Michael Q. Bailey, DVM, DACVR, AAAS/AVMA, 2024-2025 president-elect, addressing attendees during his keynote address at Fetch Kansas City

When the history of the world and medicine is discussed, it could be rare for people to mention animal health care, even though veterinary medicine is intertwined with history and crucial events throughout the world. Winston Churchill once said Those that fail to learn from history are doomed to repeat it, but what about those who fail to learn from history do not understand their capabilities?

During his Day 1 keynote address, “The History of Veterinary Medicine: A Rich Past, a More Prosperous Future,” Michael Q. Bailey, DVM, DACVR, AAAS/AVMA, 2024-2025 president-elect of the American Veterinary Medical Association, took attendees back in time to show them how veterinary medicine is one of the oldest professions in the world, and how understanding the history of animal care work can help create a better future.

According to Bailey, the profession officially began with the founding of the veterinary school in Lyon, France, by Claude Bourgelat in 1761. However, Bailey shared with the audience that the veterinary profession has been around since ancient civilizations. As these civilizations began to grow intellectually and physically, imperialism, architecture, and a need for human and veterinary care emerged.

In ancient Egypt and Mesopotamia for example, both societies noticed that animals were valuable for transportation, agriculture, and companionship, leading them to create medical practices to care for these animals. Texts from the time indicate that they were treating livestock using herb prescriptions and even medical procedures. The Mesopotamian goddess Gula, known as The Great Physician, was portrayed as a divine physician and midwife, according to Bailey. A sculpture of Gula was created, which featured her dog as well. The first veterinarian is said to be a Sumerian doctor named Urlugaledinna, who lived in modern-day Syria, Iraq, Iran, Turkey, and Kuwait. He was known to be an expert and healing animals

The Shalihotra Samhita, which is from the time of Ashoka in 3000-2000 BC Indian veterinary treatise, is known as an early veterinary treatise. Bailey discussed the edicts of Asoka, which stated that 2 different kinds of medicine were available: medicine for people and medicine for animals. When no healing herbs or people were available, he ordered they be planted.

Although not the beginning of veterinary medicine, the veterinary college founded by Bourgelat was the first of its kind. He was inspired to create the college after the devastation being caused in French herds by the cattle plague and then devoted his time to finding a remedy. Closely behind his college is the Odiham Agricultural Society, which was founded in England in 1783, becoming the foundation of the veterinary profession in Britain.

In 1853, the National Autonomous University of Mexico (UNAM)College of Veterinary Medicine was founded on August 17, 1853, by President Antonio López de Santa Anna, marking the beginning of veterinary medicine education in Mexico and the American continent. A little over 10 years later, President Abraham Lincoln signed the Morrill Act into law. Other advancements came when Iowa designated the State Agricultural College, now known as Iowa State University, as the land grant college in 1864, and The University of Pennsylvania (UPenn) proposed that veterinary medicine be taught at the school. However, it was not until UPenn university trustees donated $10,000 to establish the veterinary school in 1882, which would be a little shy of $250,000 today.

“The medical school there saw the importance of having human medicine and veterinary medicine combined. So it is a combined human veterinary program at this particular time. So, one health, again, recognized early on, seemed to bring it back and use it to bring it back,” said Bailey.

President Woodrow Wilson and Congress passed the Defense Act of 1916, creating the Veterinary Corps within the United States Army. Bailey informed attendees that each World War saw the expansion of veterinary medicine in areas we recognize today as One Health.

“We have veterinarians involved in the care of our troops. I told my sons in the reserves, we have many wonderful entities in reserves to take care of soldiers when they are hurt, but veterinarians take care of soldiers, sailors, airmen, whoever they may be, hopefully before they ever get hurt. And if they do not have healthy food, they cannot go to where battle or whatever it is, they need to be taken care of. So guess what? Veterinarians are more important than the [human doctors],” Bailey expressed.

Veterinary medicine has been linked to human medicine in ways veterinary professionals may not know. Bailey shared with attendees that a human medical first, FDA-clearing Robodoc in 1992, was built, designed, and programmed by a veterinarian, Hap Paul, DVM, and his team. Bailey closed his lecture by saying that by recognizing those who have built and sacrificed within the profession before professionals today established the foundation.

“We have a deep source. We have deep roots. I hope I've given you an idea of how important veterinary medicine is to the world, and our history, and without us, we need to get more people involved. So you see your future. Do you see our future, our profession[s]? Do you wonder what lies? I wonder. All I know is we work together, [and] we have such a wonderful profession,” Bailey concluded his lecture.

