3. Canine neutering
The importance of small animal neutering merits analysis, from both an owner’s point of view and a business perspective.
There are many aspects to consider regarding the neutering of dogs and bitches and many perceived benefits for their owners:
• Firstly, it is of course a practical and radical means of reproductive management. The collective advantage is well recognised, in that the control of canine populations is an important aspect of animal welfare and public health. Individual owners, when considering the question of reproduction, either decide to breed from their pet to ensure the continuation of their pet’s lineage, or, more commonly, opt for neutering to prevent genuine problems, whether minor (staining of carpets and furniture, straying, etc.) or more serious (unwanted pregnancies, etc.).
• From a behavioural standpoint neutering may result in a pet that is more focused on its relationship with the members of its host family and although one must not ignore the desires of those who wish to preserve the behaviour of their dog “intact”, the vast majority of owners find neutered pets easier to handle and, as a result enjoy a more gratifying relationship with them.
• The effects of neutering on the health of a pet dog remains controversial in the scientific literature. The general consensus is that it is beneficial for females (notably through the prevention of uterine infections and a certain number of cancers), whilst the pros and cons seem to be more balanced for males. In all cases, the informed consent of the owner, regarding neutering, implies they are fully aware not only of the advantages but also the potential adverse effects of neutering, notably of the increased incidence, common but manageable, of weight gain that may eventually lead to obesity (see below).
• Finally, other than the advantages cited above, neutering often represents the first general anaesthetic in the life of most young animals and as such, is always an important step for the owner. Consequently practices should not treat these perceived simple procedures lightly.
For the veterinary business, neutering is also significant for several reasons
• First of all, neutering is a common procedure. The proportion of neutered animals varies significantly from country to country and between breeds. Over 75% of both male and female dogs are neutered in the United States (1), whilst only 20% of males and 40% of females undergo the procedure in France (2). The rate of neutering is on the increase the world over and there is a trend towards routinely recommending it to owners who do not wish to breed from their bitches.
• Its importance in the eyes of the owners as well as the impact on the pet - in terms of reproduction, behaviour, and health - demand a highly structured educational approach on the part of the practice team.
• From an economic standpoint, these common surgical procedures represent a significant source of income, not only through direct sales, but also from owners who may well become regular clients.
A cultural bias
However, the realities observed in the field conflict with the importance that we have just referred to. The principal problems encountered are due to familiarity with the procedures, unreasoned low cost strategies often termed “loss-leader” and finally low interest given to the performance of these surgical procedures deemed to be ‘routine’.
The most convincing explanation of this attitude comes from a ‘cultural’ bias. Trained in a system that promotes technical prowess, veterinarians find it hard to get excited or interested in simple, routine procedures. Worse still, they project this image of simplicity, or even banality, to their clients by implementing, whether consciously or subconsciously, a strategy that combines low perceived value with a low price tag.
Low cost strategies are found in clinics that make it their principal means of development, such as the ‘pet neutering and vaccination clinics’ that are particularly prevalent in the United States and the United Kingdom. These strategies are coherent and effective for businesses focused on simple procedures (sick or injured animals are referred) in countries where the range of veterinary practices is well differentiated, where veterinary businesses are allowed to advertise, and where neutering rates are very high. Here, neutering as a routine procedure becomes a strategy, and the approach “why pay more for a standard service” finds resonance, with very diverse social groups.
Such strategies are also found in ‘traditional’ first opinion clinics with purposefully aggressive pricing on neutering in the hope of attracting clients who will then discover other aspects on offer at the clinic, notably competence and quality of service. However, unlike the previous strategies this one cannot be considered as coherent or effective, in that in terms of services, the quality-price inference does not make it possible to occupy the “low cost” position and the “most competent” position at the same time. As a result, either the competitive pricing positioning on neutering will not have been effective in recruiting new clients and it is a shame to have lost money, or it will have worked well and the recruited owners will have taken onboard the message of a cheap clinic which will subsequently find it difficult to sell them services which are principally linked to competence and quality.
Neutering procedures can be differentiated
Moreover, low cost strategies do not offer the possibilities of differentiating neutering services, in spite of their importance. Let us then try to build a strategy whereby we maximise the value perceived by the client, centred on two main areas: restoring neutering to its ‘status’ as an important surgical procedure in its own right, and integrating neutering into the general health care programme of young pets.
Evidence has shown that owners of pets that are to be neutered do not consider the procedure as routine, in that it presents all of the characteristics of surgery under general anaesthesia, generally the first in the life of their pet. The veterinarian should therefore try to reassure the owner regarding the procedure. However, in doing so, they should not promote the surgery as simple and routine but should refer to the degree of safety obtained through the use of a rigorous procedure, skilled personnel, and an appropriate surgical unit. In real terms, the recommendation is to apply the same standard procedure as for all surgical interventions carried out within the clinic. In other words to include a preanaesthetic examination (and if appropriate, according to the practice protocol, a pre-anaesthetic blood test), pain management, postoperative monitoring, and postoperative check-up 48 to 72 hours after the procedure. These elements are obviously brought to the attention of the owner – not forgetting that it is important to maximise the perceived value – at different key steps in the process, when advising the neutering (backed up with a fact sheet), when discharging the pet (with a simple surgical report), and on the detailed invoice.
