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May is Arthritis Awareness Month, which is a good time to review our approach to this common diagnosis in small animals.

Raising the standard: Arthritis awareness in veterinary practice

Pet Poison Helpline's recent installment of Toxin Tails shared the story of the Winters family, who all—including their 2 dogs—were diagnosed with ciguatera poisoning.

Toxin for one, toxin for all

From natural disasters to personal setbacks, veterinary professionals need to assess their financial risks, prepare strategically, and take control of their future with a plan that can weather any storm.

When it’s too late to prepare for the unknown and catastrophic

On this episode of The Vet Blast Podcast presented by dvm360, the Caring Pathways team joins Adam Christman, DVM, MBA, to talk all about end-of-life care 

Leveling up end-of-life care: Excellence, compassion, and the future of veterinary hospice

Videos

Kristin Kirkby Shaw, DVM, PhD, MS, DACVS-SA, DACVSMR, talks about how the condition causes changes in these felines’ mobility, quality of life, and how they interact with their owners

How osteoarthritis affects cats 

The National Veterinary Talent Acquisition Association offers resources for veterinary recruiters of varying experience levels through its membership

New association for veterinary recruiters is launched

Erica Brandt, CVT, VTS (ECC), hospital director at WestVet in Meridian, Idaho, discusses her Fetch On-Demand lecture "Shocking Voyage" in a dvm360 interview. 

Identifying shock in patients

Sixty-one students graduated with doctorate degrees in veterinary medicine, and are projected to help fulfill a critical need for animal health care providers in Texas and New Mexico. 

Texas Tech graduates first class of veterinarians

dvm360 connects veterinarians to essential medical news, veterinary expertise, and insights on pet care products and regulations.

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Dr. Sallie S. Hyman is an equine veterinarian and a veterinary writer in Purcellville, Virginia.

In addition to promising treatment options, veterinary equine researchers are working to identify horses at risk for laminitis before the debilitating disease sets in.

Recent advances in veterinary equine laminitis

An overview of how this debilitating equine condition affects the foot.

Anatomy of veterinary equine laminitis

Veterinary care is financially out of reach for many pet owners, a recent survey exploring pet owners’ experiences with veterinary care found. The same study found that more than half (52%) of US pet owners have skipped or declined necessary veterinary care for their pets despite 97% of pet parents considering their pets family.

PetSmart Charities-Gallup State of Pet Care Study: Pet Parents’ Assessment of American Veterinary Care

, conducted by PetSmart Charities and Gallup, interviewed 2498 cat and dog owners across the US between November 13, 2024 and January 9, 2025, on topics that included how often they take their pets to the veterinarian, where they obtain pet health information, and how well veterinarians offer services that meet the needs of themselves and their pets. Both web-based and mailed surveys were used to ensure representation from a broad range of pet owners, including those without internet access. Gallup also weighted the sample to reflect national demographics of US dog and cat owners, including gender, age, race, Hispanic ethnicity, education, and region, according to PetSmart Charities.

Veterinary care costs pose a concern for high- and low- income pet owners

In pet owners across different income levels, financial barriers were reported as a reason to forgo or decline veterinary care. The survey found pet owners in households with an income of less than $60,000 were most likely to avoid care due to affordability. Higher income earners, meanwhile, had a greater tendency of declining services they did not believe justified the cost. Still, in those earning $90,000 or more, a third reported skipping veterinary care due to financial constraints.

At the time of the survey, 52% of pet parents reported having not taken their pets to the veterinarian within the past year, even when they felt their pet needed veterinary care, or declined care recommended by a veterinarian.

 The percentage of these pet owners were particularly high among

Pet owners living in households earning less than $60,000 annually (55%)

Additionally, 57% of veterinarians said they were unable to provide patients with desired care due to client economic limitations, according to a 2017 survey on small animal veterinarians’ opinions and actions regarding costs of care, effects of economic limitations on patient care and outcome, and more.

According to the State of Pet Care Study survey, the most declined veterinary services were diagnostic procedures, including blood tests (22%) and preventive care, such as yearly examinations and vaccinations (18%).