Bailey M. The History of Veterinary Medicine: A Rich Past, a More Prosperous Future. Presented at: Fetch dvm360 Conference; August 23-25, 2024; Kansas City, MO.

Articles

Day 1 of Fetch Kansas City began with a trip back in time to understand the importance veterinary medicine throughout history and where it can go because of it.

Learning from the past 

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Without timely diagnosis of common equine eye diseases like squamous cell carcinoma (SCC), infectious keratitis, and uveitis, patients could quickly become blind, or even lose an eye entirely, according to Rachel Allbaugh, DVM, MS, DACVO, a professor of ophthalmology at Iowa State University in Ames. Because of this, it is crucial for early diagnosis, treatment, and monitoring to provide the outcome.

But can you recognize an equine eye disease when it presents itself at your clinic? During her lecture “You Can Do It! Recognizing and Treating the Top 3 Equine Eye Diseases” at the 

 in Kansas City, Missouri, Allbaugh, broke down how veterinary professionals can identify and manage equine eye diseases to help make them less frustrating while improving patient outcomes.

The most common tumor for equine eyes and adnexa is SCC, and it can occur on either eyelid, the third eyelid, conjunctive, libus, cornea, medial canthus, and even the orbit. SCC is commonly implicated by predisposing factors like ultraviolet radiation, breed, such as draft breeds with genetic cause, and light periocular hair/skin. Allbaugh explained that the disease typically starts as a hyperemic area on the eyelids and gradually moves to ulceration and then papillomatous masses. When it comes to other locations, SCC may show papillomatous or fleshy masses with variable degrees of necrosis, inflammation, and ulceration.

“When patients present in the early stages, there might be a hyperemic lesion, and then if it's affecting the eyelids, it actually could lead to ulceration appearance. We definitely can get papillomatosis… which I think is the more kind of classic appearance that people recognize, but because there are these varying degrees of ulceration, necrosis and inflammation, it's not always obvious that this is a cancerous process to our clients. So we, as veterinarians, want to keep it on our radar and help have owners watch for changes if they own these predisposed horses,” explained Allbaugh.

If a veterinary professional observes a lesion, they should conduct a biopsy to rule out granulation tissue, inflammatory conditions, habronemiasis, and other tumors to confirm the SCC diagnosis. Allbaugh explained that when treating SCC, the goal is to eliminate the tumor but also maintain ocular function and cosmesis. Treating SCC with a combination of surgical excision and additional therapy can help improve the success rate and adjunctive therapies such as chemotherapy, cryotherapy, immunotherapy, and photodynamic therapy can also be used.

 However, Allbaugh told attendees that the most appropriate approach for your patient will depend on location, availability, financial considerations, and size.

SCC can recur, so veterinary professionals should reevaluate horses treated for SCC every 6 months, or earlier depending on if clients notice a developing lesion and communicate with them that repeat therapies may be needed. As for prognosis, eyelid SCC is worse when compared to other ocular sites, and early detection and treatment are important for a favorable outcome. Allbaugh told attendees that reducing ultraviolet radiation in horses that are predisposed or with prior disease and can be accomplished by utilizing a mask that blocks the majority of UV Light.

Uveitis is the most common cause of blindness in equine patients and can form in any horse from systemic infectious diseases, blunt or penetrating trauma, neoplasia and idiopathic or immune-mediated inflammation. Horses with uveitis can present with multiple clinic signs, but a majority of clients notice ocular pain or vision compromise first.

“I always think of ophthalmology like a game of Clue. I'm trying to get as many clues as possible so that I can tell my story as to what all has happened. But things like aqueous flare can be pathognomonic for uveitis. Things like keratic precipitates, which we see in the ventral aspect, stuck to the endothelium in some horses can really clue you in about, yep, uveitis is what's going on here. A constricted pupil is expected with uveitis. If you have a bunch of signs of uveitis and the pupils widely dilated, well, then… Now I'm worried about it having a secondary glaucoma situation,” she explained.

“So again, just do that thorough examination. Try to get as many clues to your puzzle, and then that way you can come to your conclusion as to what is going on, qualify as many of the findings as you can, so that you can follow up with that more subjective evaluation at the recheck visits and know if things are looking better or getting worse,” Allbaugh continued.

Clinical signs and findings will vary with equine recurrent uveitis (ERU), and the disease can be unilateral or bilateral. Acute disease has active ocular pain and observable inflammation. When it comes to insidious uveitis, it can be more challenging to diagnose as equine patients may not be outwardly showing pain or subtle signs of low-grade on-go intraocular inflammation could be missed. Because they could be missed, veterinary professionals should consciously look for aqueous flare when in a darkened exam setting.

