I have highlighted 3 individuals who are leading the charge to make veterinary medicine more diverse, equitable, and inclusive. Recently, I had the honor to sit down with all 3 to ask what drives them and how others can follow in their footsteps.

Their answers were not surprising, but inspiring. All of them believe in the need to make veterinary medicine reflect the society in which we live and in their passion for a better veterinary space. Additionally, and not unexpectedly, all 3 believe in giving back to their communities. Below is a transcript of our conversation:

Juan Sebastian Orjuela, affectionally called Juancho, is a fourth-year veterinary student at 

, University of Guelph in Canada. During his time in vet school, Juancho looked around and did not see many students who looked like him. Many of us would have been discouraged but Juancho decided to do something about it. With the goal of representation in mind, Juancho cofounded the 

 (LVMA) to form a community of Latinx excellence in veterinary medicine. LVMA is open to veterinarians, veterinary professionals, students, pet parents, and allies. Additionally, Juancho is a proud member of the LGBTQ+ community.

Prior to vet school, Juancho attended the University of Wisconsin-Milwaukee. He credits his hard work ethic to having been an immigrant child. When he was just 10 years old, he and his family emigrated to Minneapolis, Minnesota, from Bogotá, Columbia, to follow other family members.

In Bogotá, Juancho’s mother was a textile designer. His father was a lawyer and ran for governor of Bogotá. Following his unsuccessful run for government, the family decided to emigrate to the United States. In Minneapolis, Juancho’s father took a job as a line cook to build a base for his family and his mother was a school cleaner. Juancho’s life is the typical immigrant story of the desire to build a better life for the next generation.

 My parents are my biggest superheroes. If it was not for them, I would not be here. Also, in third grade, I was offered a job to walk puppies. I found my mentorship through squeezing out information from other people and always questioning things and being very curious. That gave me the confidence to pursue this career. I double majored in biology and in conservation and environmental sciences in college. I also started the first preveterinary club in college.

: Coming out was really tough. I had a lot of pressure. My dad was a politician and lots of our life [consisted of putting] out a vision of our family. That caused me lots of difficulties. I thought I would be disowned. I have always been someone who was unapologetically myself; I don’t care what others have to say. I grew up really fast. I came out to my sister first. I came out last to my dad. My mom was super embracing. My mom is my number 1 fan. Following family conflict, today my dad is my second number 1 fan.

I have always had an entrepreneurial mindset. I have always been interested in law…and…I always wanted to be a servant to the people. My struggles, being told that I was not good enough to get into vet school, fueled me when I got into vet school to do something. I got into vet school and did not feel fulfilled. I felt very underrepresented. I saw zero veterinarians on social media who were Latino. I started networking with folks in the community [and] that’s when I met the other cofounder of LVMA. We joined forces. That’s when we created the mission, vision, and logo of LVMA. It was during my second year of vet school.

: How can we get other Latino/Latinx veterinarians and veterinary professionals to support the LVMA mission?

: We want to put [out] a call to action and need support from others to be part of our organization. We want the purpose to be Latinx support. We want to represent more and better. Veterinarians who are Latinx need the support. We need to serve this community which is currently underserved. We want to represent veterinary professionals and veterinary students. Most of what we are doing is to help veterinarians and veterinary students.

: I am interested in emergency medicine. I’ve always been passionate about creating change in the profession. I am a believer in being the change you want to see in the world. I see a gap and I go to fill it. That’s why I costarted the LVMA, that’s what defines me. There is so much in this profession that needs to change. I want to do more things [and]…make things better. I want to create something to make life better…to elevate veterinary medicine and have an impact. I want to help more people.

Prior to finishing our interview, I attempted to recruit Juancho into a veterinary role with my organization. I have no doubt that wherever he lands, he will continue to positively affect veterinary medicine and help patients in need. Any hospital would be lucky to have him.

Mariliz Hernandez, DVM, is the proud owner of 

 in Queens, New York, a successful multidoctor 

-accredited hospital that is focused on high medical standards. Hernandez was born in Puerto Rico and attended the University of Puerto Rico in Arecibo. In 2002, she received her doctor of veterinary medicine degree from the 

College of Veterinary Medicine at Tuskegee University

 in Alabama. Her interests include primary medicine, surgery, and dermatology, as well as communicating with her Spanish-speaking clients.

: What do most people not know about you?

: I have a fraternal twin, a brother, and I have a younger sister. I lived in Puerto Rico for 23 years before I decided to join the veterinary program [in Tuskegee]…This was always a dream of mine. A lot of people thought I wasn’t going to make it, that it was just me desiring a beautiful career. I guess I proved them wrong at the end. It was always something I was very consistent [about]. You know that kids can change; I never did. I was very focused on that goal and it was very difficult at the time because usually in Puerto Rico, as you know, there’s no veterinary program.

: I went there because it was a minority school and the most important thing for me was finances but also the surgical [opportunities]. It had the surgical experience I was looking for because I’m very crafty and I love doing things with my hands. I ended up finding my husband there. [Hernandez is married to another veterinarian]. It was one of my best experiences in the middle of Alabama, in the middle of nowhere, and it was a great school.

