 readers! We loved getting to see all of you at our Fetch Long Beach conference last week. Although that is a wrap on Fetch conferences for 2024, Fetch Charlotte is right around the corner and will be here before you know it! You can check out all our 2025 Fetch conferences, including a new location, and register 

Here is what was popular this week on dvm360.com:

 columnists Marc Rosenberg, VMD, shared his final installment of his monthly column, 

, to provide readers with the 5 most significant recommendations he would like to pass on to the veterinary industry after spending over 50 years as a veterinarian.

In the latest installment of Pet Poison Helpline’s (PPH) 

Renee Schmid, DVM, DABT, DABVT, senior toxicologist and director of veterinary medicine, 

 why clients should not be taking their pets medication, despite sounding and appearing the same as their human medications.

, host Adam Christman, DVM, MBA, sat down with Jessica Vogeslang, DVM, CVJ, to discuss the role telemedicine and social media play in the current veterinary medicine landscape.

A member of the Provincial Parliament in Ontario, Canada, 

 the introduction of The Captive Wildlife Protection Act, which would require licensing for zoos, ban the use of wildlife for certain activities, and more as a way to fill the gap in provincial regulations of wildlife animals living in a zoo setting.

, Kelley Detweiler and Peter Weinstein, DVM, MBA, shared the latest developments for xylazine regulation in the United Kingdom, and the implications this could mean for the veterinary profession.

 found that microRNAs can be useful for identifying myxomatous mitral valve disease in canine patients. The research collected serum and plasma profiles from 123 dogs and focused on 15 specific miRNA markers. 

Articles

Wrap up: Can clients take their pet's medication? And other veterinary news

editorial team is counting down our Top 20 news stories and articles of the year, from January 1, 2024, to November 15, 2024. Rank was determined by measurable audience interest and engagement.

A spotlight is shining on 1 article each day through New Year’s Eve, when the No. 1 

story of the year will be shared. The following article is No. 19 on this list:

Heartburn medication potential key to fighting cancer and immune disorder in canines

Texas A&M School of Veterinary Medicine and Biomedical Sciences (VMBS) researchers discovered that proton pump inhibitors (PPIs), commonly used to treat acid reflux and heartburn in people and animals, could potentially be effective at fighting cancer and other immune disorders in dogs.

 These findings are also building on similar ongoing research in human medicine.

“While we can’t use PPIs alone to treat cancer, we’re hopeful that we may be able to improve the effectiveness of chemotherapies by combining them with PPIs sometime in veterinary medicine in the future,” explained Emily Gould, DVM, MS, DACVIM (SAIM), PhD, an assistant professor in the Department of Small Animal Clinical Sciences at VMBS, in an organizational release.

 “Using them at certain stages of cancer treatment may improve treatment success.”

According to the release, proton pumps are considered “channels" that regulate how different molecules are distributed throughout the bodily systems.

 Although they have been designed to govern stomach acid production, recent research suggests these medications could also affect other types of pumps within the body, including immune cells or cancer.

A study that was recently published in the journal 

Veterinary Immunology and Immunopathology

 investigated which cellular systems affect PPI, with hopes the findings will give both human and animal medicine experts a more holistic understanding of PPI effects.

 The researchers found that their work demonstrated treatment of neoplastic in vitro MCs from multiple species with esomeprazole, more so than famotidine, alters cell structure, induces significant cytotoxicity, and could even alter murine mast cells.

For information about on this story, including protein pump inhibitors, references, and more, continue reading the full article: 

https://www.dvm360.com/view/heartburn-medication-potential-key-to-fighting-cancer-and-immune-disorder-in-canines

dvm360 is counting down the Top 20 news stories and articles from 2024 with this series of spotlights.

