Indu Subaiya, MD, MBA, MFA, explains technological advancements that could be of value to veterinary professionals

Interview with Indu Subaiya, MD, MBA, MFA

During an interview at the annual Veterinary Innovation Summit presented by the North American Veterinary Community and Veterinary Innovation Council (VIC) in Kansas City, Missouri last month, Indu Subaiya, MD, MBA, MFA, highlights multiple technology advancements that could be making their way into veterinary medicine as a way for veterinary professionals to make better clinical decisions, plus how telehealth could expand beyond video visits with clients and patients.

I think there are such a host of applications for AI and technology in veterinary medicine. I would say, thinking of the practice setting alone, there are going to be tools that aid veterinarians in making better clinical decisions, from diagnostics to imaging to monitoring animals, both at home and in the clinic. Then when we think of the home environment, when animals are with their owners, there's a whole number of technologies from, you know, detecting conditions just through imaging to other kinds of monitoring and having interfaces for pet owners to communicate with their veterinarians remotely. 

Telehealth for veterinary care has a number of dimensions. It's not just video visits. It could be questions and answers, kind of quick vitals and diagnoses. So I think that whether you're in the clinical setting or in the home or in the community and outside, the role of technology and AI is just really exciting.

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Indu Subaiya, MD, MBA, MFA, explains how technology and artificial intelligence advancements will help veterinarians and their patients

Future of technology in veterinary medicine

Along with mosquito season comes a rise in potentially fatal mosquito-borne illnesses in horses, including West Nile Virus (WNV) and Eastern Equine Encephalitis (EEE). Amanda Trimble, BVMS, PGCertVetEd, MS, a clinical assistant professor of equine internal medicine at the Texas A&M College of Veterinary Medicine and Biomedical Sciences, explained how WNV and EEE affect horses, and steps owners can take to prevent infections.

“About 1/3 of affected horse — typically those that are unvaccinated — may die from [WNV], while more than 90% of unvaccinated horses die from an EEE infection,” Trimble said in a Texas A&M College of Veterinary Medicine and Biomedical Sciences News story.

 “With both, disease and clinical signs may still occur in horses that are vaccinated but are usually much less severe. However, horses that survive may have permanent neurological deficits.”

UC Davis Veterinary Medicine Center for Equine Health, horses represent 96.9% of non-human WNV cases. Since first being introduced to the United States in 1999, the virus is now found in all of the contiguous 48 states. The virus enters the bloodstream through a bite from an infected mosquito, where it multiplies.

In order to diagnose WNV in horses, veterinarians first rule out other possible neurological diseases. An lgM Enzyme-Linked Immunosorbent Assay (ELISA) test measures the amount of lgM antibodies in a given sample, and is considered the most reliable method to detect WNV infection, capable of identifying the virus within 6 days, and after 2 months after infection.

Although many horses do not show signs of illness, Trimble recommends that owners contact a veterinarian if they suspect their horse has the virus, based on any of the following symptoms:

Neurological signs (sudden onset tremors, weakness, poor coordination, stumbling, or falling)

Commonly referred to as “sleeping sickness,” EEE is a viral disease that causes inflammation of both the brain and the spinal cord. EEE is the most common in the southeastern United States, with the primary vector being the mosquito 

, although it can be transmitted by other species of mosquito, as well. Once infected, horses are not required to be quarantined, as they do not carry enough of the virus to be contagious.

The virus is diagnosed through bloodwork. Possible tests include ELISA tests or polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) samples. Trimble recommends contacting a veterinarian based on an owners suspicion and recognition of the following symptoms:

Neurological Signs (inability to swallow, tremors, head pressing, seizures, circling, blindness, rapid changes in behavior, poor coordination, stumbling, or falling)

Trimble recommends creating a prevention plan with a veterinarian, which includes vaccination. The vaccines for both WNV and EEE are considered ‘Equine Core Vaccines’ by the American Association of Equine Practitioners.

 She recommends bi-annual vaccinations for horses in locations where mosquitoes are present year-round.

“These diseases do not need other horses to spread, and they can cause severe and potentially fatal neurological disease if a horse is not properly protected from them,” Trimble said.

“The vaccines are safe and effective and can help decrease the spread and severity of the disease.”

