The Innovator of the Month series, sponsored by Chewy Health, spotlights veterinary professionals who are driving positive change and inspiring their peers. By recognizing outstanding clinicians, technicians, and paraprofessionals, Chewy Health aims to highlight impactful initiatives and promote a brighter future for veterinary medicine.



Niccole Bruno, DVM discovered her passion for veterinary medicine at just 12 years old and has since, pursued a remarkable career as a practicing clinician, hospital leader, and advocate for young aspiring veterinary professionals. Despite being raised in one of the most diverse areas in the country, Queens, NY, she faced the challenge of not having access to mentorship from minority veterinarians, a significant hurdle for this Afro-Latina aspiring professional. Today, Dr Bruno is the CEO and Founder of blendVET®, an organization focused on enabling individuals to be their authentic selves, build trusting relationships and building an empowered, diverse community that increases the pathway of underrepresented minorities into the veterinary profession. dvm360® had the pleasure of speaking with Dr. Bruno about her perseverance to establish blendVET® and to recognize her for her commitment to the veterinary industry.



Note: The following interview has been edited for brevity and clarity.

May you tell us about yourself and your career as a clinician in veterinary medicine?

I’ve wanted to be a veterinarian since I was 12 years old. Growing up in New York City, particularly in Queens, I saw many stray animals walking the streets. I always wanted to take care of them. My mother would give me my allowance, and I’d use it to buy dog or cat food to feed them. That was the beginning of my interest in veterinary care.


My younger sister is also a veterinarian, so it was nice having someone to share this journey with. I led the way as the older sister, but I quickly realized that while New York City is very diverse, stepping into veterinary medicine was a different experience. I often found myself as the only person of color in veterinary settings, and that made it hard to feel connected to the profession.


My mother encouraged me to attend Tuskegee University, a private university founded in 1881 by Booker T. Washington with a long history of providing education and training to African Americans, particularly in the fields of agriculture, engineering, and the sciences. It was there that I found a sense of community while pursuing my undergraduate degree for veterinary medicine. I returned home and finished my studies at Cornell University, graduating in 2006.
I practiced small animal medicine in New York City for 11 years, and then moved to Houston. Prior to moving to Houston, I served as a medical director for a veterinary hospital in Long Island, NY. I continued my service as a hospital leader in Houston. During the COVID-19 pandemic (2020), I founded blendVET®.



What was the pivotal moment/experiences that inspired you to pursue blendVET®?

Diversity, equity, and inclusion (DEI) have always been important to me. Even after my time studying at Tuskegee and Cornell, I continued to feel underrepresented in this profession. This shaped my efforts to create inclusive environments throughout my career. The events of 2020, including social unrest and the COVID-19 pandemic, sparked a sense of urgency for me. I wanted to address the lack of DEI in veterinary medicine in a way that was actionable and relevant to everyday clinical practice.


I started researching DEI content outside of veterinary medicine but found it wasn't always applicable to what clinicians were encountering every day in our field specifically. I aimed to create training that addressed real workplace challenges, like handling microaggressions or cultural differences, not just abstract definitions.


My first DEI talk in October 2020 was for veterinary students, and the feedback was overwhelming. It highlighted how little had changed since my time in school, which motivated me even more to pursue blendVET®. BlendVET® is an organization committed to providing DEI training for veterinary professionals and increasing representation in the field through active student pipeline programs. Now, in addition to training, we focus on student pathway programming to encourage middle school students to consider veterinary medicine through exposure and support.



 What does success look like for you and your organization? What is the impact of blendVET® across the industry?

Our two main missions are to address workplace culture in veterinary medicine and to create inclusive environments. We are committed to expanding our training program. This includes not only our blendVET® Achiever Cohort Program but also individual modules that people can purchase and complete independently. Additionally, we've partnered with other organizations to integrate our content into their learning management systems, making DEI training more accessible without the need to attend a veterinary conference. This way, veterinary professionals can access training through their workplace.


Our hashtag, #BeingBuildingBelonging, reflects our approach. In the first year of our program, we emphasized self-awareness ("Being"). We aim to advance to our next phase, and blendVET® 2.0 (“building”), and eventually to blendVET® 3.0 (“belonging”), which requires us to keep developing our training content.


