Feeding the Equine Immune System: The Good and Bad Gut and Immune Health Connection

Sponsor: Standard Process Veterinary Formulas 

Nutrition plays a huge role in the overall health of the horse. We will focus on 2 key systems— digestion and immune health—and discuss how compromise can contribute to multiple common conditions we see daily in our equine patients. We will also discuss the good and bad relationship between gut and immune health. Kelly Neale, DVM, will cover key ingredients to consider for nutritionally supporting the gut and immune system.

Frustrating Otitis Cases Got You Shaking Your Head?

This course covers the essential points of diagnosis and treatment of otitis. Both acute and chronic cases of otitis will be discussed. Particular emphasis will be placed on the PSPP classification system (primary causes, secondary causes, predisposing causes, and perpetuating factors).

Your Analysis Requires Urinalysis—What AI Has to Offer

Speaker: Dennis J. Chew, DVM, DACVIM (SAIM) 

Review information about current diagnostic practices and attitudes toward urinalysis in veterinary hospitals and discuss key components of a complete urinalysis. Learn how to maximize results obtained from your urine sediment and leverage new artificial intelligence technologies with the Vetscan Imagyst by Zoetis to improve your diagnostic and treatment capabilities.

Speaker: Craig Webb, DVM, PhD, DACVIM (SAIM) 

Sponsor: Nutramax Laboratories Veterinary Sciences 

This presentation will briefly compare and contrast canine and feline liver physiology, setting the stage for the discussion of how clinicians can best recognize hepatopathies in both species.'

Feline Fine: The Value of Wellness Testing and Parasite Prevention in Cats

Speaker: Michelle Evason, BSc, DVM, DACVIM (SAIM), MRCVS 

In this podcast, Michelle Evason, BSc, DVM, DACVIM (SAIM), MRCVS, will discuss topics related to the spectrum of care and feline care and provide practical tips for communicating with pet owners about these topics.

The Role of JAK Inhibitors in Treating Pruritus Associated With Allergic and Atopic Dermatitis in Canines

This podcast will cover the causes of allergic and atopic dermatitis and outline various treatment options available on the market. We will also discuss various treatment solutions based on an individual dog’s presentation of symptoms.

Fetch On-Demand brings the value of Fetch conferences to your fingertips with recorded CE sessions led by industry leaders. Attendees can extend their CE opportunities and earn additional credits, while non-attendees can experience Fetch’s renowned faculty and education. Earn CE credits anytime, anywhere, with the flexibility busy veterinary professionals need.

Articles

Check out these continuing education opportunities now available

Flex Forecast: March/April 2025

Liver biopsy and analysis of samples are important steps in diagnosing hepatic disease. Fine-needle aspirates of the liver tend to have poor diagnostic accuracy, as low as 30% when compared with histopathology in one study, leading to the recommendation for surgical biopsies.

 Depending on the underlying disease process, these patients may be systemically ill, with prolonged clotting times, ascites, or significant cirrhosis of the liver, which can make surgical biopsies more challenging and at a higher risk for complications. The most significant risk to consider, given the function of the liver, is bleeding. As a result, checking a patient’s clotting times prior to obtaining biopsies is generally recommended.

When obtaining liver biopsies for a patient, it is important to do so in a manner that maximizes the likelihood of a diagnosis while minimizing risk to the patient. In 2019, the American College of Veterinary Internal Medicine published a consensus statement on the diagnosis and treatment of chronic hepatitis in dogs that outlines recommendations for the procurement of samples and submission processes.

Samples must be large enough that 12 to 15 portal triads are obtained. Additionally, sampling different liver lobes is recommended, as there may be variation between different lobes. Finally, samples should also be submitted for aerobic and anaerobic culture and copper quantification. Twenty to 40 mg of liver is required to submit a sample for copper quantification. Ultimately, this has resulted in the recommendation for a minimum of 3 surgical biopsy specimens from at least 2 liver lobes for histopathology: 1 for anaerobic/aerobic culture and 1 for copper quantification.

One of the least invasive options for liver biopsy is using a biopsy instrument, such as a Tru-Cut biopsy device. This core biopsy needle enables sampling larger lesions than a fine-needle aspirate. These samples can be obtained with ultrasound guidance. Studies have found these samples to be 48% to 83% consistent with surgical liver biopsies.

