Philip Bergman, DVM, MS, PhD, DACVIM, discusses his lecture “Mast Cell Tumors: The Latest and Greatest,” in an interview with dvm360

Exploring the latest findings on mast cell tumors

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Insured pets are 5 times more likely to be diagnosed with a mast cell tumor, Philip Bergman, DVM, PhD, MS, DACVIM (Oncology), explained in an interview with 

earlier this fall during the Fetch dvm360 conference in Atlantic City, New Jersey. At the conference, Bergman presented the lecture “Mast Cell Tumors: The Latest and Greatest,” where he talked all about mast cell tumors. During his session, he covered controversial topics relating to these tumors, treatment protocols—including new therapeutics, and more. Watch this interview clip to learn more about Bergman’s lecture.

Philip Bergman, DVM, PhD, MS, DACVIM (Oncology): 

We sit down and talk about some of the newer, newer literature related to risk. And one of the things that comes out is that if your pet is insured, there's a 5-time greater chance that [they’re] going to be diagnosed with a mast cell. So, it's not that the insurance caused it, it's that the insurance allowed us to have a client that could afford doing the appropriate tests to then prove that it was a mast cell. We then will sit down and talk about ‘what's an appropriate amount of staging or looking for spread in our patients?’ because that's an area of controversy currently in my world.

Then we sit down and talk a lot about some of the treatment protocols that are out there, when it's Palladia indicated, and then a very cool new therapeutic that's an intralesional treatment called Stelfonta, which is FDA approved for dogs with mast cell. We actually sit down and talk about the indications, and when you can get into trouble with that drug. And so really, it's an eye towards, you know, ‘what are the latest and greatest things that are becoming available to us?’

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Philip Bergman, DVM, PhD, MS, DACVIM (Oncology), discusses his lecture “Mast Cell Tumors: The Latest and Greatest,” in an interview with dvm360

It’s been 2 decades since I first stepped foot in the veterinary world. From the over-eager assistant who thought they knew it all, to an experienced certified veterinary technician helping to shape new professionals—it’s been a wild ride. I went from being trained to leading training sessions, and along the way, I learned that this field is as rewarding as it is relentless.

Throughout this journey, I’ve crossed paths with countless people in roles such as supervisors, senior technicians, directors, coworkers, teammates, and friends. However, among them, a select few stepped up and wore the badge of mentor. There was the brilliant, borderline intimidating surgeon who not only changed my career path but, quite literally, altered the course of my life. A clinician with a heart as big as her skills stood by me in moments that I didn’t even realize I needed a hand with, pushing me to grow beyond my comfort zone. Then there was the academic who taught me that words could wield as much power as a scalpel when used with intention. These mentors walked with me through different chapters of my journey, leaving permanent imprints on who I am today.

Why mentorship matters—and why it’s not just a buzzword

Mentorship isn’t just a nice-to-have; it’s critical in a field like veterinary medicine where burnout rates are high, and compassion fatigue is real. Did you know that nearly 50% of veterinary professionals experience burnout at some point in their careers?

Having a mentor who can guide, uplift, and challenge you to keep going can make the difference between staying in the field or burning out.

For me, mentorship goes beyond textbook definitions. It’s not about a “sage on a stage” spouting wisdom. Real mentors see your potential even when you’re doubting it. They dig in with you, guide you through the messes, and remind you why you started when the going gets tough. This isn’t just anecdotal—studies show that employees with mentors are 5 times more likely to be promoted and 22% more likely to stay with their current organization.

Mentorship cultivates loyalty and growth, not just for mentees but for entire teams.

The best mentors I’ve known were strong, fearless, and fiercely committed to seeing others succeed. They didn’t just hand out “pearls of wisdom” from behind a podium; they got down in the trenches. They opened doors, held up mirrors, and sometimes, when I needed it most, pushed me out of my comfort zone. They made me uncomfortable. They made me dig deeper, question more, and become a better, healthier version of myself.

National Association of Veterinary Technicians in America

In recent years, I’ve had the privilege of stepping into the role of mentor myself—training and coaching some truly incredible people. I tried my best to channel what my mentors instilled in me, but with my own spin. Did I get it right every time? Definitely not. There were moments of failure, but those failures taught me more than success ever could. There were days when I ended up covered in fur, sweat, and exhaustion. But every step, every lesson, was worth it.

