Gianluca Bini, DVM, MRCVS, DACVAA, describes how sedation compares to general anesthesia, including risks and benefits.

Insights on sedation vs general anesthesia

Gianluca Bini, DVM, MRCVS, DACVAA, owner and founder of the Safe Pet Anesthesia tele-consulting and training company and assistant professor of anesthesiology and pain management at Oklahoma State University, shared his expertise with veterinary professionals at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina. During the event, he presented multiple continuing education (CE) sessions on anesthesia and pain management.

, Bini provided additional insights about his CE session. In this segment of the interview, he describes how sedation compares to general anesthesia, including risks and benefits.

The following is a transcript of the video:

: The benefit of sedation is definitely timing, right? We just give an injection. The patient gets sedated. We do what we need to do, and then can either reverse them or, usually, the synaptic drugs don't last that long. So…they can wake up. The risk of general anesthesia, of course, is always that when a patient is anesthetized, that they lose a lot of their physiologic functions, or like they usually lose their swallowing reflex so they can’t protect their airways. They hypoventilate, so they start breathing less frequently and sometimes with smaller breaths.

Sedation, though…although sometimes it seems very benign, in reality, sedation can be as dangerous as general anesthesia, right? So if your patient gets too sedated, your patient is basically almost anesthetized. So the fine line between sedation and anesthesia, for me, from an anesthesiology standpoint, comes into ‘is my patient able to swallow?’ And if it is, then, I carry on with my procedure. But if, if my patient loses the ability to protect its airways, then I need to intubate it and convert to general anesthesia. So there are pros and cons to both. Sedation seems like the quick and easy answer sometimes, but it could be more dangerous than you think.

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Gianluca Bini, DVM, MRCVS, DACVAA, describes how sedation compares to general anesthesia, including risks and benefits, in a dvm360 interview.

Journal of the American Veterinary Medical Association 

), found that inhaled albuterol rapidly decreased blood potassium concentrations in cats. Study results offer a potential treatment option for cats with hyperkalemia undergoing surgery or other medical procedures.

In felines, a urinary tract obstruction is the most common cause of hyperkalemia. A ruptured urinary bladder can also lead to high potassium levels in these animals.

 Moreover, patients of any species with moderate to severe hyperkalemia can exhibit generalized muscle weakness, depression, and cardiac conduction disturbances that can result in life-threatening cardiac arrhythmias.

“Urinary tract disease is relatively common in cats, and decreased renal excretion of potassium in these conditions is the most common cause of hyperkalemia in cats,” the study's authors wrote.

In humans, inhaled albuterol is supported as a first-line therapy for acutely managing hyperkalemia, with the treatment lowering potassium concentrations within 15 to 30 minutes of administration. Effects of inhaled albuterol in humans can last up to 180 minutes.

-agonist that stimulates an intracellular redistribution of potassium through induction of endogenous insulin secretion and activation of membrane-bound Na/K-ATPase pumps in skeletal muscle and liver cells independent of insulin,” the study's authors wrote.

For the study, 20 healthy, spayed/neutered cats received albuterol sulfate at doses of either 90 µg or 360 µg through a mask that was placed over their muzzles. Fifteen were domestic shorthair, 3 were domestic longhair, 1 was a domestic medium hair, and 1 was a Sphynx. Ages of the cats ranged from 1.1

years to 7 years and the median weight was 5 kg.

Blood samples and heart rate from the participants were taken at baseline and at 10 time points following administration of albuterol sulfate, with the final sample taken 360 minutes after the tenth inhalation. Blood potassium and glucose concentrations were measured using a blood gas analyzer, while plasma insulin levels were assessed through radioimmunoassay.

Cats enrolled in the study did not have a prior or newly documented history of cardiac abnormality. Felines who had been administered any medications that may alter blood potassium—such as insulin, sodium-glucose cotransporter-2 inhibitors, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, potassium gluconate, and potassium citrate—were also not eligible for enrollment.

The results showed that inhaled albuterol rapidly decreased blood potassium levels in under 3 minutes, with peak effects happening at 30 minutes after administration and lasting for at least 180 minutes.

 The average maximum decrease in blood potassium concentration occurred in the cats who received the lower dose (90 µg) of albuterol, with the decrease being 0.52 mmol/L.