2024 veterinary news in review: #19

Marc Rosenberg, VMD, and "The real boss" (Image courtesy of Marc Rosenberg, VMD) 

After 54 years as a licensed veterinarian and the author of several hundred dvm360 Dilemma columns, it’s time for me to lay my stethoscope down. It has been so rewarding to share my half century of veterinary experiences and challenges with my colleagues. During my journey as a veterinarian, I was a practice employee and a practice owner. I shared my veterinary knowledge and experience in print, on television, on the radio, and in veterinary classrooms. I have seen the practice of veterinary medicine grow and thrive in these past 50 years and seen the changing demographic footprint of my veterinary colleagues. When I graduated from veterinary school, 10% of my classmates were women. In 2024, 80% of veterinary medical students are women. If I were asked to name the 5 most significant recommendations that I would pass on to my veterinary colleagues after more than 50 years of practice, they would be the following:

. When practice challenges arise and cause stress and emotional pain, always remember to behave ethically and professionally. Don’t escalate volatile situations, and don’t rush to judgment.

. Valuable staff and coworkers are priceless. Never let money stand in the way of acquiring or maintaining indispensable staff members.

. Fight the urge to micromanage. Staff efficiency and productivity grow when there is less micromanagement and more mentorship.

. When you have a bad day at the office, don’t bring it home to your family and vice versa. When you have a poor encounter with a client or are disappointed in treatment results, don’t let this frustration carry over to staff or pet owners. Learn to compartmentalize.

. It’s easy in the practice of veterinary medicine to fall into a comfort zone. Comfort zones are tempting but must be avoided. They prevent reasonable risk-taking. They hinder practice progress and always lead to regret.

Things were very different when I started practicing. There was no feline leukemia virus (FLV) testing and certainly no FLV vaccine. Heartworm preventive was given daily. Flea and tick control was handled with baths, dips, and sprays. No digital x-rays, and no examination room electric lift tables (oh, my aching back!). What has not changed is compassion for the pet patients, respect for these animals, and a devotion to caring for them and healing what ails them

My best wishes to all who make this profession the envy of our health care systems. Feel free to drop me a line at any time and let me know how you are doing.

A longtime columnist and veterinarian retires after more than 50 years in the industry

The final dilemma

A new study has found that microRNAs (miRNAs)—cellular RNA fragments that regulate gene expression—can be useful in identifying myxomatous mitral valve disease (MMVD) in dogs. According to researchers, these miRNA markers may also be effective in differentiating between preclinical stage (M1 and B2) and clinical stage (stage C and D) MMVD in animal patients.

“Early detection is essential for significantly improving the longevity and quality of life of dogs, especially those at risk for this challenging disease, Robert Coultous, BVSc, PhD, MS, chief scientific officer and cofounder of MI:RNA—a veterinary diagnostics company leading the study—said in a news release.

“Our research marks a significant advance in personalized veterinary care and diagnostic technique. By identifying this disease before symptoms arise, we’re empowering veterinarians with a valuable tool to intervene early, helping to potentially slow the progression of heart disease and prevent lasting damage.”

, collected serum and plasma profiles from 123 dogs, focusing on 15 specific miRNA markers. Dogs were divided into a healthy control group and an MMVD group. The MMVD group was further subdivided into preclinical and clinical groups. Twenty-six patients with MMVD who had a history or clinical signs of concurrent disease were excluded from the study

The expression profiles of the panel of 15 miRNAs helped distinguish between the dogs without MMVD and those with the disease. The optimized predictive value offered an overall area under the curve (AUC) of 0.93, cross-validated accuracy of 0.83, and high sensitivity (85%) and specificity (82%) in differentiating MMVD from healthy dogs.

The miRNA markers also showed some ability to distinguish between preclinical and clinical stages of MMVD with an AUC of 0.82, sensitivity of 0.61, and specificity of 0.79. However, the 95% confidence interval (CI) showed there was variability in the results across cross-validation runs, leading to an overall cross-validated accuracy of 0.73.

The study was led in collaboration with the University of Liverpool Small Animal Teaching Hospital in Liverpool, United Kingdom. Canine cases for the study were obtained from the Cardiology Service of the Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK and SRUC Veterinary Services, SRUC, Edinburgh, UK.

“Our collaborative study strengthens our commitment to enriching and extending the lives of pets, guided by our innovative diagnostic platform and deep dedication to their well-being,” said Coultous.

“The use of nucleotide biomarkers holds the potential to transform veterinary care of cardiac disease by facilitating early intervention and lead to better health outcomes for pets,” wrote MI:RNA in the release.

The future of myxomatous mitral valve disease

MMVD is the leading heart disease in adult dogs, with the disease affecting primarily small dog breeds and older dogs.