 There is a larger possibility of hemorrhage with this technique compared with fine-needle aspirates, although the likelihood of major life-threatening hemorrhage is low. Although this is certainly the least invasive option that exists for liver biopsy, diagnostic accuracy may be limited by sample size. If relying on needle biopsy for sampling, more than 4 specimens are recommended to ensure the requisite number of portal triads is obtained.

 These samples often also need additional care when handling because of their small size. It is easy to crush or otherwise induce artifacts into these samples.

There are multiple techniques for performing liver biopsies via a celiotomy. Ultimately, the choice of technique is at the discretion of the primary surgeon.

One of the easiest techniques is obtaining a biopsy of the periphery of a chosen liver lobe via the guillotine technique. For this technique, a portion of the liver lobe periphery that is more pointed or comes to a taper is selected, and a loop of absorbable suture, such as polydioxanone, is placed around it. The loop is tightened, and the liver lobe is ligated and then transected distal to the suture. This sample can then be submitted for histopathological analysis or, if of an appropriate size, can be divided into different portions for culture and copper quantification. Even if the sample is of an appropriate size to be divided into multiple portions, it is important to remember the previously stated recommendations regarding sampling multiple liver lobes due to potential variation between them.

Another appropriate technique, particularly if a lesion is not on the periphery, is the use of a biopsy punch. This may be used anywhere in the liver, although caution should be used toward the center and hilus of the liver lobe to be biopsied. When using a biopsy punch, care should be taken to penetrate no more than half the depth of the lobe. Some hemorrhage is to be expected, and a gelatin sponge may be placed into the defect that is created. Hemorrhage is reported to be greatest with this technique but rarely requires intervention.

Finally, it is also acceptable to use vessel sealing devices to seal and transect a portion of the liver. However, a large enough sample must be acquired, as the use of these devices will result in some thermal spread and artifact throughout the edge of the sample.

Laparoscopic liver biopsy is a safe technique that results in highly diagnostic samples. The magnification and illumination associated with laparoscopic surgery may also aid in targeted biopsy of lesions, and the use of laparoscopy can result in reduced pain and a faster recovery.

 This is typically performed with two 5-mm single instrument ports or 1 multi-instrument port to facilitate a 5-mm camera and 5-mm cup biopsy forceps. Multiple techniques exist, such as forcefully pulling once the cup biopsy has been closed over a liver lobe, rotating the forceps 360° in one direction after closing until the sample twists off, or even pulling the forceps through the laparoscopic cannula while simultaneously advancing the cannula to use it as a dissection device.

Image courtesy of Rachel Williams, DVM, DACVS-SA

All these techniques have been proven to be safe and effective, but the twisting technique is reported to have the fewest artifacts.

 Some bleeding can be expected with laparoscopic liver biopsies (

), but it should be relatively mild and self-limiting. Careful assessment of all biopsy sites for active hemorrhage should be performed prior to closure. If persistent hemorrhage is noted, this may be addressed with electrocautery, a vessel sealing device, or other hemostatic agents, or conversion to an open approach may be necessary.

Postoperatively, patients should be monitored for pain and hemorrhage. Vital signs may be early indicators of bleeding and should be recorded. Many surgeons recommend checking the packed cell volume/total solids and blood pressure 2 to 4 hours after surgery to monitor for a significant decrease in those values. If that is the case, hemorrhage is a possibility, and a point-of-care ultrasound is prudent to look for evidence and sample if indicated.

Most patients who undergo liver biopsies can be discharged the same day. They should be discharged with analgesics as appropriate for the procedure performed. There is generally no need to discharge patients on antibiotics or steroids, and prescribing these medications should be delayed until the results of the biopsy samples are available.

, is a clinical assistant professor of small animal surgery at the University of Florida College of Veterinary Medicine in Gainesville. Her professional interests include urogenital surgery, minimally invasive surgery, and wounds and reconstruction. Outside the operating room, she enjoys being outdoors with her dogs, as well as gardening and traveling.

Wang KY, Panciera DL, Al-Rukibat RK, Radi ZA. Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990-2000). 

.2004;224(1):75-78. doi:10.2460/javma.2004.224.75

Vasanjee SC, Bubenik LJ, Hosgood G, Bauer R. Evaluation of hemorrhage, sample size, and collateral damage for five hepatic biopsy methods in dogs. 

. 2006;35(1):86-93. doi:10.1111/j.1532-950X.2005.00117.x

Cole TL, Center SA, Flood SN, et al. Diagnostic comparison of needle and wedge biopsy specimens of the liver in dogs and cats. 

