 dives into the world of animal pain and behavior with guest Michael Petty, DVM. Petty joins host Adam Christman, DVM, MBA, to discuss how pain can cause significant changes in an animal's behavior. 

From litter box avoidance in cats to social withdrawal in dogs, this episode explores common examples of pain-induced behavioral shifts. Petty also emphasizes the importance of veterinarians considering pain as a potential culprit behind behavioral problems and offers tips for educating pet owners about this crucial link.

: Do you think that the pendulum has shifted in terms of the pet parents perspective on knowing that animals experience pain? And when they're getting older, there is to your point of arthritis and other ailments.

I tell you, the pendulum is a very, very slow swing that way, both in professionals and the caregivers of animals. No one wants to think that their pet is in pain. And so they often write this stuff off as, 'oh, my dog is old, my dog is just...fill in the blank.' And as veterinarians, if the owner doesn't bring it up to us, in these days, everyone's got a tight, tight schedule. Maybe it's at the back of your mind, and maybe it isn't, but you might have a tendency to not really ignore that behavior or you might have a tendency to ignore the behavior or ignore some of the subtle signs, or even take the time to do a proper pain exam on a dog that might need it. For example, a dog that's prone to hip dysplasia, a breed like a golden doodle, and the dog 6-years-old years old, it's time to take a look.

Podcasts

Adam Christman, DVM, MBA, and Michael Petty, DVM, discuss chronic pain in pets and how it can affect their behavior 

I know that dog has chronic pain, now let's convince the owner

The emergence of new veterinary clinics across various communities nationwide signifies a notable advancement in elevating pet care and expanding service availability. These modern facilities incorporate advanced technology and proficient veterinary experts dedicated to delivering exceptional medical care. With their steadfast commitment, these providers not only nurture pet welfare but also reinforce the connection between owners and their companions.

Here are 3 recent clinic and at-home services opening across the country:

CityVet, a Dallas-based network of veterinarian-owned practices, comes to Virginia with its first location opening in Virginia Beach in the the Lynnhaven neighborhood at 2005 Lynnhaven Pkwy Ste. 106. The new clinic is set to open by the end of the summer and is actively looking for veterinarians to join the team.

“As we open new locations, we are continuously looking for markets where we see a much needed consumer and veterinarian demand,” said David Boguslawski, CEO of CityVet, in a news release.

 “We are excited to grow our footprint in the Virginia Beach area as we see an opportunity in the market to provide outstanding veterinary care and introduce our unique business model.”

This Virginia Beach location, just like each CityVet clinic, will be equipped to handle medical and surgical conditions, including hospitalization when necessary, along with grooming services, dental care, and various therapies.

GoodVets in West Midtown Atlanta, Georgia

GoodVets West Midtown. (Photos courtesy of GoodVets)

GoodVets, veterinary care network, proudly opened its latest Atlanta location: GoodVets West Midtown. The clinic is located in the West Midtown area of Atlanta, Georgia on the second floor of the Interlock tower. At 2516 square feet, GoodVets West Midtown features 4 meticulously designed exam rooms, a state-of-the-art surgery and x-ray suite, a lift table for enhanced patient care, and an oxygen cage to provide life-saving aid to pets during emergencies.

Charles McMillan, DVM, at the front counter. 

 editorial advisory board member spearheaded the opening of this West Midtown location. He stated in a company release, “Although the work is never done, it's cathartic to be able to step back every once in a while, and marvel at what you've accomplished. This has been a challenging road that I could not have navigated without my unwavering support structure.”

, serving the West Buckhead community in Atlanta. Since then, he has opened several more locations.

"Atlanta is a competitive market, but I believe there is room for everyone as we increase access to care, and more importantly, access to quality pet care. I remain jealously committed to being the change I want to see in the industry and providing often devalued groups, oft forgotten and forced onto the margins, a place they can comfortably come and cultivate their dreams of becoming a veterinarian,” he added.

The Vets, leaders in at-home veterinary care, expand its services to Atlanta, Georgia. The Atlanta community will now be able to have a veterinary care model that comes directly to them in the comfort of their own homes. The Vets offers an extensive range of services, including wellness exams, vaccinations, sick visits, and comprehensive wellness plans.

“At The Vets, we’re proud to set a new standard for excellence in veterinary care. Our at-home model provides pets and their owners with the high quality, stress-free medical care right where they are most comfortable,” said Esben Mou, chief operating officer of The Vets, in a release.

 “We are thrilled to extend our home visit services to the local Atlanta pet parent community.”