: As a native Spanish speaker practicing in Queens, what can you tell me about your Hispanic, Latino, and Latinx clients?

: They’re my heart. They’re communicating in Spanish. When you practice and they know you know Spanish, their eyes open up, their shoulders go back, they relax, they understand.

: What is your management style toward hospital culture and staff retention?

: If they don’t fit in, they have to go. If you’re comfortable here, you stay. …I don’t even give them [doctors] a contract. If it’s meant to be for them to be here, they can be here. If they don't want to be here, I don’t want any disgruntled employees; [they] can go. [This] has been the foundation since I bought the place with my husband.

I would tell my younger self to work hard, be fair. And I would say be very frank and clear. Just don’t leave anything inside, express yourself in a very respectable way and try to…communicate to the client the truth straight in the eyes.

: We work as a team. I will never take full credit for my success. It is the people behind me that are watching my back and are my right hand. They’re the ones who are keeping me in business, and, of course, the trust of the clients. And the reason they trust me is because they’ve seen the good outcome. They know we’ve come from a good side. [They] know we want the same goals that they have to get their pets better. And if I am wrong, I have no problem saying I’m wrong because it is the way that we grow. We’re growing every day, and medicine, as you know, doesn’t stop improving. So imagine, at an emotional level, we’re constantly evolving and in order for you to continue evolving, you have to be open and receptive. I was really tough before, I wouldn’t even care. Not anymore. I let go. It’s much easier that way.

What are you doing with Tuskegee to help that next generation of veterinarians?

: I made a studio just for my [Tuskegee] interns to stay in. They don’t have money to stay anywhere. That’s free. You stay there and make it your own little bedroom and that’s it. And you stay there until you go. Because I was there and I had an amazing veterinarian student from Tuskegee that lent me her house with my cat at that time. You have to remember where you came from and how hard it was.

After such a tough, nearly 2 years, what keeps you going?

: I think the resilience is part of it. It’s a survival skill that comes in our DNA also. No one is going to hand it to you when you get out of your country. You want to be the best of the best to represent your country. And I think that’s in your DNA. So yes, resilience comes in our DNA and there’s no time for failure. You try and if you fail, you pick yourself back up.

: Stop doing things to impress others. Do it for yourself. You’re grown up now. You have to be happy. If that idea of being a veterinarian made you happy, go there. Find the right place, a place that can nurture your passion. I don’t want to impress anybody. I want to impress myself now. I did everything I had to do to make my parents proud. Hopefully my husband [and] my kids see what I’m doing, and I think I’m so comfortable with myself now that I hope I can inspire them too. But I’m doing this for me now.

As we continued our interview, I found myself talking with Hernandez as if she was an old friend. From the outside, it looks like she has it all. She has found a way to have a family and a successful practice and has kept her passion in place. Her humility is understated. Lastly, she reminded me again that she would not be here without the help of her doctors, staff, and hospital manager, Kyle.

 of the American Veterinary Medical Association (

) and the first Latino to hold that position. Born and raised in Puerto Rico, Arce attended Louisiana State University in Baton Rouge for his undergraduate degree and 

Louisiana State University School of Veterinary Medicine

, where he earned his doctorate in veterinary medicine. He further completed a clinical internship at Rowley Memorial Animal Hospital in small animal medicine, surgery, and emergency medicine. His medical interests include dermatology, ophthalmology, soft tissue surgery, and ultrasonography. He is also co-owner, with his wife, of 

 in San Juan, Puerto Rico, and is active in the 

Colegio Médico de Veterinarios de Puerto Rico

From a young age, Arce had a passion for animals and science and knew he wanted to be a veterinarian. He was exposed to animals on his grandfather’s farm and kept fish in aquariums while growing up. Eventually, he combined his passion and love for both and pursued the “perfect career.”

: What led you to get involved in organized veterinary medicine?

: Giving back to the profession. It’s part of why I got involved in organized veterinary medicine. My dad was involved with the American Medical Association and so it was a natural thing to me to get involved in the AVMA. I started at the Student AVMA (SAVMA).

: What is your secret to keeping employees engaged?

: I think it’s about developing that relationship with them, trusting you know them and not micromanaging everything.

: I think you have to take one day at a time and remember why you became a veterinarian. We’re all in this together to make a difference, to make the life of our clients and our patients better. And I would just encourage everyone to fight through these stressors because, at the end, I think this is the best profession on earth. I really think that most of us are here because we really think that this is a great profession. Personally, sports helped me a lot. One of my stress relievers is playing soccer. It could be walking, running, whatever. Also, separating yourself from the practice after you come home. Good nutrition is important too. If you’re going to have an unhealthy life, it’s just going to make things worse.

: How does it feel to be breaking down barriers in veterinary medicine?

 know it feels good. I feel very proud of it. At the same time, some responsibility comes with it. I’m trying to do the best job and lead by example throughout my presidency. I hope my being present in AVMA attracts other minorities. Whether [they are] Hispanic or Black or Asian American, it doesn’t matter. If I did it, anybody else can do it. When I started getting involved with SAVMA and later at the AVMA, I felt welcomed. Sometimes you hear about discrimination and I never felt that within veterinary medicine being Hispanic.

