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Video interview with Darin Dell, DVM, DACVD, discusses a systematic approach to canine ear infections.

From history to cytology: A systematic approach to canine ear infections

Addressing recurrent otitis externa in dogs requires a focus beyond symptomatic treatment. During this interview with 

, Darin Dell, DVM, DACVD, emphasized the critical importance of identifying and managing the underlying root causes, such as allergies or ear mites, to achieve long-term resolution and more through the primary, secondary, predisposing, and perpetuating causes (PSPP) approach.

Below is a transcript, edited lightly for clarity.

 Starting with your name, can you tell us a little bit about yourself?

 My name is Dr Darin Dell. I'm a veterinarian here in Wheat Ridge, Colorado, just west of Denver. I started working at a veterinary clinic in my little hometown when I was 14 [years old], so I was indoctrinated early. [I] started out cleaning kennels, mopping the floors, holding animals, [and] then answering the phones and helping the doctor on farm calls. So veterinary medicine is really how I grew up. That's why I went to vet school.

[I] went to the University of Illinois, graduated in 2001, worked for several years in general practice, and then did some overnight [emergency department work] before I decided to become a dermatology resident. Life is a whole lot easier as a dermatology resident [and then] as a dermatologist. It's also just clearly the specialty that I love; skin makes sense to me. I love making a difference for [those] with these long-term problems, and it makes me happy.

 How would you use the PSPP concept to explain why recurrence happens and your diagnostic plan to a client who is frustrated that their dog's ear infection keeps returning?

 Otis externa is super frustrating for clients. It's super annoying for the pet, too. So PSPP, when you're talking to the client, helps you say, "All right, we're here because there's an infection today and your dog's ear is very, very inflamed, so we need to treat that." But underneath that is the primary problem. And the primary problem, whether that's allergies, ear mites, or there was a tick in the ear or something else, that's what truly needs to be handled so that you stop doing this every month or every 6 weeks. We have to get to the root cause.

What are the top 3 diagnostic steps you would take to find the underlying cause of recurrent otitis externa, and in what order?

Three is good; 4 is better. No. 1—and if we had 4 options—would be history. You have to find out not just when the episode started but [also] when the first ear infection ever [occurred]. People like to focus on the "right now" because they're living the stress…. But when was the first time you ever saw an ear problem? History is important.

The entire physical exam…we're looking for: Are there allergy changes on the skin? Are the paws red? Is the groin hyperpigmented? Those sorts of things. Then the otoscopic exam. I think this also doesn't get taught very well. There are minor changes that you can observe in the ear canal that can help guide you on how you're going to treat and what you're going to tell the client. But you've got to look at every ear so you know what normal is…[and] decide variations of abnormal.

Then No. 4, for me, would be the cytology of the ear smear…. Do I have white blood cells? Do I have yeast? Do I have bacteria? The kind of bacteria can give you a lot of clues about what you're going to treat with and how severe this is. It also helps you monitor progress. So that's the other thing that I see that doesn't happen a lot: monitoring progress as you go. 

We really want to see that, yes, I've cleared the entire infection, not just part of the infection. If you don't know what your infection was when you started, you don't know where you are halfway through.

Videos

"If you don't know what your infection was when you started, you don't know where you are halfway through."

Naomi Hoyer, DVM, DAVCD, discusses the importance of multiple dental radiology images and what dental radiologists commonly see in them.

Using a full set of dental radiology images

Why is it important to view multiple radiographic images in veterinary dentistry? Naomi Hoyer, DVM, DAVDC, an associate professor of dentistry and oral surgery at Colorado State University in Fort Collins, provided insight about using a full set of x-rays in a continuing education (CE) session at the 2026 Veterinary Meeting & Expo (VMX) in Orlando, Florida. Hoyer also copresented a master class alongside 

, owner of Pawsitive Dental Education, on how to professionally interpret dental radiographs, as well as several more CE sessions that focused on veterinary dentistry.

at VMX, Hoyer discussed the importance of taking multiple dental radiographs for a more in-depth view of a patient’s mouth. In this video, she also discusses what dental radiologists commonly look for in these images.

The following is a transcript of the video, lightly edited for clarity:

 Full mouth radiographs really are the best way to evaluate a patient's dental health because most of our dog and cat patients cannot tell us, “This is where the pain is.” Having a complete set of dental radiographs is really critical when we're evaluating pain. Sometimes you'll hear people advocating…just to take an x-ray of the tooth you're concerned about. The problem is [that] sometimes the tooth looks totally normal on the outside. We can't tell until we look at the tooth on the inside that there was even a problem.

