Introduction to DNA Testing

 Hello friends and welcome to VetPerspective. Canine DNA testing has been on the rise for the past four years, becoming more popular in pets than ever. Today, we’re going to discuss the importance of DNA testing, how it works, and provide clients with a unique opportunity of customized care. My Name is Dr. Adam Christman, Chief Veterinary Officer here at DVM360. Thank you so much for joining us. We want to thank our friends from Embark for supporting this great discussion and let’s meet our wonderful colleagues! We have Dr. Lindsey Kock here and Dr. Jenna Dockweiler. How are you, my friends?

Lindsey Kock, DVM, and Jenna Dockweiler, MS DVM, DACT, CCRT, CVAT: 

Thanks for being here! Okay, so a little bit of information about our wonderful friend, Dr. Kock. She is a second-generation veterinarian from Nebraska, began her academic journey at Doane college, earning a degree in biology with a minor in chemistry. Lindsey completed her formal veterinary education as a member of the second class in the professional program in VetMed through the University of Nebraska and Iowa State University. Launching her career as an associate mixed animal veterinarian in Southwest Iowa, Lindsey was awarded the Iowa Veterinary Medical Association’s Rising Star in 2015.

After four years in clinical practice, Lindsey traded in her truck for an office job and had the opportunity to travel around the world leading the companion animal genomics business at Neogen. She was awarded Neogen’s Animal Safety Product and Marketing Manager of the year in 2020.

In 2022, Lindsey founded Deep Dive, DVM Veterinary Consulting, focusing on the adoption of data-driven technologies and animal health. Concurrently, she serves as the head of the Healthcare Product Management Division at Edcetera. Under her guidance, Edcetera’s Veterinary Portfolio, featuring prep, tech prep, etcetera, has flourished, providing essential resources for board exam preparation and professional development. We know how important that is, right?

We also have Dr. Jenna Dockweiler with us. She graduated from Kansas State University’s College of Vet Medicine with honors in 2014 and completed her small animal rotating internship at Wheat Ridge Animal Hospital in 2015. She then completed her comparative theriogenology residency at Cornell University in 2017 and became a diplomat of the American College fo Theriogenologists that year. She practiced small animal theriogenology and general practice for four years prior to becoming a veterinary geneticist with Embark veterinary.

In her spare time, Dr. Dockweiler enjoys photography, hiking, and competing in performance events and conformation with Welsh Springer Spaniels. Those are beautiful!

Jenna Dockweiler, MS DVM, DACT, CCRT, CVAT: 

All right, everybody. We want to chat about the very basics about canine DNA testing. You know, it’s been so popular as you know, Jenna. Let’s kind of take a little bit of a step back and talk about DNA testing in general. Give us a little overview of how Embark DNA testing works and is a blood test necessary?

Jenna Dockweiler, MS DVM, DACT, CCRT, CVAT:

 Absolutely. It is a simple cheek swab that can be performed at home or in the clinic. It’s a soft swab, so it’s not bristly. It’s very comfortable for the patient. You collect that simple little cheek swab, pop it into the mail with our prepaid USPS mailers, and send it off to the lab. At our lab, what happens is the DNA sample from the patient is amplified. So, many copies are made of that DNA. It is washed over our microarray platform, which just looks like a little microscope slide that has thousands of tiny little beads on it, and those beads are called probes. And each one of those little probes is designed to assess the genome at a predetermined location. Those probes could be relevant to health conditions. They could be relevant to physical traits, breed ancestry, or just be pointed at areas of interest in the canine genome. Once we have our genotype—at all of those over 230,000 predetermined locations—we then can provide a report that gives breed ancestry, health conditions, and physical traits.

 Okay, what’s the turnaround time for that?

 About two to four weeks from when we receive the sample from the lab, we’ll have results back to you.

Videos

Meet Lindsey Kock, DVM, and Jenna Dockweiler, MS DVM, DACT, CCRT, CVAT as they prepare to discuss canine DNA testing. 

Introducing Lindsey Kock and Jenna Dockweiler

“How common is allergic disease?” Julia E. Miller, DVM, DACVD, asked attendees at the Fetch conference in Charlotte, North Carolina.

 The answer: fairly common, when comparing to all other reasons pets come into the veterinary clinic. 

Miller, an assistant clinical professor of dermatology at Cornell University College of Veterinary Medicine in Ithaca, New York, shared evidence of this commonality with data conducted by Healthypaws insurance in 2017-2018. The data found 39% of veterinary clinic cases were dermatology related, and specifically allergies. This 39% was comprised of 17% to 22% skin conditions, 12% ear infections, and 5% other allergies.

