Grief is not an unknown emotion within veterinary clinics. Clients come into the doors of hospitals and have to say goodbye to a beloved pet for a plethora of circumstances, and that grief can then spreading through other clients and veterinary team. While the grief from what is happening inside the clinic is nothing new, there are veterinary professionals who come into the clinic with grief of their own. 

On this week's episode of The Vet Blast Podcast presented by dvm360, our host Adam Christman, DVM, MBA, and special guest, Andrew Ciccolini, DVM, MSOL, explore the complicated emotions surrounding grief as Ciccolini reflects on losing his son at a young age. The 2 talk about their own grief and how it has affected each of them inside and out of the clinic, plus Ciccolini shares more about the Colorado Children's Hospital and the power of therapy dogs. 

We've all experienced our children being sick and just how stressful that can be. And plenty of other veterinarians have had children and NICU or PICU or just in the hospital in general. And I think it can be really challenging being a veterinarian, having to spend time in the hospital with your kid, and then you go to work in the hospital, and you're just constantly surrounded by medicine. And it can be really overwhelming. And that's kind of what I experienced. It really got difficult for me to do my day job, just in the hospital all the time. 

I got really fortunate that I was able to find the job at the National Milll Dog Rescue around that time, because it's just a lot more laid back atmosphere, and they [have] been super supportive of me needing to take time off to take care of Ethan. Because even when he wasn't in the hospital, he was always, you know, having medical appointments. Children's Hospital Colorado, like, I just can't thank them enough, and what they did for Ethan and our family, I don't know that we would have even gotten 2 and a half years with him without them. And I know I talk a lot about his medical appointments, but I do, I think it's important [to] me to mention that, like he was a happy kid like his life was worth living.

Podcasts

One veterinarian shares how his grief inspired him to be an advocate for Children's Hospital Colorado's Medical Dog program

Grieving and giving back

Recent research suggests that fostering animals at shelters not only contributes to animal welfare but could also function as a One Health intervention and provide companionship, affection, and emotional support to these animals’ caregivers. With animal shelters in the United States receiving more than 6 million cats and dogs each year, foster care programs have been on the rise.

 The research, funded by Purina and led by Lauren Powell, PhD, researcher and lecturer of Animal Welfare and Behavior at the University of Pennsylvania School of Veterinary Medicine in Philadelphia, Pennsylvania, offers insight into the effect of animal fostering on the caregiver’s mental wellbeing, quality of life, human-animal attachment, and grief.

For the study, 131 foster caregivers from 5 US shelters, including Providence Animal Center in Pennsylvania, Humane Animal Partners in Delaware, Dakin Humane Society and Massachusetts Society for the Prevention of Cruelty to Animals in Massachusetts, and San Diego Humane Society in California, participated in 3 online surveys between March 2022 and March 2023. Eligible foster caregivers were more than 18 years old, agreed to temporarily care for a shelter animal in their home, had not fostered an animal in the past 7 days, did not plan to use the foster period as a trial adoption, and had not previously participated in the study.

Participants completed the surveys at different stages of fostering a shelter animal: before fostering, 10 days after taking the first survey, and after the foster animal had left the participant’s home.

The study found that although fostering did not notably enhance participants' mental wellbeing, many of these caregivers reported self-perceived benefits in their overall quality of life with love, affection, and companionship from their foster animals being significant contributors. Moreover, dog foster caregivers reported significantly higher emotional and social/physical quality of life than cat foster caregivers, according to the study.

 Moreover, caregivers reported low average levels of avoidant and anxious attachment, indicating that they were able to form secure bonds with their foster animals. Additionally, although some caregivers felt grief when their foster animal was adopted, most adapted well after the foster period ended.

 In terms of retention rates, 86% of participants said they were likely to foster in the future.

“Our findings suggest that fostering at animal shelters may serve as a One Health intervention to offer companionship, affection and emotional support to human caregivers while promoting animal welfare. However, these benefits did not translate to improvements in caregiver mental wellbeing, so caution should be applied when considering foster caregiving as a potential mental health promotion tool,” wrote the study’s authors.

“Dr Powell's research underscores the importance of understanding foster caregivers' motivations to better match foster animals with suitable caregivers, thereby enhancing the effectiveness and benefits of foster care programs,” wrote Purina in a news release.

