Tatiana Henriques Ferreira, DVM, PhD, MSc, DACVAA, and Marlis Rezende, DVM, PhD, MSc, DACVAA, discuss best practices

Understanding when to use inhalant anesthesia

Tatiana Henriques Ferreira, DVM, PhD, MSc, DACVAA, a clinical assistant professor at the University of Wisconsin-Madison School of Veterinary Medicine, and Marlis Rezende, DVM, PhD, MSc, DACVAA, an associate professor of anesthesia and analgesia at Colorado State University College of Veterinary Medicine and Biological Sciences in Fort Collins, co-presented a lecture on inhalant anesthesia vs total intravenous anesthesia (TIVA) at the 2025 North American Veterinary Community 

 interview, they discussed cases that commonly use inhalant anesthesia.

Using total intravenous anesthesia in certain cases

The following is a transcript of the video

Tatiana Henriques Ferreira, DVM, PhD, MSc, DACVAA

: You really can do inhalant anesthesia for any procedure, but you just have to keep in mind that inhalant anesthetics can lead to some negative effects on some body systems. And in the example of the neuro patients, when you worry about intracranial pressure, you could think about mitigating some of those negative effects by keeping the inhaling anesthetics low, like below Mac values. And this would mitigate some of those side effects.

: And controlling CO2, so that’ the same thing.

 Perhaps a little bit more aggressive in the case of inhalants, then you have to be with TIVA. But yeah, we can do those two.

 And the other case you mentioned, it's probably…not as common, would be craniotomies. We do those, brain surgery, with TIVA. But a lot of like our brains, we do them on inhalant too, if they are not particularly affected…We oftentimes do them on inhalant, doing those things like ventilating them, keeping their CO2 on the end tidal CO2 around 32-35, and sometimes using a [constant rate infusion] of propofol or opioid to sort of make sure that the concentration of ISO stays low. So we do those with inhalants too. So it's not like you have to use TIVA, but that would be probably one of the scenarios where TIVA would be the most beneficial.

Videos

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

Cancer affects millions of Americans each year, with over 2 million new cases diagnosed in 2024 alone—resulting in approximately 5,500 cancer diagnoses and 1,600 deaths per day.

 While the medical community has increasingly recognized the impact of cancer on survivors’ relationships with their children, little attention has been paid to how cancer affects relationships between survivors and pets. 

To better understand this important, but overlooked topic, we recruited cancer survivors between April 2024 – December 2024 via social media (i.e., Facebook, Twitter, Instagram, Reddit). Our sample included 930 cancer survivors, consisting of 265/882 (30%) people diagnosed with breast cancer, 220/882 (24.9%) with lung/bronchus cancer, 120/882 (13.6%) with prostate cancer, 70/882 (7.9%) with colorectal cancer, and 207/882 (23.5%) with other types of cancer. The largest percentages of participants were in Stage 1 (280/919, 30.5%) or Stage II (263/919, 28.6%), and the majority (722/919, 78.6%) reported currently receiving treatment or care. The most common type of treatment or care they were receiving included chemotherapy (341/930, 36.7%), followed by medication (e.g., tamoxifen/Nolvadex, aromatase inhibitors) (229/930, 24.6%), and radiotherapy (227/930, 24.4%). A smaller number reported undergoing any type of surgical procedure (112/930, 12.0%) or receiving hospice or palliative care (63/930, 6.8%). Most participants reported being diagnosed 2-12 months (256/930, 27.5%) or 1-2 years ago (206/930, 22.2%).

Findings from our study elucidated the most common concerns and benefits breast, prostate, colorectal and lung cancer survivors experience in caring for their pets during cancer treatment and/or recovery. Survivors reported that their pets provide them with emotional support, companionship, and motivation during treatment. In particular, 79% of participants reported that their pets create a "positive presence in the home", view their pets as "partners to relax with" (73%), make them “feel loved” (77%), and "offer the opportunity to care for another being" (69%). For many survivors, their pets were seen as a critical coping mechanism during treatment.

Participants overwhelmingly reported strong attachments to their pets. These strong bonds were associated with higher levels of reported support from their pets and higher levels of guilt when they felt unable to provide the care they wanted to give their pets. Many of our participants reported significant guilt about not meeting their pets' needs during treatment, similar to parental guilt experienced by those with children. This guilt can exacerbate anxiety and depression,

 potentially impacting treatment adherence and recovery. Yet daily tasks like walking their dogs, lifting heavy bags of food or litter, and cleaning up after their pets can become difficult or impossible during treatment. In addition, approximately 1/3 of participants reported being very or extremely concerned about the practical impact of cancer on their pets and who would care for their pet if they became unable due to cancer progression or death.

