The old-school way of practicing veterinary medicine has changed and is evolving rapidly with the introduction of new technologies, such as artificial intelligence. Clientele and business vary dramatically depending on the location, and some practices are so busy that they need to turn away clients and are just about overwhelmed with what to do next. In taking on this new challenge, there are many possibilities where you can continue to expand and grow or decide that you are happy where you are. Most of the stress that veterinary professionals experience is due to the demands and unclear expectations they put on themselves when things may be perfect as they are. Let us discuss options for addressing the challenge of too much business or deciding to stay in the status quo.

When veterinarians start a practice, they often tire of working for someone else and feel stuck with practicing medicine differently from what they believe is best. The owner starts or purchases a practice with little business acumen, and one of the top stressors they experience is earning enough money to keep the doors open. As the practice continually experiences a full schedule, there are concerns about what to do next. Most practice owners become stressed because their personal and business goals are undefined and unclear. This can be a horrible situation because the decisions could be shortsighted and negatively impact the owner. A practice’s vision and mission help clearly define where it is trying to go regarding practicing veterinary medicine, becoming a premier care provider in the region, or even expanding to multiple locations throughout the state. The owner should know the plan to sell and transition ownership to where they can continue living a lifestyle they were accustomed to before selling.

Reconsider how many days the practice is open

The worry most owners experience is the lack of support staff and veterinarians. This can be a huge factor in determining which hours and days the practice is open. When staffing is the biggest problem, this is a good time to analyze what is causing the problem. There are opinions galore about shortages, but at the core, something could be wrong with the practice’s culture. The environment starts from leadership and permeates throughout the practice. Lack of communication, timeliness, feeling valued, and even having a purpose for working at the practice beyond helping animals could be ignored. If staffing is not an issue but the practice is open 5 days per week, consider opening another half day or a full day. This can be easier said than done, especially when 1 veterinarian staffs the practice. There are work-arounds such as bringing in a relief veterinarian or making that extra day the practice is open a wellness day where technicians are needed.

There are times when the practice is at full capacity. This means all veterinarians’ calendars are packed, examination rooms are used all day, and there is no way to bring on more business even if there were more staff. This is the time to consider adding more examination rooms through a build-out, opening another location, or potentially moving the practice to a new location that can support the demand. Some veterinary hospitals with poor layouts could support a redesign to efficiently see more patients, with an office being turned into another examination room or larger rooms being reduced to accommodate more examination rooms. For those maxed out based on square footage, this is the time to consider opening another location or moving the existing practice. The options are finding another location in a strip mall to lease or purchasing land to custom build. All these options should depend on the owner’s longterm goals personally and with the business. If they all align, sometimes we must get comfortable being uncomfortable and take the leap.

Stop stressing and accept the business as is

There are practice owners perfectly content with the way their practice operates. They may turn away business sometimes, but they are doing their best with the circumstances in front of them. These owners have accepted that they are content with what they offer and that other practices can fill the gaps. Society does a great job of making us feel like we should do, buy, and expand more. This is the ideal progression for most, but not all. The practice might be highly profitable, as well as practicing high-quality medicine, and that is just what it is. Maybe the owner has not considered the possibilities and the shortfalls they could experience when they sell to continue a similar lifestyle. This is a fantastic opportunity to review everything to determine whether expanding is unnecessary. If the opposite is true, then take a deep breath, create a plan, and start taking one step at a time to get to that next level.

Practice ownership is a huge responsibility. Every day is a new experience; we all face difficult decisions depending on the environment. The best thing we can do is take a deep breath, focus on what is truly important, and design a road map to help support the most important things. Each example above is not a solution but a way to think bigger. Take the next step in your most appropriate direction and do not look back.

 has worked with practice owners and veterinarians since 2014. He is the cofounder of Florida Veterinary Advisors, which works with veterinarians throughout the US. He is also a certified exit planner (CExP), a business and personal financial adviser, and cohost of the Smarter Vet Financial Podcast.