 Miller also shared with attendees that the word “atopy” comes from the Greek word “atopia” which means uncommonness. This is ironic with how common it is for veterinary medicine.

Allergic dermatitis occurs the pet’s skin develops an allergic reaction, but veterinary professionals need to identify what is causing the dermatologic condition, before diagnosing it properly. To start, a thorough history for each patient should be taken, and it should include the following components:

Atopy is typically seen at ages 1-4 years, however there are exceptions in French bulldogs, bully breeds, German shepherds, Wheatons, and more.

38% of dogs develop a food allergy at less than 6 months of age.

What season was it at onset? (This can point to an environmental allergy vs a food one)

Is the dog taking a flea preventive? What is it? How often is it applied? What is the proper application technique?

Are there any gastrointestinal signs present? (This may point towards a food allergy)

Atopy cases are more common for an allergic disease, affecting 10% to 15% of dogs. Some common signs include scratching behind the elbows, licking and chewing the feet, rubbing at the face, and scooting. Excessive scratching and licking may also contribute to hair loss.

According to Miller, 10% to 25% of atopy dermatitis cases are caused by a food allergy. Food allergy, more formally referred to as 

, is an adverse immunologic reaction to an allergen in the diet. Food allergy is commonly a protein such as chicken, beef, lamb, or fish, however, any carbohydrate or fat may also be an allergen. Diagnosing a food allergy can be quite frustrating since it presents very similarly to environmentally-caused allergies. The same signs of scratching, licking, and scooting can be present. To get an accurate diagnosis, there needs to be a strict, prescription diet trial.

Over the counter diets are not a prescription diet trial but can be called a diet change. Home-cooked is the best practice with strict guidelines from your veterinary dermatologist.

According to Miller, after 3 weeks on a diet trial, more than 50% of dogs will show improvement. After 5 weeks, more than 85% of dogs show improvement, and after 8 weeks, this jumps up to more than 95% of dogs showing improvement. Miller stated, “So the way that I feed diets is I have the client check back in with me at 4 to 6 weeks. If there is zero change in 4 to 6 weeks, I am done. I do not feed that diet for another 2 months. If there is some change in that 4-to-6-week plan, I continue the diet a little bit longer and see how good I can get it.”

However, Miller cautioned attendees to not bother with the diet trial if the client is unwilling or cannot do it right. She emphasized that diet trials are tough because of how strict they are and how consistent clients need to be with them. “If a client is unwilling or unable to do it at trial, just don't do it,” she said.

Miller JE. The itchy and scratchy show: How to confidently diagnose canine allergies (part 1). Presented at: Fetch dvm360 conference; Charlotte, North Carolina; March 15-17, 2024.

Common dog and cat illnesses and accidents. Healthypaws Pet Insurance and Foundation. 2017-2018. Accessed March 15, 2024. 

https://www.healthypawspetinsurance.com/common-pet-illnesses-and-accidents

Collins B. Atopic dermatitis (atopy). Cornell University College of Veterinary Medicine. Accessed March 15, 2024. 

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

Articles

Brush up your knowledge on allergic disease for the itchy dog

Finding the root of the allergy

Caitlin DeWilde, DVM explains why marketing and social media can be important for your veterinary practice

Making client education easier with veterinary marketing

In an interview with Caitlin DeWilde, DVM, founder of The Social DVM, she explained why marketing and social media can be an important part of your business and how it can help clients. From her sessions at the Fetch conference in Charlotte, North Carolina, she hopes attendees take away something practical to start implementing in their clinic.

 I've always been a little bit of a nerd, but what really kind of started my passion was almost a decade ago. As a veterinarian, I was getting really frustrated with clients looking things up in the exam room as I was trying to explain something to them. And I finally asked somebody. I was working with this cat that was blocked, and it was pretty urgent and I needed authorization to move forward with treatment. And the owner was just looking at his phone. I said, 'Sir, do we need to call somebody else? How do we move this forward, I gotta get back to your cat.' And he said, 'Well, I'm trying to find your website to see if you I can find some information about this so I can just send it to my wife so that she will understand because I'm never going to understand all this stuff that you're explaining to me.'

Caitlin DeWilde, DVM, explains why marketing and social media can be important for your veterinary practice

Shawn McVey, MA, MSW, chief cultural officer of Veterinary Growth Partners, on stage at the Fetch Charlotte conference.

“The grass is always greener on the other side” is a thought process that can often cause people to move on to something that seems better, but in reality, moving doesn’t always solve the problems you had to begin with. If you are unhappy in your veterinary practice because the workplace culture is not healthy, sometimes moving to a new practice can seem like a good option. And sometimes it is. However, Shawn McVey, MA, MSW, chief cultural officer of Veterinary Growth Partners, would argue that, most of the time, if you leave a practice because of its cultural, there is still going to be a problem at the next clinic. 

