Otis (right) celebrating the holidays with Fig and Olive, his siblings. (Image courtesy of UC Davis)

When Otis, a 6-year-old pug, was 2 months old, he was brought to the UC Davis veterinary hospital’s emergency room by his owner Jennifer Newman, "an experienced pug owner." Otis presented at UC Davis with a cough and respiratory issues, and one of his littermates had recently died after presented with similar symptoms. Newman asked the team at the hospital to do a thorough workup, and they discovered Otis had Hemophilia A.

Hemophilia A is a rare, but the most common, severe inherited coagulation disorder in both animals and human beings.

 The illness is caused by a deficiency in coagulation factor VIII on the X chromosome, similar to in people, and an essential protein required for normal blood clotting. Canines that have this disease have variable presentations of the disease with mild and moderate bleeding observed in these patients.

 Dogs with Hemophilia A can also bruise easily or have extended periods of bleeding following trauma, sometimes severe enough to cause death. However, if receiving proper care, most affected canines have a normal lifespan.

Otis has received several blood transfusions over the years at UC Davis, which is sourced by UC Davis from local volunteers. UC Davis shared that every week, dogs from the local area come to the hospital to donate blood to help those in need. In 2024, thanks to the donors in its area, UC Davis has transfused more than 850 units of blood.

“Otis is a bit of a celebrity at the hospital,” expressed Steven Epstein, DVM, DACVECC, co-chief of the Small Animal Emergency and Critical Care Service and director of the Transfusion Medicine Service, in an organizational release.

“He has been an amazing patient throughout all of his stays. I was there when he first came to us as a puppy and have seen him multiple times throughout the years.”

Newman, who was conducting her own investigation into Otis’ condition, discovered a team of scientists at the University of North Carolina that were conducting research into Hemophilia A in canines. She was then able to connect that team to Otis’ team at UC Davis with the researchers at the University of North Carolina to share ideas for his care.

However, Otis’ health issues did not stop with Hemophilia A. Later in his life, he developed a severe inflammation of his esophagus and stomach, which led him to be placed under the care of internal medicine team at the hospital. His issues resulted in him being hospitalized for several weeks and received a stomach feeding tube multiple times to gain control due to Otis regurgitating his food and having bleeding issues.

As if Otis did not have enough health issues, his team at UC Davis found that he had a sliding hiatal hernia during a fluoroscopy swallow test.

 This condition caused a portion of his stomach to move into his esophagus intermittently, which causes him to regurgitate fluid. UC Davis shared that this condition does not always require surgery, but it does in Otis’ case after his condition became problematic in 2024.

According to the release, Otis developed severe esophagitis secondary to acid reflux and regurgitation of food due to multiple aspects of his condition, including the hiatal hernia and bleeding into his stomach. He was hospitalized for a week while his care team provided medical management of his conditions, but his situation was not resolved. 

“Although the bleeding predisposition inherent to hemophilia presents substantial complexities for surgical intervention, the correction of the hiatal hernia was considered an important and judicious approach to optimizing Otis' overall condition,” said Max Randolph, DVM, an internal medicine resident.

After Newman agreed to move forward with surgery, the team repaired his hernia with a preventive gastropexy, which sutures the stomach into place against the wall of the patient’s abdomen wall to prevent it from moving and decrease reflux. Otis also had a feeding tube placed in his stomach to allow medical and nutritional administration.

Otis required several blood transfusions after his surgery, but the bleeding issues were finally controlled by a mix of topical medications and IV. He was hospitalized for 12 more days, spending several in the Intensive Care Unit, before he was able to return home. He returned to UC Davis in late August for his feeding tube to be removed.

According to Newman, his condition has improved "dramatically" since the hospitalization, even citing increases in weight and appetite. He will remain on medication to control his reflux and prevent any future esophagitis episodes. Newman reported that Otis is doing great at home, and is being a playful puppy once again.

“I just feel so lucky to have found the right place for Otis,” Newman concluded.

“From the client services team to the students to the residents to the faculty and staff – I’ve had nothing but positive experiences each and every visit.”