The Vets Atlanta team will be led by Constance Drivick, DVM, and can serve neighborhoods across the city, including Marietta, Smyrna, Norcross, Duluth, Roswell, Stockbridge, College Park, and more.

CityVet, a leading network of veterinary-owned practices, is expanding to virginia with a new location in Virginia Beach. News release. CityVet. March 7, 2024. Accessed April 10, 2024.

GoodVets West Midtown: A new modern upscale addition to Atlanta's pet care landscape. News release. GoodVets. April 10, 2024.

The Vets Brings Stress-Free, At-Home Pet Care to Atlanta Families. News release. The Vets. April 2, 2024. Accessed April 10, 2024.

Articles

Take a look at these 3 veterinary clinics and mobile care newly opened or coming soon

Clinic center: New practice locations across the United States

Soho, a cockapoo, ingested the rodenticide Vacor during a family vacation in a rental home(Image courtesy of Pet Poison Helpline) 

Geoff Pender and his family decided that they wanted to go on vacation to the lake, and brought Soho, their cockapoo along for the trip. While at the rental cabin, the family noticed that Soho managed to pull something out of a crack where a stone fireplace was pulled away from the wall. Upon further examination, the family discovered he had pulled out Vacor, a deadly rat poison that was removed from shelves in the United States in the late 1970s.

"It was certainly a very dramatic situation," said Pender, in an organizational release.

 "We were sitting around the cabin when my son noticed that Soho had gotten into something tucked behind the fireplace. She ripped open the packaging and powder went everywhere. After we realized that it was rat poison, we knew we needed to urgently get this dog to the hospital. We also called Pet Poison Helpline, who gave us initial guidance and started collaborating with the veterinarian on a treatment plan."

According to the release, rodenticides like Vacor have a very narrow margin of safety, and pets who ingest rodenticides can present with an upset stomach, heart rate and rhythm abnormalities, low blood pressure, as well as neurologic signs such as significant depression, body tremors, and seizures.

 In some cases, damage to the pet’s pancreas can also occur.

"Rodenticide poisoning is unfortunately a very common occurrence," explained Renee Schmid, DVM, DABT, DABVT, senior toxicologist at Pet Poison Helpline.

 "In fact, rodenticides appear twice on our list of 

." Signs of rodenticide poisoning vary depending on the product's active ingredient but may include vomiting, anorexia, lethargy, incoordination, tremors, seizures, paralysis, increased drinking and urination, kidney failure, bruising, new swellings due to bleeding, and difficulty breathing.

Realizing the severity of what Soho ingested, the family rushed him to the closest emergency hospital located 45 miles away in Kingston, Ontario, Canada. Once there, the team at the Kingston Regional Pet Hospital induced vomiting and administered medical-grade active charcoal. The team at the hospital was advised by the Pet Poison Helpline to provide IV fluid therapy to help with cardiovascular perfusion and monitor Soho’s heart rate, rhythm, and blood pressure closely. They also monitor Soho for the development of neurologic signs and monitor blood glucose levels.

The Pet Poison Helpline team also recommended continuous monitoring of Soho’s blood glucose levels weekly post-ingestion to be on the lookout for potential damage to her pancreas.

Soho was successfully treated at the Kingston Regional Pet Hospital and released; however, she has since developed an issue with her liver. The family will be closely monitoring her to see if the liver issues are in connection with the rodenticide ingestion.

The Penders are also encouraging all property owners while they are doing any spring cleaning, especially those renting or sharing their homes, to inspect their property to help prevent dangerous situations.

"When you rent a vacation property, especially one that is advertised as pet friendly, you don't expect to have your dog poisoned by something hidden in the house," said Schmid. "While Soho's poisoning occurred away from home, we would like to remind all pet lovers to check their surroundings for dangerous materials regardless of where they are at."

Spring cleaning for pet poisons. News release. Pet Poison Helpline. April 10, 2024. Accessed April 10, 2024. https://www.prnewswire.com/news-releases/spring-cleaning-for-pet-poisons-302112165.html

Pet Poison Helpline shares why clients should be looking for deadly rodenticides with the story of a cockapoo named Soho

Watching out for hidden pet poisons this spring 

Alabama, Arizona, Arkansas, California, Delaware, Florida, Hawaii, Idaho, Kentucky, Louisiana, Mississippi, Nebraska, North Carolina, Pennsylvania, Tennessee, Utah, and West Virginia all announced that they have restricted travel on domestic cattle importations from the states where cattle have been exposed to highly pathogenic avian influenza virus (HPAI, specifically avian influenza Type A H5H1).