McVey told attendees at the Fetch conference in Charlotte, North Carolina during his keynote presentation

 that, “for the vast majority of you to work on the business need, you have to work on yourself. And my experience in veterinary medicine has taught me that many of you do not like working on yourself. In fact, many of you will go to the ends of the earth to avoid working on your stuff, including changing practices, changing partners, changing cities, only to find out that wherever you go, there you are. And you still have to deal with 

McVey explained that working on yourself first is crucial to bringing your best self to work. An entire workplace culture can suffer if each individual team member is not showing up to work with a positive attitude and energy. “There's this key element in any practice that actually makes it valuable, and that key element is culture,” he added.

According to McVey, there are 6 elements that contribute to a clinic’s culture and how each member of the team carries these elements:

“Culture is the collective opinions, beliefs, and attitudes of the people that make up any organization,” McVey said. However, he also reminded attendees that the culture is active when people 

 on these opinions, beliefs, and attitudes. A practice culture comes from how people act each and every day at work. It sometimes doesn’t matter what values the practice may have, it’s more about the actions of the team, rather than the words. However, if a practice wants to live up to their values, then their actions need to reflect that. “We don't talk about it because when we start to talk about culture, we have to start talking about people's behavior,” McVey continued.

McVey cautioned clinics to avoid referring to their culture as a family. “A lot of people say that we have a family environment in our hospital, and it makes me want to throw up in my mouth when I hear 

,” he said jokingly. “In family, you make a conscious decision to put up with people for 30, 40, 50, 60 years. And you come up with coping strategies to work around them for 50 or 60 years, including only seeing them a couple times a year. We can't operate like that at with people at work, there can't be untouchable subjects at work.” A veterinary team is people you work with everyday and it would make daily work difficult to complete if you had to tip-toe around certain people all the time.

According to McVey, stress is the single biggest response for a negative work culture. Inconsistency in a work environment and especially from leaders can create uncertainty and stress. “Stress comes from not knowing when the other shoe is going to drop. I don't know what the rules are. The rules change every single day,” McVey explained.

So, how do you make a good culture? McVey believes that the following elements can help improve your culture:

Focusing on well-being and work-life balance.

Strong leadership that embodies the good culture of the clinic.

McVey shared a 1400-response survey that showed veterinary practices received the following scores for workplace culture:

McVey emphasized that most of these scores would be a failing grade in a regular academic setting. If veterinary students are held to a higher standard for passing classes, then veterinary practices should be, too. All of these areas of a veterinary business can be improved. And if the leadership in a veterinary practice starts to take this seriously, the employees will have more respect and loyalty for the place they work.

McVey left attendees with one more note: “Finally, you have to respect the culture.” He explained that once you improve the culture, everyone in the practice needs to respect it by upholding the values that were collectively decided on.

McVey S. Culture karma: What are you creating in your practice? Presented at: Fetch dvm360 conference; Charlotte, North Carolina. March 15-17, 2024.

Keynote speaker for the Fetch conference in Charlotte, North Carolina, Shawn McVey, MA, MSW, explained how to first evaluate yourself and then apply that awareness to your workplace culture

How do you contribute to your clinic’s culture?

Many veterinarians care for exotic pets from various species. Providing medical care for these patients requires handling unique to each species. As such, many veterinary professionals are not comfortable working with exotic patients, according to Katrina Lafferty, BFA, RLAT, CVT, VTS (anesthesia/analgesia), senior technician in the anesthesia and pain management department and director of the veterinary technician internship program at the University of Wisconsin-Madison, Veterinary Medical Teaching Hospital.

2024 Fetch dvm360 conference in Charlotte

, North Carolina, Lafferty discussed basic techniques for safely and humanely handling rabbits for medical procedures.

 “[Rabbits] are probably the most common species that you are seeing if you have a practice that sees any kind of exotic animals,” she told the audience. “These are the third most popular pets after cats and dogs.”

Lafferty first discussed how improper restraint can injury a rabbit. Fractured legs, damaged pinna, vertebral dislocation or fracture, are some of the consequences of mishandling and can lead to euthanasia.

 “This is why everybody is afraid of bunnies because they’re afraid that they’ll break their back,” she said.

Although muscular in the thighs, she said, rabbits are lighter boned than other species.

