During this interview with dvm360, veterinary surgeon Brian Sutherland shares how he approaches conversations about a pet's surgery to make sure the client understands the risks and benefits

Video interview with Brian Sutherland, DVM, DACVS-SA

When a client finds out that their pet needs surgery, it can be a scary start to the process for them. To help ease their nerves, Brian Sutherland, DVM, DACVS-SA, explained in this interview with dvm360, that he tries to be as transparent as possible with clients in order to make sure they understand the risks and benefits of these procedures. 

Throughout the interview, Sutherland explains that he shares a risk-benefit analysis that he does for himself with clients to help them be fully informed, educating clients on high-risk and complex procedures, especially for those that may be rarely performed, to help veterinary professionals educate their clients to make the best decisions for their pets. 

I think my general approach is to be as open and honest as possible with owners. These are often challenging and sometimes high-risk procedures, and I think owners need to be very, very well educated on that. And a lot of times these procedures are things that aren't performed very often. And so despite someone being, you know, the most experienced, like my mentor in Colorado, one of the most experienced heart surgeons in the world for veterinary patients, still there are things that he has not done hundreds of, you know. So there are definitely certain procedures where we don't do that often and have less experience with and I think it's very important that we're...open and honest with owners about that, so that they don't have some, you know, notion that we have done hundreds and we know exactly what's going to happen and that sort of thing.

And so, as part of that, what I like to do with owners is go through that same risk-benefit analysis that I do for myself, and talk to them about what I think the benefits may be and what I think the risks might be, and then include them in that sort of discussion and thought process to whether or not they think they want their pet to have a procedure based on what they feel their pet's quality of life is, and what we think we can do to improve that quality of life with surgery. So I think the upshot is being open and honest and making sure they understand the risks. 

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When it comes to discussing surgery with clients, transparency is crucial 

A surgeon's approach to owner communication

Heather Duncan, DVM, DACVD, discussed crown amputations in patients during an interview at the 2025 Fetch dvm360 conference in Charlotte, North Carolina

When to perform a crown amputation vs a full true tooth extraction

In an interview at the 2025 Fetch dvm360 conference in Charlotte, North Carolina, Heather Duncan, DVM, DAVDC, founder and CEO of Crown Veterinary Dental Specialists in Charlotte, explained when a crown amputation is appropriate to do, instead of a full true tooth extraction. In her discussion, Duncan also provided an overview of how this procedure should be done.

Below is the interview transcript, which has been lightly edited for clarity:

So during the different presentations today, we had some really great interaction, really great questions from the audience. One thing that we discussed that wasn't really in a lecture per se, was when we can do crown amputations. So that's a big topic, especially for cats that have tooth resorption. So you get a patient under anesthesia, you do your oral exam, you know, everything may look okay or you may see that we have a tooth resorptive lesion. Sometimes you take those dental xrays or imaging, and then you find like something below the gum line, because 60% of the tooth structure is below the gum line—so xrays are really important.

So a time that you could do a crown amputation, versus true extraction of a tooth is when you see that there is no root structure left. So we don't have anything that looks like a root. There's no periodontal ligament traceable around that root. There's no root canal, you know, chamber, anything, left in that root. That's when you can do a crown amputation for a tooth. You're still going to lay your mucogingival flap like you would normally. You're going to remove as much as of a root that there is, even if there's a little one up at the top, and then do your crown amputation. And then you're going to release a tension-free flap, suture that back into place, just like you would a regular extraction. But again, there's no root to go in and get so those are the cases that we can do a crown amputation in.

Heather Duncan, DVM, DAVDC, discussed crown amputations in patients during an interview at the 2025 Fetch dvm360 conference in Charlotte, North Carolina

Joya Griffin, DVM, DACVD talks about the concept of ‘food as medicine’ and how  prescription diets can help  restore the skin’s barrier function

Treating skin conditions with food

, Joya Griffin, DVM, DACVD, talked about the role of food in holistic health, particularly when it comes to treating atopic dermatitis and allergic disease in cats and dogs. In discussing her lecture 

Food for Thought: Diagnostic and Therapeutic Diets for Derm Cases

, presented at the 2025 Fetch dvm360 conference in Charlotte, North Carolina, Griffin shared types of foods that can help prevent and control skin inflammation and reduce allergic flare.