Additionally, Trimble recommends the implementation of environmental management strategies, meant to reduce the mosquito population in the horse’s proximity. Steps can include:

Adding a garlic supplement to horses’ feed

Keeping horses inside at dusk, dawn, and overnight

Daily cleaning of water buckets and tanks

Introducing mosquito-eating fish to ponds/lakes

Regarding both viruses, Trimble said the care a veterinary team can provide is mostly supportive. “Care is largely supportive. For non-severe cases, this may include anti-inflammatories and keeping the horse hydrated and eating,” Trimble said.

 “More severe cases, which includes horses with severe neurological signs or recumbency, may need to be hospitalized or referred to a facility that can provide intravenous fluids and more intensive medical care.”

Say ‘Neigh’ to West Nile Virus, Eastern Equine Encephalitis. Texas A&M Veterinary Medicine and Biomedical Sciences News. September 12, 2024. Accessed September 16, 2024. 

https://vetmed.tamu.edu/news/pet-talk/west-nile-virus-eastern-equine-encephalitis/

UC Davis Veterinary Medicine Center for Equine Health

. August 19, 2020. Accessed September 16, 2024. 

https://ceh.vetmed.ucdavis.edu/health-topics/west-nile-virus

Young A. Eastern Equine Encephalitis (EEE). UC Davis Veterinary Medicine Cetner for Equine Health. August 28, 2020. Accessed September 16, 2024. 

https://ceh.vetmed.ucdavis.edu/health-topics/eastern-equine-encephalitis-eee

Vaccination Guidelines. American Association of Equine Practitioners. Accessed September 16, 2024. 

https://aaep.org/guidelines-resources/vaccination-guidelines/

Articles

A veterinarian shares tips for dealing with common mosquito-borne illnesses in horses

Equine mosquito-borne illnesses

Two new automatic syringes for fish vaccination have been introduced to the veterinary market. ThaMa-Vet, a provider of animal health veterinary syringes, developed fully metal automatic syringes with fixed-dosage for the mass treatment of fish.

One of the new syringes, ThaMa 405, features necessary attributes for use in wet environments, according to an organizational release. This syringe was designed for the mass treatment of fish who need up to a .1 cc dose, and also contains a .05 cc fixed-dosage piston.

Meanwhile, the ThaMa 422 allows users to administer 2 different vaccines in 2 different dosages at once, in one shot, using one needle. This syringe is also automatic and contains .05 cc to .1 cc fixed-dosage pistons.

Both syringes have an all-metal body and have an ergonomical design that allows for fatigue-free work, according to the company.

 The syringes also eliminate the need to adjust settings during the administration of mass injections. Additionally, the products have a “nechmad” valve system and parts that are interchangeable.

The ThaMa 405 and ThaMa 422 come with a maintenance kit that includes a valve spring, a valve stainless ball, valve plastic washer, and piston o-ring.

 Both syringes can be equipped with a metal needle protector, hypodermic plastic and hub needles in specialized sizes for fish vaccinations, and an all-metal draw-off kit, according to a news release

"The aquaculture industry is developing rapidly and is expected to double in size over the next decade," said Udi Nechmad, CEO of ThaMa-Vet, in a news release.

 "We have been approached by fish growers, who express their frustration with the lack of a reliable, durable and easy to handle fish syringe in the market. Recognizing the complexity of vaccinating fish, we developed the new syringes –– emphasizing the need for micro-dosage –– which are lightweight, user friendly and allow precise dosage administration, making the vaccination process significantly smoother for massive quantities of fish."

The syringes are currently in use by various vaccine companies and have demonstrated high reliability in administering vaccines to millions of fish, according to the release.

In addition to these “aqua syringes,” the company also manufactures automatic poultry syringes, cattle syringes, and swine syringes, the latter of which were 

Moreover, the company offers fowl pox syringes for vaccinating chickens against fowl pox, a global viral infection affecting chickens and turkeys. This disease causes nodular lesions that can manifest themselves in the cutaneous form or diphtheritic form.