Our student pathway programming has grown tremendously over the past three years. Our goal is to strengthen our relationships with schools and support students as they transition from middle school to high school and beyond. We also plan to collaborate with local veterinary schools to create opportunities for students, such as summer camps and research experiences, which will provide valuable exposure and experience hours, making them stronger candidates for veterinary programs.



 How has the innovation fueled through the foundation of blendVET® positively impacted the veterinary community?

 We have received overwhelmingly positive feedback and many success stories, for which I am incredibly grateful. They remind me daily of our mission with the pathway programming. It's inspiring to see students who previously had little exposure to veterinary medicine show such enthusiasm by the end of our events. Educators often approach us to express their gratitude for taking the time to visit their schools. The volunteers who showcase their experiences are equally appreciative of our efforts.


Parents have been extremely supportive as well. Often, while their children benefit from active training and exposure, parents still have many questions. We recognize that parents play a crucial role, especially with middle school students, as they need to guide them toward these opportunities. Many parents have sent me thank you emails, stating they had numerous questions they couldn't find answers to online. Being in the room with us and other participants provided them with the information they were seeking.


One of the biggest surprises has been how much the veterinary community benefits from these programs. Colleagues often share with me how these experiences help them reconnect with their "why" for entering the profession. I have seen many of them moved to tears, reflecting on how these are the kinds of programs they would have wanted as students themselves.


Recently, I received a heartwarming email from a parent who suddenly decided to move to Puerto Rico. She inquired about when we would be hosting an upcoming blendVET® event because she planned to send her daughter back to participate. The fact that her daughter has attended all three of our events in Florida and that this parent is willing to send her back for the fourth speaks volumes about the impact of our program. It truly is a win-win for everyone involved.



 How has blendVET® been received by the veterinary community, including colleagues, stakeholders, and pet owners?

The response has been overwhelmingly positive. Our stakeholders not only sponsor our events but also actively participate, providing resources and support. We’ve grown from hosting three events in a year to eight, which shows the strong community backing.



What are your plans for the future of blendVET®?

 We aim to continue developing our DEIB content and expanding our events. We want to make sure the profession is ready to welcome the diverse students we’re encouraging. Ideally, I’d love to host monthly events and ensure sustainability by keeping students engaged in the vet-med pathway as they navigate each stage of their journey into vetmed.



 What advice would you like to share with others in the industry who aspire to innovate in their field?


 I live by this quote by Daniel Pink (author of “The Power of Regret”): “Over time, people regret what they didn’t do more than what they did.”
When we reflect on our lives and consider the things we wish we had done but didn’t, we often realize that these regrets stem from fear, self-doubt, and the narratives we tell ourselves. For me, it was incredibly difficult to leave clinical practice and step into this role full-time. Being a clinician can define your identity; when you say, "I'm a veterinarian," people typically follow up with, "So where do you practice?" It's challenging to explain that I don’t practice anymore. I used to, and I miss it dearly. However, I also felt a strong calling to pursue this work.


When you feel that calling or passion that keeps you awake at night, or when you envision how you can improve the profession in a way that only you can, lean into that. I can always return to do relief work or go back into a hospital setting, but I could never replicate what I’ve accomplished over the past three years by stepping into that fear. So, I would say to everyone: just do it.



 In your opinion, what are the most pressing challenges in veterinary medicine, and how can we address them?


 Well, that’s a big question. For me, culture is fundamentally about people, and that has been important throughout my entire career. I seek out workplaces where I feel I can thrive and belong. This desire highlights why we have a sustainability problem within our profession; we’re not necessarily meeting people's needs—not just their basic needs, but the deeper needs that keep them in the profession. It's crucial to ensure that individuals feel valued, seen, and heard.


I believe there are organizations working on this issue, but it needs to become the standard for all veterinary workplaces. We must keep in mind that if we don’t actively retain people in our profession, we won’t be able to attract new talent. While I think everyone should come together to find their niche, I’m focused on tackling both aspects simultaneously.