There's so much anatomy that we see on the dental radiograph: mental foramina, for example, the little holes in the mandibles where the blood vessels come out of the sinuses, the nasal cavity, mandibular canal. All of those things are going to show up on your dental radiographs, and it's important to note what those look like so you know not to overinterpret those findings.

For more industry news and coverage of VMX, visit 

Naomi Hoyer, DVM, DAVDC, discusses the importance of multiple oral x-rays and what dental radiologists commonly look for in them.

Utah-based start-up Fearless Paws was named the first-place winner of the 2026 Pet Pitch Competition at this year’s Veterinary Meeting & Expo (VMX) in Orlando, Florida. The company presented its Split Up Scale product to judges and VMX attendees.

Katie Gray, DVM, founder of Fearless Paws, with her award.

“Fearless Paws is a company dedicated to creating innovative and low-stress solutions to help improve the lives of pets and the people [who] care for them,” Katie Gray, DVM, founder of Fearless Paws, said in a 

interview. “The Split Up Scale is our very first product launch. It is a size-adjustable, portable, low-profile weight scale.”

style program in its’ ninth year. Five finalists were invited to present their pitches to judges this year at the VMX conference hosted by the North American Veterinary Community (NAVC). The competition aims to provide new companies with the opportunity to introduce their products, services, and solutions to thousands of veterinary professionals and practice decision-makers.

Competition front-runners were showcased in the VMX Startup Circle, a dedicated area in the exposition hall that gave emerging businesses a platform to present their products and solutions directly to veterinary professionals and practice decision-makers, according to NAVC.

Finalists are also receiving mentorship, networking opportunities, and critical feedback to help accelerate their idea into a thriving business.

At the VMX Startup Circle, Gray said she designed the Split Up Scale to help relieve stress for animals in using scales. “I spent a lot of time designing this product for the animals, but also to be really useful to [veterinarians] because we need good equipment. We need equipment that helps us. And patients deserve a good experience when they're in the clinic, and that was really the inspiration behind all of this,” she said.

Gray also explained how the Split Up Scale is unique. “There's nothing on the market that's currently like our product. Traditional veterinary scales tend to be either…baby scales for cats or the really large dog scales, and none of them are size adjustable, portable, or low profile” she said.

And what’s next for Fearless Paws? Although Gray said she was “still processing” the Pet Pitch Competition win, plans are underway to market the winning product, possibly in 2026. ”We do have a patent on it, because this is new technology that no one [else] is doing right now,” she said.

“I'm just so thankful for everyone's help along the way. [I’m] thankful for the judges, the organizers, [and] everyone in the veterinary community. It's such a big deal to us as a small start-up, to have people really believing in our product and in our company,” Gray said.

Live from VMX 2026: innovation, energy and breakthrough diagnostics take over Orlando. News release. North American Veterinary Community. January 20, 2026. Accessed January 20, 2026. https://www.prnewswire.com/news-releases/live-from-vmx-2026-innovation-energy-and-breakthrough-diagnostics-take-over-orlando-302665693.html?utm_source=chatgpt.com 

Attention veterinary startups: apply for the VMX 2026 Startup Circle & Pet Pitch Competition! North American Veterinary Community. Accessed January 20, 2026. 

https://navc.com/%20vmx-event/startup-circle-pet-pitch/

Articles

Start-up company Fearless Paws received the award after presenting a pitch to judges and VMX attendees.

Innovative scale takes first place in the 2026 Pet Pitch Competition

A nationally sampled survey of UK adults reports that a measurable minority of people who lose a beloved pet meet symptom criteria consistent with prolonged grief disorder (PGD), and that the symptom structure of PGD does not differ when respondents report on pet vs human losses. The paper, published January 14, 2026, provides conditional rates, relative risk estimates, and measurement invariance testing that the author says raises questions about current diagnostic rules that restrict PGD to human bereavement.

Image Credit: © Soloviova Liudmyla | stock.adobe.com

Study author Philip Hyland analyzed responses from 975 UK adults recruited via Qualtrics between March 1 and March 27, 2024. The sample was quota-constructed to approximate the UK population by sex, age, nation (England, Wales, Scotland, Northern Ireland), and income band. Participants completed the International Grief Questionnaire—Clinical Version (IGQ-CC) and reported their bereavement histories and which loss they considered most distressing. Standard online panel quality controls (attention checks, duplicate IP screening, CAPTCHA, and response pattern filters) were applied, and study materials are available on the Open Science Framework.

Approximately one-third of respondents (32.6%, n = 318) reported having experienced the death of a beloved pet. Eighty-four percent of the sample (n = 821) reported at least 1 bereavement of any kind, and among respondents who had lost both a person and a pet, 21.0% (n = 62) nominated the pet loss as their most distressing bereavement.

