New CVS clinical improvement project aims to increase use of Diabetic Clinical Score
CVS is running a nation-wide clinical improvement project in over 30 of its small animal practices to increase the use of the RVC’s Diabetic Clinical Score (DCS).
It aims to use the recently validated tool in over 80% of patient cases to improve the treatment and control of this common and life-limiting disease. It will also support the practice teams to develop their skills and knowledge in managing this challenging condition.
Diabetes mellitus is a prevalent condition in small animals. It affects 0.26-1.3% of dogs and 0.4% -1% of cats during their lifetime. It usually presents with the animal drinking, urinating and eating more, being less active, and unintended weight loss. If diabetes is not quickly diagnosed and treated, it can shorten the life expectancy of the animal. Its effects are also not limited to the pet’s welfare; it can also have an impact on the wellbeing of the owners.
Diabetes in cats and dogs is diagnosed initially using blood glucose measurement. However, the condition can oftentimes be challenging to diagnose effectively in cats in practice due to the increase in blood glucose levels as a result of stress, causing inaccurate blood glucose readings.
The disease is also difficult to control consistently. As an untreatable disease, it cannot be cured, but it can be managed by making significant lifestyle changes. It can also be controlled with insulin injections, though these can affect an owner’s relationship with their animal. A new oral diabetes drug has come to market which is suitable for some feline patients.
The Diabetic Clinical Score (DCS) is a simple, quick, standardised scoring system to record the clinical signs of diabetes in a patient. Designed by Royal Veterinary College (RVC) Internal Medicine Specialist Dr. Stijn Niessen, it has been turned into a Pet Diabetes App for clients. The app allows owners to record and monitor important indicators of success or failure in their pet’s diabetes treatment and control. These include weight, appetite, thirst and urination changes, as well as urine and blood sugar values. The resulting ‘diabetes log’ of parameters and clinical signs can then be shared with a vet, to enable them to fine-tune the animal’s diabetes management - thus reducing complications associated with low and high blood glucose.
The CVS practices participating in the clinical improvement project will use the DCS, alongside blood glucose measurements, to diagnose and monitor patients. Veterinary nurses will refer animals coming in for six-monthly Healthy Pet Club check-ups to a vet for a possible diabetes diagnosis, whilst vets diagnosing diabetes will introduce owners and patients to the DCS to record a diabetes log, in order that their condition can be managed.
To upskill and develop colleagues in the use of the DCS, dedicated vet and nurse training sessions have been held by the clinical leadership team. This has included a kick-off ‘diabetes day’ for all participating practices - which focused on current thinking and introduced the DCS tool, and how this can be used to increase owner involvement in management of the disease.
CVS teams have also grouped together to agree a joined-up approach to managing pets with diabetes in their practice. This has included agreeing preferred protocols and the frequency and method of monitoring each patient.
In addition, supporting diabetes resources have been drafted for practices including new clinical guidelines, supporting paperwork and CPD which are provided on an online hub which also houses a discussion forum to share experience and knowledge between clinicians.
Lara Wilson, Regional Clinical Lead at CVS who was responsible for the diabetes clinical improvement project, said:
“Diabetes is notoriously difficult to diagnose and different vets can use different approaches to managing cases.
The Diabetic Clinical Score will help the whole team around the patient – the owner, vet and veterinary nurse – to effectively and cohesively manage their care. It will implement joined-up thinking and help to put a standardised disease management framework in place.
It will be fantastic to see the benefits that the Diabetic Clinical Score will bring to our patients and practices. I am certain that this will help contribute towards them providing some of the best diabetes clinical diagnosis and care in our profession.”
CVS Group operates across small animal, farm animal, equine, laboratories and crematoria, with over 500 veterinary practices and referral centres in the UK and Australia. In the last five years the company has invested nearly £80 million in its sites, facilities and equipment, in addition to industry leading training and support, to give the best possible care to animals.