However, to do things well, you need to pick a specific focus, right? For now, I’m trying to balance both, but if more people are committed to improving workplace culture or building pipelines for middle school students and pre-vet students, we could collectively dismantle the barriers preventing individuals from entering and remaining in our profession. Sustainability of our workforce is an issue we must address.



Articles

Dr. Niccole Bruno, DVM, CEO and Founder of blendVET®, has built a pioneering career as a clinician, hospital leader, and advocate, dedicated to empowering underrepresented minorities in veterinary medicine through mentorship, authenticity, and community building.

Introducing dvm360 and Chewy Health’s November Innovator of the Month: Dr. Niccole Bruno, CEO & Founder of blendVET®

As Janus kinase (JAK) inhibitors have continued to rise in popularity in human medicine, they are beginning to move into the veterinary industry. In 2024, Zenrelia became the second JAK inhibitor to hit the veterinary market for controlling pruritis and inflammation in canine patients with atopic dermatitis. As they continue to rise in popularity, how much do we know about them and their effectiveness in treating patients?

During his “Do you know JAK? How Janus Kinase inhibitors work and how they have been game changers for the treatment of canine atopic dermatitis” Andrew Rosenberg, DVM, DACVD, explained to attendees the background on atopic dermatitis and its treatments, plus how the JAK inhibitors are providing relief to the itchy patients in your clinic.

Atopic dermatitis is usually characterized by its excesses itchiness and is caused by the skin’s reaction to allergens in the environment. For dogs, these allergens are absorbed through the skin, unlike humans who inhale the allergens, but atopic dermatitis is a lifelong condition, so effective treatment is crucial to improve quality of life for these patients.

According to Rosenberg, when it comes to atopic dermatitis, the first issue is an atopic dog has a genetic predisposition to atopic dermatitis, which can lead to a defective skin barrier. Because of this, more allergens can get through the skin, causing it to become degraded by bacteria and dust.

“When I have an atopic dermatitis dog, these are my goals. My first goal is to treat any secondary skin infections because I want to prevent recurrent infections. So I mentioned a minute ago that dogs with atopic dermatitis already have this defective skin barrier, so they're more predisposed to infection. We all know this. You currently see secondarily infected dogs with allergies every day in our practice. So cytology, bacteria, and yeast, we treat the infection, the popular therapy with antimicrobials when needed,” Rosenberg explained to attendees.

The second goal for Rosenberg is to decrease the itching to make the pet more comfortable. Rosenberg explained that it is important to determine the underlying condition of the allergy because if the patient presents to the clinic with a nonseasonal allergy, he is going to do a food trial to make sure there are no food allergies and if it appears seasonal, an allergy test would make more sense for determining the allergy. Treating atopic dermatitis has traditionally been done through multiple therapies such as shampoos, rinses, mousses, Cyclosporine, and Corticosteroids for example.

 Now, the market also has access to JAK Inhibitors, such as Apoquel, and now Zenrelia.

JAK inhibitors, as Rosenberg informed the group, were named after Janus, the Roman god with 2 faces because they work by taking a partner to function. Rosenberg explained that the JAK inhibitors are in a group of tyrosine kinases, and the receptors on this cell family act as signal pathways for multiple cytokines, growth gats, and hormones. The group is made up of 4 members, JAK1, JAK2, and JAK3, and, to make things confusing, said Rosenberg, tyrosine kinases 2, or TYK2.

“Each JAK to function takes on a partner. So JAK1 may partner with JAK3, JAK2 can partner with another JAK2, but to a function, they take on a partner, and that process is called dimerizing…they dimerize according to each other, so 2 of them, and they're kind of the gateway of cells,” Rosenberg explained.

Rosenberg also shared that Elanco conducted a head-to-head study on the safety and efficiency of Zenrelia and Apoquel for submission within the European Union. The study was double-blinded and randomized with 338 client-owned dogs that were confirmed to have atopic dermatitis. The study showed researchers that one dose of Zenrelia a day is at least as effective as the market incumbent JAK inhibitors on the market at the endpoint on Day 28.3 When the product proved reliable at the assessment from the owners on Day 28, it continued to Day 112. For the duration, the itch on average with the Zenrelia patients was below 2 on the visual analog scale.