. 2002;220(10):1483-1490. doi:10.2460/javma.2002.220.1483

Webster CRL, Center SA, Cullen JM, et al. ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs. 

. 2019;33(3):1173-1200. doi:10.1111/jvim.15467

Culp WT, Mayhew PD, Brown DC. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. 

. 2009;38(7):811-817. doi:10.1111/j.1532-950X.2009.00572.x

Gauthier O, Holopherne-Doran D, Gendarme T, et al. Assessment of postoperative pain in cats after ovariectomy by laparoscopy, median celiotomy, or flank laparotomy. 

. 2015;44(suppl 1):23-30. doi:10.1111/j.1532-950X.2014.12150.x

Walsh PJ, Remedios AM, Ferguson JF, Walker DD, Cantwell S, Duke T. Thoracoscopic versus open partial pericardiectomy in dogs: comparison of postoperative pain and morbidity. 

. 1999;28(6):472-479. doi:10.1111/j.1532-950x.1999.00472.x

Buote NJ, Loftus JP, Miller AD. Laparoscopic twist technique has the best overall artifact profile when comparing three laparoscopic hepatic cup biopsy techniques for dogs. 

.2022;83(12):ajvr.22.08.0127. doi:10.2460/ajvr.22.08.0127

Sample analysis is critical for diagnosing hepatic disease

Performing a liver biopsy

Aaron Shaw, OTR/L, CHT, CSCS, shares exercises that veterinary professionals can incorporate into their routines to reduce injuries associated with patient handling

Reducing physical strain in veterinary medicine

At the Fetch dvm360 conference in Charlotte, North Carolina, Aaron Shaw, OTR/L, CHT, CSCS, healthspan coach and host of the podcast 

, led a lecture on body mechanics and ergonomics—terms that used to describe the way the body moves and the science of designing workspaces to fit the needs of the human body, respectively. In this interview, Shaw shares key takeaways from that lecture, titled “Strength in Practice: Ergonomics and Body Mechanics for Veterinary Professionals.”

Below is a partial transcript, lightly edited for clarity:

I think the key takeaways for Body Mechanics and Ergonomics for Vet Professionals, there's 2 main points to think about:

One is, in every practice setting, I bet there's something in the clinic, a piece of equipment, for example, that can be adapted or moved, made adaptable, that can decrease the physical demands for providers. This, for example, could be making sure that, you know, a workstation that many people...have to engage with often is adjustable.

...If I had $1 for every time I saw a vet kind of squat down and [twist] their neck and tie themselves into a pretzel just to assess an animal—the risk of injury is very high. But thinking about perhaps having a low stool to sit on or a little box to sit on whether you get down so there's a little bit less of a balancing act, a little bit less physically demanding to do what has to happen, you know, dozens and dozens of times throughout the day.

So, there are some environmental things to think about that I would love it if every vet or everybody on the team could go to work tomorrow and try to look at things with a clear set of eyes. ...And a good way to think about bringing something to your attention is if there's a piece of equipment or if there's something that causes you to reach over something or bend over in an unusual way, even if you only do it a couple of times a day, it's worth just taking pause and looking and wondering, being curious enough to think, “can this table be moved over a little bit? Can this chair be moved out of the way? Is this, you know, is everybody walking around a laundry basket 50 times a day when really, the whole thing could just be moved [to] make things a little bit [of] safer environment to be in, anyhow?”

Videos

With the increasing prevalence of anthelmintic resistance, Zoetis has launched an awareness campaign encouraging horse owners to rethink their deworming practices and consider purchasing less dewormer. According to Zoetis, the “Buy Less Dewormer” campaign was developed after the American Association of Equine Practitioners (AAEP) released 

updated Internal Parasite Control Guidelines

The goal of the updated 2024 guidelines is to lower the risk of parasitic diseases in horses and preserve the effectiveness of current deworming medications by delaying anthelmintic resistance.

 The revised guidelines advise against fixed-interval, year-round deworming. It also encourages owners to stop blindly rotating anthelmintic classes.

“The true goal of parasite control in horses is to keep animals healthy and reduce the risk of clinical illness. The goal is NOT to eradicate all parasites from a particular individual. Not only is eradication impossible, the inevitable result of pursuing this goal is accelerated development of parasite drug resistance,” according to the Internal Parasite Control Guidelines.

According to the guidelines, the most the majority of adult horses should be dewormed is twice a year. Veterinarians should also check anthelmintic efficacy routinely via fecal egg count reduction tests. These tests should also be conducted to identify high-shedding horses, requiring additional targeted deworming treatments.

be used to diagnose diseases in horses given that there is no link between fecal egg counts and disease-causing parasite life stages, according to the AAEP guidelines.