Across the full sample, 8.6% (n = 84) met 

International Classification of Diseases, 11th Revision 

criteria for PGD, as operationalized in the survey. The conditional rate of PGD following pet bereavement was 7.5%. Hyland reports that this figure was similar to conditional rates observed for several common human bereavement types in the same data set. The calculated relative risk for pet bereavement was 1.27, indicating that participants who had experienced pet loss were 27% more likely to meet PGD criteria than those who had not. The study’s population attributable risk percentage for pet loss was 8.1%, a metric that combines the prevalence of exposure and its association with PGD to estimate the proportion of cases in the sample attributable to that exposure.

Hyland used confirmatory factor analysis and sequential measurement invariance testing across a 2-factor model (core and associated symptoms) to examine whether the latent structure of PGD differed when respondents reported symptoms tied to a pet vs a person. Fit indices supported the 2-factor representation, and the tests indicated configural, metric, and scalar invariance between pet-bereaved and human-bereaved groups. The author interprets these results as evidence that PGD symptoms operate equivalently across pet and human losses in this sample.

Hyland explicitly lists several limitations. The study used quota sampling from a nonprobability online panel, which limits generalizability despite demographic quotas and quality checks. Symptom assessment relied on self-report via the IGQ-CC rather than structured clinical interviews, and the IGQ-CC had not previously been applied in a pet bereavement context. The analysis did not model the cause of death or euthanasia effects, factors that the author acknowledges can influence grief outcomes. Finally, cultural differences in pet ownership and bereavement norms limit the ability to generalize findings beyond the sampled UK population.

Author conclusions and recommended next steps

As stated in the paper, the author concludes that people can experience clinically relevant levels of PGD following the death of a pet and that PGD symptoms show the same underlying structure regardless of whether the loss is human or animal. The paper raises questions about the exclusion of pet bereavement from current PGD diagnostic definitions and calls for replication, investigation of cause-of-death effects (including euthanasia), and cross-cultural research to clarify these findings.

Hyland P. No pets allowed: evidence that prolonged grief disorder can occur following the death of a pet. 

 2026;21(1):e0339213. doi:10.1371/journal.pone.0339213

A UK survey of 975 adults found that 7.5% of those who lost a pet met criteria for prolonged grief disorder, with symptom patterns indistinguishable from human bereavement.

Study finds prolonged grief disorder can follow the death of a pet

Board complaints are a source of anxiety for many practitioners, but they don't have to be. In this episode of 

, host Adam Christman, DVM, MBA, sits down with Beth Venit, VMD, MPH, DACVPM, chief veterinary officer of the American Association of Veterinary State Boards, to shed more light on the process. From debunking common misconceptions to exploring possible reasons why complaints are increasing, Venit shares essential insights on what to expect and how to navigate the common pitfalls of the profession.

Is there any advice that you would give to those [who] maybe have [received] a complaint against them, just to help maintain their own mental health as they're going through this process?

Yeah, I know it hurts so bad, especially [because] it's usually the client you spent the most time with [and who] you really bent over backward for. It really does hurt. It hurts a lot. The advice that I would give is just to remember that it doesn't say anything about you as a clinician. It doesn't say anything about you as a veterinarian or as a person. A lot of this…could just be a way that the client is dealing with their own grief or regret, and just remember that they have feelings. You have feelings. There are a lot of really big feelings involved.

In terms of stress about going through this event, the board is there to have an objective eye and…is not there to take away the license. They're there to correct any deficiencies. So even if you go through the process and they do determine that there is a deficiency or you could have done something better…the most likely outcome…is [continuing education] and a fine. 

Ultimately, you will get on the other side of this. In only very extreme cases do they suspend a license or…revoke a license. And extreme cases are [when] you have continued repeated complaints that you're just not addressing…or you actually commit a felony. I don't think anybody will accidentally commit a felony. I think we're OK there. If they're listening to this podcast, I don't think we have to worry about that. Those extreme cases are one side, but for the most part, it's a fine, it's continuing education, [and] it's making you a better veterinarian. That's the main thing that I would say to just keep in mind.

Podcasts

Discover insights on managing veterinary board complaints in this episode of The Vet Blast Podcast presented by dvm360.

How to handle a board complaint 

Boehringer Ingelheim recently announced that the FDA has approved pimobendan (Vetmedin Chewable Tablets; Boehringer Ingelheim) and pimobendan oral solution (Vetmedin Solution; Boehringer Ingelheim) for delaying the onset of congestive heart failure in dogs with stage B2 preclinical myxomatous mitral valve disease (MMVD). The approval makes pimobendan the first and currently only FDA-approved treatment indicated for treating preclinical heart disease in dogs and extending symptom-free survival before the development of congestive heart failure.