In another study, Powell also investigated the 

. The study offered data on the motivations of caregivers from different age groups, underlining differences in motivations and expectations between different demographics. The research found that main reasons for fostering were typically linked to animals or community involvement.

Under the Purina Sponsorship for Human-Animal Bond Studies program, Purina scientists and pet experts offer up to $30,000 per project to researchers exploring the human-pet bond and the therapeutic benefits of pets. Moreover, the company dedicates more than $100 million annually to research, according to a news release.

Purina-sponsored research unveils dual benefits of animal foster care programs. News release. August 6, 2024. Acessed August 21, 2024. 

https://prnmedia.prnewswire.com/news-releases/purina-sponsored-research-unveils-dual-benefits-of-animal-foster-care-programs-302214893.html

Powell L, Ackerman R, Reinhard CL, Serpell J, Watson B. A prospective study of mental wellbeing, quality of life, human-animal attachment, and grief among foster caregivers at animal shelters. 

. 2024;19(5). doi:10.1371/journal.pone.0301661

Bautista-Alejandre A. Research sheds light on motivations of foster caregivers. 

August 12, 2024. Accessed August 21, 2024. 

https://www.dvm360.com/view/research-sheds-light-on-motivations-of-foster-caregivers

Articles

A study investigated the experiences of foster caregivers at animal shelters

Human benefits of fostering shelter animals

A recent study published in the August issue of the 

 journal shared that researchers identified a rustrela virus (RusV) variant in a wild mountain lion in Colorado. These findings mark the first documented case of rustrela virus associated “staggering disease” in North America. According to the American Veterinary Medical Association (AVMA),

 staggering disease is an often-fatal neurologic condition that has posed a threat to domestic felines in Europe for several decades, especially in Austria and Sweden. Staggering disease has also bee recently linked by scientists to RusV, a relative of the rubella virus that causes German measles in people.

The researchers in the study reported that in May 2023, a 1-year-old, free range female mountain lion was euthanized by the Colorado Parks and Wildlife (CPW) officials in Douglas County after it received a report that she was presenting with severe hind leg ataxia and paresis.

 When the officials arrived, the mountain lion appeared to be depressed and was reluctant to rise and had markedly decreased capacity to move or bear weight on the hind end. After the euthanasia, a subsequent tissue analysis revealed the presence of RusV.

When it comes to staggering disease, the most common clinic sign is hind-limb ataxia with generally increased muscle tone, which causes a stagger in the animal’s gait. There is also a range of other clinic signs that can occur, including the inability to retract claws, hyperesthesia, and occasionally tremors and seizures. Infected animals can also present with behavioral changes such as depression, increased affection, and enhanced vocalization, and in rare cases, aggression. The disease can usually last a few days to weeks but could continue for a year and it generally results in deterioration that requires euthanize for welfare reasons.

At this time, scientists do not know how widespread RusV is in domestic cats or wildlife. RusV causes staggering disease in cats, but also other species such as rodents, a donkey, and marsupials in Europe. Surveillance for the virus in small rodents could potentially identify a local reservoir host because rodents of the genus 

 were identified as likely viral reservoir hosts. However, 

 rodents are not indigenous to North America but there are multiple genera of small rodents within Colorado that could serve as candidates for further screening. Future studies should also consider that the zoonotic potential of RusV is not determined at this time.

“Given the wide host range of the virus in Europe, RusV should be considered as a possible cause for neurologic diseases in all mammal species in North America,” the article’s authors concluded.

Staggering disease’ discovered in Colorado mountain lion. News release. American Veterinary Medical Association. August 15, 2024. Accessed August 21, 2024. 

https://www.avma.org/news/staggering-disease-discovered-colorado-mountain-lion?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

Fox KA, Breithaupt A, Beer M, et al. Rustrela Virus in Wild Mountain Lion (Puma concolor) with Staggering Disease, Colorado, USA. 

. 2024;30(8):1664-1667. doi:10.3201/eid3008.240411.

A wild mountain lion is the first documented case in North America

Rustrela virus variant identified in Colorado

Candice Chu, DVM, PhD, an assistant professor at the Texas A&M College of Veterinary Medicine and Biomedical Sciences (VMBS) in College Station, is discovering new uses for artificial intelligence (AI) tools in veterinary clinics and classrooms.1 With her research, Chu has developed a new AI-based study tool for veterinary students. The tool, VetClinPathGPT, is based on ChatGPT technology.