According to Allbaugh, active uveitis needs to be treated aggressively at first with therapy and slowly tapered over time with treatment extending 2 to 4 weeks past the resolution of signs. The therapy goal is to reduce pain and preserve vision with the most critical treatment component being anti-inflammatory therapy.

“Topical ophthalmic dexamethasone 0.1% (as neomycin/polymyxin B/dexamethasone) or prednisolone acetate 1% should be given 4 times daily or more frequently if needed. Concurrent topical NSAID therapy with ketorolac 0.5%, flurbiprofen 0.03% or diclofenac 0.1% may be needed in severe cases or can be utilized if steroids are contraindicated. Flunixin meglumine appears to be the most effective systemic NSAID, but phenylbutazone, firocoxib, or aspirin therapy may also be considered. Alternatively, oral steroid use may be necessary,” Allbaugh explained within her proceedings.

 infection is suspected in the patient, systemic antibiotics can be administered. For more severe or frequently recurring cases could potentially require treatment from a specialist with intravitreal injections, vitrectomy, or suprachoroidal cyclosporine implantation

  to help improve chances for successful management.

ERU, also referred to as “periodic ophthalmia” or “moon blindness,” can affect any breed but are more associated with certain breeds such as Appaloosas and draft horses. ERU is not in every acute uveitis episode but can develop into ERU. Professionals should be warned of this disease process, and if 2 or more episodes of uveitis are observed a diagnosis of ERU can be made. Allbaugh told attendees that clients should contact a veterinarian for evaluation if similar occur signs occur and be cautioned against empiric treatment given the possibility of corneal ulceration, stromal abscessation, or foreign body presenting similarly.

These diseases, among others such as corneal ulceration and corneal stromal abscessation, are prevalent among horses, presenting a significant challenge in veterinary care. Early diagnosis and prompt, appropriate treatments are crucial for achieving successful outcomes. Effective management also requires vigilant monitoring to ensure that the condition improves as expected. When a disease proves difficult to diagnose conclusively, shows no improvement despite seemingly adequate therapy, or exceeds the limits of available treatment options, it is essential to consider a prompt referral to a specialist. This approach not only helps in providing the best possible care but also increases the likelihood of a favorable prognosis.

Allbaugh R. You Can Do It! Recognizing and Treating the Top 3 Equine Eye Diseases. Presented at: Fetch dvm360 Conference; August 23-25, 2024; Kansas City, MO.

Giuliano EA, MacDonald I, McCaw DL, et al. Photodynamic therapy for the treatment of periocular squamous cell carcinoma in horses: a pilot study. 

. 2008;11 Suppl 1:27-34. doi:10.1111/j.1463-5224.2008.00643.x

Gilger BC, Salmon JH, Wilkie DA, et al. A novel bioerodible deep scleral lamellar cyclosporine implant for uveitis. 

. 2006;47(6):2596-2605. doi:10.1167/iovs.05-1540

Rachel Allbaugh, DVM, MS, DACVO, advises Fetch Kansas City attendees how to diagnose and treat these common ocular diseases 

Managing equine ophthalmology diseases 

Dr Craig Clifford discusses what test veterinary professionals can perform in general practice for early detection

veterinary oncology testing for general practitioners

In a preview of his lecture later today at Fetch Kanas City in Missouri, Craig A Clifford DVM, MS, DACVIM (Oncology), explains how the BRAF test can be used by general practitioners at their hospitals to potentially provide early detection for cancers through urine testing to detect abnormalities from urethral carcinoma. 

Fetch Kansas City kicks off today, but there is still time to sign up! You can learn more and 

 today. Also, if you are at the Kansas City Convention Center and see Clifford, be sure to wish him a belated happy birthday!

Craig A Clifford DVM, MS, DACVIM (Oncology)

: One of the ones that i tend to push for is something called the BRAF test. Basically, we know is that bladder cancer in dogs is called transitional cell carcinoma or we are moving toward the term called urethral carcinoma to match that in people. Some pretty smart people at North Carolina and NIH figured out that 85% to 95% of the urethral carcinomas have a mutation inside of them and, just like on our skin, our cells are shed into the air. When the badder loses cells, they are shed into the urine. Basically, the test looks at the cells that are shed into the urine and 'do you have this abnormality?'

Videos

What can general practitioners do in a primary care setting?

