonist rodenticides, for example)
- electrolyte destabilisation
- bowel perforation
- rectal prolapse
- phosphate toxicities (cats)
The risks simply do not outweigh the benefit (or lack thereof). In fact, repeated dosing with combination preparations containing sorbitol and activated charcoal is not recommended.

This may be the most exciting news in veterinary medicine!
March 28, 2022
Intoxication: decontamination advice
Building on from last week’s blog on telephone advice, this is what I advise owners they can do at home if their pet has been exposed to a toxin.

Figure 2. The patient’s blood gas analysis and electrolyte panel. Note the sodium concentration.

The main exposure routes are ocular, dermal and gastrointestinal.

Ocular

Acids and alkalis cause the most severe effects, as they can cause ongoing damage for some time after initial contact.

Eye irrigation

Avoid contact lens solution as this can cause further irritation. Instead, I recommend:
- tepid water, saline or distilled water
- 20 to 30 minutes (ideally)
- rinse from medial to lateral, to avoid contamination of the other eye
Once the eye(s) have been flushed, recommend the animal be taken to the veterinary clinic for further assessment. Corneal ulceration can be difficult to see with the naked eye.

Dermal

Owners need to take precautions to protect themselves from contact with the toxin. The aim here is for owners to remove as much of the toxin off the skin of their pet without exposing themselves to it.

The most common method is bathing or rinsing with a mild dish soap in warm water. If it is a dry power and it safe, vacuuming off the powders may be tried, unless risk of aerosolisation of the toxin is high.

Gastrointestinal

Oral exposure

Ideally wearing gloves, instruct the owner to wipe the inside of the lips and over the gums using a damp dish cloth to try to remove any toxin remaining on the mucous membranes. Warn the pet may try to bite and, if it does, to stop immediately.

Ingested toxins

Inducing emesis depends on the type of toxin, but, either way, I do not recommend emesis induction to be performed at home. I have seen disastrous effects from salt slurries (Figures 1 and 2).

Emesis induction is most safely performed in a clinical setting where the medications that can be administered are safer and more effective.

Seizures

Nothing can be done at home to stop a seizure. If a toxin is causing a pet to seizure then it is unlikely they will stop, so will require medications. The pet will need bringing into the clinic immediately.

I suggest owners do not try to put their fingers in their pet’s mouth, as they are very unlikely to choke on their own tongue.

Wrap them in a blanket to help prevent injury to the owners. Once in the car, keep the head slightly down – if they do vomit or have large amounts of foam then it is allowed to fall out of the mouth, not build at the back of the mouth and lead to aspiration.
March 21, 2022
Don’t limit yourself

Fourth year at vet school seems to finish before it’s even begun – and that’s not a romanticism.

It’s only six months (running from September to February), so even if you factor in time spent on exams, it sort of feels like cramming a whole year into just half the space of time. Like too much butter over too little bread.

Short year

There are many maladies of fourth year that nobody quite prepares you for.

For starters, exams come before Easter (so you don’t even get a chocolate fix while revising), there’s no real summer holiday (unless you count an overseas EMS placement) and – the scary part – it’s the stepping stone between being a plain ol’ student and basically being an actual vet.

Despite these curveballs to the regular programming of the vet course, I believe fourth year has been my favourite so far. However, I’m not sure if it’s the nostalgia after intercalating for a year, the delicious lack of biochemistry and 9am dissections, or the slow and almost intangible sensation of everything coming together.

Mixing bowl

It’s most certainly a scary jolt when you realise that, academically speaking, the university staff have essentially taught you everything there is to teach you. There are no more ingredients to becoming a veterinary professional – all that’s left is to mix them all together and hope you come out fully baked.

It’s also a familiar type of “scary” – like holding your unopened A-level results envelope, or moving out of home and into halls. It’s a precipice of the unknown, but there’s also a lot of potential there. Staring into the jaws of final year is a humbling experience and it feels like the beginning of the end of a very long journey.