 Currently, H5H1 has been confirmed in 9 Texas dairy herds, 3 in Kansas, 2 in New Mexico, and 1 in Ohio, Michigan, and Idaho.

Currently, the USDA’s Animal and Plant Health Inspection Service (APHIS) is not issuing federal quarantines on cattle nor recommending any state quarantines or official holds on cattle. For cattle that must be moved, APHIS is encouraging veterinarians, animal health officials, and producers to be extremely diligent to be sure only healthy cattle are being transported and to ensure the validity of interstate health certificates.

In a guidance document released by the APHIS, it disclosed that the situation is rapidly evolving and new information is being received, reviewed, and analyzed constantly to make informed and adjusted recommendations accordingly. All testing on cattle is currently being done voluntarily and is a tool producers can use to help manage the diseases or reduce the risk of introducing them to new cattle.

Along with the cattle affected, 3 cats living on an affected farm in Texas have tested positive for the virus. It is currently believed that the primary vectors of the virus are wild birds, which have been shown capable of now infecting other species of mammals besides cats.

 The World Health Organization wants people to avoid unprotected exposure to sick or dead animals, including poultry, domesticated birds, wild birds, and other wild or domesticated animals. They should also avoid animal feces, litter, and materials contaminated by birds or animals that are either confirmed or suspected of H5N1.

Although APHIS is not issuing federal quarantines, it is recommending minimizing as much movement of cattle as possible and not moving sick or exposed animals. Cattle sick with this disease commonly present with low appetites and reduced milk protection. The animals affected have recovered after isolation with little to no morality reported.

States begin to restrict cattle imports from those with influenza cases. News release. American Veterinary Medical Association. April 9, 2024. Accessed April 10, 2024. https://avma.org/news/states-begin-restrict-cattle-imports-those-influenza-cases?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

Testing recommendations for influenza a in cattle. Accessed April 10, 2024. 

https://www.aphis.usda.gov/sites/default/files/nvsl-hpai-dairy-testing-recommendations.pdf

States with HPAI-infected dairy cows grows to six. News release. American Veterinary Medical Association. April 4, 2024. Accessed April 10, 2024. 

https://www.avma.org/news/states-hpai-infected-dairy-cows-grows-six

Cattle from states with influenza cases are facing travel restrictions, despite WOAH recommending against it 

Multiple states announce cattle import restrictions 

Joshua Broadwater, DVM, DACVO, veterinary ophthalmologist at the Charlotte Animal Referral & Emergency in North Carolina, highlighted the importance of understanding normal corneal anatomy before addressing abnormalities like corneal ulcers during his session at the 

 of this article, he outlined how corneal ulcers occur, including inadequate tear production, trauma, and foreign objects, which could potentially lead to an infection. Broadwater advised a thorough examination to identify underlying pathologies contributing to ulcers but cautioned veterinary professionals with diagnostics if the ulcer is especially deep.

Now that a corneal ulcer is identified, how can it be treated? If an ulcer is severe and deep, it may need a referral to an ophthalmologist for surgery. However, some cases may be rectified with medical management, which can be handled by a general practitioner. Overall, Broadwater recommended that ulcers with less than 50% stromal depth can be managed medically and monitored closely and ulcers of greater than 50% depth should likely pursue a referral to an ophthalmology specialist.

According to Broadwater, infected corneal ulcers are one of the most common causes of pain and vision loss in dogs and cats. However, with prompt and appropriate treatment, these poor outcomes can be avoided.

Broadwater stated, “The general 3 things to be aware of when you are thinking about treating these is treat, control, and prevent. Treat the infection. Control the pain; these are super painful, and I think it's overlooked of how painful ulcers are. Prevent self-trauma; e-collars for these [patients] are essential. Old school, hard plastic e-collars are the only ones that are going to work for this. Otherwise, they are going to ruin these eyes and they are going to make them worse in a short period of time.”

Overall, these cases need to be treated aggressively. Broadwater recommended using frequent topical antibiotics, every 1 to 2 hours. Prescribing drops over ointments is preferred because of its efficacy in treatment and penetration abilities. “Oral antibiotics would be great and injectable antibiotics would be great [in theory], except there's no blood supply in the cornea. And it's probably not going to be there for a little while,” Broadwater said. “Sometimes you have to wait for the blood vessels to get there, but you got to fight that battle until then.”

“I usually start with broad spectrum antibiotics until my culture is available and we see if we have to change it. So, I use fluoroquinolones and I tend to stay away from tobramycin or gentamicin, again, until my culture becomes available,” he added.