Warren R. UC Davis Veterinarians Lead a Long Journey Back to Health for Hemophilic Dog. School of Veterinary Medicine. December 19, 2024. Accessed January 13, 2025. 

https://www.vetmed.ucdavis.edu/news/uc-davis-veterinarians-lead-long-journey-back-health-hemophilic-dog

Hemophilia. Cornell University College of Veterinary Medicine. Accessed January 13, 2025. https://www.vet.cornell.edu/animal-health-diagnostic-center/laboratories/comparative-coagulation/clinical-topics/hemophilia

Articles

Otis, a young pug, was diagnosed with a plethora of health issues at UC Davis, including Hemophilia A

UC Davis treats pug with rare coagulation disorder 

Hemangiosarcoma (HSA) is a particularly aggressive form of cancer that begins in the cells lining the blood vessels. It primarily appears in 2 types of the disease: visceral and nonvisceral. Visceral HSA typically targets internal organs such as the spleen, liver, or heart. Nonvisceral HSA affects the skin, subcutaneous tissues, or muscles. This cancer poses a significant threat to dogs because of its rapid spread and the serious complications it can cause.

The primary treatment for localized nonvisceral HSAs is surgery. Surgeons aim to remove the tumor with clear margins to reduce the risk of recurrence. After surgery, veterinarians often use chemotherapy to address any residual cancer cells and manage potential metastases.

Radiation therapy, although less common, plays a role in managing unresectable tumors or alleviating symptoms such as pain and bleeding. Radiation therapy serves primarily as a palliative treatment to reduce tumor size and improve the patient’s quality of life.

Electrochemotherapy (ECT) represents another option, combining chemotherapy with electrical pulses to enhance drug delivery into cancer cells. This method has shown promise in reducing tumor size and controlling bleeding during surgery.

Turkey tail mushrooms used in medicinal therapies grow on tree trunks are are found throughout the world.

Chinese herbal treatments may offer additional support in managing hemangiosarcoma. The turkey tail mushroom complex, a traditional Chinese remedy, contains compounds such as Polysaccharide Kurcha (PSK) and Polysaccharopeptide (PSP) that could enhance the immune system.

 By boosting the immune response, these compounds might improve the effectiveness of standard treatments. However, the turkey tail mushroom complex is not a standalone cure for cancer.

Yunnan Baiyao, another traditional Chinese herbal formula, holds a notable place in managing bleeding associated with hemangiosarcoma.

 This herbal remedy, which contains notoginseng, known for its bleeding control properties, works by activating platelets and inhibiting the formation of new blood vessels.

 Yunnan Baiyao is available in both capsule and powder forms, allowing for oral and topical application.

Yunnan Baiyao gained recognition during the Vietnam War when North Vietnamese soldiers used it to manage injuries. Developed by Chinese doctor Qu Huangzhang in the early 1900s, Yunnan Boaiyao’s exact formula remains a secret.

 Although it has gotten attention for its hemostatic properties, its safety and effectiveness are not fully proven. Concerns about consistency, dosage, and potential risks, such as bone marrow toxicity from high doses, remain.

Veterinarians frequently use Yunnan Baiyao to manage conditions like hemoabdomen, pericardial effusion, and nosebleeds. Although the FDA has not approved it for canines, some veterinarians prescribe it off-label.

 Possible adverse effects include nausea, vomiting, diarrhea, and gastrointestinal upset.

 Veterinarians advise caution, particularly in dogs with liver disease or when it is combined with chemotherapy.

Each package of Yunnan Baiyao has 2 types of pills: 16 white capsules and one bonus red pill. The red pill included in the package is meant for severe, uncontrolled bleeding and should only be used under a veterinarian’s guidance.

Dogs with hemangiosarcoma face a poor prognosis because of rapid metastasis. Studies indicate that incorporating Chinese herbal treatments like Yunnan Baiyao and turkey tail mushroom complex into a comprehensive treatment plan may improve survival times compared to no treatment. Yunnan Baiyao shows promise in extending disease-free intervals, while turkey tail mushroom has demonstrated a mean survival time of about 199 days. In contrast, untreated dogs typically have much shorter survival rates, highlighting the potential benefits of these herbal treatments.

 These findings help veterinarians to set realistic treatment expectations for pet owners.

Veterinarians should guide the use of these herbal supplements to ensure they complement standard medical interventions rather than replace them. Incorporating them alongside conventional therapies can enhance overall treatment outcomes and help manage symptoms effectively.