ThaMa-Vet offers innovative automatic syringe for fish vaccination. News release. ThaMa-Vet. September 10, 2024. Accessed September 16, 2024. https://prnmedia.prnewswire.com/news-releases/thama-vet-offers-innovative-automatic-syringe-for-fish-vaccination-302243150.html

ThaMa 405. ThaMa-Vet. Accessed September 16, 2024. https://www.thama-vet.com/en/products/syringes/aqua/thama-405/

ThaMa 422. ThaMa-Vet. Accessed September 16, 2024. https://www.thama-vet.com/en/products/syringes/aqua/thama-422/

Bautista-Alejandre A. 2 automatic swine syringes are introduced to the veterinary market. 

. July 9, 2024. Accessed September 16, 2024. https://www.dvm360.com/view/automatic-swine-syringes-are-introduced-to-the-veterinary-market

Tripathy DN. Fowlpox in chickens and turkeys. Merck Veterinary Manual. September 2023. Accessed September 16, 2024. https://www.merckvetmanual.com/poultry/fowlpox/fowlpox-in-chickens-and-turkeys

ThaMa-Vet has developed metal “aqua syringes” that can be used in wet environments

New automatic syringes for vaccinating fish are announced

The Colorado Secretary of State’s office has certified Colorado Proposition 129, formerly known as Proposed Initiative 145, which proposes the inception of a new midlevel practitioner (MLP) position in veterinary medicine known as a veterinary professional associate (VPA). The certification of this ballot initiative confirms that it will appear on November’s ballot in Colorado, and results will determine whether the state will become the first to establish the position.

According to the initiative, VPAs would require a master’s degree in veterinary clinical care, or the equivalent, and registration with the Colorado State Board of Veterinary Medicine (CSBVM).

 The ballot measure tasks the CSBVM with the examination and determination of fitness of VPA applicants, along with the ability to issue, renew, deny, suspend, or revoke their licenses.

VPAs would be allowed to practice veterinary medicine under the supervision of a licensed veterinarian. If passed, the initiative has an effective date of January 1, 2026, with the first graduates ready to enter the veterinary workforce in 2027.

The official initiative cites a critical veterinary workforce shortage, rising concern regarding access-to-veterinary-care, those in Colorado’s agricultural industry, and Colorado’s food supply, as reasons for the proposal. The initiative claims that there is no way to solve these issues without identifying additional career solutions in the veterinary workforce.

All Pets Deserve Vet Care, one of the initiative’s biggest sponsors, reported that 65% of Colorado voters support VPAs.

 The initiative also referenced that “experts in veterinary medicine” have identified the implementation of VPAs as a solution to the workforce shortage and access-to-veterinary-care. Additionally, the Colorado State University (CSU) College of Veterinary Medicine and Biomedical Sciences is currently developing a degree program that would fulfill VPA requirements.

, Bob Murtaugh, DVM, MS, DACVIM, DACVECC, FCCM, chair, National Academies of Practice (NAP), chair, Coalition for the Veterinary Professional Associates (CVPA), expressed his support for the initiative, not only in Colorado, but across the country. He cited the veterinary workforce shortage in his reasoning.

"You don't have to look any further than [PAs] in the human medical field to see the advantages of having a similar profession in veterinary medicine," Murtaugh said. "It's helping to address the shortage in healthcare on the human medical side, and we have a shortage of providers on the veterinary side... [VPAs] could increase access to care."

Murtaugh also noted his involvement with the CVPA. "[The coalition] is made up of a large number of well-respected veterinarians and technicians that are in favor of this position," he said. VPAs could provide support to shelters that don't have veterinarians, or even technicians in some cases, in addition to large animal, equine, and food animal practices.

“Skilled veterinary technicians are already more qualified than this contemplated VPA,” Karen McCormick, DVM, Colorado State Representative, said in an opinion piece published in the 

 “They have comprehensive training, take a national exam, and are regulated by the state… Not only do we not need [this initiative], [it’s] dangerous. Please do not sign these petitions.”

Representative McCormick is not the initiative’s only opponent. The American Veterinary Medical Association (AVMA), the American Association of Bovine Practitioners (AABP), American Association of Swine Veterinarians (AASV), American Association of Equine Practitioners (AAEP), American Veterinary Dental College (AVDC), American College of Veterinary Surgeons (ACVS), Independent Veterinary Practitioners Association (IVPA), and the Veterinary Management Group (VMG) have all publicly opposed the initiative.