“So why is that important? Two is considered to be a normal level of itch in these individuals. So when we look at the proportion of dogs with a great visual analog scale for less than 2 on day 112, 77% of the Zenrelia dogs achieved that and 53% of the Apoquel dogs achieved that. Both are great drugs… both have a rapid decrease in itch. We see this small uptick in itch on day 14, when Apoquel dosing, goes from twice daily to once daily, but there was a higher number of dogs with Zenrelia that had lower than 2 on that very visual analytic scale.

Because every case of atopic dermatitis will be different, it can be helpful for clinics to have more than one JAK inhibitor on site. Rosenberg explained that JAK inhibitors have different endotypes, which is a term used for a variety of diseases where the patient is going to be a little bit different for the cytokines that cause the clinic signs presenting.

Rosenberg A. Do you know JAK? How Janus Kinase inhibitors work and how they have been game changers for the treatment of canine atopic dermatitis. Presented at: 2024 New York Vet Show; November 7- 8, 2024; New York, NY.

Cornell University College of Veterinary Medicine. Atopic dermatitis (atopy). Cornell University College of Veterinary Medicine. Published February 23, 2023. Accessed November 14, 2024. 

https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information/atopic-dermatitis-atopy

Elanco Announces FDA Approval and Launch of Zenrelia™ (ilunocitinib tablets), Offering An Effective, Safe Solution in Canine Dermatology. News release. Elanco Animal Health Incorporated. September 19, 2024. Accessed November 19, 2024. 

https://investor.elanco.com/press-releases/press-releases-details/2024/Elanco-Announces-FDA-Approval-and-Launch-of-Zenrelia-ilunocitinib-tablets-Offering-An-Effective-Safe-Solution-in-Canine-Dermatology/default.aspx

Andrew Rosenberg, DVM, DACVD, provided an overview of Janus kinase inhibitors for treating canine atopic dermatitis

Are Janus kinase inhibitors a JAKpot for allergy relief?

Veterinary dermatologist Andrew Rosenberg, DVM, DACVD, explains the effectiveness of JAK inhibitors for treating canine atopic dermatitis

Video interview with Andrew Rosenberg, DVM, DACVD

My name is Andrew Rosenberg, I am a veterinary dermatologist. I work with the Animal Dermatology Group as a clinical dermatologist in both the Wayne, New Jersey, and White Plains, New York, offices. I’m also the director of medical operations for the entire group, which is the largest dermatology group in the world. Additionally, I’m the president of the American College of Veterinary Dermatology, so I’m involved with the organization that board-certifies all veterinary dermatologists.

So it's a good question. And, you know, there's now 2 JAK inhibitors in veterinary medicine on the market. The first, of course, was Apoquel, and that was a Jak inhibitor. And now there's a new drug that was recently approved called Zenrelia, which is now the second JAK inhibitor on the market because Apoquel [has] been out for for considerably longer, there are some studies that that show that long-term, Apoquel is as effective as a medication like cyclosporine for long term, and it actually works more rapidly and Zenrelia works. You know, similar speed of onset as Apoquel does. So for long term treatment of allergies, or I should say allergy symptoms, because that's what these medications are treating, they're treating the symptoms of allergies, they're as effective as cyclosporine, and in a head to head study for Zenrelia versus Apoquel, well, they were, they were, you know, Zenrelia had a little bit better, even improvement in a periodic visual analog scale long term, when the study was extended long term, and it was shown to be non inferior than Apoquel

They're very effective at treating, you know, itch and associated with allergic dermatitis and inflammation associated with allergic dermatitis. Certainly another treatment of allergies is steroids, right? And we try to avoid long-term steroid use because of the side effects. So, but as far as your question is, how effective are they? Well, yeah, they're effective, and they work well. If we're talking about, kind of the flip side of this, which is the best long-term management of atopic dermatitis, as well as those JAK inhibitors work, I'm still recommending allergy testing and immunotherapy for long term control, and then I use those JAK inhibitors to really control the itch while I'm waiting for my immunotherapy to work, and then I can use them as needed if there are flare ups, despite being on immunotherapy, which inevitably there, there are, very commonly, some flare ups here and there.

