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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

Asking clients to record videos of their cat at home can play a major role in helping identify pain

Tips for identifying pain in cats

Tatiana Henriques Ferreira, DVM, PhD, MSc, DACVAA, and Marlis Rezende, DVM, PhD, MSc, DACVAA, discuss which types of cases are ideal for inhalant anesthesia vs total intravenous anesthesia.

Cases that use inhalant anesthesia

Practical suggestions for veterinary professionals

Supporting pet owning clients with cancer, and survivors

Elanco Animal Health’s ilunocitinib tablet (Zenrelia) was approved by the FDA in 2024.

Access to canine dermatitis therapy may soon expand to Europe

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

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Clinical

AI Masses is the seventh testing application for Zoetis' Vetscan Imagyst platform.

AI cytology tool for masses is launched

Kate Baker, DVM, MS, DACVP (Clinical Pathology) explained that although cytology can be challenging, it might be easier than you think.

A pathologist's guide to becoming more comfortable with lymph node cytology

Tick Tidbits: Ticking Off the 5 W’s on These Tiny Troublemakers 

Topics in suturing, cytology, and emergency care are presented by expert faculty for veterinary professionals

Unique labs provide hands-on training at Fetch Charlotte

Early diagnosis and treatment can help manage the disease and improve quality of life for affected patients. 

How urine albumin-to-creatinine ratio enhances CKD detection in dogs

Using lab values to identify disease that leads to aging

Brennen McKenzie, VMD, MSc, MA, director of veterinary medicine at Loyal, a biotechnology company, and a clinical practitioner, presented an education session on lab values at the 2024 Southwest Veterinary Symposium in Fort Worth, Texas. In an interview with 

®, McKenzie explained how changes in lab values help identify diseases that lead to canine aging, and be used as predictors. 

The following is a transcript of the video:

: [There are] a couple things that clinicians, I think, do with lab values that may be kind of problematic. One is, we get this idea of the normal range in our head. We take the reference interval and we look at it, and as long as the number is inside that box, everything's okay, and we don't have to worry about it. And I think most of us know, from some place back in our training, that the reference interval is just a statistical construct. You take a bunch of animals, you measure it [and] 95% of them fall in. That's the normal range, and that's considered okay. But it turns out that sometimes things can be outside of that range and still be normal, because 5% of the dogs had who were healthy had values outside that range. But also things can happen inside that box that are problematic, and you can see changes in trends over time that may be indicators of health problems, even though they haven't reached that cutoff threshold that we think of as normal.

What we found is that a lot of things that we often routinely measure can be associated with frailty and quality of life. So, for example, the liver enzymes, ALT and alkaline phosphatase. We measure them all the time. They're a routine part of clinical chemistry and practice, and if they're normal, we tend to ignore them. But both of those increase in dogs as they get older, and that increase is associated with declining quality of life and with an increased risk of frailty. And it may be that that's not causal. I don't think that the liver enzymes are causing those things to happen, but they're indicators. They're biomarkers. And the nice thing about that is they're easy to measure, because we measure them all the time already. So if we could find a way to use clinical lab values that we already are used to looking at in a new way as potentially predictors of problems, then that would flag certain patients for us for more intensive screening, for more aggressive therapies. You know, we would say, ‘well, hey, you know these 6 things, whatever they are, are going up in your dog, and they're still normal, but that's a bad sign that maybe something's coming in the future, and we should think about what we can do to improve weight, to improve diet, to improve exercise, to screen for diseases maybe that are subclinical.’ So that's our idea. These early associations with frailty and quality of life might be a trigger to us, and we could start paying more attention to some of these values before they hit abnormal.

Brennen McKenzie, VMD, MSc, MA, director of veterinary medicine at Loyal, a biotechnology company, and a clinical practitioner, discusses the use of lab values as predictors for disease. 

Conference

Learn how to start with in-house diagnostics

In house analyzers for veterinary care

And Dr. Clary, can you give me an example where, you know, we've had an opportunity where you've used in-house diagnostics on a patient that has really provided a good outcome?

