Best Practices for Vet Practices
This list of recommendations was compiled by Dr. Ashley Mitek from information provided by the Illinois State Veterinary Medical Association, the Illinois Department of Public Health and Department of Agriculture, and Dr. Jim Lowe of the University of Illinois College of Veterinary Medicine.
- Updated March 24, 2020: FAQs for veterinary practices that are seeing patients. See below.
- Updated March 20, 2020: FAQs on whether veterinary practices, pet boarding, and doggie daycare should remain open. See below.
- Read a March 20 message from veterinary anesthesiologist Dr. Stephanie Keating inviting Illinois veterinarians to register for an emergency support network in the event human medicine seeks help from the veterinary profession.
General Advice for Veterinary Practices During the COVID-19 Outbreak
- For general questions, call the state’s COVID-19 Hotline: 1-800-889-3931, email: DPH.SICK@ILLINOIS.GOV or visit the Illinois Department of Public Health coronavirus webpage.
- Make sure you have the contact information for your local health department in case you need to consult with them.
- Institute appropriate cleaning and disinfection of communal surfaces.
- Encourage staff hygiene (frequent handwashing).
- Prohibit sick or febrile staff from working in your clinic. Staff members with symptoms of COVID-19 should quarantine and not be allowed to work for 14 days.
- Likewise, if a staff member has traveled to an area with widespread transmission, consult with your local health department about any restrictions on the person returning to work.
- It is recommended that people infected with COVID-19 avoid contact with their pets, including petting, snuggling, being kissed or licked and sharing food. Another person in the household should feed and care for the pet. If the ill person must provide the care, the person should wash hands before and after interacting with the pet and wear a face mask.
- As a reminder, at this time, the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) say there is no evidence that companion animals, including pets, can spread COVID-19. However, as with any disease, it’s always a good idea to wash your hands after being around animals.
Advice on Delivering Veterinary Care During the COVID-19 Outbreak
- Triage or treat as many cases as possible by telemedicine (e.g., using FaceTime or Skype). Note: telemedicine presumes an existing veterinary-client-patient relationship, i.e., it is appropriate only for a client/patient you have previously seen in person.
- Prioritize patients that need to be urgently seen over ones that need only routine care or surgery that could be delayed.
- For cases that have to be seen (e.g., an acutely vomiting dog), nothing should move from an infected/quarantined household to a clinic without approval and clear delineation of a plan for that clinic (what, who and how you would see the case).
- If a client has a fever, cough, sore throat, or possible exposure to COVID-19, arrange for someone else to bring the sick animal to the clinic or use telemedicine for an evaluation of the animal. Contact the local health department for advice on how to safely deliver veterinary care to the animal.
- Although the risk for transmission is low, remember that pets arriving from a COVID-19–positive household have the potential to be a fomite for viral transmission.
- AVMA recommendations on Keeping Your Staff Health, Caring for Veterinary Patients, and the use of Telemedicine
- FAQs on Surgical Mask Shortage
Are primary care veterinarians “essential”? Should veterinary practices close if cities announce a Shelter-in-Place order?
Human health and safety must remain the priority in this pandemic. The COVID-19 virus appears to have high transmission rates, and shedding of the virus appears to occur before the infected person develops symptoms.
For that reason, we encourage all veterinary clinics to consider going emergency only at this time, and to cancel elective appointments and procedures until the threat to human health subsides. Tele-medicine can be made available to clientele as needed. And emergency services can remain available on an as-needed basis.
We support the AVMA’s position that veterinary practices defer elective procedures at this time to preserve medical supplies for human use.
If your practice is in a jurisdiction that has issued a Shelter-in-Place order, we strongly encourage you to close your clinic and refer cases to an emergency hospital. Or have your practice go emergency only. Every effort should be made to practice social isolation.
Are pet boarding facilities allowed to remain open?
Operating a boarding facility requires staff to come to work to care for animals, which potentially increases their risk of exposure to the virus. We recommend that if you chose to keep your boarding facility open, you minimize any human-human interaction, and pick-up and drop-off pets curbside, so pet owners do not enter the facility. Common surfaces should be frequently sanitized.
If your practice is in a jurisdiction that has issued a Shelter-in-Place order, we strongly encourage you to close your boarding facility.
What about doggie daycare?
Although unlikely, dogs may act as fomites, and carry COVID-19 on their fur. Experts believe the risk to human health is small, though transmission is possible. For that reason, if you operate a doggie day care facility, we encourage you to do curb-side drop-off and pick-ups, to minimize the number of people entering the facility, as well as minimize any risk of human-human interaction. Common surfaces should be frequently sanitized.
If your daycare is in a jurisdiction that has issued a Shelter-in-Place order, we strongly encourage you to close your facility.
Are rabies vaccines considered an emergency or urgent medical need for which a dog or cat should be seen?
The Illinois Department of Agriculture released guidance last week that says rabies vaccination should still be administered when possible, but priority should be placed on animals getting their first rabies vaccination or their first booster rabies vaccination. For those animals coming due for a booster, the guidance says to give it if possible but it can be postponed if necessary. The Department of Agriculture and the Department of Public Health are currently having conversations about an agreement to provide flexibility in due dates for vaccinations from a legal standpoint.
We do know that rabies titers in dogs typically last much longer than the three-year booster requirement for rabies.
Is there a specific way our practice should dispose of PPE equipment after interacting with patients?
There are no additional precautions when doffing PPE other than to ensure you wash your hands immediately before touching your face or the rest of your body. Double bagging is not needed.
Should all practices adopt a curb-side model where patients are picked up from the owner’s car?
Yes. The AVMA strongly encourages veterinary clinics to go to a curb-side model where patients are picked up from the owner’s car and then history, etc., is taken by telephone.
The exception to this recommendation may be for euthanasia, but then proper social distancing should be followed, if at all possible.
This protocol can also be followed on ambulatory large animal calls in many cases where the owner can have the animal secured ready to be examined before the veterinarian gets there. Once arriving on the farm, the veterinarian can call the owner to talk about the case and examine the animal, assuming the veterinarian can conduct the exam safely without assistance.
How do I disinfect cages or other surfaces if a dog from a suspected COVID-19—positive household came in contact with them?
There are a number of disinfectants that the EPA has noted as effective. The full list can be found here: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
Veterinarians can look up the EPA registration number on the MSDS reference sheet for any disinfectant they have in their practice.
Please remember to abide by the manufacturer’s recommended contact time.
What are the recommendations for interacting with pets in the home of a suspected COVID-19—positive household?
The CDC has released the following interim guidelines for managing people in home care with COVID-19 or suspected infection: https://www.cdc.gov/coronavirus/2019-ncov/php/interim-guidance-managing-people-in-home-care-and-isolation-who-have-pets.html
The overall guidance would be that the client who has or suspected to have COVID should wear a facemask. It is recommended that the veterinarian should also wear gloves and a facemask as well. The AVMA has also released additional guidance about mobile appointments that include assessing the client over the phone first to see if they are sick or possible exposure to COVID-19 and postponing all elective or preventive procedures for home visits, especially if there is a high risk the client has COVID-19.
If you still must do the mobile visit, we recommend doing as much of it as possible outside and ideally having a different household member with the pet (https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/mobile-house-call-veterinarians-covid19-pandemic)