An important step of almost every puppy programme
Integrating neutering into the health care programme of young pets implies integration with preceding and subsequent phases.
• The first key moment when advising neutering usually occurs at the last paediatric consultation at around 4 months of age. At this stage, it is essential to discuss the subject of reproduction with the client: do they have any plan to breed? If the owner does not plan to breed from their pet, the various alternatives should be discussed, relative to the gender and breed of the particular pet. When they are presented for surgical neutering, the vet or a qualified nurse discusses the advantages of the procedure, the associated risks, notably in terms of weight gain or even obesity, a risk that warrants careful adaptation of the diet of neutered animals, and the cost of the procedure. If the owner gives their informed consent for surgical neutering, the vet discusses the practical aspects, notably the ideal age for the procedure and what it involves; they then offer to send a reminder to the owner at the appropriate time. Team work, for example with an initial recommendation from the vet, reinforced by a nurse who can answer any other questions that the owner may have, will have an enhanced effect. In all cases, it is a good idea to back-up the recommendation with a simple and concise owner fact sheet, reiterating the main points of the discussion. But under no circumstances should such a document replace a face-to-face discussion.
• At the pubertal consultation prior to neutering, the advice can be reiterated and the clinical team has a new opportunity to answer the owner’s questions. In cases, generally less commonly in dogs than in cats, when neutering may represent the first contact with the clinic, it is essential to plan a preoperative consultation as opposed to a preoperative examination, meaning the owner is present. During this consultation, in addition to checking the pet’s health the vet verifies that the owner understands the procedure and gives their informed consent, but also that they are aware of the potential downsides of neutering.
• Following neutering, it is important that a vet or qualified nurse takes time to talk to the owner, firstly to prescribe a diet that is appropriate for the pet’s new metabolism, then to discuss the principal preventative measures, notably in terms of internal and external parasite control and to present the subsequent steps in the pet’s healthcare programme. The latter may involve a pubertal consultation (if it is scheduled by the clinic after neutering), or the first annual health check. The post-operative check-up, 48 to 72 hours after the procedure, is the best time to discuss these issues. At the discharge consultation, on the day of the operation, the owner is primarily concerned about the immediate condition of their pet and what they need to do for them over the next few hours. As such they are not very open to discussions about the pet’s mid to long-term future and the visit to remove the stitches is slightly too long after the operation to have this discussion.
- The post-neutering consultation should not be the first time that the need to adapt the pet’s diet is discussed. Depending on the case, it should have been discussed during the last paediatric consult or at either the pubertal or preoperative consultation. The prescription protocol should follow a standard procedure. The starting point is a brief overview of the change in metabolism induced by neutering, with a reduction in energy requirements, combined with an increase in food intake. It is then important to explain the characteristics of the recommended diet, with a lower energy density, satietogenic effect, and the presence of all necessary nutrients to cover the pet’s requirements, many of which will not have finished growing. These characteristics cannot therefore be met by the prescription of a light diet, nor by reducing the quantity of a standard diet. To be specific, the owner should be given the name of the prescribed diet and the amount to be fed. A dietary prescription sheet can be helpful for reinforcing what has been said. Finally, the practical aspects should not be neglected: What is the price of the adapted diet (in comparison with the animal’s previous feed)? How many meals should be given; and how should the new diet be introduced?
- Other than the dietary prescription, the vet or qualified nurse should remind the owner of internal and external parasite control and if necessary renew or adjust any current prescriptions. Finally, they will provide a quick overview of the next stage in the pet’s health care.
Teamwork and simple marketing tools
Such a strategy relies first and foremost on the commitment of the team in devising a standard medical protocol and above all of applying it day-to-day. Four simple aids can provide valuable assistance: an information sheet, given to the owner at the time of advising neutering, the neutering reminder card, the postoperative report, which presents all of the steps of the procedure (notably the pre-anaesthetic examination, pain management, and postoperative monitoring), and the dietary prescription sheet.
The strategy that we have described makes it possible to differentiate canine neutering in an effective manner. Strengthened by pricing in the upper sector of the market, it is an important element in the success of first opinion veterinary practices.
This article was kindly provided by Royal Canin. If you would like printed copies of this material or other Focus publications please contact your Veterinary Business Manager:
1. American Pet Products Association (http://www.americanpetproducts.org/).
2. Chambre syndicale des fabricants d’aliments préparés pour chiens, chats, oiseaux et autres animaux familiers (FACCO) (http://www.facco.fr/article67,67).