Yeah. And that almost happens if not hourly, daily. With you know, with all this advent of the veterinary shows on TV, people see some of the care that's available. And they come in our clinic expecting that care. Well, with things like the Imagyst, our in-house diagnostics, we're able to really meet a lot of those needs that maybe weren't able to meet 10 years ago. With a shortage of veterinarians, the one thing I like about the Imagyst is it kind of spreads out the specialist...lets everybody have access to them without, you know, having to go to Dallas or far away from us. It's been a game changer for me, because even if I think I know it, if I have somebody backing me up, that client has a lot more belief in my abilities.

Yeah. And we have clients that say, I want to treat today, not tomorrow. And I know you had an example where it was a fecal analyzer that you were using, right?

Yep. In our part of the world. we probably go years without really diagnosing Giardia. Since we've had the fecal analyzer and stuff, it's a lot more common. We have a lot more animals this summer that had Giardia that I would have never diagnosed. And it's pretty neat to take in a picture that Imagyst takes...take it in here and show the client "Hey, this is how many are in there.” How many pictures of have hookworms? I had a cat where the coccidia was like 1200. Literally drives home the point, "Hey, this is what your animal has; this is how we're going to treat it." And those, I think we have a lot better client compliance with that those results because they can see it, you know, and we're such a visual society anymore. If you can't see it, you may not believe it. But can you see that picture? Like, "Oh, wow, how do we treat this?" And it’s done today; we’re not sending out for tomorrow. You know, I hear people say, well, most diarrheas will get better. I don't want diarrhea in my house for three days. I want to treat it now be done with it. And also I don't have to call the client back taking up valuable phone calls, phone time.

And you think a zoonotic perspective, Dr. Penn with something like this too. I mean sometimes I would have to wait two, three days to get a stool sample back. But now you know, you're worried about zoonotic risk. So, this is a great example, just what you were just talking about, right?

Absolutely. You have that report that you can literally say, "Hey, I would like to, you know...here's what we've got going on." To Dr. Clary's point, here's the medication that we're going to utilize to tailor an individualized treatment for your pet and the compliance from the pet owner, as Dr. Clary mentioned, they're going to say, "Oh, wow, yeah, we need to get this taken care of," and you can really have that face-to-face conversation. And then, you know, in that case, where you say, "Hey, I would maybe like a little guidance on a case, you know, with the Zoetis virtual laboratory, and having that access to specialists, you can really individualize that patient care for that patient with that consultation, and you can do that. For those cases where you're like, "Hey, maybe I'd like maybe a little bit of somebody from a specialist standpoint to come in here and provide me some information to help me guide that treatment plan and path moving forward.

See how in-house diagnostics have provided fast results, individualized treatment, and better care

Products

In-house analyzers allowing you to treat patients today

Andi Flory discusses her session from Fetch Long Beach 2023

OncoK9 with Andi Flory

The conversation around canine cancer detection and treatment has evolved significantly over recent years. Shedding light on innovative methods that could redefine how we approach canine healthcare, Andi Flory, DVM, DACVIM (Oncology) and the Chief Medical Officer of PetDx recently discussed the transformative potential of liquid biopsy tests for dogs during a comprehensive session. These tests, centered on cell free DNA biomarkers extracted from blood, offer a revolutionary approach to detecting cancer through both quantity and quality-based analysis. By employing next-generation sequencing techniques, akin to those used in human liquid biopsy tests, these methods prove reliable and offer substantial promise in early cancer identification. This technological evolution mirrors human healthcare's emphasis on preventive screenings with advancing age. The availability of diverse blood tests tailored to different canine health scenarios signifies a crucial stride toward comprehensive cancer care in veterinary medicine.

Flory emphasized the pivotal role of early cancer detection, highlighting its profound impact on patient outcomes. With cancer being a leading cause of canine mortality beyond a year of age, the importance of proactive detection cannot be overstated. The introduction of OncoK9, an affordable test utilizing quantity-based analysis through next-generation sequencing, presents an important addition to wellness panels for senior dogs or those predisposed to certain breeds. This test boasts a rapid turnaround time, clear interpretive guidelines, and a strong clinical validation demonstrating its efficacy across various clinically relevant cancers.