The following is the interview transcript, which has been lightly edited for clarity:

So, we are what we eat. Food has so many different applications in holistic health, especially when we're talking about treating atopic dermatitis and allergic disease. And dogs and cats use prescription diets to help to restore the barrier function of the skin because if you have diets that are high in fatty acids, that can help to restore that protective layer of the skin to prevent inflammation, reduce allergic flare, and holistically control overall inflammation in the body.

I think we're still learning about food as medicine, I think even in human medicine. So there's a lot that we still need to know, but I love the idea of starting to use prebiotics and probiotics to normalize the gut flora, because if there's inflammation inside the body, that will provide inflammation elsewhere in the body. And so, if we can balance bacteria in general, usually we have decreased inflammation, and that can be a source of improvement for some of these atopic patients. I'm starting to look at utilizing that for my patients that have chronic inflammatory conditions, and [it is] just really cool how we can use food, because everybody's got to eat. Use food. Food is medicine for controlling that inflammation

Joya Griffin, DVM, DACVD, discusses the concept of ‘food as medicine’ and how  prescription diets can help  restore the skin’s barrier function

Christopher Pachel, DVM, DACVB, CABC (IAABC), discusses how behavioral conditioning works to help improve quality of life for a patient and the pet’s owner.

Conditioning patients to manage noise fears

Fireworks, thunderstorms and other loud, sudden noises can be fearful for some companion animals. A 

 at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina, presented by Christopher Pachel, DVM, DACVB, CABC (IAABC), a practitioner at Animal Behavior Clinic in Portland, Oregon, discussed using a comprehensive approach with a variety of intervention strategies to address noise phobia and anxiety in canines. During a 

interview, Christopher Pachel, DVM, DACVB, CABC (IAABC), discusses how one of those intervention strategies, behavioral conditioning, works to help improve quality of life for a patient and the pet’s owner.

Understanding phobia and anxiety in patients

The following is a transcript of the video:

Christopher Pachel, DVM, DACVB, CABC (IAABC)

: When we're doing a conditioning exercise to try to change either their emotional response or the behavioral response—essentially, ‘how do I feel?’ and ‘what do I do when that situation happens?’—what we need to be able to do is essentially avoid the scenario that's triggering the panic response. Not because that fixes it, but because we're trying to get them out of that sort of habitual response, and then to be able to create more intentional exposures at a very specific intensity level.

What I mean by that is. if I make that intensity level of the stimulus—the volume, the duration of the sound, whatever it is that we're manipulating—too soft, too short, enough so that it's not even on the pet's radar, we're not going to give them any opportunity to learn a different set of coping skills. On the other hand, if I'm making it too long, too intense, too much on whatever metric we're working with, I'm more likely to trigger more of the panic response, which now becomes a sensitizing event.

So it's kind of like this little Goldilocks experiment to say, ‘Okay, not too much, not too little, but right in that sweet spot,’ where we have that animal who is alert, aware, and has the opportunity to still be in the thinking part of their brain to learn from that exposure. So we're trying to create that sweet spot, and then whether we're trying to focus more on the emotional response or the behavioral response, then we're kind of programming. That's the conditioning part to then say, ‘Okay, can I pair that with something that is enjoyable for you? Is that food? Is that play? Is that petting? Is it praise? What would be enjoyable to you?’ And can I pair those 2 things so that the experience of that noise, in the case of a noise phobia, can then start to be associated and actually become predictive of a pleasant or enjoyable experience.

And so, both the order of how those things happen as well as the intensity of how those things are being compared or exposed or conditioned, it all matters. We start out at a low enough level that we're able to start to see some momentum, and we get an animal who starts to respond to that predictive conditioning. Once we get that sense that the animal is hearing, experiencing the stimulus and now has that conditioned expectation—amazing—now we can start increasing the difficulty level, and then we can start increasing the duration or the volume or the frequency of the exposure in a way that allows us to build up to something that would replicate the real world experience.

And that's the point at which we're no longer avoiding or sidestepping. We're now connecting the dots that we've onboarded, a set of coping skills to allow that animal to actually function and to continue that process of conditioning.