: How do we make veterinary medicine more accessible to underserved minority communities?

We have to get to these areas. We’re not there yet. The underserved communities are something we have to reach out to by getting kids from these communities interested in becoming veterinarians. That’s going to change and we’re going to have veterinarians in the middle of some of these underserved communities for the rest of our lives. We just need to get that interest, tell them that you can be a veterinarian if you’re from South LA [Los Angeles] or from the Bronx.

: I invite everybody from any background, …any type of practice, sexual orientation, or whatever it is, to get involved. Given the opportunity, get involved: whether it’s in your county VMA [veterinary medical association], your state VMA, the AVMA, AAHA [American Animal Hospital Association], or whatever association…, [you] can make a difference.

Arce knows he has a large task ahead of him and he is facing it head-on. His commitment to veterinary medicine and his need to serve is admirable and infectious. When we sat down, he was 45 days into his AVMA presidency. His 

Promoting AVMA diversity and inclusion in membership and leadership

Improving the student debt-to-income disparities in veterinary medicine

Promoting the health and well-being of veterinarians and veterinary students

Articles

This operations support manager engages in a Q&A with 3 figures in the veterinary field striving to make the industry more diverse, equitable, and inclusive. 

Shattering the glass ceiling in veterinary medicine

Laura Champagne, CVT, BS (Veterinary Technology), Surgery & Anesthesia Nurse at BluePearl in Waltham, Massachusetts, began her career at 

 in 2016. However, like many others who pursue a career as a veterinary technician, veterinary medicine was a second career. Prior to a career in pet health, Champagne obtained a bachelor’s degree in English, and took steps to attain master’s degree in teaching. She worked for several years, but nothing seemed to fulfill her.

Although Champagne had little exposure to the veterinary field while growing up (other than family veterinary visits), she recognized her love for animals at a young age. She decided to follow her passion and return to school for a career in veterinary medicine in 2012. During school, she interned at various pet hospitals, including BluePearl. After graduating with a Bachelor of Science in Veterinary Technology, she landed her first job at BluePearl as an Advanced Patient Care Associate. She immediately fell in love with the medicine and science aspect of the role, the challenge of pet health, and the diversity and variation of each day’s work, specifically surgery.

“When an adorable dog or sweet cat comes into the clinic and I get to love on them, there is nothing better,” said Champagne. “I have an innate love for animals and a passion for science, so a career in veterinary medicine felt just right. I love fixing pets, specifically through surgery to remove bleeding or cancerous masses, repairing fractured bones/cruciate tears, or opening airways.

Although new to the field, Champagne says the 

 was very encouraging, and this helped her to advance within her role. After passing the Veterinary Technician National Exam, she quickly rose to a veterinary technician level 1, then level 2, then level 3. As a recognized leader within her hospital, Champagne was asked to run the technician internship program, which she did, from 2017 until 2020.

“My management recognized that I enjoyed teaching others and was really enthusiastic about learning, so I was able to take that and apply it to new interns who were in a similar boat that I was when I first started working at BluePearl. The feedback I always received while running the internship program was that we throw them ‘into the deep end’ and allow them to get hands-on with trying skills and working with patients, instead of hugging the walls and watching from the sidelines like many of the other hospitals do,” explained Champagne. 

“I think a lot of the techs and doctors are super encouraging and have patience to allow someone new to try practicing skills enough times to get really good and improve," she continued.

Shortly after Champagne got her footing at BluePearl, she began to look for ways to expose local high school students to veterinary medicine and animal sciences. In 2018, she started to research and visit local technical schools that did not have any animal science programs. The greatest luck she had was with Minuteman High School.

“I feel it’s important for people to be introduced to this career at a younger age, and it is lacking representation in primary education when I approached Minuteman, they were already thinking about starting a similar program, so the partnership was a perfect match," said Champagne. 

"It took 3 years of work with an amazing committee of people that wanted to see this program succeed to launch the program. Half of being a great nurse in veterinary medicine is the hands-on experience, and with a program like this, students can start gaining these kinds of experiences prior to stepping into a hospital,” she continued.

Minuteman High School added Animal Science to its list of career technical education majors for the 2021-22 school year. The Massachusetts Department of Elementary and Secondary Education approved Minuteman’s Animal Science program for Chapter 74 career/vocational-technical education status in June, with the help of BluePearl committee members.

Outside of work, Champagne has been a program coordinator of the Veterinary Medicine program presented by the Boston Leadership Institute each summer since 2018. It is a three-week program that offers students across the U.S. (and internationally prior to the COVID-19 pandemic) immersive courses that cover multifaceted aspects of veterinary medicine, including how to detect pain through physical examinations and how to analyze imaging from x-rays, MRIs, and CT scans.

“I worked with a surgeon in our hospital who coordinated the program for the first 2 years, and this past year, I took over as coordinator,” said Champagne. “I also coordinated a new one-week middle school program the Boston Leadership Institute started, only with a little less depth. I found it really rewarding to be able to engage and work with students that were from across the country, educating them and perhaps inspiring them to carry some enthusiasm and interest back to a specific area of animal medicine.”