My thanks will always go to those who lifted me up when I needed it, and to those who refused to let me quit when things got rough. They’ve shaped me, and I hope to keep passing that gift on to others. Mentorship in vet med is at its best when we lift each other up.

To those wondering if mentorship is worth the effort, I say this: 88% of professionals with mentors report greater job satisfaction,

 and in a field as demanding as ours, we need every ounce of support we can get. Let’s keep opening doors, building each other up, and remembering why we started this journey.

Because in the end, mentorship isn’t just about teaching. It’s about walking side-by-side, through every triumph and every mess, making sure no one has to go it alone. So, let’s connect, grow, and mentor like we’re meant to—boldly and authentically.

Steffey MA, Griffon DJ, Risselada M, et al. Veterinarian burnout demographics and organizational impacts: a narrative review. 

. 2023;10:1184526. Published 2023 Jul 4. doi:10.3389/fvets.2023.1184526

Mentorink. Mentoring Statistics 2025: Tomorrow’s Blueprint. Mentorink. Published November 14, 2024. Accessed November 21, 2024. 

https://www.mentorink.com/blog/mentoring-statistics/

Moore M. Promoting manager success. twomentor. Accessed November 21, 2024. https://www.twomentor.com/want-an-88-boost-in-productivity-say-yes-to-mentoring-your-managers/

Articles

Mentorship is how we thrive—not just survive—in this profession


Mentorship: Make it personal to keep it professional

When our technicians discuss vaccinating dogs for Lyme disease with clients, some decline. What should they say to be more persuasive?

Client conversations about vaccinating for Lyme disease need to happen before, during, and after appointments. An American Animal Hospital Association study found repetition of the message increases compliance.

When you send recall messages to clients who have pets due for care but haven’t scheduled appointments, list all services due, including Lyme disease vaccination. Depending on your practice information management software and third-party reminder service, you could include hyperlinks or client information sheets. 

Send online forms with appointment confirmations 

Clients will complete and submit forms before appointments. This saves 10 to 15 minutes that technicians and assistants previously spent asking history questions at the start of appointments. Clients’ answers can be reviewed before exams, resulting in more efficient use of exam time. 

Ask questions related to Lyme disease on wellness forms such as the following: 

Have you seen any fleas or ticks on your pet? 

Which flea/tick preventive do you use, and when did you give the last dose? 

Do you travel with your dog to areas where ticks or mosquitoes may be present? 

Have you ever found a tick on your dog or on any other pet or person in your home? 

Check the purchase history of flea/tick preventives 

Technicians should know when preventives were last purchased, how many doses were sold, and how many dogs are in the home in case the client is sharing a box of preventives among pets. 

Identify whether you previously discussed the need for Lyme disease vaccination with the client. Did the client accept or decline the Lyme disease vaccine on the last visit? 

Exam rooms are classrooms. Posters, digital photo frames, slideshows on computers, and brochures will help you educate clients about Lyme disease. The Companion Animal Parasite Council offers prevalence maps by county and state. In Saratoga County, New York, for example, 1 in 10 dogs has tested positive for Lyme disease this year. Preview services when starting exams At the beginning of appointments, technicians should explain their roles and summarize services that will be delivered during the day’s appointment. 

Say, “I am , who will assist Dr <name>. <Pet's name> needs an exam and vaccines for distemper/ parvovirus, rabies, 

, leptospirosis, and Lyme disease. We will test for intestinal parasites and heartworm/tick diseases. <Pet's name> needs refills of flea/tick and heartworm preventives. I will tell you about rebates so you may save the most. What questions may I answer before we begin?” 

 when discussing services due rather than the wiggle word of 

. Clients may hear that Lyme disease vaccination is just a recommendation and is not medically necessary. If the pet owner doesn’t understand or declines Lyme disease vaccination, the technician will explain, “Lyme disease is transmitted to humans and animals through the bite of infected ticks. Symptoms may include lameness, swollen lymph nodes, joint swelling, fatigue, and loss of appetite. Lyme disease can cause serious kidney complications. Two boosters are given several weeks apart the first time your dog is vaccinated, and then it is given annually. Shall we vaccinate your dog for Lyme disease, or do you want to talk with the doctor?” 