In a dvm360 interview, Christopher Pachel, DVM, DACVB, CABC (IAABC),
discusses how behavioral conditioning can work to help improve quality of life for a patient and the pet’s owner.

Joya Griffin, DVM, DACVD, loves seeing her patients experience ‘extreme makeovers.’ The practicing dermatologist in Louisville, Kentucky—and star of television’s Nat Geo Wild unscripted show 

—said the ‘extreme makeover’ of one of her first patients ultimately led her on the path to her career specializing in dermatology.

Griffin presented the morning keynote address on Day 2 of the 2025 Fetch dvm360 Conference in Charlotte, North Carolina. Her talk—sponsored by Blue Buffalo—took attendees on a journey of her career in veterinary medicine, which began as a young child, growing up in Ohio. At that time, Griffin resided across the street from a veterinarian who was also her science teacher at school.

“He was really an integral in my life and my development as a young student,” Griffin said. “And then I also had the example of a Black veterinarian in Dayton, Ohio, who we would take our pets to, and they would do our vaccines for us. And that was really kind of a great experience too…Seeing that really allowed me to see the possibility for myself in veterinary medicine, and so my parents supported me, and they pushed me forward.”

She spoke about her family’s menagerie of animals, which included cats, dogs, and frogs as well as a snapping turtle and, for a day, a rabbit. “Like many of you, I felt like I had a special connection to animals, and I wanted to spend my life treating them,” Griffin said.

Her sister’s dog Gizmo was adopted when Griffin left home for college at Johns Hopkins University in Baltimore, Maryland. “[Gizmo] had this terrible skin disease. She lived in this E collar for a year,” Griffin said. “She was miserable.”

“Gizmo did not have the care that she needed for her skin,” Griffin said. At the time, she said, some of the technologies and medications that we have now to treat skin disease were not available then. “We also didn't have the finances, really, to commit to her on a continuous basis to keep her skin as good as it needed to be,” Griffin added.

After a groomer recommended euthanasia for Gizmo, and Griffin had moved on to Cornell University College of Veterinary Medicine in Ithaca, New York, she sought more specialized care for the family pet. “I stole her from my sister, and I took her to Cornell with me. And the first thing that I did was I took her to the dermatology service,” Griffin said.

The team’s treatment plan first focused on relief, reducing inflammation and resolving infection. They also addressed active parasites and potential food hypersensitivity, while working to rule out causes of the skin disease. Antibiotic and antifungal medications, and an intense bathing routine were among the therapies the team tried with Gizmo. ”Eventually, during my internship year, I was able to perform intradermal testing on her and start her own immunotherapy after we had achieved the diagnosis of atopic dermatitis,” Griffin said.

The speaker next showed Fetch attendees a photo of Gizmo post-diagnosis and treatment. The image showed a healthy dog with a full coat of thick hair, and Griffin added that the pet no longer had the odor associated with her skin disease. Gizmo’s journey to wellness is what drew Griffin to veterinary medicine, she added.

“Gizmo was my extreme makeover,” Griffin said. “I saw firsthand what it meant when you can clear up the skin disease in a patient, and what that can mean to the family, and how you can improve the quality of life of that animal and of that pet parent.”

As a Cornell student, Griffin earned multiple awards for her work in veterinary medicine. These accolades included the Dermatology Service Award for demonstration of aptitude in clinical dermatology and for her research on 

 otitis externa. She later completed an internship in Chicago, Illinois, at VCA Berwyn and Aurora Animal Hospitals, and earned the Intern Abstract Award for a presentation on methicillin-resistant 

, before returning to Cornell for a residency.

Griffin, who admitted that she enjoys “gross things,” now practices veterinary dermatology at Animal Dermatology Group in Louisville. She has shared some patient cases and clients she sees in the clinic on television, as part of 

and with the Fetch audience, addressing multiple conditions in the hour-long lecture.

“It truly is amazing, these extreme makeovers we can give these pets,” Griffin said. She then left attendees with an actionable question: “What extreme makeover are you going to make?”

Griffin J. Extreme Makeover: Derm Edition. Presented at: Fetch dvm360 Conference; March 14-16, 2025. Charlotte, NC.

