In 2005, researchers at Harvard and the Broad Institute of MIT released the genomic sequence of the dog.  Researchers based at the National Cancer Center in Fredrick, Maryland published the first fully mapped feline genome in 2007. These groundbreaking pieces of research have allowed veterinary scientists to develop genetic tests that evaluate risk factors for large numbers of diseases ranging from cardiomyopathies and bleeding disorders to musculoskeletal conditions such as degenerative myelopathy in the dog. As these diagnostic screenings have become commercially available, the number of inherited genetic diseases that can be identified has increased and become extremely cost effective.

At the same time, genetic testing for humans is becoming widespread. Advertisements for tests
that identify heritage are commonplace. Screening for devastating diseases, such as the breast
and ovarian cancer-inducing BRCA gene mutation became well-publicized by actress Angelina
Jolie’s personal story. It should not be a surprise that owners are expecting veterinarians and
veterinary teams to be able to provide a similar level of insight into not only the heritage of mixed
breed dogs and cats, but also as a tool to help in managing their pets’ health.

Why Genetic Testing?

There are several reasons that an owner might request that DNA testing be performed on their
pets:

• to determine the breed composition in mixed breed dogs or cats
• to screen for inherited diseases and carrier status in breeding animals
• to screen animals at risk of developing breed related diseases
• to help make definitive diagnoses for animals with clinical signs
• to ascertain parentage of pure breed animals
• to help minimize the risk of breeding animals that carry the genes for undesirable breed characteristics, such as coat length and color.

How Does This Knowledge Help the Client and Pet?

It is easy to understand the value in preventing the planned breeding of dogs or cats that might
produce offspring affected by any number of genetic conditions that impact health or contribute to
undesirable physical characteristics. However, the benefits to pets and clients far exceed this
narrow scope.

By identifying the heritage of the mixed breed pet, veterinarians can provide invaluable insight
into diseases that are common in the breeds that represent the ancestry of that pet. Not all
diseases are easily screened for using DNA due to complex modes of inheritance. One example
would be hip dysplasia, which not only has multiple genetic factors but also may be strongly
influenced by environmental causes. Using genetic testing, a veterinarian can ascertain if the
dog is descended from breeds that have a high likelihood of developing hip dysplasia. This
allows the animal health care team to proactively partner with the pet owner in developing a life
genetic plan. This plan will address strategies such as weight management, appropriate
nutritional counseling and exercise recommendations to minimize the environmental risk factors
contributing to hip dysplasia.

As illustrated in the example above, screening pets that are at risk for developing breed related
diseases allows for veterinarians to partner with their clients to develop a life plan based on the
genetic profile of the pet. Insight into the DNA profile of a patient helps veterinarians make good
clinical choices that enhance patient safety. Knowing that a dog has the genetic mutation for
multi-drug sensitivities helps practitioners avoid medications that might not be cleared
appropriately, preventing severe drug toxicities. Pro-active management and appropriate life
planning incorporates a team approach that helps to offer support and improved quality of life to
both the pet and the pet owner.

What is a Genetics Life Plan and How Do I Incorporate it into my Practice?

A genetics life plan begins with the pet’s initial visit to the veterinary hospital. Along with a
comprehensive physical examination and other wellness recommendations, team members
discuss the advantages of genetics testing with clients. They explain that knowing the genetic
make-up of the pet directly impacts the ability of the veterinary team to make more
comprehensive health recommendations for the pet and provides the owner with better care
options.

When the results of the test are received by the veterinarian, a consultation appointment is
scheduled with the client. During this consultation, the genetics profile is discussed with the
client. These results, as well as information gathered during the comprehensive physical
examination such as body condition scores, pain scores, current exercise and nutritional
programs and wellness diagnostics are combined to create an inclusive care plan for the pet.
This plan may incorporate recommendations for additional diagnostic testing such as coagulation
profiles, radiographs, echocardiography; rehabilitation services and nutritional changes. The
owner should be provided with a written copy of this plan, with clear recommendations.
Outcomes of additional diagnostic testing with modifications to the genetic life plan should be
clearly communicated. This plan should be reviewed and updated on an annual basis, during the
yearly physical examination appointment.