Once you have the proper antibiotics to treat the infection in the cornea, the next focus of treatment is stopping the “melting” process of the matrix metalloproteinases (MMPs) 2 and 9, which is an enzymatic degradation of the cornea. This is caused by the infection but needs additional medical management to combat.

To fight the enzymatic degradation and melting of MMP-2 and MMP-9, Broadwater advised to use topical serums or oral doxycycline. “We talked about oral antibiotics being of limited use and while that's true, doxycycline is probably the one exception. We're not really using it to treat the infection, per se. We're using it to stop that enzymatic degradation,” Broadwater said.

Once the infection and enzymatic degradation is being treated, the final thing to focus on is treating the pain, because these cases can cause high levels of pain for patients. Topical or oral pain medication will work effectively, and a combination of both can also be an option. The brand can be dependent on your own preferences, according to Broadwater.

Avoid topical steroids and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in these cases, however oral NSAIDs are safe. Broadwater stated that topical steroids and topical NSAIDs, “can increase the risk of infection at that time.”

Overall, when faced with an infected corneal ulcer that appears excessively deep or complex, seeking referral to an ophthalmologist stands as an invaluable resource. By doing so, patients can receive specialized care, including potential surgical interventions if necessary. Nonetheless, equipped with adept medical management skills, general practitioners play a crucial role in the initial assessment and treatment of such conditions.

For more coverage from Fetch Charlotte, visit our dedicated conference news page at 

Broadwater J. Infected corneal ulcers: medical and surgical management. Presented at: Fetch dvm360 Conference; March 15-17, 2024; Charlotte, NC.

After diagnosing an infected corneal ulcer, determine the appropriate medical management as a general practitioner or determine if it needs surgery from an ophthalmologist

Mastering corneal ulcers (part 2)

Officials with the FDA have approved pradofloxacin injection (Pradalex; Elanco) solution for certain respiratory diseases in cattle and swine. Pradofloxacin is a medically important antimicrobial in the fluoroquinolone class and may only be prescribed by a licensed veterinarian as a single injection, according to the FDA.

The FDA’s approval for this pradofloxacin injection is indicated for the treatment of bovine respiratory disease (BRD) associated with 

Mannheimia haemolytica, Pasteurella multocida, Histophilus somni

 in cattle intended for slaughter and cattle intended for breeding that are less than 1 year of age. Notably, it is not approved for use in cattle intended for breeding 1 year of age and older, beef calves less than 2 months of age, dairy calves, and veal calves.

The FDA also approved pradofloxacin injection for the treatment of swine respiratory disease (SRD) associated with 

Bordetella bronchiseptica, Glaesserella (Haemophilus) parasuis, Pasteurella multocida, Streptococcus suis

 in weaned swine intended for slaughter. This prescription drug is not indicated for use in swine intended for breeding or nursing piglets.Each mL of the approved product contains 200 mg of pradofloxacin, and it is supplied in 100 mL and 250 mL bottles. The drug is administered by subcutaneous injection in cattle at 10 mg/kg body weight and by intramuscular injection in swine at 7.5 mg/kg body weight.

Over the past several decades, the FDA has implemented policies to help ensure that medically important antimicrobials approved for use in animals are used in a manner that is consistent with principles of antimicrobial stewardship. For example, all medically important antimicrobials for animals require the authorization of a licensed veterinarian because the FDA believes that, given their specialized training and experience, veterinarians play a critical role in antimicrobial stewardship and can help reduce the risks of antimicrobial resistance.

Elanco’s pradofloxacin injection is a 3rd generation fluoroquinolone, which is ranked as a critically important antimicrobial, and the labeling of the drug includes a statement that it should be used only after considering other, nonfluoroquinolone therapeutic options. Additionally, since 1997, the FDA has prohibited the extra label use of fluoroquinolones, such as pradofloxacin injection, in food-producing animals for any indication other than those the agency has approved.

The sponsor conducted multi-site field studies to demonstrate that pradofloxacin injection is safe and effective for treating BRD in cattle and SRD in swine. The FDA also assessed the safety of edible products from cattle and swine treated with this drug.

FDA approves new antimicrobial drug for cattle and swine. News release. FDA. April 9, 2024. Accessed April 9, 2024. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-approves-new-antimicrobial-drug-cattle-and-swine?utm_medium=email&utm_source=govdelivery

Elanco's pradofloxacin injection (Pradalex) must be prescribed by a licensed veterinarian. 