Champagne is currently applying to advance to veterinary technician level 4 through BluePearl’s career pathing platform, 

. CareerTrax is the industry’s largest electronic career pathing platform, which supports a first-of-its-kind leveling and compensation structure. Champagne is also applying for her VTS (Veterinary Technician Specialty) certification in Anesthesia & Analgesia, with hopes to attain this by 2022.

Beyond these goals, Champagne wants to continue to foster a relationship between BluePearl and other local clinics, hospitals, farms for the students to participate in co-op possibilities during their senior year. A specific long-term goal is to help develop an on-site clinic, staffed primarily by students, on the Minuteman High School campus which provides general practice care for community pet owners at lower costs.

“Minuteman program is mainly capable of working with small animals, but I hope it can grow into utilizing large animals and potentially exotic, marine, or wildlife animals,” said Champagne. “As for me, personally, I really enjoy being a source of support for new coworkers who are learning the ropes of our hospital and may need help with odds and ends; things that aren’t necessarily ‘tech’ questions."

Champagne summed it up by demonstrating her core values and passion for for the profession. "I believe supporting one another helps us do our best on a daily basis and this uplifts the level of medicine we practice. I am simply passing along the insights and encouragement that was given to me when I first started in the field, because I know I am only as skilled as I am today because of those who taught me.”

Laura Champagne, CVT, BS (Veterinary Technology), BA, is a level III Surgery & Anesthesia Veterinary Technician at BluePearl Specialty and Emergency Pet Hospital in Waltham, MA. She is also the interim secretary for NAVAS (North American Veterinary Anesthesia Society) and sits on the New Programs Development Board for Minuteman Regional Vocational Technical School. She also is an instructor for the Boston Leadership Institute–Veterinary Medicine Track, and member of MVTA, NAVTA.

BluePearl veterinary technician shares her unique journey into the veterinary sector and how it's inspired her mission of implementing animal science education into high schools and technical schools.

More than a career: A level 3 veterinary technician shares her incredible career path journey

Phlebotomy is a skill practiced daily by veterinary technicians. Blood samples are used for numerous diagnostic tests that guide patient care. While it seems some technicians can “hit” every vein they look at, it is a skill that can be developed and mastered by any technician with time and practice. During a session at the recent Atlantic Coast Veterinary Conference, Karen Roach, RVT, VTS (ECC), of Mount Laurel Animal Hospital in New Jersey, discussed phlebotomy tips for technicians.

The ability to obtain blood samples rapidly without altering cells in the sample is essential to maximize diagnostic quality. Syringe, vacutainer, and needle size should be appropriate for the size of the patient. Syringes that are too large can damage cells and vessel walls with excessive vacuum. Roach reminds technicians to fill tubes appropriately, especially lavender top tubes, which contain EDTA, as an inappropriate ratio of EDTA to sample can alter cell morphology.

The timing of sample collection is also important to maximize accurate results. Cell degradation can begin as soon as the sample is collected. Additionally, administration of fluids and medications can alter results, so samples should be drawn from patients prior to administration of fluids and medications when possible. Patients who have eaten recently may have lipemic samples, which can interfere with some test results. Consider recommending a fast prior to scheduled blood draws when scheduling appointments.

When preparing a site for venipuncture, ensure that the skin is free from obvious infection and inflammation. Roach notes that wiping the site with alcohol prior to venipuncture not only removes superficial contamination but also improves visualization by wetting down the fur and causing vasodilation of the vein beneath the surface of the skin. Full sterile preps should be performed if sampling is being done for blood cultures.

Finally, patient fear, stress, excitement, and struggle can alter some values, such as white blood cells (ie, presence of a stress leukogram), cortisol, and blood glucose (especially in cats). Repeated sampling from the same site can also increase leukocytes and platelets in the area, which could confound results. If a technician notes that any of these events are occurring, they should note it on the patient chart and inform the veterinarian in charge of the case to help aid in the most accurate interpretation of results.

There are numerous sites available for venipuncture in canine and feline patients. The most common sites are the cephalic and jugular veins, the lateral saphenous vein in dogs, and medial saphenous vein in cats. For patients who may be hospitalized, the cephalic vein should be avoided for venipuncture as it is the preferred side for placement of an intravenous catheter.

Roach reminds technicians that proper restraint is critical for successful phlebotomy. The handler is responsible for positioning the patient in a way that maximizes visualization of the vein while maintaining patient and staff safety and minimizing patient stress. If a vein cannot be palpated or visualized, Roach does not recommend poking blindly as it is “doomed to failure and causes unnecessary discomfort to the patient.” Following sample collection, pressure should be applied to the site for a minimum of 30 seconds. For patients with known coagulopathies, additional pressure will be needed.

Roach shared several positioning tips with her audience:

For jugular venipuncture, patients can be in sternal or lateral recumbency with the head and neck extended. This vein tends to roll less than other veins.

For neonates, holding the patient with the head down and inserting the needle in a caudal direction for jugular venipuncture will allow blood to pool in the direction of the needle and improve sample yield.

For the lateral saphenous, placing the patient in lateral recumbency is ideal, though some patients will tolerate this from a standing position. The vein will roll easily and will need to be stabilized, usually by the phlebotomist.