Additionally, plasma insulin levels increased rapidly after the administration of inhaled albuterol, peaking at 30 minutes and decreasing below baseline by 360 minutes. Time significantly impacted these levels but albuterol dose and the interaction of albuterol dose and time did not impact plasma insulin levels. Both low- and high-dose albuterol cohorts saw significant increases in plasma insulin compared to baseline, but there were no significant differences between the 2 doses.

Additionally, blood glucose levels rose after inhaling albuterol, peaking at 60 minutes for the low-dose group and at 120 minutes for the high-dose group, with both returning to levels below baseline by 360 minutes.

Conducted by researchers at Midwestern University College of Veterinary Medicine in Glendale, Arizona, and Michigan State University in East Lansing, the study’s findings suggest a more affordable and easily accessible treatment option for lowering potassium levels before surgery or other procedures, offering an alternative to other existing methods, according to the AVMA.

Study identifies possible treatment for cats with elevated potassium levels due to urinary obstructions. News release. American Veterinary Medical Association. March 27, 2025. Accessed April 2, 2025. 

https://www.avma.org/news/study-identifies-possible-treatment-cats-elevated-potassium-levels-due-urinary-obstructions?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

Constable PD. Disorders of potassium metabolism in cats. Merck Veterinary Manual. September 2024. Accessed April 2, 2025. https://www.merckvetmanual.com/cat-owners/metabolic-disorders-of-cats/disorders-of-potassium-metabolism-in-cats

Jaffey JA, Cunha A da, Kushiro-Banker T, et al. Inhaled albuterol rapidly decreases whole blood potassium and increases plasma insulin concentrations, with peak effects 30 minutes after administration in cats. 

Journal of the American Veterinary Medical Association

. Published online March 26, 2025:1-8. doi:10.2460/javma.25.01.0054

Articles

A recent study explored the effect of inhaled albuterol sulfate in reducing blood potassium levels in felines, which offers a potential treatment option for urinary obstruction-related hyperkalemia

Inhaled albuterol offers more accessible treatment option for elevated potassium levels in cats

 scrapes the surface of the news you need to know, and the American Veterinary Medical Association’s latest economic report is packed with insights worth paying attention to.

Let’s look at the data from the previous year and break down what some of these trends mean for your practice.

Student debt is growing – corporate hiring power is, too

After a brief decline, student debt was back on the rise last year, with more new graduates carrying over $300,000 in DVM loans. That means corporate groups, with their ability to offer hefty sign-on bonuses, may regain the upper hand in hiring.

However, private practices aren’t out of the running—they just need to play to their strengths. While money matters, multiple studies show that workplace culture is just as important to job seekers. So, how can you stand out?

Define and market your employer value proposition. What makes your practice a great place to work? If you don’t know, start figuring it out—because nearly half of practices don’t have a mission, vision or value statement, and 83.5% lack an employee wellness plan.

 Fix that, and you’ll already be ahead of the curve.

Relief veterinarians are on the rise—with one concerning trend

 that 45% of veterinarians were either planning to switch to relief work or considering it.

 Now, 2 years later, we’re seeing that movement materialize – the percentage of relief vets in private practice has increased from 6% in 2023 to 9.1% in 2024.

What does this mean for you? It’s been said before, but it bears repeating, retention is key. Full-time veterinarians aren’t leaving just for the flexibility of relief work—they’re often driven away by workplace factors like administration, culture, and leadership.

 If you want to keep your team intact, make sure you’re not giving them a reason to look elsewhere.

At the same time, there’s a growing concern: relief veterinarians are the only group whose burnout has increased since the pandemic. They are also the least satisfied with the profession.

 What’s fueling the stress and dissatisfaction? These are critical questions worth investigating—especially for practices that rely on relief vets to fill staffing gaps. As the workforce shifts, the conversation around retention will likely need to shift, too.

Tech gaps, telehealth declines, and the push for efficiency

The report repeatedly emphasizes one critical takeaway: veterinary practices need to prioritize efficiency and make better use of technology. More clinics are adopting digital tools, but there’s still a significant gap. Shockingly, 23.5% of practices still don’t use a practice management system, leaving them without a central hub to manage appointments, records, and client communication. That’s not just an inconvenience—it’s a competitive disadvantage.