Veterinarians educate themselves on these 2 herbals’ use in veterinary medicine through resources such as 

 By staying informed, veterinarians can provide a more holistic approach to managing HSA in dogs.

De Nardi AB, de Oliveira Massoco Salles Gomes C, Fonseca-Alves CE, et al. Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET. 

. 2023;15(7):2025. Published 2023 Mar 29. doi:10.3390/cancers15072025

Morrison BJ. Yunnan Baiyao for dogs. PetMD. Published July 3, 2023. Accessed August 28, 2024. Available from: 

https://www.petmd.com/dog/general-health/yunnan-baiyao-dogs

Robinson NG. Complementary and alternative medicine for cancer: the good, the bad, and the dangerous. In: Withrow SJ, MacEwen EG, eds. 

Withrow and MacEwen’s Small Animal Clinical Oncology

. 5th ed. Elsevier; 2012. doi:10.1016/B978-1-4377-2362-5.00016-5.

Integrative therapies can enhance a patient’s survival and quality of life

Integrating herbal support in canine hemangiosarcoma management

Karen Kline, DVM, MS, DACVIM (Neurology), offers insights for veterinarians handling neurologic emergencies

Considerations for neurologic emergencies

In this pre-Fetch dvm360 conference interview, Karen Kline, DVM, MS, DACVIM (Neurology), talked about her lecture “Neurologic Emergencies: Stay Calm, Cool and Collected,” presented at the Fetch dvm360 conference in Long Beach, California. Additionally, she shares key considerations veterinarians should keep in mind when handling neurologic emergencies, including beginning with basic blood work and avoiding assumptions.

Below is the interview transcript. It has been lightly edited for clarity.

Karen Kline, DVM, MS, DACVIM (Neurology): 

Yeah, “Neurologic emergencies,” the point of this lecture is to talk about mainly acute brain trauma and other diseases that will cause an acute presentation in the dog and cat. The reason we want to stay calm, cool is and collected is to do the best by your patient.

I think the most important thing is assume nothing. You want to start with basic blood work, making sure that your patient doesn't have an underlying systemic illness that's a cause of the neurologic issue, and then going ahead and doing your neurologic exam to localize where the problem is, and then instituting various therapies that we'll talk about in our lecture. But it's important to stay on point and delegate your staff and the team to handle this emergent case that comes in. And not all cases that look bad turn out poorly. So, I think that's the most important thing to realize as well—when bad cases turn good, so I think that's very important as well.

Videos

Photo courtesy of Mount Laurel Animal Hospital

The Veterinary Emergency and Critical Care Society (VECCS) has accredited Mount Laurel Animal Hospital (MLAH) in New Jersey as a Level 1 facility. MLAH is now one of 17 facilities across the US to earn the designation.

“Achieving VECCS Facility Certification is a testament to the hard work and dedication of our entire team. We strive every day to be cutting-edge in our approach to veterinary care, ensuring that we provide the best possible services to our patients and their families. This certification not only recognizes our commitment to excellence but also enhances our capability to serve our community better,” Krista McDermott (CVT, CVPM), practice manager at MLAH, said in a news release.

The VECCCS Facility Certification program aims to generate awareness of high-quality veterinary facilities that practice emergency and critical care medicine. The program offers 3 certification levels that are required to meet criteria for operating hours, equipment, personnel and staffing, building standards, infrastructure, medical records and other resources.

To achieve Level 1 designation, a facility must meet requirements that include those specified for Level 2 and Level 3. Additional requirements for a Level 1 facility are a backup power supply, a CT scanner, an intensive care unit ventilator, capability to provide total parenteral nutrition, a minimum of 1 full-time-employed ECC specialist, and at least 2 technicians certified as ECC specialists. Level 1 requirements also include a facility’s need for equipment used for invasive blood pressure monitoring, bronchoscopy, and echocardiography.

Tips to help prepare clients and the veterinary team for a disaster situation

MLAH’s achievement makes it one of 20 VECCS Level 1 certified animal health facilities in the world, including several in Canada and the United Kingdom, according to the VECCS website. The newly certified hospital also joins NorthStar VETS in Robbinsville, New Jersey, as the 2 VECCS-certified Level 1 facilities in the Garden State.