Pet owners are aware of the risks of skipping veterinary care

Fourteen percent of pet owners who skipped veterinary care said their pet’s condition worsened, or their pet died. Only a third of those who declined veterinary care saw an improvement in their pet’s condition after skipping care.

According to the survey’s findings, 30% of pet owners said they knew a friend or family member whose pet passed away because the owner could not afford the necessary veterinary care. Seven percent of survey participants reported declining lifesaving surgeries for their pet. Additionally, 11% reported knowing someone who had to surrender a pet because veterinary care was too expensive.

Seventy-three percent of survey participants who declined care due to cost indicated not being offered a more cost-effective option. Of the pet owners who declined care that was not practical for them or their pet, 46% said they were not offered an option that better fit their needs.

“...While the most advanced care is an option that should be explored for pet parents, it should not be presented as the only option—or perhaps not even the first option—given the number of pet parents who have financial considerations and the robust research on first-recommendation bias,” wrote the authors of the State of Pet Care Study.

Sixty-four percent of pet owners said payment plans would make it possible for them to afford to pay at least twice the amount for lifesaving treatment for their pet. Still, less than 1 in 4 owners has ever been offered a payment plan, according to the survey’s findings.

Approximately 4 in 10 pet owners were interested in alternative veterinary care methods for their pets, such as community clinics (38%), home visits from a veterinarian (38%), or telemedicine (37%). Black pet owners (54%), 18- to 29-year-olds (48%), and those living in households earning less than $60,000 annually (47%) reported the highest interest in community clinics.

"The data show that many pet parents are not being presented with alternative care options that could make veterinary services more accessible, despite interest in such options," Zach Hrynowski, a senior researcher at Gallup, said in a news release.

 "Our analysis of the data points to a clear opportunity for the veterinary industry to expand affordable, flexible solutions that meet pet parents' needs."

Pet companionship offers extensive mental and physical health benefits, with the Human Animal Bond Research Institute estimating that pet ownership saves the US healthcare system nearly $23 billion annually.

Yet, approximately 50 million pets in the US lack access to appropriate veterinary care, ie., care that meets the basic standards, according to PetSmart Charities.

“The hope is the findings in [the]...State of Pet Care Study... will influence the evolution of veterinary care to include more affordable, flexible, and accessible models,” wrote Aimee Gilbreath, MBA, president of PetSmart Charities, in the study’s foreword.

 Robyn Jaynes, DVM, director of veterinary affairs at PetSmart Charities, stressed the urgent need for collaboration across the veterinary field to improve access to care, noting that change will require efforts from clinics, schools, and leaders alike. "The veterinary industry must unite to ensure every pet has access to care, as the magnitude of the problem is such that no one entity can solve this on their own," she said.

"Clinics should practice flexibility and focus on providing options that work for each pet family’s needs. Veterinary schools must train vets in spectrum-of-care practice and continue research supporting lower-cost models, and industry leaders need to drive innovation that also reduces costs. Together, we can build a system that meets families where they are, because access to veterinary care shouldn’t be a privilege," Jaynes continued.

According to PetSmart Charities, the organization has committed to $100 million to improving access to veterinary care. The charity is offering grant funding to expand affordable veterinary care clinics, support research on affordable payment options, investigate single-service models to help lower costs for pet owners, and more.

"We estimate the cost to ensure adequate care for all pets currently going without it is over $20 billion annually using traditional care delivery models," said Gilbreath.

 "Systematic solutions to this crisis go well beyond what 1 organization can provide—we need a united front from veterinary industry leaders, schools, practices and nonprofit animal welfare leaders to produce sustainable change."

PetSmart Charitites-Gallup State of Pet Care Study: Pet Parents’ Assessment of American Veterinary Care. Gallup, PetSmart Charities. Accessed April 17, 2025. 

https://www.gallup.com/analytics/659123/gallup-petsmart-charities.aspx

New study finds more than half of U.S. pet parents skip or decline needed veterinary care. News release. PetSmart Charities. April 16, 2025. Accessed April 17, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-study-finds-more-than-half-of-us-pet-parents-skip-or-decline-needed-veterinary-care-302429953.html

Kipperman BS, Kass PH, Rishniw M. Factors that influence small animal veterinarians’ opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and Burnout. 