The medial saphenous vein can be used in both dogs and cats and requires patients to be placed in lateral recumbency. A butterfly catheter and vacutainer are helpful to use when drawing blood from this site.

Finally, Roach discussed handling considerations for fractious and fearful patients. “We really need to get away from the culture of calling in 5 staff members to lay on a dog to get blood from it,” she said, “By causing undue stress to our patients, we are just making things worse for the next time.” Instead, she recommends using Feliway spray for cats, spending time with canine patients to improve trust, and using minimal restraint and distraction when possible. In cases where a blood draw is planned, premedicating patients with trazodone and/or gabapentin, depending on the species, can be very helpful. In some cases, chemical restraint in the form of injectable sedation will be necessary.

Some patient characteristics or disease conditions can make venipuncture especially challenging, even for the most skilled technicians. Roach shared several tricks to improve outcomes:

Severe dehydration: administration of fluids by intravenous or subcutaneous routes may be necessary prior to sample collection

Hypotension: warm pack the site for 10 to 15 minutes prior to sampling, use 2 tourniquets, and pump the limb.

Peripheral edema: massage of the limb can redistribute fluid temporarily to improve visualization.

Obesity: use a longer needle for jugular venipuncture and don’t be afraid to press hard on the neck over the vein.

In some cases, other sampling sites must be considered when traditional venipuncture sites are not easily visible, scarred, swollen, or bruised. When a small sample size is needed, such as for a blood glucose or lactate reading or creation of a blood smear, the marginal ear vein can be used. Roach also notes the dorsal pedal vein can be helpful in obese patients or patient with peripheral edema, as the foot is usually less swollen and has less fat present.

Considerations for arterial blood sampling

In some cases, arterial blood samples are needed. These samples provide the best assessment of pulmonary function. There are several considerations when sampling arterial blood. First, a syringe containing a heparin anticoagulant should be used. These are available commercially or can be created by coating a syringe with lithium heparin prior to blood draw. Second, pressure should be applied for at least 1 minute following sampling and the site should be monitored for 5 minutes for hematoma formation or continued hemorrhage.

The dorsal metatarsal artery is used most commonly to collect these samples. Patients should be positioned in lateral recumbency. The needle should be inserted at the site where the pulse is best palpated. Alternative sites include the femoral artery and, for anesthetized patients, the sublingual artery.

Phlebotomy is an important skill for veterinary nurses to master. Taking a few moments to plan an approach through site selection, patient positioning, and collecting the appropriate-sized equipment can maximize outcomes. Reducing patient stress should be a priority when obtaining samples from dogs and cats to minimize alteration to the sample and prevent the patient from becoming more reactive for future blood draws. When blood draws become difficult, technicians should not get discouraged, but instead consider alternative approaches and sites to obtain the needed samples.

Dr Kaitlyn Boatright, a 2013 graduate of the University of Pennsylvania, is a practicing veterinarian and freelance speaker and author in western Pennsylvania. She is passionate about mentorship, education, and addressing common sources of stress for veterinary teams and recent graduates. Outside of clinical practice, Dr Boatright is actively involved in organized veterinary medicine at the local, state, and national levels.

Editors note: All veterinary technician content for this month is supported by Banfield Pet Hospital.

Learn how you can improve your skills as a phlebotomist to maximize successful blood draws by understanding what affects sample quality, proper patient positioning, and how to work with difficult veins.

Tips for technicians to improve phlebotomy skills

We hope you enjoyed the 2021 Atlantic Coast Veterinary Conference (ACVC) as much as we did! Following the success of our second in-person conference of the year, we are bringing a robust mix of the latest (and greatest) industry news and coverage. 

 for a safe, comfortable end-of-life transition for the pet and a considerate process for the owner.

identify your core values, passions, and purpose

 for a fulfilled life in and out of the clinic.

In this video interview, Chris Pachel, DVM, DACVB, CABC, offered insight on the 

This recent research demonstrates the significant 

 for patients, clients, and practices alike.

, plus he shared workable solutions to this “elephant in the room” problem.

Stay tuned on social media and dvm360.com for more veterinary news.

Check out this week's headlines and conference coverage.

News-wrap up: This week's veterinary headlines, plus highlights from ACVC

When it comes to correcting various behavioral conditions in patients, animal behavioral expert Christopher Pachel, DVM, DACVB, CABC, urged veterinary professionals to explore how dietary changes can help. During a recent dvm360

interview at the Atlantic Coast Veterinary Conference (ACVC), Pachel shared multiple factors he considers when investigating dietary changes regarding behavior—starting with quality.

“I tend to look at quality first and, in my opinion, that’s just as important for dogs and cats as it is for us. If we are eating poor quality foods, that gets reflected in our overall health as well as a general feeling of well-being,” Pachel informed dvm360 staff.

“So, I am looking at quality knowing that [quality] is a subjective way to look at that," he continued. "So the quality for me [is] that I’m really looking at the physical health of the animal and saying...‘does this really feel like it’s fitting these animals in terms of their individual needs?'”

To learn more, watch the full interview below.

Videos

During a recent interview, animal behaviorist expert Dr Christopher Pachel highlighted a few dietary changes to consider if you're looking to correct problem behavior. 

