Veterinary opthamologist Jennifer Sheahan, DVM, DACVO, shares the common ocular diseases that general practitioners can come across in their clinics

Video interview with Jennifer Sheahan, DVM, DACVO

Before going to a veterinary ophthalmologist, patients suffering from ocular diseases will first find their way into their general practitioners office. During an interview with dvm360 at the Fetch Long Beach conference in Long Beach California, Jennifer Sheahan, DVM, DACVO, shared how dry eye can present itself in the clinic, and the outcome of it for patients suffering. 

So we often see dry eye in the veterinary ophthalmology field, and the most common cause for dry eye is autoimmune. People get dry eye as well. So the most common treatment for dry eye is immunosuppressants topically, just like in people, people have Restasis because with chronic dry you can go blind, it's itchy, it's uncomfortable, you can get ulcers and infections in the eye. You get eyelid masses. You know, little lumps and bumps as we get older, people get them. 

The same thing with animals. So you get eyelid masses. The good [and] Interesting thing about eyelid masses is that 87% of them are benign. So you know, the key to eyelid mass issues on the eyelid is that you want to take care of them early on, because once they exceed 25% of the eyelid margin. Then you have to borrow tissue from your forehead or cheek to recreate your eyelid they have come too big to do primary closure.

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Jennifer Sheahan, DVM, DACVO, shares the common ocular conditions that general practitioners can be on the lookout for in their clinic

Common ocular diseases in general practice

What are the features of a good friendship? In a keynote session at the Fetch Long Beach conference December 6-8, 2024, Mary Gardner, DVM, cofounder and chief information officer of Lap of Love Veterinary Hospice & In-Home Euthanasia; and Eric Garcia, internationally recognized information technology (IT) and digital strategist working with veterinary practices, and founder of Simply Done Tech Solutions, shared anecdotes of their unwavering friendship rooted in accountability and mutual support, explaining that good friends can not only lift each other up, but help each other grow and navigate life.

“The world as you view it, no matter how it is, it can be a dark place at times and we can go through our own personal challenges,” began Garcia in the session titled “Evolving Together Through Friendship, Accountability, and the Ever-Present Learning Curve.” “With Mary and I, no matter what's happening, we're always super happy about just how we view life, and we contribute a lot of that to having close friends and to being each other's best friends.”

Gardner and Garcia shared 7 features of their friendship, which Gardner and Garcia call their “friendship creed,” that help them bond and make the friendship a great one. These values consist of “brutal” honesty; “crushing” work, or putting in effort; laughing harder; fueling the fun; accountability; continuous learning; and having an inner circle.

“These are things that we really focus on every day when we're talking to each other or when things happen within our lives or goals and mindset,” said Gardner.

Garcia and Gardner explained that an important part of a good friendship consists of being able to be one’s authentic self. “You have to be okay with being silly in your friendship. You have to be okay with being who you are, to think about who you really are. Think about who you were in your younger years, in your early being. Think about that weird person that you used to be, that you suppress because societal norms asked you to be a certain way,” emphasized Garcia.

Good friends challenge each other to succeed and work hard, or “crush work,” as Gardner and Garcia explain. “We challenge each other every year in going into every single event that we do, whether speaking at a conference here or somewhere else. We're always like, ‘Bring your best a game. Do the best you can. Make sure your slides look good. Make sure you know what you're talking about.’ We always challenge each other, and ultimately, it led us to win an award [a few years ago] together in different categories,” Garcia shared. However, he also emphasized that this feature of a good friendship also consists of celebrating friends when achievements happen.

Being “brutally honest” and holding each other accountable

“It's really important, I feel, in friendship[s] to be able to be brutally honest with the person that you're good friends with,” explained Garcia. He emphasized the importance of having open conversations with friends, sharing that when Gardner is “brutally honest” with him, he does not “look at that brutal honesty and say that it hurts [his] feelings.”

Accountability, like open honesty, should also live freely in friendships. In the talk, Gardner and Garcia explained that they are constantly holding each other accountable and keeping each other in check. Earlier this year, Gardner took on the challenge of climbing Mount Kilimanjaro despite having never climbed a mountain and having no experience hiking. As Gardner and Garcia shared, Garcia helped hold Gardner accountable by reminding her to prepare for the climb.

Good friends push each other to continue learning new things, explained Garcia and Gardner. They shared that their friendship pushed both of them to search for a hobby and try new things—something they did not have prior to their friendship. 

“We often complain about what's wrong with the world… instead of complaining, we should channel that energy differently, and we should think about what we're doing to put good into the world,” said Garcia, quoting a lecture he attended on the art of happiness. He explained that both him and Gardner challenged each other to text the other for 31 days straight about something they did to “put good into the world,” pushing each other to learn more about the world.