Videos

Andrew Rosenberg, DVM, DACVD, discusses the effectiveness of JAK inhibitors for treating allergy symptoms in animals

How effective are Janus kinase inhibitors? 

In this episode, Anne Chauvet, DVM, DACVIM, CHT-VT, shares insights with our host Adam Christman, DVM, MBA, and listeners from her extensive career treating neurological conditions. 

Chauvet also explores the importance of distinguishing clinical symptoms from radiographic findings in disc disease, especially in prone breeds, the complexities of brain tumors in aging dogs, highlights MRI as a key tool for precise diagnosis, and more throughout the episode. 

: The big thing I tell veterinarian, just remember, when you're thinking about brain tumors, they don't usually happen unless you have a certain age. Now, I'm going to have a caveat in that that the youngest one I've had was 3 1/2 year old with a little Jack Russell, but usually it's 4 years and older. So if you have a 2 1/2 and a half year old little dog that begins seizuring, so therefore has a cortical lesion in the brain, the odds of that being a brain tumor are pretty darn low to none. If you have a 9-year-old pit bull, you have a much greater chance of having a brain tumor over idiopathic epilepsy. So you're going to make your decisions on whether you work up or not, or how far you can push your client for that. So the signs you're going to see are dependent entirely on the anatomy. So if I section out the brain, the front is going to be usually seizures. 

The cortex is very prone to seizure, particularly in what we call the Piriform lobe, which is the part of the brain that on each side of the brain will turn around, curl towards the midbrain that's very prone to seizure, and it's a lovely place for gliomas to launch themselves in all those pit bulls, Bulldogs, they tend to have a lot of gliomas. Boxers famous for it as well. So that's an area that often gets seizures. Then you look at things like midbrain, we see a lot of midbrain problems with pituitary tumors. Those are more of the dog that's very dull, aimless walking is going to kind of start running into things that often people label it for senility. Be careful with that senility label, because if you overlook it. It might be too late for us to be able to help the patient.

Podcasts

Anne Chauvet, DVM, DACVIM, CHT-V, takes listeners into the world of veterinary neurology 

The physical exam approach to the neurologic patient

Neil Mittelman, DVM, DACVIM, offers his top 3 tips for conducting a neurological exam

Advice for veterinarians doing a neurological exam, from a veterinary neurologist

 delivers expert-led veterinary continuing education on your schedule. With 

, you can access top-tier sessions anytime, anywhere—whether at home, in the clinic, or on the go. Ready to earn CE credits? Watch this session and more on 

During the Fetch dvm360 Conference in Atlantic City, New Jersey; Neil Mittelman, DVM, DACVIM, sat down with 

 to talk about his lecture “Neurological Examination from Head to Tail.” During the interview, Mittelman also offered his top 3 tips for veterinarians that are conducting a neurological exam.

So, the biggest thing is to be as thorough as possible and try and evaluate all the important parts of the examination.

But also, to get an accurate history is part of that. The neurological examination needs to be performed in its entirety, but also not to forget their basic physical examination, because a lot can be garnered in terms of information for ultimately making a diagnosis, having known what their vital parameters are and what the history was from the owner.

The last thing is not to get overly intimidated by doing a neuro exam. You know, even the concept of performing a neurological evaluation can be overwhelming for owners, for their pets, and for clinicians alike, and sometimes it doesn't fit into a tiny box of ‘this problem is x’ or ‘this problem is y,’ so to be as thorough as possible, not to forget the basic thorough examination that we do normally, and to try and be as thorough as possible, but if you can't put a bow on it and say exactly what it is, just to write exactly what you see. That's the best we can do, and then we put that information together.

Neurological exam pearls, from a veterinary neurologist

The American Heartworm Society (AHS) has updated their Feline Heartworm Guidelines for veterinarians. The guidelines—last revised in 2015—addresses persistent underdiagnosis and undermanagement of heartworm disease in cats, and provides more robust data on prevention, testing and treatment, according to AHS.

The guidelines update was spearheaded by a committee of AHS board members. The revisions were completed after a thorough scientific review by experts from the fields of parasitology, cardiology, and clinical practice. It includes revised advice on heartworm screening, mosquito control and treatment options for heartworm-positive cats.