: Tom Seeko, CExP, is a Registered Representative and Financial Advisor of Park Avenue Securities LLC (PAS). Securities products and advisory services offered through PAS, member FINRA, SIPC. Financial Representative of The Guardian Life Insurance Company of America® (Guardian), New York, NY. PAS is a wholly owned subsidiary of Guardian. Florida Veterinary Advisors is not an affiliate or subsidiary of PAS or Guardian. California Insurance License #0K80141. Florida Veterinary Advisors is not registered in any state or with the U.S. Securities and Exchange Commission as a Registered Investment Advisor. The individuals associated with Florida Veterinary Advisors do not maintain specialized licenses or qualifications for the financial services provided to veterinary professionals. 2024-176685 Exp 6/26

Articles

With the increase in patients since the COVID-19 pandemic and technological advances, how can practices handle the surge?

Smart ways to handle too much business

Anaplasmosis, a global disease that typically affect ruminants, including cattle, sheep, and goats, is a common disease in southern United States. Moreover, anaplasmosis can sometimes result in death, particularly in adult cattle.

 The spread of this illness has been reaching unprecedented levels across the US, according to a news release.

 Helping to tackle this issue is an inactivated bovine anaplasmosis vaccine, the world’s only one of its kind.

The vaccine by University Products, a specialist in approved bovine vaccines for experimental use, provides a cost-effective, sustainable, and easy-to-administer solution for a “cattle industry under siege,” according to the company. Although conventional approaches like pest control and chlortetracycline (CTC) medications offer partial relief, they do not offer effective protection of herds both presently and in the long term.

 According to the FDA, CTC Type C medicated feeds are not approved for treating or preventing anaplasmosis. Rather, these feeds are approved only for the control of active infection of this illness.

“Antibiotics were never meant to be a routine cure, but are an emergency response to breakthrough infections," Gene Luther, director at University Products, said in the news release.

 "Antibiotic overuse can lead to major antibiotic resistance. They're also not cost-effective. Vaccination is really the only route that makes sense, both biologically and economically.”

The inactivated bovine anaplasmosis vaccine was developed at the Veterinary Science department of Louisiana State University in Baton Rouge. It received USDA approval for its production and sale as an experimental anaplasmosis vaccine to veterinarians in 29 states. There have been no reported cases of neonatal isoerythrolysis in calves of vaccinated cows and the vaccine has been administered to cows at all stages of pregnancy without any reported issues, according to the company. The USDA, however, has not conducted efficacy or potency tests on the vaccine.

The vaccine necessitates 2 doses in the 1st year, followed by an annual booster. Given its prevention mechanism, it offers protection against the loss of animals to the illness and reduces antibiotic resistance, unlike the CTC feed. Moreover, the vaccination is less costly than the combined expenses of using CTC feed and continuous pest control efforts. Additionally, the cost of testing animals for anaplasmosis and then culling or isolating those infected further strains ranchers financially, making vaccination a more economical choice, according to company.

, a bacterium that does not infect humans but is infectious in ruminants.

 It mainly spreads via infected tick and horsefly bites, with horseflies having the ability to transmit the disease for up to 2 hours after feeding on an infected host.

After animals have been infected, anaplasmosis can spread through contaminated equipment or through blood. Symptoms typically appear 3 to 6 weeks after an animal has been infected and can include anemia, fever, depression, and isolation. Severe symptoms in infected adult cattle consist of jaundice and death. In young ruminants, however, early diagnosis proves difficult, as they may only show signs of fever and increased breathing rates, making many of these young animals chronic carriers.

Anaplasmosis in cattle. The University of Tennessee Extension. Accessed July 19, 2024. 

https://utbeef.tennessee.edu/wp-content/uploads/sites/127/2020/11/AnaplasmosisInCattle-ASB288-FMH-WWG.pdf

University Products' bovine anaplasmosis vaccine: The superior solution over pest control and CTC medicines. News release. University Products LLC. July 17, 2024. Accessed July 19, 2024. 

https://prnmedia.prnewswire.com/news-releases/university-products-bovine-anaplasmosis-vaccine-the-superior-solution-over-pest-control-and-ctc-medicines-302199392.html

Questions and answers: FDA Approved free-choice feeding options for anaplasmosis control in cattle. U.S. Food and Drug Administration. Accessed July 19, 2024. 

https://www.fda.gov/animal-veterinary/development-approval-process/questions-and-answers-fda-approved-free-choice-feeding-options-anaplasmosis-control-cattle

History of anaplasmosis vaccine. University Products LLC. Accessed July 19, 2024. 