 “The reason for this is so that they can move quickly away from a predator,” Lafferty said. “If they’re not against the ground and they kick out their back legs with nothing to stop them, they can actually make a full 180 [degree] arc. That’s where the fracture comes into place. If they kick out their back legs without anything to stop them, that’s where they can dislocate or fracture their backs.”

To prevent vertebral dislocation or fracture, Lafferty said, ensure hind legs are secured. “You’re always supporting the hind end,” she added.

 Handlers should also avoid restraining a rabbit by the ears, which can cause pain and cartilage damage.

Veterinary handlers can also become injured when using an improper restraint technique with these pets. Lafferty noted that deep scratches and bites are common consequences of mishandling rabbits.

In removing a rabbit from a cage, Lafferty recommended that handlers do not lift the patient but rather slide the animal toward you. The feet should be on the ground until the rabbit is in the handler’s hand, she noted.

Handlers should be holding one hand on the scruff of the neck while supporting the rump and /or hind legs firmly with the other hand. Proper restraint of the hind legs will help prevent the pet from kicking, avoiding injuries to the rabbit and handler.

Lafferty said she also secures rabbits during transport by holding a hand on the scruff of the neck, and the rump in the other hand while transporting these patients. “I’m making sure that I’m controlling both ends of the patient,” she said.

Restraining a rabbit during transport can also be accomplished by holding a pet like a football, Lafferty said. In doing so, the patient’s head is placed in the crook of the arm supporting the body with the other hand holding the scruff of the neck.

 “They go into a state of ‘if I can’t see anything, nothing can hurt me’,” she said.

Another restraint technique is “the burrito.” This method requires a towel and swaddling the rabbit, “like a baby,” Lafferty said. None of the limbs should be able to kick out, but she cautioned about wrapping the towel too tight, which can restrict the airway and breathing.

Additionally, with the burrito technique, the ears should remain exposed.

 “They thermoregulate through their ears,” Lafferty said. “If you have those ears tucked within a towel or a blanket, they’ll overheat rapidly.”

Characteristically nervous, timid and excitable, rabbits can be startled when approached and sometimes resist restraint. Excessive stress is a concern for both the rabbit and handler. Restraining a rabbit in a gentle but firm manner will often cause the animal to calm down.

“Never remove them from the cage without supporting the back end. Never pick a rabbit up by its ears, and never put a rabbit into a cage head first,” Lafferty emphasized.

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

You gotta know when to hold ‘em: exotic animal restraint. Presented at: Fetch dvm360 Conference; Charlotte, NC. March 15-17, 2024. Accessed March 15, 2024. 

https://ce.dvm360.com/learn/course/fetch-charlotte-2024-proceedings/proceeding/fetch-charlotte-2024-conference

Rabbit handling. University of Bristol. 2023. Accessed March 15, 2024. 

https://www.bristol.ac.uk/media-library/sites/vetscience/documents/clinical-skills/Rabbit%20Handling.pdf

Animal specific training: rabbits. University of Wisconsin-Milwaukee Animal Care Program. Accessed March 15, 2024. 

https://uwm.edu/animal-care/training/manual/rabbits/

In a lecture at the Fetch Charlotte conference, Katrina Lafferty, BFA, RLAT, CVT, VTS (anesthesia/analgesia) discussed the dangers of improper handling for rabbits and best practices for improving outcomes.

Preventing injury in rabbits with proper restraint

Joya Griffin, DVM, DACVD, explains what makes diagnosing and treating allergic disease in cats so difficult 

The challenges of feline allergic disease

Joya Griffin, DVM, DACVD, explained her start in veterinary dermatology and why she is passionate about this field of work. She also described the lack of information surrounding feline allergic disease and the lack of treatment options available compared to what is known about canine allergic disease.

 I had a pet that was my family's dog when I started vet school and she had terrible skin. And of course, this was before we had drugs like Apoquel [Oclacitinib] and Cytopoint [Lokivetmab], available to us. And she would cycle through infection after infection after infection to the point where she had to live in a little e-collar. Our family groomer actually had recommended that we euthanize her. And I just thought this was so terrible... So, I took her to Cornell [University] with me my first year there and the first thing I did was I made an appointment with the dermatology service. They were able to make an amazing, complete transformation in her skin. They literally gave me my dog back, and I saw firsthand what that meant.

Cats are just challenging in general and unfortunately for feline allergy, we don't know as much as we do for the dog counterpart. And unfortunately, we don't have a lot of the same medications for use in cats. There's very little treatment options that are actually licensed and labeled for use in cats and so I think that presents a treatment challenge.

Joya Griffin, DVM, DACVD, explains her start in veterinary dermatology, plus what makes diagnosing and treating allergic disease in cats so difficult 