Use yes-or-yes technique to lead the client to accept the vaccine or to get more information from the veterinarian. With further education, the client may accept Lyme vaccination. 

Protecting dogs from Lyme disease is like a 3-legged stool. The first leg is testing for tickborne diseases, which is a recurring annual screen. Say “recurring” instead of “routine” to communicate that the test repeats annually and is medically necessary. The second leg is vaccinating for Lyme disease annually. The third leg is giving flea/tick preventives monthly. This pyramid of protection is best. If you remove 1 of the 3 legs, the stool will fall over. Likewise, if the dog is unvaccinated for Lyme vaccine, it cannot be fully protected with the remaining 2 legs of flea/tick preventives and testing. 

Before the doctor enters the exam room, the technician will let the veterinarian know whether a client questions or declines a vaccine. The veterinarian can explain area prevalence, health consequences, and cost of treatment. This additional information from an expert may persuade the pet owner. 

Almost no one refuses when Chris Brockett, DVM, owner of Saratoga Veterinary Hospital in Wilton, New York, tells clients: “ shared that you declined the vaccine for Lyme disease for your pet. We live at ground zero for Lyme disease in both pets and people. While core vaccines such as rabies, distemper, and parvovirus are important, the likelihood of your pet being exposed is quite small. On the other hand, the chances your pet will be exposed to Lyme disease are quite high. I know this because our doctors diagnose multiple dogs every week. Lyme disease can create chronic inflammatory disease and, in severe cases, kidney damage in your pet. Almost everyone I know has a friend with Lyme disease and those inflammatory problems. The vaccine is extremely safe and protects dogs against the disease they are most likely to encounter in their lives. Lyme vaccination is an important one to include with our services today. Shall I vaccinate your dog for Lyme disease, or do you need more information?” 

If the client still declines, note the decision in the medical record. Revisit the need for vaccination during the next exam, as persistence may get results. 

Have technicians make medical callbacks 1 week later 

The first no is not the final no. Create a service reminder called “Lyme vaccine needed” that will print on the client’s receipt and trigger a callback in 7 days. The outpatient technician will call the client because they have an existing relationship, and the client is more likely to remember the technician who helped with last week’s appointment. 

Say, “This is <technician's name> with <hospital name>. I enjoyed seeing you and <pet's name> last week. Dr <name> asked me to follow up with you on our discussion about the need to vaccinate for Lyme disease. Because is current on a doctor’s exam, we can schedule a technician appointment to give the Lyme vaccine. The cost of the vaccine is $__. Our next available technician appointments are <date, time 1> or <date, time 2>. Which do you prefer?” 

Use the doctor’s name to bring credibility and authority to the call. You also communicate that Lyme disease vaccination is medically necessary. Explain the vaccine cost and that paying for another doctor exam isn’t required. Use the 2-yes-options technique to nudge the client to schedule a technician appointment.

Best known as the "Queen of Scripts," Wendy S Myers, CVJ, has taught communication and client service skills for more than 2 decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Myers was a partner in a specialty and emergency practice. Visit Csvetscourses.com to learn more.

Scripts for confident client conversations

When clients decline vaccines

In veterinary medicine, the use of proton pump inhibitors (PPIs) has become a standard approach for treating gastrointestinal (GI) issues such as ulceration, bleeding, and gastroesophageal reflux disease (GERD) in dogs and cats. However, determining the optimal dose and frequency of administration remains a challenge, especially for larger dogs. Veterinarians rely on human pharmacodynamic targets such as gastric pH due to the lack of canine-specific benchmarks. Although effective, PPIs like omeprazole and its isomer esomeprazole can cause adverse effects such as vomiting, diarrhea, and appetite loss, which can be challenging for pet owners, especially with larger dogs.

 evaluated whether lower esomeprazole doses could achieve therapeutic pH goals while minimizing adverse effects. Investigators administered 0.5 mg/kg and 1 mg/kg doses once daily to 9 healthy, medium to large breed dogs. Intragastric pH capsules measured pH changes over 96 hours, with both doses significantly raising pH levels compared to baseline. However, one-third of the dogs did not meet therapeutic targets with once-daily dosing. For these dogs, twice-daily 1 mg/kg dosing successfully achieved the desired pH levels.