How can dietary changes help with correcting behavioral issues?

Hey everyone, welcome back to The Vet Blast Podcast. You know, we said this before on some of our other episodes about how amazing veterinary medicine is with technology. It is so innovative. Today I'm excited to learn more with our listeners too. We're going to be exploring new technology in veterinary diagnostics, and with us today is Ashley Wood, PhD, from 

I'm doing well. Thank you so much for having me. I'm excited to be here.

I'm excited, listen, I am excited to learn about this too. I've heard about it, but I wanted to hear it straight from you too.

So, to our listeners that aren't familiar with Ashley, a little bit about her. So, she joined Zomedica in 2019 to facilitate the development of 

[bulk acoustic wave technology] BAW technology

. You're [probably] like "what is that?" We're going to chat about for use in veterinary medicine. She now leads the company's research and development activities. Ashley's expertise is in the areas of molecular biology, cell biology, imaging techniques, and biochemistry.

Prior to her current role, Ashley was part of the R&D group at Swift Biosciences where she was responsible for creating market viable products as the lead scientist in the advancement of next-generation sequencing assays. Her responsibilities included assay development, bioinformatics analysis, and transfer to manufacturing. Ashley has also served as a research assistant professor and completed a postdoctoral research fellowship in the cell and molecular biology department at Northwestern University's Feinberg School of Medicine.

She has coauthored several papers that have appeared in industry prominent journals. She graduated with honors from Duke University with a degree in biochemistry and earned a PhD in molecular biology from Johns Hopkins University. 

Well, congratulations for all those accolades, my friend.

That's fantastic. And we have to thank our friends at Zomedica for sponsoring today's podcast. And you know what let's get into it, I mean, you must be just as excited as we are at the veterinary space about all the latest and greatest in point of care services. Now I've heard about this, I heard in the pipeline a little bit about B-A-W technology. So, to our listeners, why don't you kind of peel back the curtain a little bit and tell us a little bit about what that is?

Sure. I would love to. So, BAW, or B-A-W technology actually stands for Bulk Acoustic Wave technology. And what this is—this may sound complicated but it's actually very simple as we get into it—basically, this is a microresonator technology. And it converts electrical energy to mechanical acoustic energy and when it does this, it creates a very stable and precise oscillation. We'll get into a little bit more about how we use that. 

What I want you to know to begin with is the reason that we, at Zomedica, kind of focused on this technology, because these resonators are widely used in wireless technologies. So, they're in, you know, every cell phone that's out there, they're in Wi-Fi routers, they're in 5g cellular towers. So, this is a very simple, robust technology that really has widespread use. But what we've done and what's kind of different now is we're working with our partners at Qorvo Biotechnologies to adapt this BAW technology and make a biosensor. So, we're using a technology that's really well-vetted and has been used for years in wireless technologies and now we're bringing it to veterinary medicine as a biosensor, and that's what's new and innovative here. And what we're really excited to talk a little bit more about.

So, this has been around [it] sounds like? So, the BAW technology—do you love by the way to our listeners how I call it my Jersey accent 

I do. It sounds way more exciting that way, right?

So, tell me a little bit about how it works in the veterinary space?

Sure. So, what we're actually talking about is a resonator. This resonator is made of a piezoelectric material, and it actually resonates or vibrates at a very specific frequency. What's really cool about the BAW technology is that it's vibrating or resonating at a very high frequency, and that's important because that's how we get to the really high sensitivity of the sensor that we're using. But, what's also interesting is, we're using a kind of traditional chemistry, so we're creating immunoassays—and for those of you who aren't really familiar with what an immunoassay is—basically this is just using an antibody to detect an analyte of interest. So, the most traditional kind of immunoassay is called a sandwich assay, you basically have one antibody that recognizes your analyte of interest. Then that first antibody is called the capture antibody, it's usually immobilized on some sort of solid surface or bead, and then it captures your analyte of interest.

So, this is whatever molecule you want to measure in a sample. It could be for us, you know, TSH, or thyroxin, or something like that. Then you have a second antibody that can come on and it sandwiches that analyze that's why it's called a sandwich assay. We get that second antibody that comes on and recognizes the same analyte. So, this is how most immunoassays work. And we're doing that same chemistry. But what we're doing is we have a different way of detecting that chemistry. So, most devices that are out there are going to use something like optical detection or they're looking at radioactivity. But what we're doing is using this BAW sensor to measure when an analyte is present in the sample. We have a resonator that's our technology, our BAW biosensor is a resonator, and we take that capture antibody, and we immobilize it on the surface of the resonator. So, we actually attach that first antibody to the sensor, and then when an analyte binds and when a second antibody binds—you can imagine if you have something that's vibrating at a specific frequency when you get weight or mass on top of that sensor, it's going to slow down. I mean, that's just logical, right? If you put something heavy on something that's vibrating, it's going to start vibrating at a slower frequency and that's what we're actually measuring—the rate of vibration.

As you get more and more analytes on the surface of the sensor, it's going to slow down, and we measure that shift in resonance frequency, and then we just convert it to an analyte concentration. So, it's a really simple process, it's just all we're doing is measuring vibration, rates of vibration, and then how they change when a sample is applied to the sensor.