Gardner and Garcia explained that it is important to surround oneself with people who “fuel your fire.” Friendships evolve and grow stronger when they are built on trust and support. Gardner and Garcia explained that it is all right to cut people who are not supporting you off, or those that are hindering personal growth.

During the session, Garcia shared an experience during the COVID-19 pandemic with a cyberbully who began attacking him and a business that he ran with Gardner. According to Garcia, Gardner supported him throughout the entire process. When Garcia addressed the issue publicly, both the community and Gardner stood by him.

“Unapologetically fight for your friends,” said Garcia.

Gardner M, Garcia E. “Evolving Together Through Friendship, Accountability, and the Ever-Present Learning Curve.” Presented at: Fetch dvm360 Conference; Long Beach, CA. December 6-8, 2024.

Articles

Mary Gardner, DVM, and Eric Garcia shared several facets of a successful friendship in their talk at the Fetch Long Beach conference in Long Beach, California

Building strong friendships

Allergic dermatitis in canines can cause quality of life issues for patients and lead to caregiver burden for pet owners. Complex cases can also be frustrating for clients and veterinary teams.

Understanding condition management frustrations and the unique experiences of patients, pet owners and veterinary teams can help guide treatment plans. In an educational session at the 

2024 Fetch dvm360 Conference in Long Beach

, California, talk, Brittany Lancellotti, DVM, DACVD, a Fear Free-certified practitioner at Veterinary Skin and Ear in Los Angeles, California, provided insights about these experiences from different perspectives.

Quality of life (QOL) can decrease for an animal with allergic dermatitis, while also elevating the pet’s fear, anxiety and aggression. Dogs with the condition have also shown a significant decrease in trainability, according to Lancellotti.

In addition to emotional behaviors, clients may observe in pets with allergic dermatitis scratching, licking, chewing, rubbing, biting, head shaking, scooting or nibbling—all of which can worsen clinical signs of the disease. Allergic dermatitis can also cause disruptions in a pet’s play behaviors, in the job performance of working animals, and in sleep, Lancellotti added.

Those effects create an important welfare issue for these animals. However, Lancellotti said that early recognition of behavioral problems that may be associated with chronic allergic dermatitis of the skin and ear can lead to improved treatment outcomes and QOL for the animal and their owner and may help minimize pet relinquishment.

“The great news is that we have a lot of different options for individual relief from allergic dermatitis,” Lancellotti said. She followed with an overview of drug therapies that included glucocorticoids, modified cyclosporine, Janus kinase inhibitors, and lokivetmab.

Veterinary teams can work with clients to ascertain the best path forward with treatment plans. For example, Lancellotti said, a client that finds it difficult to clean a pet’s ear or administer medication may need to work with the veterinary team to overcome the challenge or pursue a new treatment tactic.

“Eliciting from owners any difficulties with the treatment and where the pet might be struggling can provide an opportunity to creatively troubleshoot and overcome the discrepancy between improvement of clinical signs and improvement in quality of life,” Lancellotti said.

In the lecture, Lancellotti noted that client education about allergic dermatitis should include an explanation of 

treatments are being recommended. Veterinary teams should also allow pet owners to share their concerns about the treatment plan and offer solutions to potential problems including how an animal is responding to therapies.

“There is no one size fits all treatment for these animals. Each pet is their own special snowflake, and so we'll adjust our management plan based on how that pet is responding. That means that good communication with the veterinarian is really crucial to finding a plan that works best,” she said.

Client expectations can be managed by communicating what the condition means long-term and how a pet’s QOL may be affected. Caregiver responsibilities such as expenses associated with treatment, including costs for doctor visits, condition management products and associated therapies, as well as the time commitment needed to continue addressing the condition, should be adequately conveyed.

A survey of 283 veterinary dermatology practice clients was conducted by the American College of Veterinary Dermatology in 2019. Respondents of the study—cited in Lancellotti’s lecture—reported their dogs had dermatology conditions that included pruritus, ear problems, coat changes, and skin lesions.

Results of the survey revealed that 73% of clients had visited their primary care veterinarian more than 3 times to have their pet’s dermatologic condition evaluated before being referred to a dermatology specialist. Forty-two percent of these clients reported visiting their primary care veterinarian an average of 5 times before receiving a referral.

“Now, going [to a veterinarian] 5 times and not having an answer is incredibly frustrating. Never mind the 5 times these pets are getting packed up, poked and prodded. That's also 5 times the owner has the opportunity cost of spending their time going back and forth to the vet visit. These repeat visits are just one thing that is going to contribute to caregiver burden, and that's the strain that an owner feels from the challenges of providing care to a companion animal,” Lancellotti said.