“AI is a powerful assistant that can help clinicians, educators and students reduce the time they spend on repetitive work,” Chu said in a news release.

 “By reducing repetitive tasks, individuals can spend their time on the most important parts of their work, like completing assignments or helping students and patients.”

Chu has expressed that it is both her desire, and her expectation, that AI will become a regular facet of the veterinary classroom in the future.

 VetClinPathGPT is designed to assist students as they learn clinical pathobiology, focusing on disease diagnosis, treatment, and prevention. Students can ask the AI questions about terms and concepts that they are unsure of, and educators can use AI tools to reduce their time spent on repetitive tasks, like writing exam questions.

“Imagine having a microscope connected to a camera with AI capability so students can look down at their slides and essentially have a clinical pathologist there to explain what they’re seeing,” Chu said of AI’s upside as a learning tool.

 “They could ask the AI, ‘What’s that cell?’ and it could tell them not only the type, but also how to identify it. Veterinarians are in high demand, and it’s a good thing to have lots of students in the classroom. But 1 instructor cannot work with every student individually at the same time, so in my ideal world, AI would be able to help with that.”

Chu also explained the role that VetClinPathGPT can play as a study partner. Students can upload their course readings, and the AI can ask them relevant study questions based on the text. “Once you read one passage, you can test your knowledge or use the AI to help you prepare for the exam,” Chu said.

Chu predicts that AI tools will continue to serve veterinary professionals well past their time in a classroom. The tools can assist with tasks like record keeping that traditionally take away from time otherwise spent working with patients.

“It would be very helpful to have a tool that could go through medical record and pull examples from cases,” Chu said of AI’s potential use in clinical settings.

 “Imagine having a tool that could fill out medical records while you’re talking with a patient’s owner.”

A primary drawback regarding the use of AI in such avenues has to do with privacy concerns and ensuring that these tools don’t compromise the privacy of confidential medical records. Chu expressed shared concerns over the fact that, for AI tools to read patient medical records, those records would need to be shared with developers, which would violate patient privacy laws. She is confident, though, that it’s only a matter of time before someone develops AI tools that satisfy patient privacy protocols, referencing pre-existing private versions of ChatGPT, or the possibility of an AI tool that exists only locally on a clinic’s computer or network.

Another major concern addresses the accuracy of AI-provided information. “Artificial hallucination” refers to the generation of implausible but confident responses by an AI tool.

 Chu cited a 2023 article that covers these hallucinations, noting that ChatGPT sometimes fabricates references with incoherent PubMed IDs.

As large language models (LLMs), tools like ChatGPT are trained on accessible online data and are refined through conversations with users. This, as Chu points out, can also raise some concerns regarding copyright infringement and privacy violations. She also notes that some may be concerned by the fact that the FDA has not yet authorized any medical devices that use generative AI or LLMs.

“The key to getting high-quality, relevant answers to your prompts is to make sure that the information uploaded to the AI is reliable,” Chu said, acknowledging concerns that some may have regarding the accuracy of AI-provided information.

 “For example, VetClinPathGPT doesn’t use just any information from the internet, it uses the ‘eClinPath’ website, an online textbook developed by the Cornell University College of Veterinary Medicine [in Ithaca, New York].”

An advocate for its implementation, Chu sees AI as the ideal complement to humans in veterinary medicine, not as a replacement. “Neither are perfect on their own, so bringing them together increases our ability to diagnose, teach, and learn” Chu said.

 “One thing I tell people is not to worry that AI will replace you; it’s the person who knows how to use AI who will replace you. I think that in the future, knowing how to incorporate this technology will be a basic requirement to be an efficient and competitive veterinary educator in the job market.”

In addition to her research and role as an assistant professor at VMBS, Chu announced a partnership with VMBS’ Gastrointestinal Laboratory and the Texas A&M Institute of Data Science on a machine learning project to see if AI can help diagnose acute pancreatis in dogs. This fall, Chu will deliver a keynote lecture this fall at the American College of Veterinary Radiology Scientific Conference, and is also scheduled to attend the Texas Taiwanese Biotechnology Association Symposium and the American College of Veterinary Pathologists Annual Meeting, where she is expected to share her research.