We found that certain populations faced greater challenges managing pet care during cancer treatment, including recently diagnosed patients (within 2 months), those under 30 years old, and those with young children. These demographic groups reported higher levels of concern and guilt regarding pet care during treatment.

When queried about support, approximately 2/3 of cancer survivors reported receiving support for pet-related needs from partners, family, and friends, but only half of the participants felt supported by their veterinarian or medical professionals.

 These results suggest that more can be done to help support cancer survivors, with veterinary professionals uniquely positioned to help support pet owners with cancer during both treatment and recovery.

Recognizing the limitations within busy veterinary practices, we offer the following suggestions to help support pet owners with cancer:

Include a sensitively worded owner health question within client paperwork. For example, "Are there any health challenges you're currently experiencing that might affect your ability to care for your pet?"

Train staff to recognize signs that clients may be struggling with illness (frequent rescheduling, appearing fatigued, mentioning treatment schedules) and how to respond compassionately.

Offer flexible scheduling options for clients undergoing treatment, including same-day appointments when possible, drop-offs, and telehealth options when appropriate.

Move immunocompromised clients to an exam room as soon as possible to reduce stress and infection risk.

Create a "Cancer Care Kit" for clients that includes information about

Local pet service resources (dog walkers, pet sitters, mobile groomers)

Modified payment plans or financial assistance programs, if needed

Adaptive pet care tools (e.g., extended leashes, elevated food bowls, ramps, etc.)

Potential concerns for pet owners undergoing cancer treatment such as:

Radiation safety concerns for pets (maintaining distance after certain treatments)

Educate clients about chemotherapy safety and pets:

Provide detailed guidelines about the safe handling of chemotherapy medications, including proper disposal of any pill containers or sharps

Advise on precautions if bodily fluids may contain traces of chemotherapy drugs (particularly important during the first 48-72 hours after treatment)

Suggest protective measures for immunocompromised pet owners, such as wearing gloves when cleaning litter boxes or picking up waste

Handling pets while immunocompromised (safe petting practices, avoiding scratches)

Managing pet care during long treatment days and hospital stays (planning calendars, caregiver instructions)

Adjusting pet care routines to accommodate reduced energy (using puzzle toys instead of long walks)

Information about pet waste handling during chemotherapy treatment

Create a list of clients willing to volunteer to help owners experiencing serious illness with pet care tasks (e.g., transportation to appointments, dog walking, temporary pet sitting during treatments).

Offer suggestions for low-energy pet care options

Indoor enrichment activities for dogs when walks are difficult (scent games, puzzle toys, gentle training sessions)

Automated feeders and water fountains to reduce daily maintenance

Alternative exercise options (hiring dog walkers, doggy daycare)

Litter box modifications for easier cleaning (automatic or larger systems)

Adaptive equipment for pet care (extended-handle pooper scoopers, lightweight leashes)

Discuss temporary living arrangements if needed

Information about reputable boarding facilities

Guidance on preparing pets for temporary stays with friends or family (providing familiar items, maintaining routines)

Suggestions on how to maintain their connection with their pet during separation (video calls with pets, sending items with their scent)

Acknowledge the pet's importance in your client's cancer journey. Simple statements like "I know Bella must be a comfort to you during this difficult time" can validate their feelings.

Address pet-related guilt by normalizing these feelings and emphasizing that temporary adjustments to care routines will not harm their relationship with their pet.

Listen compassionately when clients express concerns about their ability to care for their pet during treatment. Statements like "Your pet will still love you even if you can't walk them as often right now" can be reassuring. Explain how pets often adapt well to temporary changes in routine.