The inactivated bovine anaplasmosis vaccine may help reduce antibiotic resistance to medicated feed

Experimental bovine anaplasmosis vaccine may offer cattle protection

In recent years, domestic cats and dogs are living significantly longer lives, with roughly 20-40% of current pets being considered “old” (more than 11 years of age).

 This is largely due to better quality veterinary care and diet formulation. Despite this trend, information on how cats and dogs age as well as guidelines on their nutritional requirements is limited. This leads researchers to interpret most information about aging from omnivores like humans, who are physiologically different from cats and dogs.

A group of researchers from multiple universities and institutions in New Zealand and Canada aimed to improve our understanding of this area. They reviewed and summarized recent publications regarding canine and feline aging and nutrition. This study found that cats and dogs have several differences in their nutritional requirements, nutrient digestion and intestinal morphology, and microbial diversity. The researchers also discovered specific health benefits of nutritional interventions.

Nutritional requirements differ in both the specific nutrients including amino acids, fatty acids, vitamins, and minerals, and the amounts required. An example of this is the amino acid taurine, which is an essential amino acid for cats, but not for dogs. Additionally, cats are considered obligate carnivores, while dogs are facultative carnivores (animal tissue provides optimal nutrition but is not required). Beyond this information, there is little known about the specific nutritional requirements of cats and dogs.

Fat and protein digestion appears to decrease with aging in cats, indicating that they may be undergoing significant changes in intestinal physiology which can be met with nutritional interventions. On the other hand, dogs undergo changes in intestinal morphology, but experience no changes in intestinal permeability or absorption with aging.

Microbial diversity appears to decrease in aging dogs, affecting their metabolism, nutrient absorption, and response to diseases. In contrast, cats maintain microbial diversity with aging.

Nutritional interventions have shown to improve key processes in aging of cats and dogs including immune status, cognitive function, and maintenance of lean muscle mass. In normal aging, these processes lead to increased frailty and increased risk of diseases and mortality. These nutritional interventions included increasing protein and fat content, and adding nutrients including beta carotene, vitamin E, fatty acids, antioxidants, B vitamins, dietary lipids, carnitine, and amino acids.

The results of this study indicate that aging cats and dogs have different, specific nutritional requirements and a close relationship between diet and their aging processes. With the increasing number of older cats and dogs, this stresses the importance of further research and development of specific nutritional guidelines for aging cats and dogs.

 is a 2025 PharmD Candidate at the University of Connecticut School of Pharmacy

Bermingham EN, Patterson KA, Shoveller AK, Fraser K, Butowski CF, Thomas DG. Nutritional needs and health outcomes of ageing cats and dogs: is it time for updated nutrient guidelines?. 

. 2024;14(3):5-16. doi:10.1093/af/vfae008

Researchers across the globe are working to get a better understanding of the nutritional needs of older patients 

All eyes on nutritional needs of geriatric pets 

Photo courtesy of Blue Cross Animal Hospital

The lobby of the Blue Cross Animal Clinic in Albuquerque, New Mexico

Three veterinary hospitals have been named grand prize winners in dvm360’s 2024 Hospital Design 360 Competition. These newly built or recently renovated facilities were each named Hospital of the Year, in 3 structure size categories, and 7 more hospitals are receiving merit awards. All winners are being recognized for the quality and uniqueness of their layouts, décor, and amenities as well as spaces that serve staff, clients and patients well.

The 3 grand prize winners will be presented with their awards Sunday, August 25, 2024, with a celebratory luncheon during the 

, Missouri. Selected by a panel of judges, the 2024 Hospital of the Year honorees are as follows:

: Blue Cross Animal Clinic in Albuquerque, New Mexico

: Habitat Veterinary Hospital in Boise, Idaho

: The Vet Vision Center in Lambertville, New Jersey

“With the highest number of submissions this year, these 3 winners did a fantastic job showcasing their outstanding veterinary hospital designs, setting a new benchmark for excellence in our profession,” Adam Christman, DVM, MBA, chief veterinary officer for dvm360, said. “Their arduous work, dedication and passion for innovation are celebrated in each of these outstanding hospitals.”