Flory A. An Affordable New DNA-Based Blood Test to Detect Cancer in Dogs. Presented at: Fetch dvm360 conference; Long Beach, California; December 1-3, 2023.

Learn how liquid biopsy is changing the way one veterinarian approaches oncology patients

Early canine cancer detection with a simple DNA-based blood test

Trends in veterinary diagnostics

And Dr. Penn, there's so many trends that are happening right now in the industry. So, what are some current trends that you're seeing in our industry? And how are these trends different versus, let's say, 2010?

Yeah. So, I think that we what we're seeing now is we're seeing, which is a good problem, right? Lots of families are adopting pets, and we see a lot more of that happening. But with that comes increased caseload and as we went through the pandemic, we had a lot of those families who were sitting home who maybe didn't notice those things from their pets before they were watching them kind of every single day. And now they're more in tune with doing that and watching and really seeing what's happening with their pet. So, the caseload went up. And we know that as we think about caseload, we think about all of the efficiency concerns that we talk about. And you know, if we have all of these cases coming in, and we're trying to be as efficient, as thorough, because our pet owners...that pet is a member of their family, and they want a really thorough workup that can be communicated across to them. Back in 2010, When we think about what was available, there was not as much available. So, as we've had this increased caseload, really the need in veterinary medicine, in my mind, that was really there was to provide a way for practitioners or veterinary professionals to really have a way to help with workflow efficiency, to help with consistency, and to provide that value to be able to educate and communicate with those with those pet owners, which I think is just vital. And I think that has changed between now to where it was in 2010.

And Dr. Hann, curious to get your opinion, because as an internist, you must have seen such a rapid change in the way in which we communicate to your point about technology as general practitioners. So what has it been like for you?

Well, it's very interesting, just the trends we've seen of kind of the standard of care and the expectations of pet owners and what they want for their pets. And so, having technology and access to specialists in hand with that, just really bringing up the level of standard of care and what we can offer to them. So having easier access to a quicker diagnosis, and it's having our pet owners trust and understand what's going on, and then being able to access specialist sometimes beyond just the diagnosis, to really build up the opportunities and kind of the different aspects of care so that we can really maximize and pinpoint the exact needs of that particular case, rather than it just staying kind of more of a general workup and maybe not even really getting to that diagnosis in order to kind of really give the best care possible.

Examine the changing expectations of pet owners and the pivotal role of technology in providing individualized patient care 

Trends in veterinary diagnostics and the standard of care 

Learn how veterinary diagnostics have changed

The evolution of in-house diagnostics

Okay, friends, let's get into it. We're going to talk about Zoetis Diagnostics and improve patient outcomes. I want to start off by discussing the importance of in-house diagnostics. Dr. Wolfe, what has this experience been like for you from where we were say, years ago to where we are now?

Well, you know, I started this career as a veterinary technician in 1999. And the practice still had a QBC machine. And at that time, we were doing beta testing for what's now known as the 40X. And then in veterinary school, I worked in clinical pathology around rather large machines. And when I started my first career in 2005, at a much more scaled down version of hematology and chemistry—still did a urinalysis via the dipstick—and over time now we've got the machine that reads the dipstick. We now have the SediVue to analyze the cellular debris. We have multiple rapid tests available now. We have coagulation; we have we have critical care. And then now with the Imagyst, we now have artificial intelligence to be able to run our fecal samples and our cytology's on and receive data in as little as 12 minutes to as long as two hours for send out pathology reviews.

That's really neat. And Dr. Clary I'm sure it's come such a long way to where we are now in your practice, right?

Yes. The QBC, I had one that was called a Reflotron, and you know, I can remember on Sunday mornings being up there doing my test by myself. And you know, you weren’t really confident in it. With the Zoetis products, I feel really confident like with the Imagyst. I love it because I've got somebody that's board-certified, backing me up on what I might be thinking versus what they really know. And it's really a game changer for my confidence and the way I practice. That's been my biggest advantage. 

Yeah and the footprint of these has really gotten smaller as well, where space is precious in a veterinary clinic. These machines now are very small and don't take up much room in the lab as well, so...

I would say space is a commodity in vet med for sure.