A treatment plan for managing canine allergic dermatitis should be individual to the patient since no 2 pets will respond exactly the same way to the same plan. 

"Symptomatic treatment should be aimed at targeting pruritus and/or inflammation, depending on the individual pet,” Lancellotti said. “With proper medication selection, once you understand the individual [patient] and the tools you have available, we can help relieve what that patient is going through, but also relieve what some of the owners are going through."

Lancellotti B. Quit your itchin: managing pruritis and client frustration from canine allergic dermatitis. Presented at: Fetch dvm360 Conference; Long Beach, CA. December 6-8, 2024.

Hanna B. Earlier dermatology referral rewards primary care practice (part 1): easing client expenses and enhancing patient care. 

. May 18, 2022. Accessed December 6, 2024. 

https://www.dvm360.com/view/earlier-dermatology-referral-rewards-primary-care-practice-part-1-easing-client-expenses-and-enhancing-patient-care

In an education session at Fetch Long Beach, presenter Brittany Lancellotti, DVM, DACVD, discussed how patient, client and veterinary care providers all contribute to improving outcomes for pet with skin condition

Using experiences to guide dermatologic care

Atopic Dermatitis

At the 2024 Fetch dvm360 Conference in Long Beach, California, Brittany Lancellotti, DVM, DACVD,  explains how managing atopic dermatitis requires a comprehensive understanding of its multifactorial nature, which includes genetics, environmental factors, and the animal’s unique microbiome. 

My name is Dr Brittany Lancellotti. I am a board-certified veterinary dermatology specialist working at Veterinary Skin and Ear in Los Angeles. I'm also the founder and host of 

, a client education podcast for pet owners.

Atopic dermatitis is very complicated. This is a multifactorial disease involving genetics, the environment, and an animal's individual microbiome. When managing this condition, we have to consider the animal's clinical presentation, their comorbidities, how the disease is presenting in them, how they've responded to previous treatments, and what the long-term goals are for their care, as well as any side effects they've experienced.

We also need to think about what the animal is dealing with in terms of non-dermatologic medical issues and take that into account when selecting medications. These are really complicated cases that involve not just the skin but the whole animal. There are so many factors to consider when choosing the therapy that will be most effective for a specific patient.

Atopic dermatitis isn’t just a skin problem—it’s a multifactorial disease requiring a holistic, patient-specific approach

The multifactorial nature of atopic dermatitis

Ansell Glove Technology

 Hey everyone, Dr. Adam Christman, Chief Veterinary Officer here at DVM360. I'm joined by Martin Jewell, Associate Director of Alternate Care of Ansell. Thank you so much for being here. 

We're going to talk today about something very important in our field and that is surgical gloves. As of December 2016, the FDA banned powdered surgical gloves and absorbable powder used for lubricating surgical gloves due to health risks for healthcare providers, patients, and other individuals. What arose of this ruling were companies like Ansell who wanted to make safe powder-free gloves. However, Ansell decided to take that a step further by developing various types of gloves to make them easier to use during appointments and also in surgeries. As a result, the market has shifted, with veterinary professionals now relying on powder-free surgical gloves while Ansell's innovative donning technology offers a solution for easier applications when needed. This commitment to safety and usability ensures a higher standard of care for both patients and healthcare providers. So, with that, let's talk about this. What sets Ansell's gloves apart from the competitors out there? 

The powder to powder-free happened in the human side almost 20 years ago. So, we had designed gloves with what we call DermaShield. It's our proprietary hand donning technology. It is a silicone that is compounded as we make the glove that allows the hand to don while it's damp. It works with emollients, it also works with sanitizers, so that you're not blocking and you're not breaking through gloves when you're donning. You have less waste, you can perform your procedure faster and better. 

Excellent. There's so much innovation and safety so how has this evolved in the types of gloves that we have today? 

Well, today is no longer just a white surgical glove with no donning. We've evolved into micro gloves, we have textured surgical gloves. We also have synthetic ranges for folks with latex allergies. So, we have neoprene, polyisoprene, and we have PI hybrid, which is a combination of neoprene and polyisoprene for those with latex allergies. But our whole range of products, one of the things that we feature on each of our gloves are the DermaShield technology and then we also have what's called sure-fit technology. That's to prevent the cuff from rolling down because you've got a slick polymer on a gown and you can have cuff roll down and then you can compromise your sterility. If you notice, we have an ergoform technology on our formers so that means less hand fatigue, less worked time off, less problems with your hands and strength. So, this particular glove that you're looking at, I don't know if you want to try to put that on, that is an Encore micro glove. 

We found that within the vet procedures, and you see how nicely that goes on, now that was a dry hand but we'll take it with a damp hand as well. That is a glove that was designed for cardiovascular, peripheral vascular surgery years ago and ophthalmics. You notice the color’s brown because folks work under light. They don't want the glare. It's 20% thinner so you can feel the small suture and the small needle as you conduct your procedures no matter how small or how fragile that procedure is. 