 However, diagnosis and treatment options for the disease are advancing, with the latest findings on miRNA's potential being just one several recent breakthroughs.

Researchers from the University of Cambridge have developed an 

 that can detect and rate heart murmurs in dogs from audio recordings. The AI, which can also grade heart murmurs, may help primary care veterinarians identify heart disease like MMVD earlier in dogs.

 Vetmedin Solution by Boehringer Ingelheim, a pimobendan oral solution for treating congestive heart failure (CHF) caused by MMVD or dilated cardiomyopathy (DCM) in dogs. The drug is the first oral solution for CHF caused by MMVD or DCM to be approved by the FDA.

Palarea-Albaladejo J, Bode EF, Partington C, et al. Assessing the use of blood microrna expression patterns for predictive diagnosis of myxomatous mitral valve disease in dogs. 

https://doi.org/10.3389/fvets.2024.1443847

Study paves the way for earlier detection of common heart disease in dogs. News release. MI:RNA Diagnostics. December 12, 2024. Accessed December 12, 2024. [email]

Bautista-Alejandre A. AI is detecting heart disease in dogs with the accuracy of cardiologists. 

. October 30, 2024. Accessed December 12, 2024. 

https://www.dvm360.com/view/ai-can-now-detect-heart-disease-in-dogs-with-same-level-of-accuracy-as-cardiologists

Coppock Crossley K. Oral solution approved by the FDA for canine heart failure. 

. November 22, 2024. Accessed December 12, 2024.

These miRNA markers also hold promise for differentiating between preclinical stage and clinical stage MMVD

MicroRNA can detect myxomatous mitral valve disease in dogs, new study finds

Mae in the hospital (Image courtesy of DoveLewis Veterinary Emergency and Specialty Hospital)

While at work one day, Nick, the owner of a 3-year-old Australian Shepherd named Mae, noticed that she was acting strange on their home security camera. Nick rushed home to work to discover that Mae had ingested an entire bottle of 5-Hydroxytryptophan (5- HTP) capsules, a human supplement that is often used for mood support by increasing the serotonin levels in the brain. This caused Mae to develop serotonin syndrome.

Mae’s family rushed her to the local clinic where she was sedated to manage the seizures activity and was encouraged to bring her to DoveLewis Veterinary Emergency and Specialty Hospital (DoveLewis). When the family arrived at DoveLewis, Mae was unresponsive, unable to breathe on her own, experiencing seizures, blindness, and other clinical signs of serotonin syndrome. The team began treating her with continuous renal replacement therapy (CRRT), a dialysis-like treatment that removes toxins from Mae’s blood and support her failing organs.

“We started the treatment with a very poor prognosis,” explained Lindsey McGuire, DVM, DoveLewis staff veterinarian. “We didn’t expect her to survive, but her recovery was nothing short of miraculous. I still can’t believe we were able to send her home.”

Serotonin syndrome occurs when an animal is experiences excessive effects of serotonin, which can lead to a variety of mental challenges, neuromuscular abnormalities, and alter body function. Clinical signs can be gastrointestinal signs, decreased appetite, elevated heart rate, muscle tremors, and muscle rigidity. Pets suffering from serotonin syndrome can also appear restless, panting, and pacing with an agitated appearance.

 In severe cases, like Mae, affected dogs can have seizures. 

The prognosis of serotonin syndrome depends on the severity of the clinical signs, how fast treatment is initiated, and pets overall health. For those experiencing mild clinical signs and receiving prompt treatment will have a good prognosis and should recover within 36-48 hours. The more severe symptoms or pets being untreated for a prolonged period of time can make the prognosis guarded.

Because of the CRRT treatment, Mae not only survived this ordeal, but made a full recovery and regained her vision. Forty-eight hours after arriving at DoveLewis, Mae walked out the doors with her family and went home.

“Mae didn’t just survive, she’s thriving because of everyone at DoveLewis,” said Kim, Mae’s owner. “Without them, Mae wouldn’t be alive. We’re forever grateful.”

Mae’s Miraculous Recovery After Ingesting Over 3x the Lethal Dose of 5-HTP. News release. DoveLewis Veterinary Emergency and Specialty Hospital. December 11, 2024. Accessed December 12, 2024.