Oncology testing in general practice

A recent pop-up clinic in Houston, Texas, hosted by Low Cost Pet Vax

Low Cost Pet Vax, a Texas-based pet health care provider with a focus on affordability, has opened their first pop up vaccination clinics in Miami, Florida. The clinics are walk-in only, operating on weekends in the parking lots of local businesses, with veterinarians on-site to supervise the services.1 Pet owners are encouraged to visit during operating hours for affordable services that include microchipping, flea and tick prevention, and deworming, as well as vaccinations for cats and dogs.

A pet owner with a Low Cost Pet Vax veterinary care provider at a clinic in Texas

“Our goal is to make preventive pet health care accessible to local pet owners,” Rodney Munsell, DVM, founder and CEO of Low Cost Pet Vax, said in a news release.

 “We see a real need for more affordable pet vaccinations for Miami pet owners, and we’re excited to offer a convenient, lower cost option.”

A 2024 survey by Petco Love found that 40% of surveyed pet owners had never taken their animal to see a private veterinarian. Similarly, just 36% of respondents reported that their pets had been vaccinated before, and only 27% of pet owners regularly brought their pets to private veterinarians for annual checkups.

These numbers could be attributed to the rising cost of veterinary care. According to the Bureau of Labor Statistics, the price of urban veterinarian services saw a 6.2% increase from July 2023 to July 2024. That’s more than double the average price increase of all consumer items.

 As a result, some pet owners in Miami are being faced with a new financial barrier to basic pet health care.

Low Cost Pet Vax looks to directly address this issue. At the pop-up clinics, pet owners can vaccinate their pets for rabies at a cost of $10, and dog owners can receive all recommended vaccinations for their dogs for $59.

 The clinics also offer vaccination packages for cats and dogs, bundling all annually recommended vaccines to make things easier for pet owners, and they do not charge exam or appointment fees.

“We don’t have the overhead of a traditional veterinary clinic,” Elsa Diaz, an operations manager at Low Cost Pet Vax, said.

 “This allows us to keep costs lower while still providing the same quality veterinary care.”

Low Cost Pet Vax, founded in 2016, has worked to make basic pet health care accessible to all, with convenient locations and affordable prices.

 Information regarding all available vaccines, services, and packages, can be found on Low Cost Pet Vax’s website. Pop up clinic locations are updated weekly on their website, as well as their Facebook page.

Affordable Pet Healthcare Provider Low Cost Pet Vax Open Vaccination Clinics in Miami. News release. Low Cost Pet Vax. August 22, 2024. Accessed August 22, 2024. 

https://prnmedia.prnewswire.com/news-releases/affordable-pet-healthcare-provider-low-cost-pet-vax-opens-vaccination-clinics-in-miami-816457564.html

Kogut S. Survey Says: Millions of Pets Go Without Basic Vaccines. 

. March 7, 2024. Accessed August 22, 2024. 

https://www.linkedin.com/pulse/survey-says-millions-pets-go-without-basic-vaccines-susanne-kogut-8nbkf/

Consumer Price Index for All Urban Consumers (CPI-U): U.S. City average, by detailed expenditure category. United States Bureau of Labor Statistics. Accessed August 22, 2024. 

https://www.bls.gov/news.release/cpi.t02.htm#cpipress2.f.1

Vaccination Prices & Services. Low Cost Pet Vax. Accessed August 22, 2024. 

https://www.lowcostpetvaccinations.net/services/

Low Cost Pet Vax is providing vaccinations to walk-in patients in Miami

Affordable pet health care provider opens new pop-up clinics

Sigmund Fetch KC

, Alex Sigmund, DVM, DACVO, shares a bit about his upcoming lectures at Fetch Kansas City, where he will be discussing practical management of corneal ulcers, dry eye, and complications that can arise from ocular medications. Here, he delves into how topical steroids and dorzolamide can lead to certain health issues, including altered metabolism in the cornea, kidney problems, and dysregulation in patients with diabetes.

Registration for our Fetch dvm360 conference in Kansas City, Missouri—August 23-25, 2024—remains open! 

 today to attend and learn more about eye conditions, ocular medications, and a plethora of other topics from established veterinary professionals.

So topical steroids, when we're using them really, really frequently, can predispose [a patient] to infected ulcers. They can cause altered metabolism in the cornea that can result in fat deposits and even calcium deposits in the cornea that can lead to other issues. In [patients with diabetes], topical steroids have been shown to sometimes contribute to dysregulation. So, especially those that are getting cataract surgery, it's something that we think about when they're going to be potentially on topical steroids after surgery. And there's some research about steroids causing nasolacrimal punctal stenosis, where it narrows if you're using it all the time. So there's a few things that tropical steroids can cause, which is why I try to get patients off of tropical steroids, kind of as quickly as we can, as safely as we can, if there's an alternative.