Veterinarians share how Zoetis’ Vetscan Imagyst has improved their patient outcomes and practice efficiency by using artificial intelligence for fast and reliable results

The evolution of in-house diagnostics from QBC® to Vetscan Imagyst®

Meet the panel who will discuss AI diagnostics

Meet the Zoetis diagnostics experts

Hey everyone. Great to see you all here for another dvm360 Pet Connections panel discussion proudly sponsored by Zoetis. In this dynamic conversation, we'll discuss the power of innovation and collaboration in veterinary medicine where Zoetis is leading the way towards a future of enhanced care and better outcomes for our furry companions. I'm your moderator, Dr. Adam Christman, Chief Veterinary Officer here for dvm360, and I'm thrilled to introduce today's panelists. Joining us over here is Dr. Cory Penn. Dr. Cory Penn received his DVM from the University of Missouri College of Veterinary Medicine following his Bachelors of Science from Eastern Illinois University. Before joining Abaxis and Zoetis, Dr. Penn was a small animal veterinarian and medical director in central Illinois. He joined Abaxis Global Diagnostics in 2016 as a professional services veterinarian for the central and western United States and after the acquisition of Abaxis held the same role with Zoetis Diagnostics. Dr. Penn is currently the Senior Veterinary Diagnostic Platform Lead for VETSCAN IMAGYST with Zoetis Global Diagnostics. Dr. Penn currently resides in the Midwest with his wife Emily, three daughters—Harper, Reese, and Charlotte—Labrador Retriever Chloe and his cats Fluffy and Pinky. In his free time, Dr. Penn enjoys spending time with his family and being outdoors. Also with us is Dr. Lisa Hann. Dr. Lisa Hann decided to bring global adventure to her veterinary education by pursuing both undergraduate studies and her Doctorate of Veterinary Medicine Degree at St. George's University in Grenada and completing her clinical year at the University College Dublin. Dr. Hann also volunteered at a mixed animal practice in India and a zoo in Costa Rica during her schooling. After these travels, Dr. Hann pursued a rotating internship in New York City, during which she fell in love with internal medicine. She followed up her internship with a residency in small animal internal medicine at the University of Pennsylvania. During her residency, Dr. Hann was involved in hematology and transfusion medicine research. Prior to joining the consultation team with Zoetis, Dr. Hann worked for a decade at specialty and emergency referral hospitals with a very busy and varied caseload in both Seattle and New York City. Dr. Hann enjoys all aspects of the challenging and ever-complex world of internal medicine. However, she is especially interested in gastrointestinal diseases, endocrinopathies, immune-mediated processes, and hematologic disorders. Dr. Hann looks forward to partnering with veterinarians in case discussion and collaborating to develop intelligent and approachable diagnostic and treatment plans for patients and clients. Dr. Hann currently resides in Seattle with her husband, a kidney donor orange tabby cat named Penne Pasta—love it—and a rambunctious Chow Chow named Gimli. Also joining us as our wonderful friend and colleague, Dr. Carl Clary. Dr. Clary has been practicing veterinary medicine for over 25 years and is highly skilled at performing orthopedic surgical procedures. He is exceptional at performing knee CCL repairs, hemilaminectomy, and ventral slot surgeries, bone fracture repairs and more. His veterinary interests include orthopedic surgery, theriogenology, and internal medicine. When he's not practicing Dr. Clary enjoys being outdoors, racing, welding, and spending quality time with his wife Petra and their two children Gage and Portia. And also we have Dr. Shelli Wolfe that's here. Dr. Wolfe has been practicing in Lubbock, Texas since graduating from veterinary school at Texas A&M in 2005. Her veterinary interests include feline medicine, dentistry, internal medicine, and ultrasonography. Dr. Wolfe is very thorough in her practice of medicine and excels at working up complex cases. Outside veterinary medicine, she enjoys being a wife and mother to her husband, Matt and their two children, Reese and Logan. They are avid baseball fans and enjoy attending baseball games, especially the Texas Rangers. So I guess go Rangers, right?

Get to know four veterinarians with diverse backgrounds and interests as they share their experiences on how to provide enhanced care and better outcomes for pets

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