Provide information about reputable boarding facilities

Provide a template for pet care instructions that clients can easily complete for times when they are undergoing treatment or to plan for extended hospitalization or declining health, including:

Lists of daily, weekly, and monthly pet care tasks

Medication schedules with clear instructions for temporary caregivers

Behavioral information about the pet to help temporary caregivers manage successfully

Behavioral quirks and management strategies

Comfort techniques (where the pet likes to be petted, words they respond to)

Warning signs of stress or illness specific to their pet

Create a handout to help clients develop an "Emergency Pet Kit" 

2-3 days of pet food, medications, and supplies

Care instructions with feeding amounts, medication dosages, and routine details

Veterinary contact information and medical history summary

Comfort items (toys, blankets) to reduce pet stress

Pet description including personality traits and preferences

Develop a "Veterinary-Oncology Liaison Program"

A program where interested staff members receive additional training on cancer treatment effects and pet care, becoming specialists in supporting these clients within your practice.

Veterinarians have a unique opportunity to support pet owners facing cancer and help preserve the human-animal bond. By acknowledging both the practical challenges and the emotional benefits pets provide to survivors of cancer, veterinarians can help reduce pet-related guilt and ensure that the human-animal relationship remains a source of comfort rather than stress during cancer treatment.

Simple interventions, including flexible scheduling, resource sharing, compassionate listening, and practical care planning, can make a significant difference for clients managing both cancer treatment and pet care responsibilities. By extending compassionate care beyond the animal to include the needs of the owner facing cancer, veterinarians can support animal health, and help preserve the human-animal bond during one of life's most challenging times.

The American Cancer Society. 2024 Cancer Facts & Figures Cancer | 2024--First Year the US Expects More than 2M New Cases of Cancer. 2025. Accessed February 17, 2025. https://www.cancer.org/research/acs-research-news/facts-and-figures-2024.html

Kogan LR, Bussolari C, Currin-McCulloch J, Packman W, Erdman P. Dog owners: Disenfranchised guilt and related depression and anxiety. 

Kogan LR, Currin-McCulloch J, Bussolari C, Packman W. Cat owners’ disenfranchised guilt and its predictive value on owners’ depression and anxiety. 

Kogan, L R. and Currin-McCulloch, J (in press). Unrecognized Bonds: How Pet Ownership Affects Guilt, Concerns, and Quality of Life During Cancer Treatment. Cancer Nursing: An International Journal for Cancer Care Research

Articles

Practical suggestions for veterinary professionals

Supporting pet owning clients with cancer, and survivors

and login or create a free CE account and claim your credit after listening to this episode.

In this podcast interview, Lisa Ziemer, VMD, DACVR, provides an overview of Antech RapidRead, the AI-assisted radiographic interpretation tool, what the tool does, how veterinarians can utilize AI-powered tools in practice, and looks at a RapidRead case study.

Understand how and when to use RapidRead in clinic, along with what makes the tool different from others

Examine a case study using RapidRead that illustrates the tool’s utility in everyday practice

Evaluate situations where AI tools might help provide enhanced veterinary care


Podcasts

On this episode of The Vet Blast Podcast presented by dvm360, Lisa Zimer, VMD, DACVR, and host Adam Christman, DVM, MBA chat about the use of AI tools in veterinary practice

Podcast CE: Understanding how and when to utilize AI in imaging

An immunosuppressant indicated to manage pruritus associated with canine allergic dermatitis and for atopic dermatitis in dogs has received a positive opinion from the European Medicines Agency's Committee for Veterinary Medicinal Products (CVMP), which may lead to marketing authorization in Europe by the end of the third quarter of 2025.

 The ilunocitinib tablets (Zenrelia; Elanco Animal Health) were approved by the FDA for use in the United States in September 2024.

Ilunocitinib tablets are administered to patients orally once daily. The drug contains a nonselective Janus kinase (JAK) inhibitor.

 “It can be used for both short-term acute cases of allergies like flea hypersensitivity or contact allergies or even flare ups in a longer term case, and it could also be used for long term treatment, as in chronic cases of atopy,” Mara Tugel, DVM, veterinary technical marketing-companion animal therapeutics for Elanco, said in a 

The CVMP noted the efficacy of ilunocitinib tablets in treating the indicated conditions in its’ opinion, according to Elanco. The CVMP also recommended marking authorization in the European Union based on quality, safety and efficacy demonstrated in the data provided to the committee.

"This milestone marks a significant advancement in the expansion of Zenrelia, Elanco's fastest globalized product with eight major regulatory approvals expected in just 18 months," Ellen de Brabander, PhD, executive vice president, innovation and regulatory affairs at Elanco, said in a news release.

 "As part of the EU approval process, Elanco has done a head-to-head noninferiority study versus the marketplace incumbent, and we are very pleased with the result. With millions of itchy dogs unable to find relief, we're excited to bring this new solution to veterinarians across the EU."