There’s also been a sharp decline in telehealth from 38% in 2023 to 29.2% in 2024, but online appointment scheduling is growing.

 Meanwhile, software innovations are exploding—just look at the new tools showcased at VMX and WVC 2025. Artificial intelligence scribes, inventory automation, virtual assistants—it’s all there to save time and money. If you’re not using these tools yet, why not? Most have free trials, so there’s no excuse not to explore what’s out there.

New veterinary practices are opening at a steady clip: total numbers grew from 32,634 in 2021 to 34,000 in 2022, with an 18.5% growth rate since 2009.

 Larger hospitals (20+ employees) are becoming more common, while sole proprietorships are shrinking. This likely points to more corporate ownership but could also mean more independent vets are incorporating for legal or tax benefits. Either way, the trend points to a move away from small, solo-doctor models toward larger, more structured veterinary businesses.

Clinic hours are stretching longer, too. In 2024, the average practice was open 10 hours on weekdays, compared to 9 hours in 2023.

 Extended hours and bigger teams suggest the industry is adapting to meet rising pet care needs – but here’s the catch: the number of available appointment slots hasn’t budged. A full-time veterinarian in companion and mixed animal practice is still averaging 13 to 14 appointment slots per weekday. So, what’s driving the longer hours? Could general practices be extending their hours to keep up with the booming urgent care market and attract pet owners after work, or simply offset declining revenue by maximizing service hours?

All practice types except companion animal predominant saw a slight decrease in gross revenue last year. However, when companion animal exclusive and companion animal predominant practices are grouped together, the overall revenue trends align more closely across the board. Not surprisingly, but certainly worth noting, is the substantial gap in median revenue: small animal veterinarians generate over $600,000, significantly outpacing all other practice types.

 Even with the highest ratio of full-time equivalent non-veterinarian staff per veterinarian, companion animal doctors are far ahead of their counterparts in revenue generation.

Here’s an interesting one: revenue for 100% brick-and-mortar practices took the biggest hit, while mobile practices experienced the most significant growth, highlighting a change in how and where pet owners are choosing to access care. Could mobile services be pulling clients away from traditional clinics? Definitely something to watch.

No survey is without gaps, and understanding the respondent pool helps put the results in perspective. Of the 524 practices surveyed, most were independently owned (93.9%) and 100% brick-and-mortar (56.6%). Meanwhile, the Mission Veterinary Partners and Southern Veterinary Partners merger just brought over 420 practices under one corporate umbrella. With groups estimated to own around 30% of US veterinary practices—and generating more than half of companion animal revenue—it’s fair to wonder if these numbers tell the whole story.

2025 AVMA Report on the Economic State of the Veterinary Profession. 

https://ebusiness.avma.org/ProductCatalog/product.aspx?ID=2215

Kogan LR, Rishniw M. Relief and mobile veterinary careers may offer a path towards improved quality of life. 

Javma-journal of The American Veterinary Medical Association

. Published online November 1, 2023:1-7. doi:

2024 AVMA Economic State of the Profession. https://ebusiness.avma.org/ProductCatalog/product.aspx?ID=2157

Wogan L. Veterinary relief practice is having a moment. Veterinary Information Network. Published August 1, 2022. Accessed March 31, 2025. https://news.vin.com/default.aspx?pid=210&Id=11050604&f5=1

Brick-and-mortar clinics are feeling the squeeze, mobile vets are thriving, and competition is heating up—veterinary practices are in for a dynamic year

2025 economic state of the veterinary profession: Trends and opportunities for your Practice

Technology company VEA has been named the Grand Prize Winner of the 2025 Purina Pet Care Innovation Prize (PCIP) presented by Nestlé Purina North America. Four additional startup companies were also awarded prizes in the competition that culminated at the 2025 Global Pet Expo in Orlando, Florida.

Based in Alexandria, Virgina, VEA provides services for streamlining veterinary documentation and workflow using artificial intelligence (AI) technology. VEA aims to assist veterinarians with better predicting disease, generating diagnostic plans and supporting nutrition for longevity through its’ intuitive AI-driven platform, according to PCIP and VEA.