Feline heartworm disease can be life-threatening. It starts with a bite from a mosquito infected with the parasitic worm 

allowing heartworm larvae to enter the cat’s bloodstream. The larvae thrive and develop in subcutaneous tissues before moving into muscle tissues, the heart, lungs and arteries.

Immature worms’ arrival into the small arteries in the lungs initiates a severe inflammatory response that damages not only the arteries, but also the bronchioles (small airways) and alveoli, according to Cornell University College of Veterinary Medicine in Ithaca, New York. “Between 60 and 100 days after the initial infection, you can start to see signs of pathology in an affected animal’s body, even though the parasite has not yet reached maturity,” Dwight Bowman, DVM, PhD, a professor of parasitology at Cornell, said on the university’s website. 

The revised AHS guidelines recommend routing heartworm screening for cats. The 4 primary reasons for screening, according to the AHS, are as follows

to help establish a diagnosis when a veterinarian finds clinical evidence of infection;

to monitor the status of cats already diagnosed with heartworms;

to establish a baseline prior to beginning a heartworm prevention product;

and to better understand the relative risk of feline heartworm in a practice area.

“While dogs are routinely screened for heartworms during annual check-ups, testing in cats has primarily been limited to cases when a veterinarian suspects heartworm infection based on a cat’s clinical signs,” Jennifer Rizzo, DVM, president of AHS, said in a news release.

 “With so few cats tested, it has been difficult for veterinarians to get a handle on the true incidence of heartworm in cats—even though cats are at risk wherever heartworm infection occurs in dogs.”

According to the revised guidelines, cats should be screened using both antigen and antibody tests. The AHS further recommends that veterinarians conduct antigen tests with heat-treated serum, which differs from their canine guidelines. Heat-treated serum dissociates potential antigen-antibody immune complexes and helps obtain the most accurate results. The second component of heartworm screening in cats is antibody testing.

Other diagnostic techniques outlined in the revised guidelines include radiography, echocardiography and point of care ultrasound.

 “There’s no question that testing limitations have been a significant factor in heartworm underdiagnosis in cats,” Rizzo acknowledged in the release. “By using the most accurate screening procedures and screening cats on a more routine basis, we hope to greatly improve the veterinary profession’s understanding of the disease 

initiate steps to best manage affected patients.”

With more routine testing, the AHS says its experts expect the numbers of cats diagnosed with heartworms to increase. Treatment objectives are to relieve the clinical signs of disease and, in the case of adult infections, to prevent sudden death of the cat.

 “While no approved adulticide treatment is available for cats, our guidelines include updated recommendations for managing infected cats,” Rizzo said.

Several classes of medications, along with dosages, are described in the revised guidelines, from anti-inflammatory drugs to leukotriene modifiers to antibiotics, according to AHS. Techniques for surgical removal of adult heartworms are also described in the revised guidelines.

Meanwhile, the AHS guidelines continue to recommend that all cats be on year-round heartworm prevention with a macrocyclic lactone product. However, the revised guidelines now also address the importance of vector control as well as preventive products. The goal of vector control in cats should be to reduce the risk of mosquitoes in the environment rather than on cats themselves, according to AHS.

“As an organization dedicated to reducing the incidence of heartworm disease and its impact on pets, the AHS has long been concerned about the underdiagnosis and undermanagement of heartworm disease in cats,” Rizzo said. “Fortunately, we now have scientific information that supports a more proactive approach to heartworm diagnosis, as well as greater specificity in prevention and treatment approaches.”

The revised guidelines can be accessed on the AHS website at 

American Heartworm Society announces updated guidelines on management of feline heartworm disease. News release. American Heartworm Society. November 12, 2024. Accessed November 13, 2024. 

https://www.heartwormsociety.org/in-the-news/910-american-heartworm-society-announces-updated-guidelines-on-management-of-feline-heartworm-disease

Cornell Feline Health Center. Heartworm in cats. Cornell University College of Veterinary Medicine. Accessed November 13, 2024. 

https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/heartworm-cats

Last revised in 2015, the document provides guidance for addressing underdiagnosis and undermanagement of the disease, as well as fresh data on  prevention, testing and treatment