Texas A&M Researcher Explores Benefits of AI In Veterinary Medicine, Education. News release. Texas A&M College of Veterinary Medicine and Biomedical Sciences Communications. August 20, 2024. Accessed August 21, 2024. 

https://vetmed.tamu.edu/news/press-releases/ai-in-veterinary-medicine/

Chu C. ChatGPT in veterinary medicine: a practical guidance of generative artificial intelligence in clinics, education, and research. 

https://doi.org/10.3389/fvets.2024.1395934

Alkaissi H, McFarlane SI. Artificial Hallucinations in ChatGPT: Implications in Scientific Writing. 

. 2023;15(2):e35179. Published 2023 Feb 19. doi:10.7759/cureus.35179

A Texas A&M researcher is discovering new ways for animal health professionals to use AI to their advantage

How artificial intelligence can be used in veterinary medicine and education

“I am somebody,” stated Gerelyn A Henry, DVM, MBA, BS, DACVP, hospital director and clinical professor at the University of Missouri-Colombia’s Veterinary Health Center, during her lecture at the 2024 American Veterinary Medical Association (AVMA) Convention in Austin, Texas.

 But she was not referring to just herself—she was speaking of the young people from underrepresented racial demographics with dreams of becoming veterinary professionals who are told they cannot do it or are not good enough: “Yes we can. [You] are somebody,” she said to the audience. In her lecture, Henry discussed several barriers to practice ownership for underrepresented minorities, outlining ways to improve practice ownership for this group. She also discussed barriers veterinary students and aspiring veterinary students face in accessing veterinary education.

“We have a shortage of veterinarians. We have a critical shortage of underrepresented minority veterinarians, and we can fill those gaps. We just have to do the work,” said Henry during her lecture.

According to Henry, underrepresented minority veterinarians may encounter challenges in their search for employment or in owning practices due to discrimination, bias in hiring and promotion practices, limited access to capital and resources, and other factors. As a result, disparities in income, career growth, and professional independence may arise.

 These challenges have also left African American veterinarians with fewer opportunities for employment compared to their White counterparts, explained Henry.

Barriers in veterinary medicine for underrepresented minority veterinarians and students

Henry shared with attendees statistics from 2015 that showed that out of 5,531,169 businesses in the United States, 4,483,080 (81.05%) were White-owned, 996,248 (18%) were owned by underrepresented minorities, and 113,643 (2.05%) were owned by African Americans.

When it comes to starting or purchasing a veterinary practice, limited access to capital is a significant barrier that disproportionately affects African American veterinarians, according to Henry. Entry into veterinary practice ownership bears a high cost, and African American veterinarians may have difficulty securing business loans from financial institutions because of limited collateral, lack of established business networks, and lower credit scores. 

Moreover, unconscious biases in the banking industry can lead these institutions to perceive African American veterinary practice owners as higher risk investments, leading to higher interest rates and stricter lending requirements. Additional biases regarding the financial competence of minority-owned businesses can also discourage investment in these businesses.

A lack of mentorship and networking opportunities can also make it difficult for these veterinarians to start their own practice, as a diverse network from other veterinary professionals is vital for gaining guidance, support, and access to capital, according to Henry. Underrepresented minority veterinarians may have restricted access to associations within the veterinary community, which are frequently dominated by White professionals, according to the lecture. Moreover, without established networks and relationships with potential partners or investors, these veterinarians may have a harder time obtaining financing for opening a practice.

Systemic barriers in the profession, which Henry defined as structural inequalities and biases embedded in the profession that disproportionately affect underrepresented minority veterinarians, also impacts these professionals’ ability to thrive. Racial bias may come from these veterinarians’ clients, colleagues, and supervisors; potentially leading to unequal treatment in the workplace, assumptions about competence, microaggressions, and difficulties establishing trust and rapport with clients and communities that are culturally diverse or come from varied socio-economic backgrounds, explained Henry.

For underrepresented minority veterinary students, barriers to education and training pose challenges. These students may face difficulties accessing quality veterinary education due to factors such as financial constraints, lack of mentorship and support, and limited opportunities for academic preparation. As a result, fewer racial and ethnic minorities may have the resources to attend veterinary school, leading to lower diversity in the veterinary profession.

Henry offered several ways to improve practice ownership. Among those were coming together as a community; developing scholarships and loan forgiveness programs; and providing more mentorship and diversity, equity, and inclusion (DEI) training for veterinary students and veterinarians. She highlighted organization like Veterinarians as One Inclusive Community for Empowerment (VOICE)—which is a student-run organization—, blendVet, Pawsibilities, BlackDVM Network, and the National Association of Black Veterinarians (NABV), who focus on diversifying veterinary medicine and providing opportunities for underrepresented veterinarians, students, and/or aspiring veterinary professionals.