“The industry has seen increasing resistance levels to several parasite treatments, which can be caused, in part, by deworming too often and with active ingredients that do not target the right parasites at the right time,” Nathan Voris, DVM, MBA, director of Equine Technical Services at Zoetis US, said in an organizational release.

“Our aim with the “Buy Less Dewormer” campaign is to raise awareness around best practices focused on less frequent deworming, and to get horse owners and equine practitioners to re-evaluate their current protocols, which for many, are set on autopilot.”

The campaign will also include educational activations with trivia, dewormer giveaways with coupons, and paid print, digital, and social advertisements at the Defender Kentucky Three-Day Event—an equestrian competition event. The campaign will also bring to attention that active ingredients are not all the same.

According to Zoetis, its Zoetis Quest line of dewormers, Quest

 Plus Gel (moxidectin/praziquantel) are the only dewormers on the market formulated with moxidectin. One dose of moxidectin can effectively treat adult small strongyles, encysted small strongyles larvae, adult large strongyles, migrating large strongyle larvae, roundworms, bots, pinworms, hairworms, and stomach worms.

 These dewormers, according to Zoetis, support parasite treatment for healthy adult horses.

Zoetis Equine launches “Buy Less Dewormer” Campaign. News release. Zoetis Inc. April 23, 2025. Accessed April 28, 2025. 

Bautista-Alejandre A. Internal parasite control guidelines for horses are updated. 

. August 9, 2024. Accessed April 28, 2025. 

https://www.dvm360.com/view/internal-parasite-control-guidelines-for-horses-are-updated

Internal Parasite Control Guidelines. American Association of Equine Practitioners. Accessed April 28, 2025. https://aaep.org/resource/internal-parasite-control-guidelines/

Zoetis launched the campaign following updated American Association of Equine Practitioners Internal Parasite Control Guidelines that emphasize growing anthelmintic resistance 

“Buy Less Dewormer” campaign is launched to raise awareness for less frequent deworming 

Lola, a 9-year-old golden retriever, was diagnosed with oral melanoma, which had already spread to her lungs in February 2023. At the time of her diagnosis, Allison Roth, Lola’s owner, was told by her veterinarian that Lola had less than 6 months to live, and referred her to the oncology service at the UC Davis William R. Pritchard Veterinary Medical Teaching Hospital for treatment options.

Lola, a 9-year-old golden retriever, was treated at UC Davis William R. Pritchard Veterinary Medical Teaching Hospital for an oral melanoma that had spread to her lungs (Image courtesy of UC Davis College of Veterinary Medicine) 

“When Lola was a puppy, I was treated for a brain tumor at the Mayo Clinic,” said Roth, in an organizational release.

 “Through my multiple brain surgeries, she was always by my side. When it came time for her cancer treatments, I was thrilled that she would be treated at UC Davis—what I would call the ‘Mayo Clinic for dogs.’”

After consulting with the specialists, Roth had to decide between 2 options for Lola: either receive palliative radiation treatments that could give her more time or participate in a study at the school’s Veterinary Center for Clinical Trials. The trial was showing success for a new immunotherapy, and Roth decided to enroll Lola in the clinical trial.

The study at UC Davis, “Intravenous Doxorubicin and Inhaled IL-15 Immunotherapy for Treatment of Lung Metastases,” was the latest version of an ongoing series of clinical trials of immunotherapy treatments that involves inhaling cancer-fighting medication, according to an organizational release.

 Sponsored by the National Cancer Institute at the National Institutes of Health, the collaborative study was led by co–principal investigators Robert Rebhun, DVM, PhD, Michael Kent, DVM, DACVIM (Oncology), DACVR (Radiation Oncology), and Robert Canter, MD. 

The researchers for the study wanted to explore additional treatment options since previous iterations of the IL-15 clinical trials were demonstrating success. This study, which is the third version of the trial, enrolled 10 canine patients with pulmonary metastasis greater than 1 cm with a goal of determining whether preconditioning the immune system with chemotherapy improved the response rates to the inhaled IL-15 drugs.

“The previous trials we conducted found that inhaled IL-15 is well tolerated and resulted in durable responses in a subset of dogs with metastatic melanoma or osteosarcoma,” explained Rebhun.

 “We were excited to see if modulating the immune system with chemotherapy might improve response rates in patients with metastatic tumors to the lung.”