The reception space at Vet Vision Center uses natural light, separations, and a beverage bar to help keep clients and patients comfortable and relaxed.

The celebratory event in Kansas City will also feature a panel discussion with the winning practice owners, as well as an architect and design expert. These scheduled speakers include Christman; Ashlee Andrews, DVM, owner, Blue Cross Animal Clinic; Sohaila Maleki, chief visionary officer and founding partner, Habitat Veterinary Hospital; Reed Linenberger, DVM, chief financial officer and partner, Habitat Veterinary Hospital; Shelby Reinstein, DVM, MS, DACVO, owner and founder, The Vet Vision Center; and Becky Gasser, NCARB, director of design and partner, BDA Architecture, PC.

In an interview with dvm360, Maleki and Linenberger spoke about the significance of Habitat Veterinary Hospital’s being selected a grand prize winner. “It means a lot, actually, because we put so much thought and energy and all the things that we've learned through the years together to create this beautiful space. To be recognized for that is really, really special to us,” Maleki said.

“I think it also helps us in our grand vision… veterinary medicine is changing a lot, and we feel very appreciated that [dvm360 is] recognizing us as a smaller hospital,” Linenberger added.

Photo courtesy of Habitat Veterinary Hospital

An outdoor space at Habitat Veterinary Hospital welcomes patients during their visits.

Although the competition brings attention to the winning hospitals, Reinstein said the program also helps bring awareness to designers and the work they do for hospitals. “Veterinary medicine is coming into a new age, where it matters what your hospital looks like. It matters what it does. All of it matters,” she said.

In addition to the grand prize winners, the competition judges recognized the following Merit Award recipients:

Partners Animal Hospital West Loop in Chicago, Illinois

Red Barn Animal Hospital in Gilberts, Illinois

All Creatures Great and Small in Downers Grove, Illinois

dvm360’s John Hydrusko, vice president, sales, MJH Life Sciences, congratulated all of the competition winners in a statement. “We are honored to add these incredible clinics into our Hospital Design winner's circle. Creating a beautiful workspace for employees, the clients and pets they service is a true testament to exceptional veterinary care,” he said.

Abi Bautista-Alejandre, assistant editor, contributed to this article.

Grand prize winners were named Hospital of the Year in 3 size categories, and 7 additional facilities receive the Merit Award 

dvm360 announces 2024 Hospital Design 360 Competition winners

The design of a feeding trial for dog food with cultivated chicken is expected to be submitted to the United States Food and Drug Administration (FDA) later this month. Cell-cultivated chicken is a novel ingredient that has not yet received approval for animal consumption.

 Further Foods, a subsidiary of CULT Food Science—a disruptive food technology platform evolving the commercialization of lab-grown meat and cellular agriculture—is developing a Target Animal Safety (TAS) study to ensure the safety and effectiveness of including cell-cultivated chicken in future formulations of Noochies!, nutritional yeast-based freeze dried treats for cats and dogs.

The feeding trial design protocol, which is being developed in partnership with Sarah Dodd, BVSc, MSc, PhD, DECVCN, is expected to be submitted to the FDA later this month. The FDA aims to provide a response within 45 days of submission, according to a news release. Once the FDA approves the design of the protocol, the company has plans to begin the feeding trials in the 4th quarter. According to Further Foods,

 they are the sole company currently in dialogue with the FDA regarding feeding trials for a cultivated chicken dog treat, as far as it is aware.

"I'm thrilled to be collaborating with Further Foods and Noochies! on this very exciting feeding trial. Cultivated meat is an area I am personally exceptionally excited about, for both its nutritional potential for animals and for its positive impact on the environment. I look forward to navigating the regulatory pathways and feeding trial requirements with the FDA and advancing this first of its kind trial forward,” said Dodd in the news release.

According to the company, the TAS study will be a 26-week minimally feeding study where 30 healthy adult dogs of different breeds and ages will receive 1 control dose, 1 test done, and a high inclusion dose. Factors including feed intake data, hematology, serum biochemistry, urinalysis, weight, fecal analysis, and digestibility will be monitored to ensure the safe inclusion of cell-cultivated meat for these canines.

