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IDEXX: Contributing to something bigger

All dogs are the same, roughly, right? All cats are just small dogs, right? Wrong! Of course, every veterinarian understands that each patient is special to their owner and unique as a living organism, but do individual patients need truly individualized care? Furthermore, is the veterinary medical profession at a point where truly individualized patient care is even available? Let’s start at the beginning.

Prevention as an approach to medicine and health care is not new, however, preventive medicine has certainly evolved with the times. Despite a basic recognition of disease prevention by Hippocrates in the fifth century BCE, preventive medicine was largely ignored all through the Middle Ages and leprosy and plague abounded. From the first sanitary act in England in 1388 to the first efforts at quarantine and isolation in the 1500s, prevention has always cost a mere fraction of a cure. Indeed, as our understanding of disease and pathology expanded through the seventeenth and eighteenth centuries, the introduction of mortality statistics and population trends and the invention of vaccines in 1798

, prevention of disease has been as coveted as the cure. In 1902, Thomas Fuller wrote in 

Practical Spelling: A Text Book For Use in Commercial Schools

, “He who cures a disease may be the skillfullest, but he who prevents it is the safest physician.” Fast forward to modern-day medicine and public health measures are almost exclusively focused on prevention of disease.

The progression of veterinary medicine and the integration of preventive measures runs nearly parallel to human medicine. Unfortunately, the concept of One Health and its application in disease prevention would not be formally recognized until much later, but I digress. Truly the cornerstone to preventive medicine in the veterinary field has traditionally been vaccination, nutrition and husbandry. These 3 continue to be critical in the prevention of such life-threatening diseases as rabies, distemper, parasitism, nutritional hyperparathyroidism, etc. As veterinary medicine has evolved, so, too has the recognition of the importance of a healthy microbiome in the long-term health of most creatures. In fact, with 70 to 80% of immune cells being present in gastrointestinal tissue

, the gut microbiome has taken on a near mythical importance in the health of animals. Transfaunation procedures to help restore the normal microbial flora in the gut are more commonplace than ever before. Additionally, the avoidance of oral antibiotics to avoid unnecessary disturbance of the gut microbiome is more commonplace than one might think in veterinary clinics. And speaking of oral issues, molecular analysis can be used to identify feline chronic gingivostomatitis and periodontal disease based on changes in the oral microbiota.

Gastrointestinal and oral microbiota are not the only focus of the ongoing revolution in the field of prevention in veterinary medicine. Just as human medicine is exploring the application of genetic analysis, veterinary medicine can now leverage genetic testing to impact current medical and husbandry decisions. Genetic analysis seems to have started with a “name-that-breed” approach wherein pet owners could submit samples to determine pure bred status of their pet or specific breeds contained within a dog of unknown origin. While the novelty of such testing is appealing, little medically applicable information is likely gleaned from such superficial analysis. The decision matrix for whether or not to perform a diagnostic test is fairly simple in my opinion: Will the test result change anything? The answer to that question regarding genetic analysis is evolving. Recent developments in canine genetic analysis testing do allow for medical intervention and disease prevention.

 Two commercially-available canine genetic test panels provide results for more than 200 different health-related issues from joint dysplasia to nasal pigment loss to urolith formation.

Genetic testing and recognition of point mutations and their impact on overall health may allow for the most individualized veterinary medical approach to care to date. For example, if a kitten is determined to possess a point mutation associated with renal disease, the attending clinician can make recommendations to the owners to feed a low-protein diet as early as 6 months of age. Additionally, more intensive monitoring of urinary output and specific gravity earlier than traditional recommendations of 7 years or older would be appropriate and allow for earlier recognition of renal compromise followed by more effective intervention. The conversation regarding avoiding the feeding of table scraps to a Maltese puppy takes a more serious and significant tone if the puppy is determined to be genetically predisposed to pancreatitis. Currently, several complex diseases are correlated with specific canine genetic markers: hip dysplasia, granulomatous colitis (GC) and idiopathic epilepsy.