Journal of the American Veterinary Medical Association

. 2017;250(7):785-794. doi:10.2460/javma.250.7.785

Nearly 1 in 3 pet parents says they know someone whose pet passed away because the owner could not afford the necessary treatment.

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Many pet owners cannot afford veterinary care, survey finds

Vet Watch Episode 1

Alice Jeromin, DVM, RPh, DACVD, and host Christopher Lee, DVM, MPH, DACVPM, open the premiere episode of 

 with a comprehensive exploration of how isoxazoline parasiticides have revolutionized ectoparasite management in small-animal practice. In the episode, Jeromin and Lee discuss the mechanism of action of these parasiticides, their extralabel uses, and the different isoxazoline products available, detailing their differences, doses, and duration. They also share diagnostic tips and anecdotes about older treatments before the advent of isoxazolines and talk about the challenges of public education on flea treatment, including incorrect use of products and more.

Check out the episode above to hear the full dialogue and deepen your understanding of these transformative compounds. Your next challenging case of unexplained pruritus may have a simple, science-backed solution.

Below is a partial transcript of the video, which has been lightly edited for clarity:

Today, we're talking about isoxazolines, or as they’re called, "isox." So to help everyone get on the same page—I don't know, the first time I heard of isox, I thought they were Bluetooth leggings that I had to have for some reason. So, what are isox? How do they work, and what are they?

 First of all, every veterinary dermatologist you can ask is in love with isoxazolines. We'll get into the reason for that later, but they are both insecticidal and acaricidal, which means they're pretty good at what they do for insects, fleas, ticks—that kind of thing.

Thankfully, we've got several to choose from. Their method of action is that they antagonize GABA [gamma-aminobutyric acid], which is...like a double negative. I always think of GABA as an inhibitory neurotransmitter. So they're antagonizing an inhibitory neurotransmitter, which in turn controls chloride channels. They also—at least in invertebrates—antagonize glutamate-driven chloride channels. So there's kind of a 2-fold mechanism of action in invertebrates, and invertebrates—like mammals, us—they do...the antagonism of GABA, which is a real long mouthful, but it just results in hyperpolarization, and then the being dies. We know that insects are much more sensitive [to] these GABA receptors than mammals are. So that's good because we don't want to have any of the neurological issues that can occur with some of these insecticides and acaricides, particularly the GABA-mediated ones.

 Yeah, it's great having that level of safety. And speaking of safety and just overall efficacy...you and I have both been practicing veterinary medicine for a while, so when we look at it and you have over 35 years of experience...for some of our listeners [who don’t]—let's kind of go back. I think you and I both remember 1993 when Frontline was first law. What was it even before that? Do you have any stories from [the pre-Frontline era]?

Alice Jeromin, DVM, RPh, DACVD—Before earning her DVM degree from The Ohio State University, Jeromin graduated from the University of Toledo with a BS in Pharmacy and practiced as a hospital pharmacist. She completed her veterinary dermatology residency with Patrick Breen and dermatopathology training at Procter & Gamble, Miami Valley Labs, as well as a fellowship in human dermatology at MetroHealth Medical Center, Cleveland, Ohio, with Bryan Davis. Jeromin is currently an adjunct professor at Case Western Reserve University, lecturer at Northeast Ohio Medical University College of Pharmacy, and former practice owner of Veterinary Allergy & Dermatology, Inc. She is a former member-at-large on the American Veterinary Medical Association's Council on Biologics and Therapeutic Agents as chairman of the supplements and compounding committees. Along with publishing in human and veterinary journals, she authored the dermatology chapter in 

Pharmacotherapeutics for Veterinary Dispensing

. Her interests include human-animal comparative dermatology and skin lipid research, with publications in both areas. Because of her pharmacist background of counseling patients, she is a strong believer in client education and maintains her website,

, for clients to be educated with evidence-based information, as well as her podcast, 

. The podcast is geared toward pet owners of allergic pets to provide them with accurate, evidence-based information.

Introducing Vet Watch! Christopher Lee, DVM, MPH, DACVPM, and Alice Jeromin, DVM, RPh, DACVD, discuss the clinical benefits and practical applications of isoxazoline parasiticides for year-round ectoparasite control.

Sallie S. Hyman, DVM, DACVIM, CVA

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