“This ballot measure attempting to create a ‘veterinary professional associate’ would be disastrous for pets and other animals and endangers public health, considering that 75% of emerging infectious diseases in humans originate with animals,” Sandra Faeh, AVMA president, said in an 

 “The proposed training for this position is completely inadequate and will lead to missed or delayed diagnoses, ineffective treatment, and repeat visits, all of which lead to more suffering for the animal and increased cost for the client.”

The Colorado Veterinary Medical Association (CVMA) has also announced their opposition of VPAs. In a February 2024 survey of CVMA members, 60% of respondents did not think VPAs would positively benefit the profession.

Some of the biggest concerns indicated in the survey’s open-ended section included VPA’s ability to perform surgery with 2.5 years of schooling, additional liability for veterinarians, and the underutilization of existing veterinary technicians.

a 2023 survey conducted by the American Association of Veterinary State Boards (AAVSB)

. The survey found most veterinarians and technicians supported better utilization of credentialed veterinary technicians (CrVTs) as the solution to veterinary workforce shortages, instead of VPAs.

"It's not an either-or in our profession," Murtaugh said. "We need to use technicians more. We need to make sure they have title protection to make sure practices are working at their highest efficiency possible, but we have a shortage of veterinarians in all fields."

He explained the ways in which the initiative could provide not only better access to care, but benefit technicians. "[There is] a limited ceiling for what technicians can [currently] achieve, both in earning power and the ability to practice within their hospital environment," he said. "[The initiative would] allow a career path for technicians that could get them into 6-figures."

In response to concerns about the qualifications of VPAs, Murtaugh explained that the CVPA is collaborating with the Commission on Accreditation of Allied Health Education Programs (CAAHEP), an accrediting agency for human health professions. The collaboration is working on accreditation and standardization programs for VPAs. The CVPA is also in the process of working with 3 different licensing testing organizations to establish a national examination equivalent to the Veterinary Technician National Exam (VTNE) and the North American Veterinary Licensing Examination (NAVLE).

"So, these people would graduate from accredited programs with standardized learning objectives, [meet the] criteria to pass a national certifying examination. They would also require a state license, and they would be under the supervision of a veterinarian," Murtaugh explained. "So, where's the harm?"

To qualify for the ballot, 124,238 signatures were required in support of the initiative. On July 29, roughly 200,000 signatures were submitted by All Pets Deserve Vet Care.

 The initiative was initially filed by Apryl Steele, DVM, president and CEO, and Ali Mickelson, senior director of advocacy and education, of the Dumb Friends League, a nonprofit animal welfare organization that is sponsoring the initiative.

The future of veterinary medicine in Colorado, and potentially the country, now rests in the hands of Colorado voters on November 5, 2024.

Larkin M. Colorado ballot measure calls for nonveterinarians to diagnose, do surgery. American Veterinary Medical Association News. August 29, 2024. Accessed August 29, 2024. https://www.avma.org/news/colorado-ballot-measure-calls-nonveterinarians-diagnose-do-surgery

Colorado Proposed Initiative #145. Colorado Department of State. Accessed August 29, 2024.

Mitchell J. Initiative to create a new type of licensed veterinary professional will appear on Colorado’s Nov. ballot. Ballotpedia News. August 28, 2024. Accessed August 29, 2024. https://news.ballotpedia.org/2024/08/28/initiative-to-create-a-new-type-of-licensed-veterinary-professional-will-appear-on-colorados-nov-ballot/

Colorado Veterinary Professional Associate Initiative (2024). Ballotpedia. Accessed August 30, 2024. https://ballotpedia.org/Colorado_Veterinary_Professional_Associate_Initiative_(2024)

Colorado Voters Say All Pets Deserve Vet Care. All Pets Deserve Vet Care. Accessed August 30, 2024. https://allpetsdeservevetcare.com/learn-more/

McCormick K. Karen McCormick: Ballot initiatives 144 and 145 will not help animals. 

. June 17, 2024. Accessed August 30, 2024.