Another lesser-known area of research is individual sensitivity to different pharmaceutical products. Point mutations can indicate a propensity for pharmacological sensitivity allowing veterinarians to move beyond the old adage “White on feet, don’t treat” and make informed decision on individual patient sensitivities. Imagine being able to predict gastrointestinal upset associated with doxycycline administration? Certainly, if a patient has a propensity toward sensitivity to the only effective antimicrobial available for their clinical condition, clinicians should not withhold treatment. Rather treatment should be initiated along with mitigating ancillary care such as antihistamines and even probiotics to support that ever-important microbial flora. While genetic testing and understanding of the ever-enlarging role of the gut microbiome are surely driving a revolution in preventive veterinary medicine, neither exists in a vacuum and both emphasize the importance a holistic approach to the veterinary patient.

Genetically based preventive care may seem like Star-Trek stuff to most practitioners (and it kind of is), but there is no reason that veterinarians should fear the future or avoid integration of all available tools into treatment regimes. However, talking with geneticists can be intimidating. The universe of genetic medicine naturally has its own vocabulary. So, what are the most common, yet important, terms to know and why? A critical term to understand is “penetrance.” Penetrance is the likelihood that a clinical condition will occur when a particular gene or mutation is present.

 For example, if a shih-tzu has SLC2A9 (Exon) – chr3 mutation

 present and that mutation has an 80% penetrance and is linked to urolith development, then that dog is almost for sure to develop uroliths in its lifetime vs if the mutation only has a 5% penetrance. Another term of art when discussing genetic testing for prevention is “linkage.” Linkage is tendency for genes or DNA segments that are close to each other on the chromosome to be inherited together.

 Such tendencies are important when relying on “linkage analysis.” Linkage analysis is a technique used to infer the presence of a disease-causing gene by identifying other genetic markers that are known to be near the target gene and are typically co-inherited. It is basically the genetic analysis equivalent of being guilty by association. Dogs that are positive via linkage analysis are a bit trickier to interpret. For example, if a corgi is positive for the FGF4-chr12-chr12 gene, the dog may not be more likely than any other corgi to develop intervertebral disc disease (IVDD), experience an IVDD event, or require surgical intervention for IVDD. However, if the corgi has multiple copies of this mutation, the dog is approximately 46 times more likely to have an IVDD event

 and approximately 5 to 15 times more likely to require surgical intervention

 for an IVDD event than a corgi without the mutation. Such hard statistics and professional lingo are sure to encourage more chondrodystrophic breed lovers to purchase at least one more set of stairs for their beloved pups, right?

While preventive veterinary medicine may not be the newest clinical approach, it has surely stood the test of time better than any other. With the evolving understanding of the importance of the gut microbiome in the immune response and the break-neck pace of genetic discoveries, preventive veterinary medicine is definitely cool again. So, let’s put down our firehose long enough to start looking to prevent clinical fires rather than simply arriving on scene in time to put them out.

Preventive medicine. Encyclopædia Britannica, Inc. Accessed August 11, 2022. 

https://www.britannica.com/science/preventive-medicine

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Dolieslager SM, Riggio MP, Lennon A, et al. Identification of bacteria associated with feline chronic gingivostomatitis using culture-dependent and culture-independent methods. 

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Leeb T, Müller EJ, Roosje P, Welle M. Genetic testing in veterinary dermatology. 

Rokhsar JL, Canino J, Raj K, Yuhnke S, Slutsky J, Giger U. Web resource on available DNA variant tests for hereditary diseases and genetic predispositions in dogs and cats: An Update. 

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Hayward JJ, Castelhano MG, Oliveira KC, et al. Complex disease and phenotype mapping in the domestic dog. 