In addition to Level 1 accreditation, VECCS claims 25 certified Level 2 facilities, including 2 in New Jersey, 4 in South Korea, and 1 each in Canada and China. There are also 9 facilities in the US currently certified as Level 3.

Along with its designation as a Level 1 facility, certification by the VECCS provides benefits to MLAH. According to the hospital, it now has access to valuable resources that include counseling sessions for full-time staff members and subscriptions to clinical sites. MLAH will also be recognized for its Level 1 status in the 

Journal of Veterinary Emergency and Critical Care

According to MLAH, its entire team is committed to maintaining and exceeding the VECCS certification requirements. “This commitment is evident in every interaction with clients and their pets, fostering an environment of trust, compassion, and professionalism. The hospital’s focus on continuous improvement and innovation ensures that it remains a leader in veterinary medicine, offering cutting-edge solutions for the evolving needs of pet care,” noted the release.

, Mary Anne Evans, BS, CVT, VTS (ECC), spoke about her work in emergency care. She noted that the type of emergency cases a hospital sees often is area dependent. In this suburban New Jersey hospital, for example, urinary obstruction is a common condition seen by the emergency team as well as aspiration, pneumonia, pancreatitis and diabetic ketoacidosis. “We also see a lot of exotics, so I’ve been seeing a lot of rabbits that have GI obstructions,” Evans said.

As part of a larger expansion project, MLAH announced in November 2024 a hospital addition that will be constructed specifically for serving critical care needs. The new space will include an intensive care unit that is larger than the current facility, as well as an expanded isolation area.

"As we continue to grow, we are dedicated to enhancing the quality of care we provide to our patients and their families. This expansion reflects our commitment to meeting the evolving needs of our community,” Christopher Torre, VMD, co-owner of MLAH, said in a news release.

MLAH provides a range of services including advanced diagnostics, surgical procedures, and specialized treatments as well as emergency care. “[The hospital’s] team of experienced veterinarians, specialists and dedicated support staff work collaboratively to create personalized care plans that cater to the unique needs of each patient,” according to the release.

Mount Laurel Animal Hospital achieves Level 1 facility status as a VECCS certified facility. News release. Mount Laurel Animal Hospital. January 9, 2025. Accessed January 13, 2025. 

https://www.einpresswire.com/article/775501251/mount-laurel-animal-hospital-achieves-level-1-facility-status-as-a-veccs-certified-facility

Find a VECCS certified facility. Veterinary Emergency and Critical Care Society. Accessed January 13, 2025. 

https://veccs.org/certified-facility-directory/

Facility certification. Veterinary Emergency and Critical Care Society. Accessed January 13, 2025. 

https://veccs.org/facility-certification/

Here they grow again: Mount Laurel Animal Hospital announces ambitious expansion. News release. November 14, 2024. Accessed January 13, 2025. https://www.einpresswire.com/article/760681443/here-they-grow-again-mount-laurel-animal-hospital-announces-ambitious-expansion

Mount Laurel Animal Hospital achieved the designation as it prepares to expand its critical care facilities

New Jersey hospital earns VECCS Level 1 facility certification 

A case of highly pathogenic avian influenza (HPAI) in domestic birds in Puerto Rico has been reported. This marks the first instance of the virus in domestic birds in Puerto Rico since the onset of the outbreak in February 2022.

The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) confirmed the detection of the virus in a backyard poultry flock in Puerto Rico on January 13, 2025. Flock samples were confirmed positive for HPAI after testing at the APHIS National Veterinary Services Laboratories in Ames, Iowa, according to an APHIS announcement.

Further surveillance and testing in regions around the affected flock are being conducted by the APHIS and the Puerto Rico Department of Agriculture as part of ongoing avian influenza response plans, according to the agency.

“The United States has the strongest [artificial intelligence (AI)] surveillance program in the world, and USDA is working with its partners to actively look for the disease in commercial poultry operations, live bird markets and in migratory wild bird populations,” wrote the APHIS in its release.

Findings will be reported by the USDA to the World Organization for Animal Health (WOAH) and its international trading partners. “USDA also continues to communicate with trading partners to encourage adherence to WOAH standards and minimize trade impacts,” the release continued.