Ilunocitinib tablets are currently available in Brazil, Canada and Japan, in addition to the US. Elanco noted that, once the European Commission has adopted the CVMP’s recommendation, the EU label will be consistent with other markets outside the United States.

The FDA has publicly noted that ilunocitinib tablets are safe and effective when used in accordance to the label. However, the product labeling has a boxed warning stating that dogs should not be vaccinated at least 28 days before and after treatment with the drug. The warning was prompted by fatal vaccine-induced disease and inadequate immune response to vaccines.

Jason B. Pieper, DVM, MS, DACVD, assistant professor at Iowa State University, acknowledged the warning, in a 

interview. He provided insights about the concern about vaccines and addressed adverse effects.

“Zenrelia is a newer drug. The biggest concern with it is it does have a black box warning around vaccinations and suppression and whatnot. But they've done some further studies with vaccination, showing that dogs that have previously been vaccinated and are then getting booster vaccines are easily able to achieve tighter levels for the distemper and rabies vaccine. And those were done in much larger studies: 4 times the quantity of dogs [than in] the initial study…. So, from that aspect, I think it's very safe—I'm not worried about the vaccines aspect with them. I think it's relatively safe there,” Pieper said.

“Side effects, since it's also in that JAK inhibitor category and that same first generation of them, I believe that the side effects are relatively low. I have yet to see a side effect with those dogs either,” Pieper added.

In the US, ilunocitinib tablets are available by prescription from a licensed veterinarian and in scored tablets in 4 strengths: 4.8 mg, 6.4 mg, 8.5 mg, and 15 mg. Each tablet strength is available in 10 and 30 count blister packages and 90 count bottles.

“The dose has been optimized to allow for once daily dosing from the start, and this has some really clear advantages for both veterinarians and pet owners,” Tugel said.

 “It's just simpler. So communicating once daily dosing from the beginning to a pet parent is easier than talking about having to do a dosing change partway through treatment.”

Elanco receives positive opinion on Zenrelia (ilunocitinib) grom EU’s Committee for Veterinary Medicinal Products (CVMP). News release. June 12, 2025. Accessed June 13, 2025. 

https://www.prnewswire.com/news-releases/elanco-receives-positive-opinion-on-zenrelia-ilunocitinib-from-eus-committee-for-veterinary-medicinal-products-cvmp-302480544.html

FDA Approves New Treatment for Allergic Skin Conditions in Dogs. News release. US Food and Drug Administration. September 19, 2024. Accessed September 19, 2024. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-approves-new-treatment-allergic-skin-conditions-dogs?utm_medium=email&utm_source=govdelivery

McCafferty C, Tugel M. An overview of Zenrelia. 

. October 9, 2024. Accessed June 13, 2025. 

https://www.dvm360.com/view/an-overview-of-zenrelia

McCafferty C. Treatment for allergic skin conditions receives FDA approval. 

. September 19, 2024. Accessed June 13, 2025. 

https://www.dvm360.com/view/zenrelia-receives-fda-approval

Bautista-Alejandre A, Pieper JB. Treatment options for moderate to severe atopic dermatitis, and when to use what. 

. February 17, 2025. Accessed June 13, 2025. 

https://www.dvm360.com/view/treatment-options-for-moderate-and-severe-atopic-dermatitis-and-when-to-use-what

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

Access to canine dermatitis therapy may soon expand to Europe

Benjamin Bergstrom, DVM, MS, DACVO, discusses the challenges of managing glaucoma in feline patients 

Latanoprost limitations in cats with glaucoma

Treatment options for cats often lag behind those available for dogs, and ophthalmology is no exception. In this interview clip on his lectures at the Fetch dvm360 conference in Nashville, Tennessee, this past month, Benjamin Bergstrom, DVM, MS, DACVO, owner of The Eye Vets, a veterinary ophthalmology practice in Nashville, discusses the challenges of managing glaucoma in feline patients. He highlights that glaucoma is often more manageable with medical therapy in dogs than in cats, depending on the cause. Bergstrom also discusses the limited utility of latanoprost—a key medication in treating canine glaucoma—in feline patients, reminding practitioners that the medication is not as long-lasting in cats as it is in dogs.