That's great. I'm thinking of the ophthalmology procedures too with such delicate tissue and the suture material is so fine and you can definitely feel. I have good dexterity with it so that's pretty good. I like it.

 Yeah. Then the next step from that is if you have spay and neuter procedures and you're using animals with a lot of fatty tissue, we have a fully textured very aggressive latex surgical glove. Orthopedics now are becoming more common in the veterinarian practice. So, we have thicker orthopedic gloves. Double-gloving has become sometimes a priority. So, we have an under-glove, we have a glove-in-glove double-glove system out of the poutch, the only one out of the pouch and the only one in the world. And while we do this, we keep all of the things that are so important now to environmental and safety and social governance on our packaging and our missions. We want all of our packaging to be fully recyclable. By the year 2026, we're going to reuse the water and all of our plants are employed. We own and we employ those individuals there. We have our research and development centers there and we do our own sterilization there. That's a big deal now. After seeing the global shutdowns, we have three manufacturing facilities in three different countries, each with their own sterilization ability. So that gives us a lot of flexibility in the future.

That’s fantastic. And I hear something about WEI, what does that say? 

That’s really just the whole umbrella: the worker improvement and the technology of all of our technologies combined together under our one umbrella with Ansell. So, the DermaShield is what enhances the gloves’ ability to go on a damp hand and where that really comes into play is if you're doing repetitive surgeries over and over and over and you're scrubbing and you're going back and forth and you're getting gloves on your damp hand, you don't have to stop. You don't have rips and tears, you don't have the waste, and you've got the ergo form technology on the gloves, so you've got a more comfortable feel as you go through the work day. 

 That's fantastic. So much easier for workflow. And talk to me more about the Ansell sure-fit technology that's available. 

The sure-fit technology is to ensure that when this is up over a gown, that it's a sticky band on the inside of the glove, so that it does not roll back down, and it does not compromise the surgical technique of the procedure. So, you know all of these technologies together make a better experience with using our gloves. 

 Excellent. Nice. I see that we have a lot of products over here focused on safety. Tell me a little bit about that. 

Well, this is our Sandel® safety solutions line. We have a whole portfolio of safety solution products that were designed by healthcare workers. All of these ideas for products came from healthcare workers and these are designed for never events in the OR space. We’re sharing that more now in the animal health space to make sure you're doing the correct procedure on the correct patient and on the correct body part. 

Working on the right leg and sort of the left leg and so forth, those are excellent. 

Just following more with the OSHA guidelines that are required now for the veterinary hospital. We also have a full offering of non-latex disposable examination gloves. Dental practice has become very prominent now, and so we have half sizes in our exam gloves, so that is a big thing. If you can't find your fit, we've got the small mediums, and we've got the medium and the smalls that I call this smediums. 

 Oh, that's great, I didn't know that. Wow, that's really cool. And where can we learn more? 

 for our surgical gloves and our examination gloves, and you can go to 

 Great, thank you for all the great work you and the company do. Thank you for being here. 

And thank you for tuning in here, Products360. We'll see you next time. Take care, everybody.

How Ansell's innovative surgical glove technology has been applied to the animal health world. 

The evolution of surgical glove technology

The 4 P's

At the 2024 Fetch dvm360 Conference in Long Beach, California, Kelley Detweiler and Peter Weinstein gave 4 lectures on controlled substance compliance for veterinary practices. In a pre-conference interview with 

, the pair shared how focusing on "the 4 P's"—people, processes, paperwork, and products—practices can have a simplified framework for remaining compliant and avoiding DEA violations.

Kelly and I were talking about veterinary practices and the different components of them when it comes down to controlled substance compliance, and it just felt natural to talk about people and processes and paperwork and then the products, because that's really it—it wraps around the veterinary practice. So really, the fifth P is practice, and people, products, processes, and paperwork are what you need to be in control of to remain compliant.

We take each of those areas and dive into them to help you understand what you need to do: to have your people under control, to have your products under control, to understand what products you need to be concerned about, and to recognize that paperwork will either cover your assets or kick your assets.

When it comes down to processes—and I'm a big process guy—if you learn how to do things the same way each time, every time, all the time, you can prevent problems (if you want to keep with the alliteration). From that standpoint, yep.

And I'll say that one of the key elements, keeping with the alliteration, is how Dr. Weinstein instills this concept of the Four P's. It's a perfect breakdown for replication and driving home the 4 P’s. We're just constantly trying to drive it in a memorable way, keeping it simple.

Veterinary practices can simplify controlled substance compliance by focusing on 4 essential pillars