Barnette C. Serotonin Syndrome. VCA Animal Hospitals. Accessed December 12, 2024. https://vcahospitals.com/know-your-pet/serotonin-syndrome

Mae, a 3-year-old Australian shepherd, ingested an entire bottle of the human supplement 5-Hydroxytryptophan, resulting in serotonin syndrome 

Canine miraculously survives 3 times the lethal dose of 5-Hydroxytryptophan

Dietary fiber works in the gastrointestinal (GI) tract to regulate digestion, modulate appetite and satiety, and serve as a microbial energy source.

 Understanding dietary fiber fundamentals is helpful to veterinary professionals managing gastrointestinal conditions. These fundamentals include, but are not limited to, terminology, measurements, uses, effects, and indications.

Valerie J. Parker, DVM, DACVIM (SAIM, Nutrition), a clinical professor at The Ohio State University College of Veterinary Medicine in Columbus, provided an overview of how to use dietary fiber for optimizing GI health in pets, during an educational session at the 2024 Fetch dvm360 Conference in Long Beach, California.

 “When we utilize fiber, it often reduces the need for other microbiome modifiers,” she said.

“We've basically got to the point in [veterinary medicine] where we have pretty good evidence to say that antibiotics really are not indicated for management of acute or even chronic diarrhea in many instances. I also think that fiber is often more effective than even probiotics for gut health,” Parker added.

Essentially, fiber is complex, nonadjustable carbohydrates that originate in plants, according to Parker. In her talk, she explained that types of fiber vary in molecular structure and size, and provide different effects on a body. They are generally classified by the functional properties: solubility, fermentability and viscosity.

Solubility is a measure by water disbursement in fiber, and fermentation by the intestinal microbiota leads to the production of short chain fatty acids.

 Viscosity measures a fiber’s ability to thicken and form gels, and is typically associated with soluble fibers.

Soluble fiber can bind water in the intestinal tract. It is often more fermented than nonsoluble fiber.

 “I think of [soluble fiber] almost like Jello powder, just kind of rolling through, picking up water, increasing viscosity, and slowing GI transit time,” said Parker. “Those short chain fatty acids are going to serve as an energy source for colonocytes, reduce colonic pH, which can impede pathogen growth, maintain a healthy epithelial cell barrier, stimulate mucus production and also interact—not just locally in the gut, but far reaching in the body—with many other organs through host micro communication.”

Parker mentioned some examples of foods high in soluble fiber and high fermentation. These include citrus pulp, and fruit pectin.

Insoluble fiber is less fermentable. It acts more as a bulking agent, she said, and increases GI tract mobility.

 “It can, in theory, stretch the intestinal wall and help stimulate peristalsis,” said Parker.

Fiber also functions as a prebiotic. Prebiotics that in­clude oligosaccharides and inulin are commonly added to pet foods, according to Parker. “The by-products of the fermentation of prebiotics serve as nutrients for commensal microorganisms and are not used by the host animal,” she noted.

Overall, Parker said, every patient being treated for a GI condition might benefit from smaller amounts of fiber, and ideally a mixture or psyllium only. Patients with stress-induced colitis, fiber-responsive diarrhea, or constipation, may benefit from higher amounts of bulking, for which soluble fiber is more appropriate.

Dietary fiber is an “indispensable” factor for managing GI conditions, according to Parker. She noted that positive effects of fiber in the diet can be observed within 2 to 3 days of administration.

 “[Fibers] should be considered before antibiotics, at least in mild diseases, but especially in chronic cases,” she said.

Parker VJ. How to use fiber to optimize gastrointestinal health. Presented at: Fetch dvm360 Conference; December 6-8, 2024. Long Beach, CA.

Moreno AA, Parker VJ, Winston JA, Rudinsky AJ. Dietary fiber aids in the management of canine and feline gastrointestinal disease. 

. 2022;260(S3):S33-S45. doi:10.2460/javma.22.08.0351.

Valerie J. Parker, DVM, DACVIM (SAIM, Nutrition), explained how different foods can be used to manage GI conditions during a CE session at Fetch Long Beach