Despite promising results, the study highlighted significant variability in how individual dogs responded to esomeprazole. This variability was linked to factors such as differences in drug metabolism, inconsistent drug administration timing, and environmental influences like diet and housing conditions. For instance, cytochrome P450 enzyme activity probably played a role in affecting PPI metabolism, resulting in variations in intragastric pH responses. Given these factors, veterinarians should adopt a patient-specific approach when prescribing PPIs, especially for dogs that do not consistently respond to once-daily dosing.

Adverse events during the study occurred infrequently but followed a dose-dependent pattern. Only one dog experienced vomiting, which expelled the pH capsule shortly after administration. Diarrhea was more common, with the higher 1 mg/kg dose, affecting 3 dogs. In contrast, the lower dose (0.5 mg/kg) caused fewer GI effects, suggesting it could be a safer alternative for sensitive dogs. Reducing esomeprazole dosages may help minimize adverse effects without compromising efficacy for many dogs.

Both 0.5 mg/kg and 1 mg/kg doses of esomeprazole increased intragastric pH in healthy medium to large-breed dogs. However, the higher dose led to more GI adverse effects, highlighting a trade-off between efficacy and tolerability. Twice-daily dosing was essential for achieving therapeutic pH levels in non-responding dogs, underscoring the need for individualized treatment plans. Veterinarians must balance cost, efficacy, and side effects when prescribing esomeprazole, tailoring therapy to each dog’s unique needs and circumstances to provide more effective care for dogs with GI conditions.

Ava Landry is a 2026 PharmD candidate at the University of Connecticut in Storrs, where she is studying veterinary pharmacy.

Ostronic A, Gremillion C, Zhang S, Steiner JM, Tolbert MK, Gould EN. Pharmacodynamics of 2 dosages of orally administered esomeprazole in client-owned, healthy dogs: A prospective, crossover study. 

 October 8, 2024. Accessed November 25, 2024. doi:10.1111/jvim.17233

A recent study evaluated whether lower esomeprazole doses could achieve therapeutic pH goals while minimizing adverse effects. 

Individualized proton pump inhibitor therapy for canine gastrointestinal conditions

The Fetch dvm360 Conference in Long Beach, California, (December 6–8, 2024) promises an exciting lineup of sessions and activities. We're excited to bring you hands-on labs, expert-led workshops, and sessions covering the latest in veterinary medicine, technology, and practice management. Topics include advanced dentistry techniques, managing complex behavioral cases, and strategies for overcoming client communication challenges.

Beyond the CE sessions, attendees can enjoy engaging networking events, explore the bustling exhibitor hall showcasing the latest products and innovations, and participate in wellness-focused activities like yoga and mindfulness sessions to recharge. Fetch Long Beach offers the perfect mix of education and fun!

Fetch dvm360® is thrilled to welcome an exceptional lineup of keynote speakers who are shaping the future of veterinary medicine. Kris Otteman, DVM, ABVP, CAWA, a contract forensic veterinarian specializing in shelter medicine and animal cruelty investigations, will share her expertise on addressing critical and often overlooked aspects of animal welfare. Kwane Stewart, DVM, widely recognized as “The Street Vet,” will highlight the profound human-animal bond through his work serving pets in underserved communities. Eric Garcia, of Simply Done Tech Solutions, will provide actionable insights on leveraging technology and digital marketing to help veterinary practices thrive. Mary Gardner, DVM, co-founder of Lap of Love Veterinary Hospice, will deliver a heartfelt keynote on improving end-of-life care, focusing on patient care and compassionate client communication. 

All conference attendees are also welcome to join us for the 2024 dvm360 Veterinary Heroes® Awards Luncheon being held on December 8, 2024 from 11:30 AM-1:15 PM PT. This a celebration of individuals who have achieved landmark successes within veterinary medicine. The program recognizes those who have positively impacted animal care, demonstrating leadership, expertise and a commitment to improving the health and well-being of animals. These recognized individuals have excelled in their professional roles and influenced the broader veterinary community, setting new standards and inspiring others to continue evolving the practice of veterinary care.

Start Saturday, December 7, with a refreshing Tai Chi session led by Dr. Christopher Shapley! Join us from 6:30–7:30 AM in the room 104 foyer area for gentle movements, deep breathing, and a peaceful start to your day. Open to all attendees. This is a non-CE session and light refreshments will be provided!