The approval builds on the drug’s conditional approval in 2022 and marks the first time the FDA has granted full approval for an animal drug indication that was initially conditionally approved. Two multisite studies supported the decision. In one 2016 study, the EPIC trial, dogs with stage B2 preclinical MMVD treated with pimobendan experienced a delay of 15.6 months in the onset of congestive heart failure or cardiac-related death compared with untreated dogs.

 A second study, according to Boehringer Ingelheim, found that 79% of dogs with stage B2 preclinical MMVD remained free of congestive heart failure after 1 year of pimobendan therapy.

Additionally, studies have also shown that pimobendan can extend survival and improve quality of life in dogs with heart failure due to MMVD or dilated cardiomyopathy.

The safety of Vetmedin chewable tablets and oral solution has not been established in dogs with asymptomatic heart disease caused by etiologies other than MMVD or in congestive heart failure caused by etiologies other than MMVD or dilated cardiomyopathy, according to Boehringer Ingelheim.

The company also noted that in field studies, the most frequently reported non-cardiac adverse reactions included poor appetite, lethargy, diarrhea, dyspnea, vomiting, musculoskeletal pain, and ataxia.

Heart disease is one of the most prevalent conditions affecting dogs and cats.

Researchers estimate that the disease affects approximately 10% of dogs, with MMVD accounting for approximately 75% of heart disease cases in dogs.

 Smaller-breed dogs, especially, are more at risk of MMVD.

Meanwhile, larger dogs, according to the Purina Institute, are more likely to develop dilated cardiomyopathy.

In dogs and cats, MMVD and dilated cardiomyopathy can progress to congestive heart failure, a condition characterized by the heart’s inability to effectively pump blood to the body, causing fluid to accumulate in the abdomen (peripheral edema) or lungs (pulmonary edema).

Dogs in the early stages of MMVD often show no clinical signs and generally appear healthy. For dogs in stage B1, a heart murmur may be detected, but there will be no evidence of cardiac remodeling. By stage B2, there will be evidence of cardiac remodeling, although the disease will remain subclinical.

MMVD progression is often unpredictable, though left atrial enlargement is a reliable sign of advancing disease. Research shows that dogs that reach congestive heart failure tend to have shorter survival compared with those in the early stage of MMVD.

“Heart disease is most often present in dogs long before symptoms are visible, so the ability to treat dogs with Vetmedin early, before the disease progresses to [congestive heart failure], is incredibly significant and will help increase the survival time and quality of life in dogs," Daniel Watkins, head of US Pet at Boehringer Ingelheim, said in a news release by Boehringer Ingelheim announcing the drug’s approval.

 "Vetmedin has been helping dogs with heart disease for more than 25 years, and we are thrilled that this full additional approval will allow us to improve the lives of more dogs."

The approval broadens the drug’s label, which already covers the management of mild to severe congestive heart failure in dogs with clinical MMVD or dilated cardiomyopathy, including use alongside other congestive heart failure therapies such as furosemide when indicated.

FDA approves first drug to delay the onset of congestive heart failure in dogs. News release. Boehringer Ingelheim. January 19, 2026. Accessed January 20, 2026. https://www.boehringer-ingelheim.com/us/animal-health/companion-animals-horses/pets/fda-approves-first-drug-delay-onset-congestive-heart-failure-dogs 

Boswood A, Häggström J, Gordon SG, et al. Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC study—a randomized clinical trial. 

 2016;30(6):1765-1779. doi:10.1111/jvim.14586

Häggström J, Boswood A, O’Grady MR, et al. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. 

 2008;22(5):1124-1135. doi:10.1111/j.1939-1676.2008.0150.x

Lombard CW, Jöns O, Bussadori C. Clinical efficacy of pimobendan versus benazepril for the treatment of acquired atrioventricular valvular disease in dogs. 

Fuentes VL, Corcoran B, French A, Schober KE, Kleemann R, Justus C. A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy. 

 2002;16(3):255-261. doi:10.1892/0891-6640(2002)016<0255:adrpso>2.3.co;2

Cardiac conditions. Purina Institute. Accessed January 20, 2026. https://www.purinainstitute.com/science-of-nutrition/transforming-heart-health/cardiac-conditions

Keene BW, Atkins CE, Bonagura JD, et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. 

 2019;33(3):1127-1140. doi:10.1111/jvim.15488

The approval broadens the drug's label, which already covers the management of mild to severe congestive heart failure in dogs with clinical myxomatous mitral valve disease or dilated cardiomyopathy.