CVMA position statement opposes mid-level practitioner. Colorado Veterinary Medical Association. January 13, 2024. Accessed September 3, 2024. https://www.colovma.org/advocacy-news/cvma-releases-position-statement-on-the-veterinary-professional-associate-mid-level-practitioner-proposal/

CVMA releases results from member survey on veterinary professional associates. Colorado Veterinary Medical Association. February 17, 2024. Accessed September 3, 2024. https://www.colovma.org/advocacy-news/cvma-releases-results-from-member-survey-on-veterinary-professional-associates/

McCafferty C. Surveys find a lack of support for midlevel practitioners in the veterinary industry. 

. July 18, 2024. Accessed August 30, 2024. https://www.dvm360.com/view/surveys-find-a-lack-of-support-for-midlevel-practitioners-in-the-veterinary-industry

Colorado could become the first state to introduce veterinary professional associates by 2026 

Initiative to establish veterinary professional associates will appear on Colorado ballot

This year, the Purina Animal Hall of Fame inductees were recognized for saving their owners’ lives. The Animal Hall of Fame by Purina is the longest-running Canadian pet recognition program. Since 1968, Purina has honored 194 exceptional animals for their notable acts of bravery and heroism.

According to Nestlé Purina, this year’s 2 new Purina Animal Hall of Fame inductees have received this recognition as a tribute to their bravery and instinct, showing acts of courage of wit during life-threatening situations.

 The following 2 inductees join 166 dogs, 27 cats, and 1 horse that have earned a place in the hall of fame for their heroism, exceptional intuition, and strong dedication to their humans, according to a news release.

Bear, a Siberian Husky and Golden Retriever mix

In the early hours of an October night in Bonfield, Ontario, Bear, a Siberian Husky and Golden Retriever mix, startled his owner Janice awake by jumping on her bed and howling in her ear. When Janice woke up, she realized Darren—her husband of 35 years and a Canadian Armed Forces veteran—was not in bed. Janice followed Bear down the stairs of their home and discovered Darren unconscious in the family room, with Bear jumping on his chest. Janice immediately called for emergency help, and Darren was rushed to the hospital.

At the hospital, doctors found out that Darren had suffered a widowmaker heart attack—one of the deadliest kinds of heart attacks that is caused by a key artery responsible for moving blood to the heart becoming almost of completely blocked.

 After Darren awoke in the hospital, the couple learned from the doctors that he had likely been unconscious for 3 hours before Janice found him. According to the doctors, Bear’s repeated jumping on Darren’s chest had been an effective form of CPR that kept him alive.

With Bear’s lineage tracing back to 2 former service dogs, he has always been Darren’s closest companion, according to a news release.

 Darren now calls Bear the family's furry hero who was born to serve, per the release.

Maggie May. (Photo courtesy of Nestlé Purina)

Months after suffering heart failure, Martin was recovering at home with his 9-year-old Red Fox Labrador Retriever, Maggie May, by his side for support and comfort. He was given heart medication to manage his decreased mobility and his new condition. He also relocated to a bedroom on the main floor, where Maggie May stayed with him every day.

On a cold night in March 2023, Maggie May alerted Amy, Martin's wife, who was upstairs in their home. Maggie May guided Amy downstairs, where she found Martin out of bed and the back door wide open. Maggie May then dashed outside, leading Amy to discover Martin in a snowdrift in a catatonic state, unresponsive. After calling 911, paramedics told Amy that Martin's new medication likely caused hallucinations and disorientation, prompting him to go outside. Doctors later informed Amy that Maggie May’s intervention likely saved Martin’s life. Martin and Amy are immensely grateful for canine companion, who they now call as their Super Hero Pup, according to a news release.

"These incredible animals remind us that the bond between humans and their pets goes far beyond companionship—it's a partnership of trust, loyalty, and sometimes, life-saving bravery. As pet people, we are proud to share these inspiring stories," Jenn Terra, vice president of marketing at Nestlé Purina PetCare Canada, said in the release.

 "Since 1968, the Animal Hall of Fame has celebrated remarkable pets, and these 2 new inductees join a long list of animals whose acts of heroism have touched countless lives."

A legacy of bravery: Two Canadian dogs recognized for saving their owners lives. News release. Nestlé Purina. September 12, 2024. Accessed September 16, 2024. https://prnmedia.prnewswire.com/news-releases/a-legacy-of-bravery-two-canadian-dogs-recognized-for-saving-their-owners-lives-898849308.html

Brown S, Seed S. Widowmaker heart attack: Why is it so dangerous? 