Looking back, the past five years seem like a blur and despite the fact most of the friends I started university with are now working 9 to 5 and getting on the property ladder, I can’t quite believe I’m already here. Is it really that time already?

Limitless

Academics aside (you know, the actual important bit), I’d say my takeaway from my time so far probably boils down to just one point: don’t limit yourself.

This applies to every aspect of life at vet school – from trying different clubs and sports in your first year, to keeping your options open when it comes to what type of vet you actually want to be. For example, when I first started writing for Vet Times as a wee 19 year old, I knew down to my bones that I wanted to be a farm vet… until I didn’t.

That’s not to say that cows aren’t still the cutest things that fill me with absolute joy, because they do. It’s even become a sort of car game among my vet friends to point out fields of them on long journeys. The fact of the matter is, I don’t know what I want to be any more, unless there’s an option for everything?

Growing confusion

I never really considered myself an exotics enthusiast, or a conservationist, or a wildlife welfare advocate until halfway through my veterinary degree, and with each passing EMS placement I become more and more torn as to which area I’d like to branch into.

“Don’t limit yourself” is also applicable to your life and interests outside of the course, to giving yourself a much-needed break during the revision period, and not being scared to ask questions of that vet who knows everything now, but was once just like you.

Don’t miss out

It makes for a very cheesy motto, but if you get too caught up in where you think you should be going when you first start vet school, you might miss out on some really incredible opportunities along the way.

It’s natural for you to end up being a very different person at the end of the course than you were when you first applied (a culmination of all of those years and experiences) – I know I certainly am.

March 16, 2022
Intoxication: working out possible ingested dose

We frequently field telephone calls from owners concerned about their pet being intoxicated or having access to a toxic compound.

These are the list of questions I always ask owners:

What is your pet doing?

The main reason I ask this question first is to determine if the pet’s life is in danger. If the pet is seizing, collapsed, neurological, bleeding or having difficulty breathing then they need to come into practice immediately.

What led to the suspicion of toxic exposure?

This can help provide useful background information.

What is the product?

In some situations, owners can tell you accurately over the telephone what they think they have been exposed to.

Asking them to bring the packaging, and whatever is remaining of the toxin, with them can help determine a possible dose they have been exposed to.

When did this occur?

A timeline, and when they think the pet could have been exposed to the toxin, is critical as it can help put presenting clinical signs into perspective.

I always ask if they could have had prior exposure to the toxin. An example where this may be important is with rodenticides.

What have you done in response to this?

Owners may have tried to address the situation themselves, using information gained from the internet.

Attempts to induce emesis can also make pets incredibly ill and result in neurological signs.

Have they passed faeces or vomitus with the toxin?

If the answer is yes, ask them to bring the pet into the practice. This can help identify the toxin; some baits are coloured and can easily be seen. These samples may even be able to be sent away for further testing.

Do you have any other pets that may have also had access to the toxin?

Other pets that may have had access will need to be seen in practice as well. A classic example is a multi-dog household where one pet is the scavenger. Owners may neglect to inform you their other pets may have been the culprits, but did not because they assumed it was the one with the history of being a scavenger.

Next week, we will cover the decontamination steps owners can carry out at home.

March 14, 2022
Icteric serum
The final discolouration of the serum we are going to cover is icteric serum.

Icteric serum is caused by the presence of excess bilirubin in the blood stream.

Icteric serum is caused by the presence of excess bilirubin in the blood stream as a result of increased production (pre-hepatic) or inappropriate excretion (hepatic and post-hepatic).

The most common cause of pre-hepatic icterus is haemolytic anaemia, while hepatic disease and biliary tract obstruction are the most common causes for hepatic and post-hepatic icterus, respectively.