CULT Food Science subsidiary Further Foods announces imminent FDA trial design for cultivated meat in pet food. News release. Cult Food Science Corp. July 18, 2024. Accessed July 18, 2024. 

https://prnmedia.prnewswire.com/news-releases/cult-food-science-subsidiary-further-foods-announces-imminent-fda-trial-design-for-cultivated-meat-in-pet-food-824567776.html

Further Foods plans to submit its feeding trial design protocol for use of lab-grown chicken in dog treats to the FDA later this month

Feeding design trial for cultivated meat dog treats to be submitted to FDA for approval

Caring for the Diabetic Cat

Sponsored by Boehringer Ingelheim. To watch the full video and earn 0.5 CE credits, click 

Diabetes is a common issue among cats. Between better recognition from veterinarians and more owners bringing their cats to the vet, it is being diagnosed more and more. Adam Christman, DVM, MBA, of dvm360® Live, spoke with Patty Lathan, VMD, MS, DACVIM, about the differences between canine and feline diabetes, what is happening within the body, and medications that are changing how diabetes is treated. 

 It is between 1 and 2 out of every 400 cats. A veterinarian will likely diagnosis a cat with diabetes every month or so.

Feline diabetes is much different from canine diabetes. It is like type 2 diabetes in humans whereas canine diabetes is more like type 1 diabetes. Once a dog becomes diabetic, they invariably need insulin for life, whereas type 2 diabetes in people can often be managed with diet, exercise, and oral medications. They may eventually need insulin, but that isn’t always the case. However, cats have often been treated with insulin due to a lack of effectiveness with oral medications. Now there are options.

How do amyloid deposition and glucose toxicity play a role in cat pathophysiology?

 Whenever insulin is secreted, so is amyloid, which helps decrease blood glucose over time. When you have more insulin resistance, β cells make more insulin, and the more insulin that’s produced, the more amyloid there is. Unfortunately, excess amyloid can deposit on the islets of the pancreas and cause inflammation as well as the destruction of β cells. Amyloid deposition is linked to Alzheimer disease.

Glucose toxicity, on the other hand, happens when β cells can’t keep up with the rising glucose levels. Glucose is toxic to β cells. This toxicity makes it so the β cells can’t make insulin. However, if you catch it soon enough, we think glucose toxicity is reversible.

What are the goals of treating and managing feline diabetes?

 My primary goals are to decrease clinical signs—frequent drinking and urination, weight loss—and improve the quality of life of the cat and the owner. While doing that, I also want to help prevent some of the complications associated with diabetes like hypoglycemia, diabetic neuropathy, and decay.

Christman: Walk us through the traditional treatment options when diagnosing feline diabetes. What are some common objections?

 We’ve used either protamine zinc insulin (PZI) or glargine insulin. We typically start the cats on 1 to 2 units twice daily depending on how high the glucose is and how big the cat is.

The first common objection is we’re often working with people who have not given injections before. They may have a needle phobia or are afraid of hurting their cat. Secondly, these are twice-daily injections, 12 hours apart. It doesn’t have to be to the second, but it does have to be consistent. So, it can get to a point where these injections affect the quality of life of the pet owner. The other side of this, too, is you want to enjoy time with your pet. If a cat is running away because they don’t want the needle and the pet owner is stressed about the cat’s glucose level, that tampers with the human-animal bond.

 The new class of drugs are sodium-glucose transporter-2 (SGLT2) inhibitors. Glucose is filtered through the glomerulus and reabsorbed from the renal tube. SGLT2 is responsible for 90% of the reabsorption in the renal tubes, so the idea is, if we inhibit SGLT2, then glucose is excreted rather than fully reabsorbed. It is through the excretion of glucose that blood glucose concentration decreases. This class of drugs has been used on people for about 10 years and they have shown improvements in cardiac and renal outcomes.

The great thing about these medications is they can be given orally: Senvelgo is a liquid whereas Bexacat is a pill. Regarding adverse effects, some cats can develop diarrhea at the beginning of this treatment regime. The main thing to keep an eye out for is diabetic ketoacidosis because as the medication is working, some cats who may not be able to make insulin anymore due to the destruction of β cells can’t inhibit ketone formation.

How new medications on the market are improving the lives of cats and pet owners.