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

: Glaucoma in animals is a very, very frustrating disease. The treatment of glaucoma in dogs is different than it is in kitties. And in a lot of instances, we can manage it a little bit longer in dogs with medical therapy than we can in cats depending on the cause. And so, I think the important fact about glaucoma and its differences between cats and dogs is latanoprost, for instance, which is our most potent best medication we have as a defense to glaucoma in dogs, does not work or does not work for as long in kitties. And so, we don't have that in our arsenal to be able to manage the disease as well as we do in dogs.

For more on ophthalmology and to listen to the rest of the interview with Bergstrom, check out the following:

Understanding and managing cataracts and lens luxation in cats and dogs

Differentiating nuclear sclerosis from early cataracts during an ophthalmic exam

Enucleation conversations: A lecture preview

Summer in veterinary medicine isn’t a season—it’s a pressure cooker. Appointments double, emergencies happen, clients get crankier, the team’s shortstaffed, and the air conditioning is barely hanging on. People are melting. Morale is slipping. And stress isn’t creeping in—it’s kicking down the door.

So here’s the question: What if instead of letting the summer grind break your team down, you used it to build your team up?

This isn’t another Kumbaya moment. It’s a tactical move. One small, deliberate action a day—over 30 days—to reconnect, reset, and recalibrate your clinic’s culture. Not with fancy consultants or culture committees. With your actual people, in your actual hospital, during actual chaos.

Burnout thrives in isolation. And summer, with its heat and high caseloads, everyone’s in survival mode. What this challenge does is interrupt that pattern. It builds micromoments of intention, reflection, and collaboration. It pulls teams out of the grind—just long enough to remember they’re not alone in it. And while you may have your ups and downs throughout the workweek, through it all you are a team that does what’s right for your clients and their pets.

We’re not fixing culture in 30 days. We’re rewiring how we show up for each other while keeping it real.

One challenge per day. Each takes 2 to 20 minutes, tops.

Complete it as a team. Even if it’s just whoever’s on that day.

Miss a day? No guilt. Just pick up where you left off.

Post your progress (if you want). Use #Vet30Reset to let the world know your team is in it, and tag @dvm360 on Instagram or Facebook.

You can customize it, print it, even write it on a whiteboard. These are just some ideas for you to react to and see how this can be implemented into your practice. But once you commit, lean in and go for it!

The 30-day veterinary culture reset challenge

(You can mix up the order, repeat favorites, or assign a team member each day to pick.)

: Shout out someone’s invisible win from yesterday. Do it with a dance break.

: Clean 1 zone together for 10 minutes—with music blasting.

: Each person teaches a weird clinical tip/hack they swear by. No gatekeeping.

: Handwrite a thank-you card to at least 1 team member and mail it to their home.

: Share a photo of your pet and one sentence on why they keep you going.

: Watch a dvm360 webinar together online at dvm360.com/flex.

: Put a quote or words of wisdom in a team member’s locker. Do it for multiple ones.

: “Two-minute grounding.” Everyone stops and breathes/meditates together.

: Try a different phrase for a difficult client conversation. Rework your reframing.

: Write down 1 thing you want to get better at. Post it up.

: Bring a favorite snack. Everyone creates a snack attack bag.

: Choose 1 technology tool or software feature no one’s using—and test it.

: Hydration station. Encourage each team member to finish their water intake.

: What’s 1 way someone helped you this week? Tell them.

: Team stretch break. Two minutes. Make it count.

: Post-it gratitude wall. Fill it. Show your attitude of gratitude.

: What’s 1 step in your day that feels pointless? Talk about it. How can it improve?

: Choose a code word to use when you need a reset or backup or a bad day from home.

: Take a team selfie. Caption it honestly and post it.

: Pick 1 patient who made your day this week. Share the story and why.

: “Before I go home today, I will…”—each person sets a microgoal.

: What’s the weirdest thing you’ve seen in veterinary medicine? Laugh it out.

: Choose 1 way to surprise a client with kindness today.

: Ten-minute lunch table topic: What would make this job 10% easier?

: Ask each team member to write down everyone’s birthday. The one who knows the most wins a gift card.

: Water balloon toss/run for your life in the backyard. You’re welcome.

: What’s 1 boundary you’re working on setting? Support each other.

: Handwrite thank-you notes to your top 2 or 3 clients and mail them out.

: Bring in a joke or meme and post it at the front desk.

: Celebrate! Ice cream social! Goat yoga! All of it. You made it!

One intentional action a day to keep your team sane and cool this summer