Lola receiving IL-15 treatment that required her to inhale cancer-fighting medication 

X-rays of Lola’s lungs showed many spots prior to the trial and she did not tolerate the single dose of chemotherapy well to begin the trial, and x-rays following the inhalation treatments, which were 2 times a day for 2 weeks, were not better. The UC Davis team hoped for her x-rays to show either the same as pretreatment or an elimination of some tumors, but Lola’s showed even more tumor growth. Because of this, she was pulled from the trial twice, leading Roth to change her course of action to palliative radiation treatments. In May and June 2023, Lola received 2 treatments of radiation twice a week for 3 weeks. 

The radiation treatments were able to shrink the tumor located in Lola’s mouth completely, but another x-ray showed continued tumor growth on her lungs following the radiation. Roth explained that they thought they would lose Lola in the summer of 2023, but she managed to hold on for the entire summer. Then, to the shock of Lola’s team and family, in September 2023, another x-ray showed all her tumors were gone. Researchers believed that she had experienced a delayed response to the IL-15 trial.

“In people, immunotherapies can sometimes result in inflammation of tumors, making them appear larger before they shrink,” Rebhun explained. “This is termed 

, and it appears to have happened with Lola.”

Two years later, Lola appears to be cancer-free and continues to receive regular checkups at UC Davis, and none of her tumors returned.

Dog beats cancer odds after successful completion of clinical trial. News release. April 23, 2025. Accessed April 28, 2025. https://www.vetmed.ucdavis.edu/news/dog-beats-cancer-odds-after-successful-completion-clinical-trial

Lola, a 9-year-old golden retriever, was referred to UC Davis William R. Pritchard Veterinary Medical Teaching Hospital after she was diagnosed with oral melanoma

Canine patient triumphs over cancer following clinical trial success

The societal shift towards environmentally friendly, forward-thinking lifestyles changed how consumers interact with brands, evaluate products, and support companies. Eco-consciousness is particularly prominent in the food industry as more and more people gravitate towards sustainable options. The same is true regarding pet food; however, there is less information on how major pet food brands communicate sustainability practices to the public.

Sustainability is a multifaceted concept with 3 key dimensions—environmental, social, and economic. Various factors impact a product or company’s sustainability. Examples of ways to measure each dimension include the following

Environmental sustainability—land use, greenhouse gas emissions, energy efficiency, waste management

Social sustainability—employment, worker welfare, animal welfare, community support, respect for human rights

Economic sustainability—economic support for producers, consumer prices

Pet food production has several ecological implications. Initiatives to improve ingredients in diet formulations, optimize resource use, better waste management, and reduce overfeeding and excess nutrition have minimized adverse effects. Despite this, marketing strategies to communicate sustainability efforts to pet owners are not fully understood.

 explored how the largest pet food companies in the United States (US) and European Union (EU) communicate their sustainability practices. The study aimed to achieve the following

analyze information presented on company websites, focusing on the environmental, social, and economic dimensions of sustainability

explore and compare the sustainability-related topics communicated in two different geographical locations to identify differences in the approaches adopted

Both global regions effectively highlight environmental sustainability approaches like water conservation, soil preservation, and reducing emissions. Aspects of social sustainability, including animal welfare and respect for working conditions, are also addressed but to a lesser extent. Little to no communication regarding economic sustainability is mentioned on company websites, according to the authors. Emphasizing the social and economic dimensions in marketing campaigns to enhance brand reputation and increase consumer trust has potential competitive advantages.

Investigators found the US and EU differ in consistency across companies. The EU has stricter regulations in sustainability communication policies, showcased by homogenous and structured communications among websites. In contrast, US brands are more generic and have greater diversity from website to website. Additionally, US companies have more partnerships and collaborations, especially surrounding energy and emission management.

Using sustainability to advertise products influences consumer behaviors and brand perception. Understanding pet food company communication strategies is crucial to making educated purchasing decisions. Increasing transparency in the pet food industry regarding sustainability can reduce greenwashing and ensure high-quality products for beloved pets.

Miranda Morman, BS is a 2025 PharmD candidate at the University of Connecticut School of Pharmacy in Storrs.

Sparacino A, Mastromonaco G, Merlino VM, Borra D, Blanc S. How do pet food companies communicate sustainability practices on their websites? 

. 2025;19. doi:10.1016/j.envc.2025.101154

A recent study explored how large companies producing meals for animals communicate their sustainability practices