Patricia Porter, CEO of VEA, said winning the grand prize is an “incredible honor” and “deeply meaningful” to the company. “We’re not just building technology for the future of vet med—we’re building it for the exam room today. Winning the PCIP validates the urgent need for innovation in veterinary care, and it fuels our mission to elevate every aspect of the clinical experience,” Porter said in a news release.

The winning pitch earned VEA a total of $50,000 with nondilutive funding and a cash prize. The grand prize winner also receives mentorship from the Pet Care Innovation team from Purina and Active Capital, a partner of Purina’s in the corporate venturing group 9 Square Ventures.

According to Porter, VEA started its’ journey with the goal of bridging gaps in veterinary care with AI-driven innovation. “This recognition reinforces the impact we’re making,” Porter said in a news release.

 “Seeing VEA help veterinarians provide smarter, more efficient and more compassionate care is what drives us every day. We are so grateful for Purina championing innovation in pet health and supporting companies like ours that are shaping the future of veterinary medicine.”

Patrick Mullen, co-lead of 9 Square Ventures group and vice president of strategic planning at Purina, noted that the PCIP judges’ panel saw “immense potential” in VEA. “We are proud to be a part of VEA’s growth journey and look forward to seeing the many ways each of our incredible finalists will continue to grow, innovate and make their mark on the pet care industry,” Mullen said in a news release.

Four PCIP competition finalists received $25,000 each as well as mentorship from Purina and Active Capital. These finalists also have the opportunity to participate in an accelerator boot camp at the Purina headquarters in St Lousi, Missouri. These 4 finalists include the following companies

: This New York-based company created a health sensor that can continuously monitor the wellbeing of patients and provide early identification of clinically relevant changes. The technology allows pet owners and veterinary teams to treat patients more effectively through earlier diagnosis of health concerns.

: A startup based in San Francisco, California, it produces clean animal protein for felines. Ten Lives uses microbes to develop protein converted from sugar, and made without animals. This protein is the same that’s found naturally in animals such as rabbit, fish and lamb, according to PCIP. 

: Businesses that provide pet services can collaborate with industry brands for the benefit of selling more products through ShopDot Pet, based in Missoula, Montana. The platform is affording animal care professionals including groomers, trainers and veterinarians the ability to sell essential items without inventory and shipping costs and, thus, generate more revenue.

: This company in Austin, Texas, offers all-natural, long-lasting canine cheese chew. According to PCIP, these chews are made with simple, ethically sourced ingredients.

In its’ ninth year, the PCIP provides support to early-stage companies that are working to advance pet care through innovation. Candidates include products and services providing meaningful solutions in pet health and wellness, services, technology, food, and litter.

Finalists, including VEA, were selected from hundreds of applicants.

 “Each year, this collaboration with forward-thinking startups like VEA and our impressive 2025 cohort inspires us to push harder every day to find new ways to enrich the lives of pets and their people,” Mullen said.

“Being part of this year’s PCIP cohort has been nothing short of transformative,” Porter said.

 “We’re incredibly grateful to Purina for championing innovation in this space and for creating a communitywherefounderscanlearn,grow,andcollaborate.Thebestisyettocome—andwe’re just getting started.”

Veterinary Tech Startup VEA Wins Grand Prize in 2025 Purina Pet Care Innovation Prize. News release. VEA. March 31, 2025.

VEA wins grand prize as annual pitch competition to secure 2025 Purina Pe Care Innovation Prize. March 27, 2025. Accessed April 2, 2025. 

https://petcareinnovation.net/vea-wins-grand-prize-at-annual-pitch-competition-to-secure-2025-purina-pet-care-innovation-prize/

A veterinary exam assistant driven by artificial intelligence took the grand prize in the 2025 pitch competition that honored 5 startup finalists

Purina Pet Care Innovation Prize winners are announced

NorthStar VETS announced earlier this week that it has entered a strategic partnership with Philadelphia Animal Specialty & Emergency Group (PASE). Through the partnership, both hospitals will collaborate to bring together the 2 hospitals, each veterinarian-owned, to enhance patient care, encourage innovation, and offer more services for the referral community. 