. June 20, 2024. Accessed September 16, 2024. https://www.webmd.com/heart-disease/widow-maker-heart-attack

This year’s inductees each saved the life of their owner

2024 Purina Animal Hall of Fame inductees are recognized for life-saving heroism 

A recent study has provided new insights into reticulo-ruminal motility patterns in goats, through the use of cutting-edge imaging technology. Investigators from Hunan Agricultural University in Changsha, China, have found that reticulo-ruminal motility was divided into primary and secondary contraction, and the movements of ruminal digesta depended on reticulo-ruminal motility.

, allowed for visual analysis of reticulo-ruminal motility video, noted variation of motility times, and determined that the rumen dorsal sac and the rumen dorsal blind sac had common motility after reticulum contraction. The research offers new insights for the study of gastrointestinal motility, encouraging future studies of artificial rumen, according to the study's authors.

Investigators used 6 Xiangdong black goats as model specimens. Using medical barium meal imaging and dynamic digital radiography (DR) technology, the team obtained 56 complete reticulo-ruminal motility videos—32 from bucks and 24 from does—in addition to 10 stages of images captured in 3-minute segments. The videos were analyzed using image annotation and the centroid method, which found there to be 24 instances of secondary motility across all videos; 14 for the bucks, and 10 for the does.

There were 4 stages of reticulo-ruminal primary movement indicated in the study:

 The initial stage, marked by the 2-phase contraction of the reticulum.

 Common for relaxation of the reticulum, contraction of the rumen dorsal sac and the rumen dorsal blind sac.

 Common for relaxation of the rumen dorsal sac and the rumen dorsal blind sac.

 The contraction and relaxation of the rumen abdominal blind sac.

Investigators noted that the motility frequency of the rumen abdominal blind sac was low during the complete reticulo-ruminal motility cycle. Rumen digesta were distinguishable in the images because of the dispersion of the barium sulfate solution. 

In the video, ruminal digesta motility was divided into 3 continuous stages

Contraction of the reticulum squeezed the digesta into the rumen.

Relaxation of the reticulum and contraction of the rumen dorsal sac and the rumen dorsal blind sac divided digesta movement in 3 directions.

Relaxation of the rumen dorsal sac and the rumen dorsal blind sac, as well as contraction of the rumen abdominal blind sac, leading to reciprocated motility. Additionally, there is movement of some digesta from the rumen abdominal sac/rumen abdominal blind sac to the rumen dorsal sac.

Results of a comparative analysis indicated that stages I, II, III, interval, and secondary contraction time were longer in bucks, whereas stage IV was longer in does. This is something that researchers attribute to variations in nerve regulation between sexes. Additionally, through video analysis tracking the capsule cavity area “labeled” by barium sulfate solution, investigators were able to determine that reticulum motility involved a 2-phase contraction. Through the same analysis, they found that the rumen dorsal sac and the rumen dorsal blind sac had common motility following reticulum contraction.

The study verified the feasibility of using dynamic DR, barium meal imaging technology for the assessment of reticulo-ruminal and digesta motility. Early studies in reticulo-ruminal motility relied on methods including fistulas and electromyography, which improved the understanding of rumen contractions. Tools including ultrasound and CT provided investigators with noninvasive alternatives to observe motility, though they came with their own limitations—ultrasounds had a restricted field of view and CT required anesthesia, which could affect motility patterns.

Findings of the study aligned with previous research, but the use of dynamic DR allowed for a more detailed view of the sequence and interactions within goats’ digestive tracts. The study is a significant contribution towards the overall understanding of ruminant digestion, emphasizing the potential of further improvements in imaging techniques, according to the authors. Investigators expressed their interest in future research, ideally combining motility with artificial rumen—flexible material 3D printing—in order to simulate natural motility characteristics and construct a comprehensive 

 flexible artificial rumen simulation device.

1. Song Y., Lan X., Liu L., et al. Exploring the reticulo-ruminal motility pattern in goats through medical barium meal imaging technology. Front. Vet. Sci. 2024;11. 

https://doi.org/10.3389/fvets.2024.1371939

A recent study used new imaging techniques to investigate digestive system movement