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Joya Griffin, DVM, DACVD, shared her love of ‘extreme makeovers’ for patients in a keynote address at Fetch Charlotte. 

Veterinarian follows a call to dermatology

Understanding chronic kidney disease (CKD)—one of the most common diseases in older cats—is an important task. At the 2025 Fetch dvm360 Conference in Charlotte, North Carolina, Christopher Byers, DVM, offered a comprehensive lecture on CKD in felines. Highlights of his session include understanding signs of hypokalemia in patients with CKD, the clinical presentation of the disease, the physical exam, and IRIS staging.

Hypokalemia in cats without CKD and those with the condition may present in different ways, with the manifestation including cervical ventroflexion, paresis, and a stiff gait. During his session, Byers explained that hypokalemia is one of the differentials for cervical ventral flexion, which renders a cat unable to lift their head up.

 However, as Byers emphasized, hypokalemia does not manifest itself through cervical ventral flexion in the typical cat with CKD.

Instead, “the typical CKD cat may have their hypokalemia manifest as just lethargy—just reduced activity—or very commonly, at least stiff gait,” Byers emphasized.

Many owners of patients with CKD may believe their cat’s stiff gait is because of arthritis in old age. However, as Byers stressed, in cases where the patient is documented or suspected to have CKD, it is imperative to check the patient’s potassium status, as these signs raise a red flag.

“Sometimes patients at the low end of normal—so 3.4, 3.5 [mEq/L]—maybe [even] that is...too low and we want to push them toward the middle range of the reference range, or the upper part of the reference range,” Byers said. “...Potassium supplementation for these patients is often needed.”

A patient with CKD “can look like a completely normal cat or dog,” Byers said. In the early stages of the diseases, polyuria and polydipsia (PUPD) is the most common clinical sign, with polyuria being primary and polydipsia being compensatory. Clients may report not being able to keep the cat’s water bowl full, finding more clumps in the litter box, and having to change the litter box more often.

 “But that may be the only sign,” expressed Byers.

When conducting a serial exam, weight loss may be noted by the veterinarian. “Owners may not recognize that their pet is losing weight because they're looking at them every day,” added Byers.

As the disease progresses, the patient may exhibit the following clinical signs

Byers explained that except for uremic halitosis, none of these clinical signs are pathognomonic for CKD.

“What I want to emphasize, [is] look for the stiff gait issues in the senior and geriatric patients, and 

 is, obviously, you're looking for the overt changes, like a retinal detachment,” he continued. “But sometimes, you're going to be able to pick up on some subtle things, like retinal vessel tortuosity that gives a red flag that, oh, ‘I'm really concerned about systemic hypertension....’”

As Byers explained, the fundus exam will not always show an overt retinal hemorrhage or detachment, but rather “very subtle retinal changes that give [the veterinarian] red flags and justification for sharing more information with the owner about some additional investigation to do for those patients.”

During the physical examination, veterinarians should look for the following

Tachypnea, due to anemia and/or metabolic acidosis

The CKD IRIS staging for cats, a presented by Byers, is as follows

Creatinine (CREA): <1.6 mg/dL (<141.5 umol/L)

Symmetric dimethylarginine (SDMA): <18 ug/dL

As patients with CKD begin to lose muscle mass, SDMA may be a more reliable indicator of stage in patients with sarcopenia, explained Byers.

“There’s also sub-staging that [we] need to do,” Byers said. For feline patients with or without proteinuria, the sub-staging is as follows

Non-proteinuric: <0.2 urine protein-to-creatinine ratio (UPC)

For hypertension, the IRIS sub-staging, relative to blood pressure, is as follows

Patients with CKD may not exhibit any signs, with PUPD being the most common sign in patients in the early stages of the disease. Veterinarians should be careful to note if the patient has a stiff gait, as this may indicate hypokalemia in a feline patient with CKD. Moreover, a fundus exam should also be conducted, as some findings could indicate systemic hypertension.

Byers CG. Chronic kidney disease. Presented at: Fetch Charlotte; Charlotte, North Carolina. March 14-16, 2025.

Christopher Byers, DVM, delivered a session on CKD in cats at the 2025 Fetch Charlotte conference in North Carolina