"Merging with PASE allows us to provide seamless access to top-tier specialty and emergency veterinary care for even more pets and their families in the Mid-Atlantic region," expressed Daniel Stobie, DVM, MS, DACVS, founder and chief medical officer of NorthStar VETS, and a 2021 recipient of 

"PASE shares our core values, culture, and dedication to clinical excellence. Together, we will elevate the standard of care and continue to support referring veterinarians and the communities we serve," he continued.

According to the release, NorthStar VETS and PASE will both continue to operate independently to make sure the current processes and expectations for the hospitals are not unchanged for clients and referring veterinarians.

 The goal is to make this partnership a seamless experience for both new and existing patients for PASE’s veterinary team and services.

"This partnership is a union of like-minded veterinary specialists and professionals devoted to providing the best possible clinical outcomes for pets in need," said Adam Yoskowitz, VMD, DACVR, head of diagnostic imaging and partner at PASE.

 "We're excited to join forces with NorthStar VETS and remain a veterinary-owned and led organization. We will both benefit from shared operational support and unified medical leadership.”

Contact information for both hospitals will remain the same.

NorthStar VETS Partners with Philadelphia Animal Specialty & Emergency (PASE) to Enhance Veterinary Care for the Community. News release. NorthStar VETS. April 1, 2025. Accessed April 2, 2025.

NorthStar VETS and Philadelphia Animal Special & Emergency will join forces to enhance pet care to patients in Philadelphia and New Jersey 

Veterinary practices partner to enhance specialty and emergency care for the community

Deborah Thomson, DVM, talks about One Health Lessons’ recently launched “Bird Flu Lessons”

Avian influenza, One Health, and a new resource for educating communities 

In the face of rising avian influenza cases, the need for education and awareness on the topic grows. That's why 

reached out for an interview with Deborah Thomson, DVM, to talk about about One Health Lessons—an educational nonprofit organization—and its recently launched “Bird Flu One Health Lessons.” Thomson is the founder and executive director of One Health Lessons, author of the acclaimed book 

, and chair of the World Veterinary Association’s One Health Education Subgroup. In this interview, Thomson encourages veterinary professionals to use these lessons and other resources to help educate themselves and the public about avian influenza to help protect their communities, families, and pets. 

Below is a partial interview transcript, lightly edited for clarity:

One Health lessons is an educational nonprofit organization that I started back in 2020 and we—volunteers from around the world, veterinarians, physicians, nurses, university students, whoever it is—we train these adults to improve their communication skills, to improve their impact in their community, and we train them to deliver lessons focused on One Health: again, that connection between our health and the health of the environment, animals and plants.

So recently, we've published a bird flu lesson that teaches about the risks, the preventative measures for bird flu, and then also the symptoms of bird flu. We have developed these lessons for children as young as 6 years old, and we have 5 different lessons available in English, Spanish and French. We also have lessons for adults as well.

So, this can be delivered in your local library. This can be delivered at your local Rotary Club or Lions Club, or even with a Girl Scout troop. So think about where you can deliver these types of lessons in order to educate your community and protect your community.

You can take it upon yourself to learn how to do these lessons, or we can train you through our train the trainer program, so whatever you feel most comfortable with there is at the very end of the lesson a classroom-teacher survey so that we can evaluate how this message lands on the ground in your community. And that's not only helpful for us to develop future lessons, but it's also helpful to see really what the temperature is on the ground of interest around the planet.

Veterinarians, veterinary students, technicians, tech students, vet staff—they should all care about these lessons, because not only will it help you as an individual, improve your communication skills, but it will also educate you on bird flu. Plus, if you want to think about it in this way, it'd be also really good advertisement for your clinic if you go into a library, for instance, and say, ‘Listen, we're from X, Y and Z clinic, and we're here to talk about bird flu,’ that's very good advertisement for you and your clinic, so food for thought.

As a veterinarian, I feel like it is my responsibility to educate the public about not only bird flu, but all other zoonotic diseases. After all, it's not only important for us as veterinarians to protect ourselves and our families, but of course, we hold a responsibility to the public.

So, what is our role in veterinary medicine in educating the public?

Well, we can, of course, have pamphlets in our lobbies. We can give community talks at libraries. We can speak one-on-one with our clients. But also, it's important to make sure that we protect ourselves...