One very easy way to incorporate genetic testing into a practice is to include it as a wellness plan
item for all puppies and kittens, as well as an add-on option for all adult wellness plans. This
allows the client the opportunity to include this service in the monthly payments for the wellness
plans.

How Do I Obtain Animal Health Care Team and Client Buy-In?

In my experiences as a hospital owner, managing DVM and technical services veterinarian, I
believe that teams will endorse recommendations that benefit patients, if they understand the
“why” behind the recommendations. By providing your team an understanding of how genetic
tests can help them provide enhanced patient care and safety, they will be positioned to convey
these advantages to clients.

Below are some discussion points that can be used to help facilitate discussion and training:

• Ask your team what they know about genetics testing in animals.
• Share stories of how individual genetics tests have helped patients and their families.
  • Have you used the MDR-1 test to screen mixed breed and herding dogs for multidrug
    sensitivities? How has this information changed clinical drug usage such as
    decreased dosages of acepromazine or avoiding high doses of ivermectin to treat
    demodicosis?
  • Did you confirm that the dog with hind end weakness had the genetic
    predisposition for degenerative myelopathy? What modifications did you make to
    the patient’s diagnostic and treatment recommendations based on these results?
  • Do you have a case that, in hindsight, you regret not utilizing genetic screening?
    How might the patient’s and the pet owner’s outcome have differed?
• What concerns your team about recommending genetic testing?
  • When discussing the utilization of genetic testing with teams, the most common
    concern that I hear is “What if the results indicate that the pet being tested has a
    disease that will be hard to manage or deadly? What if the owner wants to
    euthanize a pet that is currently clinically healthy?”
    Be prepared to have a candid discussion around how your practice would handle
    these client concerns. One important point for teams to hear is that these tests
    provide the opportunity to partner with clients in developing a plan that will help
    better manage the patient and improve the quality of life. This patient benefit far
    outweighs the unlikely risk of a client requesting euthanasia.
  • This is just one more thing to try to “sell” to clients
    Genetic testing is a diagnostic that, for most pets, is only going to be done once
    during their lifetime. Clients deserve to be educated about the advantages
    conveyed by genetic testing (enhanced patient safety with clinical
    recommendations, pro-active care to manage and minimize the impact of the
    disease on the pet, prevention of breeding animals with inherited conditions). It
    helps provide pieces of the puzzle otherwise unknown so that the veterinarian and
    owner can partner together to make the best decisions for the health of the pet.
  • A discussion with your team that genetic testing will not be embraced by all clients.
    Some clients might be scared by the prospect of finding out that their pet has a
    genetically detectable disease that might impact the pet’s longevity, preferring not
    to know. Others might feel it is too intrusive or extreme. Teams should be
    confident in the value of their recommendations and embrace the idea that clients
    deserve to be educated about their options. When a client declines genetic
    testing, a notation should be made in the client’s file that it was offered and
    declined.
• What benefit does your team see to genetics life plans?
  It is helpful to role play the above points during team training meetings. A clear protocol
  regarding genetic screening recommendations should be developed by the team. This will help
  to establish a baseline for this new initiative and serve as a valuable training tool for new team
  members.

About the Author:
Wendy Hauser, DVM, established Peak Veterinary Consulting in January 2015 after working as an industry
Technical Services Veterinarian. With a DVM from OK State in 1988, she practiced for 28 years as an
associate and owner. She is highly engaged in AAHA leadership having served as a member of the Board
of Directors, as the Board Vice-President and currently serves as the AAHA Delegate to the AVMA House
of Delegates. She helped design and facilitate Colorado VMA’s Power of Ten. Dr. Hauser is a
communications coach at Colorado State University’s College of Veterinary Medicine. The co-author of
“The Veterinarian’s Guide to Healthy Pet Plans”, she enjoys consulting and presenting workshops on
hospital culture, leadership, client relations and operations. Wendy is a member of Orivet Veterinary
Advisory Board. She may be reached at drhauser@peakveterinaryconsulting.com

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