Give me an example then in vet med; how would that look like to us? And, you know, it sounds like it's really specific and sensitive too.

Yeah. So, we've developed a device called TRUFORMA, and we have 3 assays that are currently available, and we're developing more, but 1 of those assays is for TSH, so to look for thyroid diseases in both dogs and cats. And for that TSH assay, what I'm talking about, is a traditional sandwich assay. So, we put a TSH antibody, and we attach it to the surface of the sensor, then the sample flows over so we have microfluidics that allows that sample to flow over the sensor.

Any TSH molecules that are in that sample are going to be captured by that TSH antibody. We then release another second antibody, the detection antibody, and that flows over the surface of the sensor. And that second antibody is then going to recognize that TSH molecule as well. So, if a sample has a lot of TSH in it, it's going to slow down that resonance frequency more than a sample that has less TSH in it. And we have a standard curve that just allows us to convert that shift in resonance frequency to the concentration of TSH molecules in the sample.

That's incredible and so fascinating. It really is. So, it really is about those vibrations that you're talking about. Right?

Yep. And what makes it so kind of special here is that, again, it's about the sensitivity and the robustness of the sensor. So, this is what hasn't existed kind of in previous devices that might be available. So, because that sensor can resonate at such a high frequency that allows us to capture really low concentrations of molecules and a sample, and that's something that people haven't been able to do in this kind of device previously. Also, because the sensor is so robust, small, and cost-efficient, we can put it into a really small, pretty little package, that can be a device that can go just in the clinic. It doesn't have to be in a reference lab. It's not some huge piece of equipment. It's just a very small, concise device that can go just on the benchtop in a clinic.

I was going to actually say that I saw it online and I was like, "Oh my gosh," I thought when I was reading this I said, "This has got to be a huge piece of equipment." But coming into the veterinary space, I can tell you that space is a commodity and [when] I saw this I said, "Oh my gosh, this is literally like a countertop space," like it's almost even smaller than some of the centrifuges that I see out there.

It's tiny. We say it's like the size of a shoebox and I think it weighs about 7 pounds. I measured them a couple of times. But yeah, I mean, it's really small, it's really light, and you can move it around. Like if you needed to, you could move it from one place to another if things in the clinic are changing.

Yes. So, is this being done on the human side at all, then?

Yeah, so our partners, I think I mentioned Qorvo Biotechnologies, so that's who we're working with to develop this technology, and they are also developing assays on a very similar device for human medicine. So, they actually have 1 assay, it's a SARS-CoV-2 Antigen Test that actually just recently received emergency use approval from the FDA. That was really exciting. We're really happy to see that because this is really showing how BAW technology is advancing in medicine across the board. But we were able to bring this to veterinary medicine first because we don't have the same regulatory constraints that we have in human medicine. So just the timeline can be faster. But it's been a really cool process to see, especially [with the], lessons learned from both sides. Veterinary medicine helps human medicine and human medicine helps veterinary medicine, and then everybody, you know, advances.

Yeah, yeah, everybody advances too. You know, I’m thinking of the accuracy of something like this that you're using with the B-A-W technology, BAW technology. So, how can you be sure that BAW technology produces accurate results?

It's all about our development process. So, at Zomedica and at Qorvo Biotechnologies, we really have made an effort to make sure that we're taking all the proper steps to create really good, accurate, high-performing assays, and this starts from the very beginning. So, a lot of assays, I mean, this is just something that we all know happens in veterinary medicine, a lot of times, there's a human assay or human test that's created and optimized, and then it just gets validated for use in animals. But it really wasn't developed for use in animals. Well, Zomedica is taking a different approach.

From the very beginning, we are optimizing and developing our assays to work on the samples where we intend them to be used. Right now, we've been using dog and cat serum samples and plasma samples. And from the very beginning, whenever we do our testing, we're doing that testing on those kinds of samples, because we think it's important for our patients, you know, our animals, that we make sure these assays are optimized for use on them. Because there are differences, you know, between humans and animals, there are some differences that come about. So, if you have an assay that was, you know, made for use in humans, and then you're just using it in a cat, for example, you might not have the optimal performance, and one example of that is actually the TSH assay we were talking about earlier.

The TSH assay that's available right now, this one's a little bit different, was optimized for use in dogs. So, when you send out a TSH sample to the reference lab, you're actually getting—even if it's a feline sample—it's being tested on a canine test. Well, the problem with that is it works, and it's been validated, you know, you can measure TSH levels, but in dogs, you're really looking at high levels of TSH because you're looking for hypothyroidism and dogs where TSH levels become high. Well, in cats, cats tend to be hyperthyroid, so you're looking for very low TSH levels. Well, the canine TSH test doesn't measure low enough to really differentiate a normal healthy cat, it may just have a slightly low TSH from a hyperthyroid cat. So, that test doesn't have the sensitivity that you need to make the actual diagnosis. So, we've made sure when we were developing our TSH assay, we optimized the assay for use in canines, but also, we optimized an assay for felines, so our feline TSH assay can measure a lot lower than the canine TSH assay, and that's because that's where it matters, clinically. So that’s part of what we're doing that’s different and that makes sure not only are the results accurate, but they're also clinically useful.