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NCI Dictionary of Genetics Terms. National Cancer Institute. Accessed August 11, 2022. 

https://www.cancer.gov/publications/dictionaries/genetics-dictionary/expand/P

Donner J, Kaukonen M, Anderson H, et al. Genetic Panel Screening of Nearly 100 Mutations Reveals New Insights into the Breed Distribution of Risk Variants for Canine Hereditary Disorders. 

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Brown EA, Dickinson PJ, Mansour T, et al. 

 retrogene on CFA12 is responsible for chondrodystrophy and intervertebral disc disease in dogs. 

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Batcher K, Dickinson P, Giuffrida M, et al. Phenotypic Effects of 

 Retrogenes on Intervertebral Disc Disease in Dogs. 

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During this interview with dvm360®, Melody Martinez, CVT, president-elect of the Multicultural Veterinary Medical Association, shares her journey to becoming a veterinary technician, and why she believes awareness months are important for educating the public on different demographics and identities. 

The following is a partial transcript of the video.

: If I am really thinking about the importance of these... observed time periods I think it is important because it brings awareness to a specific demographic or specific identity...there is a symbolic important meaning behind these months and it allows us to remember that our country [and] our society is not made up of just one kind of person. 

Videos

In a dvm360® interview, Melody Martinez, CVT, outlines her career in veterinary medicine, and shares the importance of awareness holidays 

Meet MCVMA president-elect: Melody Martinez, CVT

The American Veterinary Medical Association (AVMA) has exceeded 100,000 members, furthering its growth and increasing its standing as a prominent voice for veterinarians nationwide.

 AVMA membership consists of approximately three-quarters of all US veterinarians, including members in every US state and territory and over 60 countries.

“Almost 160 years ago, about 40 veterinary surgeons from seven states gathered in New York to form what became the American Veterinary Medical Association,” said Janet Donlin, DVM, executive vice president and CEO of the AVMA, in the release. “We are so immensely grateful for the support and commitment of our members, and we are honored to serve them in all that we do, from policy, resources, tools and continuing education, to important advocacy work, insurance plans and so much more."

“When I reflect on the scientific advancements, education, training and expert care that have brought us to this day, and the dedication, compassion and service that our members deliver for our patients and clients on a daily basis, I see an innovative and ethically grounded profession with an amazing past and a very bright future. As always, we are stronger together,” Donlin added.

Millennials (those born between 1981-1996) consist of the largest generation represented in the association’s membership at 37.2%, but AVMA members range from the Greatest Generation (born 1901-1927, at 0.3%) to Generation Z (born 1997-2012, at 0.4%).

Additional generations represented include the Silent Generation (born 1928-1945, 6.2%), Baby Boomers (1946-1964, 25.8%) and Generation X (1965-1980, 30.1%). Those who identify as female consist of 61.5% of AVMA membership (up from roughly 50% in 2010), meanwhile those who identify as male represent 38.4% and those identifying as nonbinary comprise 0.1%.

Reaching 100,000 members is a significant milestone, according to AVMA President Lori Teller, DVM, DABVP (canine/feline), CVJ. This displays the success of AVMA’s efforts have been in meeting the evolving needs of the profession and society.

“Most of our current members can’t remember when society transitioned from horse-and-buggy days to automobiles, and the profession transitioned as well,” she commented, in the release. “The AVMA was there for its members then, and now, as we increasingly incorporate technology into our practices, the AVMA is here to help veterinarians utilize technology appropriately, not be replaced by it.

“The veterinary profession is vibrant because people can do a variety of things with a veterinary degree, and a diversity of opinions allows the AVMA to continue to be relevant,” Teller added. “The AVMA is known as the great convener because we are able to bring together people from diverse backgrounds to work together to find real solutions to problems that everyone can utilize.”