Your Fetch registration doesn’t stop working for you once the event ends. Attendees gain access to an extensive library of on-demand CE courses, allowing you to continue learning on your own schedule. This added benefit makes Fetch an unbeatable choice for busy veterinary professionals looking to maximize their time and investment.

Maximize value with a special Black Friday offer

From Black Friday through 11:59 PM Monday, Fetch is offering an incredible 50% off conference registrations. This is your chance to secure premium veterinary education at a fraction of the cost. With your registration, you’ll unlock access to both the in-person conference and the on-demand CE library, giving you the best of both worlds.

Click here to get the Black Friday deal now

Fetch dvm360® Conferences deliver unparalleled education, networking, and value for every veterinary professional.

A sneak peek of Fetch Long Beach

It’s easy to fall into the trap of thinking that more inventory is better, driven by the fear of running out of essential items, the lure of bulk orders to save money, or a tempting special offer that seems too good to pass up.

But here’s the catch: when you start piling up inventory as a safety net, you’re actually tying up a significant amount of funds that could be better used elsewhere in your practice. It's about the ongoing carrying costs—money spent on products that sit on the shelf, risking expiration, shrinkage, or even theft. If these items are not generating revenue, they inflate your costs of goods sold (COGS) and quietly strain your practice’s finances.

Getting to the root of overstocking lets you tackle the problem head-on, making sure every dollar you spend on inventory truly pays off.

Bulk ordering can be a savvy strategy, but it's important to remember that these offers are often designed to boost sales volume or clear out stock nearing its expiration date. To make the most of bulk deals, calculate the amount you need for a specific period—like 3 months—based on your order history. This way, you can avoid overstocking and ensure you're only buying what you'll use.

Redundant formulary refers to stocking multiple products that essentially serve the same purpose, such as different brands of the same medication or both generic and brand-name options. This often arises from varying preferences among veterinarians.

Carrying multiple stock keeping units (SKUs) and extra safety stock for each product increases your total inventory, inflates carrying costs, and heightens the risk of shrinkage. Additionally, managing different interchangeable products can lead to inconsistent pricing and confusion in margin management, impacting your COGS and profitability.

Encourage doctors to engage in discussions and reach a consensus on product preferences, focusing on efficacy, product reviews, and other relevant factors. It’s also important to be strategic with your pricing strategies—whether it’s cost-plus, percentage-based, or another method—setting strategies by product category and sales type is important to create, monitor and maintain optimal results.

Misestimating the actual demand for products can cause hospitals to order too much. Without accurate forecasting, inventory levels can become skewed, leading to unnecessary excess.

Use historical data to anticipate and manage seasonal fluctuations. Year-over-year trends can serve as reliable indicators for determining both timing and quantity of orders. To address seasonal demand, consider increasing your safety stock—extra inventory held to absorb variations in demand—and adjust the frequency of replenishment accordingly. For example, if you typically reorder parasiticides every 4 weeks, you might shift to ordering every 1-2 weeks to calibrate for spring.

Backorders are a reality, and they’re rarely predictable. The fear of a shortage can trigger panic buying, which ironically worsens the situation by depleting stock faster across the board. This overreaction can lead to excess inventory as you try to plan for these contingencies.

For critical items, it's crucial to have a clear understanding of available alternatives so you can pivot when necessary without compromising care. For low-cost items with long shelf lives, ordering in bulk may be more economical, allowing you to absorb normal market volatility without inflating your overall inventory. The key is to strike a balance—preparing for potential disruptions without creating new issues by overstocking.

Relying on Practice Information Management Systems

While Practice Information Management Systems (PIMS) are invaluable tools, they often struggle to keep up with the complexities of a service-driven environment like that of a veterinary hospital. PIMS relies on transactional data to track inventory levels—recording inventory when it is purchased and then deducting it based on sales invoices. It works well in straightforward retail settings where items are simply bought and sold in similar units. In a veterinary practice, where up to 50% of inventory is consumed directly within the hospital and never actually transacts, PIMS falls short in capturing true usage. As a result, practices can overestimate their needs and order too much, while staff end up spending extra hours on manual counts to ensure accuracy.