But then just you're asking about accuracy. The other thing that we do is verification. We do validation on all of our assays—we're comparing the results from our tests to reference lab results, and we make sure that we're testing along the way we make sure all of our assays are functioning the way that we know that they should, and we're really comparing to what we consider a gold standard test to make sure we're giving the veterinarians an accurate result.

Right, right, and, you know, I was also thinking, as a general practitioner, if I have the TRUFORMA benchtop, do I have to run an accuracy test or, you know, quality control tests every day, or how does that work from a practical standpoint?

Yeah. This is a really good question. That's one of the things about this technology that makes it kind of unique. So as opposed to some of the other detection methods that might be using optical detection, where you really have to constantly be running calibrators and making sure the instrument is performing the same on a daily basis, our instrument really does not show any sort of drift over time, and we've shown this and so we don't require that kind of constant calibration on a daily or weekly or monthly basis. The other thing that we do is all of our reagents come in a disposable cartridge. So, that cartridge contains our calibration curve and is actually factory calibrated. So, you don't have to worry about any differences from one lot to the next, which is a lot of time what you're doing when you run those kinds of calibrators. All of that is done for you by the manufacturer. So, all you have to do with your sample into the cartridge, put it in the instrument, and let it go. Yeah. So, we don't require that kind of QC over a period of time and that's just because it's a different kind of sensor, different kind of technology.

You know, I want to share some interesting statistics, get a load of this. So hypothyroidism in dogs, one of the most common endocrine diseases with a prevalence rate estimated at .2% to 1.89%. That's pretty significant, and hyperthyroidism in cats is a significant cause of morbidity in older cats having an estimated prevalence of 4.5%.

Then this other statistic I always find interesting too, [this is courtesy of Qorvo.com], is Cushing's disease in dogs, another common endocrine disorder in dogs with an estimated incidence of one to two cases per 1000 dogs per year. The reason why I mentioned that to you is that I do think that we really need to start using more point of care services, you know? Because, you know, pet parents want answers yesterday or sometimes it's a matter of "Do I need to ship or refer this animal out when I have pending lab results?"

So, you know, to that point, how will the BAW technology enhance, you know, in-house diagnostic capabilities?

Yeah, and I think those statistics are exactly why we targeted these markets. You know, we think this is really a place where there's a gap right now, where veterinarians cannot do what they need to do. So we're trying to put control back in the hands of those veterinarians, so we don't want them to have to wait to get those results by sending a sample out to the lab or you know, the lab doesn't run samples over the weekend or on certain days.[If Veterinarians] have a patient that comes in on Saturday—we want them to be able to get their results on Saturday if that's what they need. By doing this, I mean, the issue has constantly been that you just can't get the same quality result in-house as you can when you send it out to the reference lab, and that's what we're trying to fix. That's why when we sat down and thought about, okay, what's missing? Why can we not provide the right result or the correct, or that most accurate or highest performance assay at the point of care? What we decided was that the problem is really the detector, it's not the chemistry, it's not the immunoassay, it's the detection method. That's why Zomedica went out and found a different detection method that we realized is actually superior to what can currently be done. And we brought this to veterinary medicine and said, “Okay, we're going to create a device that really gives veterinarians what they need at the point of care, and allows them to diagnose and provide, you know, better results to pet owners and for the patient also.”

Yeah. So, what's generally speaking, the turnaround time from when I insert it into the machine and then get those results?

So right now, our assays are 20 minutes or less and we're really going to stick around that time point because I think that's something that allows the right amount of time that they need the results while the animals in the clinic. They can get it if they want to wait, maybe run it a little bit later and just get it the same day they can. But, I think that's the timing that we've established.

Excellent, you know, listen, like I said, with curbside and whoever knows what the future holds in veterinary medicine. You know, it’s so helpful to have these tools and diagnostics at point of care services because me—as a dog dad myself—I want to make sure I know the answers and these are life-changing decisions that we might have to make too, so it's really important. So, I can't thank you enough for all the hard work that you're doing.

So, to our listeners that are tuning in, where can they find more information about all this, Ashley?

[Listeners] can go to our website, which is www.zomedica.com, and they should be able to find all the information they need on the assays that we have available at the moment and the instrument itself, and they can reach out we have contact information there if they want to reach out and they have additional questions, we would always be happy to talk to them.

Excellent. Ashley Wood and our friends at Zomedica, thank you so much for joining us today.

Thank you so much for having me. This has been a lot of fun. We love your podcast. So thanks for everything you're doing.

Thank you. This is why it's called The Vet Blast Podcast! And to our listeners thank you so much for tuning in. Thank you for all your hard work please stay safe out there and continue to stay pawesome. Take care everyone.

Podcasts

On this episode of The Vet Blast Podcast, Ashley Wood, PhD, director of research and development at Zomedica, talks with Adam Christman, DVM, MBA, about the application of bulk acoustic wave (BAW) technology to veterinary diagnostics, and how a new in-clinic biosensor testing platform is utilizing this technology to provide reference lab accuracy at the point of care. (Sponsored by Zomedica)