AVMA membership surpasses 100,000. News release. American Veterinary Medical Association. September 20, 2022. Accessed September 23, 2022. https://www.avma.org/news/press-releases/avma-membership-surpasses-100000

The 100,000 milestone signifies a nearly 20% increase in membership over the last decade

AVMA surpasses 100,000 members

Yesterday marked the first day of fall! As you dust off your sweaters, pull out the Halloween decorations, and enjoy a pumpkin coffee, be sure to bring along your phone, laptop, or tablet to catch up on dvm360.com’s latest stories.

Here is what was popular this week on dvm360.com:

 of The Vet Blast Podcast, Jessica Trichel, DVM, sat down with Adam Christman, DVM, MBA, to discuss tips and tricks for those interested in opening their own veterinary practice.

 with dvm360®, Denise Rollings, CVT, VTS, offered an inside look into a lecture she will be delivering at the upcoming Atlantic Coast Veterinary Conference next month in Atlantic City, New Jersey.

In honor of National Cat and Dog Gut Health Awareness Day on September 21, 2022, we put together 3 must-read 

 on gut health in pets, and its importance to overall health. 

During his lecture at the 2022 Fetch dvm360® Conference in Kansas City, Missouri, Steve Dale, CABC, 

 how post-pandemic life has led to an emergence of canine separation anxiety cases.

Earlier this week, the University of Kentucky’s Gluck Equine Research Center 

 the four 2022 inductees to the Equine Research Hall of Fame. 

Have you registered for our Atlantic Coast Veterinary Conference? Don’t worry there is still time! Join us on October 10-12 in Atlantic City, New Jersey, for a week full of fun and education. Register 

News wrap-up: This week’s headlines, plus tips on starting your own practice 

, Denise Rollings, CVT, VTS (Dentistry) expresses her interest in attending general practice topics at the Atlantic Coast Veterinary Conference (ACVC) including some behavior lectures. She also explains the benefits conferences like ACVC can have for attendees. 

I'm actually looking forward to attending some of the behavior [lectures]. I've been in dentistry for a decade, so I am way out of practice in general practice, especially in nutrition and behavior. 

Denise Rollings, CVT, VTS (Dentistry) discusses what ACVC sessions she is looking forward to attending

Denise Rollings, CVT, VTS (Dentistry) shares her excitement for ACVC

Merck Animal Health has signed a definitive agreement detailing to acquire Vence, a privately held company specializing in virtual fencing for rotational grazing and livestock management, from its founders and shareholders.

the acquisition is expected to be completed in the third quarter of 2022, subject to customary closing conditions. Specific terms of the agreement were not disclosed.

“The acquisition of Vence will broaden our portfolio with complementary products and technologies to advance animal health and well-being as well as outcomes for our customers,” expressed Rick DeLuca, president, Merck Animal Health, in the release.

“Vence is a natural fit with Merck Animal Health’s growing portfolio of animal intelligence products that include identification, traceability and monitoring products. This new technology will give cow-calf producers the ability to track their cattle and the ability to move them from pasture to pasture,” he added.

Vence delivers advanced technology for producers and ranchers to track, monitor, and manage cattle movement via a high-tech platform of virtual fencing solutions to promote rotational grazing. Vence’s virtual fencing technology can decrease the need for fencing to subdivide pastures. It also enables producers and ranchers to manage their cattle and grass inventory, while reducing costs of labor and fencing materials.

“I believe that Merck Animal Health is the best long-term home for this technology and our team. Their unparalleled expertise in the livestock space, ability to develop and scale hardware products, high-quality customer support, and a strong global footprint to expand Vence’s market reach make us really excited to join Merck Animal Health,” said Frank Wooten, founder and CEO, Vence.

Currently, Vence technology is available in the US and parts of Australia.

Merck Animal Health to acquire Vence. News release. Merck Animal Health. September 22, 2022. Accessed September 23, 2022. https://www.businesswire.com/news/home/20220922005501/en

Vence is an ideal fit with Merck Animal Health’s expanding portfolio of animal intelligence products featuring identification, traceability, and monitoring products 

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