Tips on where to start

If icterus and concurrent anaemia exist, my first suspicion would be some kind of pre-hepatic cause. The most common causes are immune-mediated haemolytic anaemia and infectious haemolytic anaemia, such as haemotropic mycoplasma and babesiosis.

Other causes can include snake envenomation and oxidative injury from heavy metal toxicity or onion ingestion.

Regarding hepatic and post-hepatic causes, unfortunately it is not always clear-cut. Both are commonly associated with elevation in both alanine transaminase (ALT) and alkaline phosphatase (ALKP), and, although no specific changes are pathognomonic for hepatic or post-hepatic disease, the pattern of change may help identify the origin of the cause. ALT is released from the inside of hepatocytes, and in higher amounts when cell damage occurs.

Hepatic hints

Some pointers on what you can do to help differentiate:
- Compare the ALT and ALKP elevation; if one is in order of magnitudes higher than the other then it can help point to an origin.
- If the cause is of hepatic origin, one would expect the ALT to be significantly more elevated than the ALPK. Likewise, this is usually true in reverse for post-hepatic causes. However, it should be noted in chronic hepatic diseases, where active damage to hepatocytes is comparatively lower, a mild increase in ALT and marked increase in ALPK does not preclude disease of hepatic origin. Therefore, biopsies should always be used for definitive diagnosis.
- If other biochemistry parameters such as albumin, glucose and cholesterol are low, or prolonged clotting times are present, the case for a hepatic origin is strengthened.
- The gallbladder and bile duct can be assessed using abdominal ultrasonography. The presence of a dilated bile duct, or evidence supportive of pancreatitis, is highly suggestive of a post-hepatic cause.
Finally, it is important to be aware of the impact on hyperbilirubinaemia on laboratory testing. Hyperbilirubinaemia generally causes decreased cholesterol, triglyceride, creatinine, lipase, total protein and gamma-glutamyltransferase levels.
March 7, 2022
Lipaemia – the bane of biochemistry
Last week we covered haemolysed samples – this week we’re looking at lipaemic samples.

Lipaemic samples are caused by an excess of lipoproteins in the blood, creating a milky/turbid appearance that interferes with multiple biochemical tests and can even cause haemolysis of red blood cells.

A severely lipaemic sample (red arrow). IMAGE: eClinPath.com (CC BY-NC-SA 4.0).

Lipaemia can follow recent ingestion of a meal – especially one high in fat. Although not pathognomonic for any diseases, its presence can help increase the suspicion of certain diseases, including:
- pancreatitis
- diabetes mellitus
- hypothyroidism
- hyperadrenocorticism
- primary hyperlipidaemia (in some specific breeds, such as the miniature schnauzer)
It warrants further investigation in patients that have been ill and inappetent.

Irksome interpretations

Lipaemia can dramatically impact laboratory testing and is often troublesome in critically ill patients, making interpretation of biochemistry particularly difficult, if not impossible.

Lipaemia can affect different analysers in different ways, most commonly causing:
- Falsely increased calcium, phosphorus, bilirubin, glucose and total protein (via refractometer) and some liver parameters such as alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, haemoglobin concentration, and mean corpuscular haemoglobin concentration.
- Falsely decreased sodium, potassium, chloride, albumin and bicarbonate.
Tube tips

Assessment of a centrifuged haematocrit tube before running a biochemistry panel can help reduce wasted biochemistry consumables.

If the sample is lipaemic in the haematocrit tube then maybe try some of the following tips.
- If blood tests are planned in advance, try fasting the patient beforehand for 12 to 24 hours.
- Repeat sampling a couple of hours later may yield a less lipaemic sample.
- Collecting and centrifuging a larger amount of blood (3ml to 5ml, for example) can sometimes yield enough clear sample between the lipid layer and red blood cells.
- Refrigeration of the sample can help the separation.
- Extract lipids using polar solvents, such as polyethylene glycol.
- Centrifugation at higher than normal speeds (if possible) can also assist in clearing the layer.
February 28, 2022