To manage inventory efficiently, leverage data and optimize cycle counts. Accurate data helps predict demand and account for changes, enabling you to set efficient replenishment frequencies and improve inventory turnover. Incremental cycle counts, rather than comprehensive monthly/quarterly/annual audits, can help you replenish inventory just in time and keep a close watch on your inventory's value. This approach reduces value variability, shrinkage, and the time spent managing excess inventory.

Optimizing inventory turnover helps prevent overstocking by ensuring that inventory is moving efficiently and aligning with actual demand. This involves managing several key metrics. First, evaluate your COGS, which varies depending on hospital type, location, formulary, and sales mix. As a general guideline, COGS should be between 20-24% for a general practice hospital, 10-14% for an emergency or specialty practice, 26-30% for mixed animal practices, and over 30% for large animal practices.

Next, consider the value of your inventory relative to your average monthly revenue, which should ideally be around 20%. While this will vary depending on your hospital’s specifics, it serves as a solid benchmark.

Lastly, aim for an inventory turnover rate of 3-4 times per year on average. High-volume, expensive items should turn over every 2-3 weeks (15-25 times per year), while low-cost, low-volume items might only turn over 4-8 times annually. Keeping up with these turnover rates ensures your inventory stays in line with real usage, avoiding excess stock and minimizing overstocking.

Supplier relationships and Group Purchasing Organizations

Group Purchasing Organizations (GPOs) often partner with specific suppliers or groups of suppliers, allowing practices to benefit from bulk pricing in exchange for committed orders. These arrangements can help you achieve the balance between cost savings and maintaining an appropriate level of inventory.

Maintaining a close relationship with your suppliers allows you to lean on them when challenges arise, such as unexpected demand surges or inventory shortfalls. A sales representative who values your business will be more willing to go the extra mile to support you and loop you in on upcoming promotions or new product launches.

Just as it's frustrating when clients focus only on price and overlook the value of your talent and care, the same applies when selecting suppliers—don’t judge them solely on cost. The best suppliers understand that their success is tied to your success, and they focus on delivering excellent service consistently. Look for suppliers who are committed to minimizing backorders and who have a reliable supply chain management process in place.

Just-In-Time inventory and software solutions

The most effective way to streamline inventory is by implementing a Just-In-Time (JIT) process, which ensures you have the necessary supplies without accumulating excess stock. While JIT is traditionally ideal for manufacturing environments with highly predictable demand and supply chains, the concept can be adapted for veterinary hospitals by incorporating a slightly larger margin of error to account for the variability in demand.

Using inventory management software can significantly enhance this process. For example, Inventory Ally tracks your inventory in real time, providing insights into consumption patterns and guiding replenishment based on your transaction history. Data shows that after implementing Inventory Ally, one GP saw a decrease in COGS from 43% to 31.9% in just 1 month, translating into $333,000 in annual savings.

 An emergency room and specialty hospital reduced inventory carry by $100,000 in just 3 months by optimizing turnover.

 These results demonstrate how effective inventory management software can be in enhancing efficiency and improving your bottom line.

Emmitt Nantz, MBA, cofounder of Inventory Ally

, has been part of the veterinary family for nearly 2 decades and is driven by a personal mission to make the veterinary domain better. Nantz spent 12 years working at Banfield, starting out as a single-site hospital manager. Having majored in agriculture business management, he expanded his education to include an MBA, a Black Belt in Six Sigma, and a Project Management Certification.

Nantz applied these learnings at Banfield and later as a Chief Operating Officer at SmartFlow where he helped hundreds of practices improve their operations. In pursuit of his passion for workflow optimization, Nantz honed his expertise in a critical area that often plagues hospitals' bottom lines – inventory management. He co-founded Inventory Ally, an all-in-one cloud software designed to help veterinary professionals reduce inventory costs, streamline processes, and save time.

Nantz E. Todd County Animal Clinic’s Inventory Success Story. Inventory Ally. Published March 13, 2024. Accessed November 20, 2024. 

https://inventoryally.com/news/todd-county-animal-clinic-success-story/

Nantz E. Inventory on Autopilot: How a Specialty Hospital Maximized Its Earning Potential. August 13, 2024. Accessed November 20, 2024. 

https://inventoryally.com/news/inventory-on-autopilot-how-a-specialty-hospital-maximized-its-earning-potential/

Overstocking in veterinary hospitals is a challenge that often goes unnoticed