The second one is dorzolamide, which is an antiglaucoma medication. And dorzolamide, more recently, has been shown to have some effects on the kidney, especially in cats, where it will start to actually decrease their potassium levels in their blood, which can cause some clinical signs. We've also seen that dorzolamide can cause an inflammatory response in some dogs, in their corneas and in their conjunctiva that doesn't respond to anything else except stopping the medication, and that can be a challenge for our glaucoma patients when we really only have a few medications that are even options. 

Alex Sigmund, DVM, DACVO, discusses health issues that topical steroids and an antiglaucoma therapy can cause, ahead of his lecture at Fetch Kansas City

How ocular medications can cause other health complications

Obesity poses a serious threat to pets—dogs who are overweight have a shorter lifespan compared to their leaner counterparts.

 Yet, more than 50% of dogs in the United States are overweight and/or obese. Simply cutting back on feeding portions rather than giving these canines food intended for weight loss is rarely successful in the long term, according to the authors of a recent study that was presented during a poster session at the 2024 American Veterinary Medical Association (AVMA) Convention in Austin, Texas.

The study compared canine food with a combination of ingredients intended to promote weight loss to dog food that did was not formulated for weight loss. The study revealed that participating canines achieved more weight loss on this combination food than on food not formulated to support weight loss.

At the convention, Kristen M Carnagey, PhD, senior nutrition scientist at Hill’s Pet Nutrition, and coauthor of the study, presented the study’s findings. The research focused on the efficacy of a combination food designed to support weight loss in overweight or obese dogs with osteoarthritis. The objective of the study was to compare the weight loss of dogs fed Hill's Prescription Diet Metabolic + Mobility (HPDMM) to those fed an adult dog food fortified with vitamins and minerals. The weight loss success of both foods was assessed in a 12-week randomized blind feeding study.

To do this, 66 canine patients of the same age and gender, and similar weight and Body Fat Index (BFI) categories were brought to a clinic for a baseline measure. After these dogs’ weight and BFI were assessed, they were randomly assigned to either a test or control group. 

Owners received feeding recommendations to promote the gradual and steady weight loss of their participating dogs. Moreover, feeding recommendation charts were created based on the analytical data of the foods and the participants’ weight. The foods and treatment codes were not disclosed to veterinarians nor technicians.

Along with the prescribed food, participants also received 20 minutes of daily exercise. Evaluations were conducted on day 42 and day 84. At the day 42 check-up, veterinarians had the opportunity to modify the feeding recommendations for dogs that were not losing weight as expected.
“Both foods were well accepted by dogs. We didn't have any problems with consumptions. Both dogs ate both foods exactly as we wanted them to, and also both foods were acceptable to owners,” said Carnagey during her presentation.

 “Owners did notice that the Metabolic + Mobility smelled a little bit stronger, but [the dogs] didn't find that aroma to be off putting.”

Canines who received HPDMM saw a significant decrease by at least 10% in their BFI, according to Carnagey. Moreover, dogs fed HPDMM lost 2.8 times as much weight as those fed PDC in 12 weeks.

“That weight loss was statistically different…and it continued on,” emphasized Carnagey.

 “That part is important because we really didn't reduce the feeding amounts by that much. We're talking around a 1 to a 1.1 times RER [resting energy requirement] from their actual body weight. So we didn't even convert to ideal body weights on these dogs… and we still generated almost 3 times more weight loss for the [HPDMM] group.”

“Dogs were able to achieve and maintain controlled weight loss throughout the duration of study, and we did that without significantly…reducing feeding amounts,” Carnagey explained. “You know, sometimes when you go to help dogs lose weight, you might cut…like 70% of what they might be eating, but we were able to achieve weight loss with only 1.1 times RER.”

Weir M, Williams K, Downing Robin. Obesity in dogs. VCA Animal Hospitals. Accessed August 13, 2024. 

https://vcahospitals.com/know-your-pet/obesity-in-dogs

Carnagey KM. Combination food formulated to support weight loss and joint health in overweight or obese dogs with osteoarthritis. Presented at: American Veterinary Medical Association Convention; Austin, TX: June 20-25, 2024.

A poster session at the 2024 AVMA Convention showed the benefit of canine food formulated to support weight loss