WOAH trade guidelines encourage countries to base trade restrictions on sound science. These guidelines also ask countries to limit restrictions, when possible, to specific regions and animals, as well as animal products that present a risk of disease spread. They also advise against banning international poultry trade in reaction to cases in nonpoultry species.

APHIS advised in its announcement that those engaged in poultry production, including both small backyard and large commercial producers, assess their biosecurity activity and practice good biosecurity habits. The agency also urged all bird owners to avoid contact between their birds and wild birds, and report ill birds or unusual bird deaths to state and/or federal officials through their state veterinarian or APHIS at 1-866-536-7593.

“APHIS urges producers to consider bringing birds indoors, when possible, to further prevent exposures. The Animal Health Protection Act authorizes APHIS to provide indemnity payments to producers for birds and eggs that must be depopulated during a disease response,” wrote the APHIS in the release.

 “APHIS also provides compensation for disposal activities and virus elimination activities. Additional information on biosecurity for backyard flocks can be found on 

Currently, the public health risk from avian influenza is low, according to the US Centers for Disease Control and Prevention (CDC).

 Avian influenza activity in humans is being monitored by the CDC with flu surveillance systems.

As of January 10, 2025, 133,910,844 poultry and 924 dairy herds have been affected by HPAI. Fifty states have had outbreaks in poultry, with 16 seeing outbreaks in dairy cows. As of January 7, 2025, HPAI has been detected in 10,948 wild birds. In wild birds, the virus has been confirmed in 51 jurisdictions, according to the CDC.

USDA confirms highly pathogenic avian influenza in backyard non-poultry flock in Puerto Rico. News release. Animal and Plant Health Inspection Service. January 13, 2025. Accessed January 13, 2025. 

https://www.aphis.usda.gov/news/agency-announcements/usda-confirms-highly-pathogenic-avian-influenza-backyard-non-poultry-2#:~:text=This%20is%20the%20first%20case,Services%20Laboratories%20in%20Ames%2C%20Iowa

H5 bird flu: Current situation. US Centers for Disease Control and Prevention. Accessed January 13, 2025. 

https://www.cdc.gov/bird-flu/situation-summary/?CDC_AAref_Val=https://www.cdc.gov/flu/avianflu/avian-flu-summary.htm

The agency is urging producers to keep birds inside when possible

USDA reports Puerto Rico's first case of avian influenza in domestic birds during current outbreak

Weave Products360

Hey everyone, welcome to Product360. Doctor Adam Christman, Chief Veterinary Officer here, and we want to thank our friends at Weave because we got a lot to chat about. We got Sydney Samuels in the house, Director of Sales at Weave, and we thank you so much for being here.

 Thank you for having us. Happy to be here.

 Listen, we're busy. So much is happening. So, we're gonna chat a little bit about that, but beforehand, tell us a little bit about Weave in general.

Weave is able to consolidate your business phone solution inside the office along with whatever texting solution you guys already have. Appointment reminders. Vaccine reminders. We're going to put everything all in one place to help save time.

 You're on the human side too? Medical? Dental?

 Correct. Optometry, ophthalmology, plastic surgery. We service a lot of industries.

 And what does that look like in the veterinary space?

 It translates wonderfully because you guys are probably our busiest vertical honestly that we work with. We've designed it to help you guys save time.

We are able to integrate our business phone inside the office with our Weave phones. They're going to be able to integrate into your PRIME system that they're currently utilizing. It's gonna be able to scan through, pull up the client that's calling in, upcoming or overdue vaccines, unconfirmed appointments, all of it.

 I love that when a client is calling, it already pulls up their medical record. How cool is that? It's anticipating a little bit. So, I know when I call my practice up, they'll say, oh, it looks like Connor’s due for his rabies vaccine. How did you know? Time is saved instead of flipping through the computer system.

 Or flipping through different screens. It always comes in one.

 That's exactly right. I love it, OK? And what about missed appointments or missed calls? I know it goes to a text message, right?

 That’s actually called our missed call text. So, every single missed phone call with Weave, you guys are actually going to be able to get a missed call text. It's customized to say whatever you want for during office hours versus after office hours. It’s going to come from the practice phone number though, so it's not some random number. Have you ever gotten an appointment reminder where you’re like, “who is this?” All of our texting reminders, vaccines, missed call texts, is going to come from the practice phone number.