Henry also emphasized promoting diverse veterinarians’ competence within the workplace and establishing connections. “We need to promote that competence and awareness among our colleagues and our mentors and our clients. We need to establish public, private partnerships so that we are doing things with others in the community to promote veterinary medicine. We need to work with financial institutions to improve programs especially tailored for African American and other culturally diverse applicants that want to start their own businesses,” she said.

“I've heard it said so many times year after year…that they can't find enough African American students that are bright and capable and interested in veterinary medicine. [In] one meeting…they had hundreds of students that [were] interested in veterinary medicine, and each one of them [had] a seed of greatness in them. And if we nurture them and we guide them and we give them the resources that they need, they can help fill the gaps of veterinary medicine,” Henry emphasized.

“We can do it. Yes, we can. I am somebody,” she concluded.

Henry GA. Creating the future of veterinary medicine through diversification of practice ownership. Presented at: American Veterinary Medical Association Convention; Austin, Texas: June 20-25, 2024.

Gerelyn A Henry, DVM, MBA, BS, DACVP, explains barriers underrepresented minority veterinarians face when opening their own clinic and highlighted opportunities for change 

Barriers and change: Practice ownership for diverse veterinarians 

Beyond the Myth

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

Despite cats being susceptible to a wide array of external and internal parasites, they often remain unprotected in spite of a market with safe and effective parasiticide products. It is also important to remember that indoor cats are at risk just as much as outdoor cats. Adam Christman, DVM, MBA, of 

, spoke with Susan Little, DVM, PhD, DACVM about how common some of these risks are, what to do about them, and how to break down barriers for feline parasite protection.

Common misunderstandings about flea infestations in cats.

Flea denial is real. One misconception is that fleas are seasonal, regional, or there is a thought of “not my cat.” We also have the feeling that cats are good groomers and independent, so they’re going to remove the fleas they have. However, as veterinarians, we know they can’t get them all and they need to be on flea control to eliminate those infestations.

Fleas are more than happy to come indoors to set up the infestation. If it’s not a cat going outside, it could be a dog or human in the same household that transmits the fleas to the cat. There is a report from a few years ago that said 10% of pet cats in the US had fleas, with regional numbers of 17% in the southeastern US and 20% in the Pacific northwest.

Another misconception is that once fleas are discovered, there won’t be a problem anymore after treatment. As fleas build up in an environment—because of the larvae and pupae—the adults will emerge and reinfest the cat. Cats and people don’t live in closed environments. We are continually reintroducing fleas and that is why they have to be protected.

What information do veterinarians need to consider when we think about tapeworms?

 because cats often ingest fleas as part of their normal grooming habits. We haven’t been able to document that tapeworms are very common in cats until very recently because fecal flotation doesn’t have a high sensitivity for eggs due to their weight and low likelihood of floating. Newer antigen and PCR testing is how we discovered the high number of infected cats nationally. 5-10% of cats nationally are infected with 

Although many people are familiar with flea infestations in cats, we often hear that “cats don’t get ticks” or “I’ve never seen a tick on my cat.”

some of the myths associated with ticks in cats?

Not only do cats become infested with ticks, they also can become infected with tick-borne diseases that are potentially fatal. The most serious tick-borne disease in cats in North America is cytauxzoonosis, which is transmitted by the lone star tick, 

. Lone star ticks are expanding both geographically and seasonally. We’re seeing activity from them most months of the year. So tick prevention is needed all year-round rather than certain months of the year.

Cats will develop a severe, highly febrile disease. They may also be extremely lethargic and even jaundiced. We perform a blood smear to identify the organisms.

Roundworms are phenomenally common in cats. Cats never get the age-related immunity that dogs do, especially cats that have access to prey species which they ingest, like rodents or birds. Combining a cat’s love for hunting with less frequent parasitic control means that so many cats are not protected from infection. Cats remain susceptible to roundworms throughout their life, meaning they’re going to be shedding eggs that will then contaminate the environment. These larvae then present a zoonotic risk. Hookworms can infect cats as well, but roundworms are more prevalent. Their natural behaviors increasing their exposure to these parasites are a good reason for vets to recommend a broad spectrum parasiticide for their feline patients.

Better ways to understand and protect felines from parasitic infections