 Excellent. Now is there a mobile app component to it?

Of course, of course. Yes, I just happen to have a record up. This is our mobile app. It's going to be able to show all of your phone calls, which are recorded. If people take after-hour emergencies, it's going to be right here. You're going to be able to view your schedule and again, if you need to call or text a client, it's all going to come from the practice number.

That's excellent. Can you do a demonstration for us and walk us through it?

 So with Weave, you're gonna have your business phone system that Weave is able to provide. As soon as a client calls, I'm assuming most of your staff is asking the “hi, what's your first name? Pet’s name?” All of that. With Weave, It's actually gonna be able to pull up all this information as soon as the client calls in. Now the conversation is “Hello, Sydney. How are you doing?” 

You're able to click into these pets and actually see overdue vaccines just right here as soon as you answer the phone. You're going to be able to look at upcoming and overdue appointments as well, appointments that haven't been confirmed yet. So, “Hey, are you looking to confirm your appointment that's coming up on December 11th at 11:15?” All of the phone calls, text messages, are all gonna be documented and saved within the client as well. Phone calls can be recorded. Only admins can listen back to phone calls as we know. And so that's all going to be documented and saved within Weave as well.

Well, what about a missed call? I'm calling the clinic. What happens?

Well, I mean, no one has time to get back to every single phone call, right? It’s almost impossible. So, you can go ahead and hang up that phone call. We all know 80% of people aren't going to leave you a voicemail anymore, OK? We’re all kind of lazy, especially in the vet industry. If you don't answer, I’m going to keep calling until you pick up. With Weave, you will get a missed call text that is designed to say whatever you guys want for during office hours versus after office hours.

 So, it currently says, “Sorry, I missed your call. I’m currently assisting another customer. Please text me and let me know how I can assist you. Sydney Samuels.”

 OK, I'm going to say rabies vaccine appointment for Carl.

Perfect. So again, all of our text messages are actually going to be notified right away up on the screen. If you don't have Weave open, you're going to be notified right away that you have a text. It's going to hover over whatever you are doing. You can reply back there, or you can click into our text messages.

Weave is also customizable so you can actually make this platform a little bit bigger and it becomes a little bit more feature rich as well. All of our techs are in here. I can respond back and am going to say “hi” to be a little bit quicker. True to texting, all the texting comes from the practice phone number. If you need to tag someone else in this message—so hey, this is actually more of a doctor question—you can tag different people. They're also going to be notified that they have a text they need to respond back to. You're going to be notified on your mobile app.

That's really neat. OK, so this is awesome. What about the payment system?

 Weave is also able to consolidate your merchant solution. We’re gonna be able to provide a terminal for the location, of course. Everything's a flat rate, whether they pay with MasterCard, Visa, etc. We also have a text to pay solution, so text to pay online bill pay. I can kind of show you what it looks like. So, I can see that this patient still has not paid. We’re going to try to collect payment from them. We can use text to pay, a card saved on file. All of this information is just right here.

Yeah, I mean, we love to invoice our clients out in the exam room, and this is how you can do it, right?

AI is huge. Are there any AI integration components in Weave?

 Of course. Quite a few things that we do actually with AI. One of our newest releases is our call intelligence. Since all of our phone calls are recorded, Weave can listen back to your phone calls with our AI tool. 

It’s going to identify missed scheduling opportunities. It can create tasks for stuff like billing questions or get on a quick fill list or an ASAP list if the appointment wasn’t soon enough. All of that information will be in here and this is actionable. You can click into these and be able to see customer sentiment: if they were happy, calling about an emergency, and so forth. It's going to give you a breakdown of what happened on that call instead of actually having to listen back to it all on the phone.

Yeah, that's really smart. Excellent. Sydney, this has been fantastic. Thank you for being here.

. However, we're also going to put a QR code in here. So please scan it and you’ll be directed to book a demo through Weave.

 I love it. Thank you so much and thank you to Weave for supporting this great conversation. We’ll see you next time right here on Product360. Take care, everybody.

How Weave's all-in-one phone system is saving veterinary practices time with making appointments, vaccine reminders, missed calls, and more. 