Specialty care

So, tell us a little bit of the clinical signs of why Zahara presented to the veterinarian initially.

So honestly, we didn't have a ton of heads up given for her diagnosis. What happened was, she was getting ready to go for her one of her regular checkups, and it was scheduled on Thursday. And on Sunday, I noticed that I could feel her lymph nodes a little bit when I was just, you know, checking her up in the morning, putting on her collar. And I said, how that's interesting. Maybe she has an infection. I'm going to see the vet anyway, this week, we'll check it out. And they actually, you know, became more distinct over the course of those few days, go into the vet have a normal checkup. And quite frankly, everybody thought that she was doing great. She, you know, she looks like she's in good condition overall. I mentioned she said, "Yeah, I see that you want to get those aspirated to check." And I said, "Yeah, let's, let's do that." So, she takes an aspirate while we're there at the clinic; they check it. And she's, you know, used to her...she was able to take a quick look using the various diagnostics that they've brought in recently and see that there were abnormal cells. So, when she came back, she was like a 180. You know, she came in very optimistic initially, comes back and very somber and said, "You know, I think that she may have lymphoma, and that you should go get a consult with Dr. Wolfe to figure out what is the next thing to do for her." And within just that short period, she went from just detecting them by just palpating them to actually being visible, within a very short period of time. So, my assumption is that this was a very aggressive form of lymphoma. And that when I did get a chance to actually talk to Dr. Wolfe, she asked me if I wanted to start chemo that day. And I said, yeah, you know. I realized that this was dire, and that this was kind of a now or never situation. And I said, "Well, let's give it a shot." And Dr. Wolfe, with her extensive experience, really made me feel comfortable and confident in this decision.

That's wonderful. So what was that experience like then when she referred, knowing that you had a diagnosis of lymphoma, then what happened from that point forward, then the treatment plan?

From that point forward, then we went ahead, and we discussed different options, presented data to her knowing, again, her career background there. And we talked through the different protocols with the most aggressive protocol being CHOP, and what that would entail, and what the visits that would be required in the labs and my expectations for adverse events and financial constraints. And we talked through other options. We did talk through other options that were available, other protocols that were available, but we made a decision together that we were going to pursue CHOP. We had a long in-depth conversation about that I'd never done chemotherapy on a Basenji and so there was a healthy apprehension there and she wasn't your traditional Pitbull/Terrier/Boxer type of case there. And so, we kind of worked together to anticipate any adverse events that we might have. And together, we made a decision that we were going to move forward with CHOP, and we started that day.

Did you use a consultation service at all, too?

I didn't initially with CHOP, I went ahead and elected the 19-week protocol. But after week four, when we had the doxorubicin event, which ended up being a severe hyperproteinemia, hypoglycemia, severe diarrhea, she had to…she actually spent two weeks in our clinic, receiving supportive care throughout this. We knew that we had to change, and that CHOP was not going to be what would be in her best interest. And so at that point, then I did submit a case consultation to the oncology service. I was able to do that online. I was able to schedule an email. That worked better for me. And so she had access to all of the labs. She had access to the images to into the labs, and then my clinical description. And so she gave me different options. And she did it with a little humor as well. There is a funny little sentence in there that made it seem very personalized to me. I could tell that it wasn't any kind of cut and paste consultation. She started by saying, Dr. Wolfe, I think that chemotherapy protocols for COP are a lot like chocolate chip cookie recipes. We each have our own and we each believe that our chocolate chip cookie recipe is the best but at the end of the cooking process, what we have is cookies. And so she gave me different options, but we elected to do COP after that based upon that consultation service. And I did go ahead and respond to her is there one that you have is a favorite and so there's that availability to have dialogue back and forth. So we use the oncology service and decided together that we would move forward with COP, and we are currently on I believe round four.

Oh, That's great. Lisa, having that collaborative approach with the oncologist through the reference lab through Dr. Wolfe. That must give you that confidence to know like we're all in you know on the same page and doing what's best for Zahara, right?

Absolutely. Absolutely. This was you know, again with given my background I really do appreciate getting other expert advice. I really value expertise and so that we had access to just talk to somebody get a consult quickly, really helped make me feel more comfortable and confident in our decisions for her care.

Right. Thank you so much. Thank you so much. Lisa Bono and lots of love to Zahara. We love you.

Videos

See how a vet and a Zoetis Virtual Laboratory specialist worked together to treat lymphoma

The Power of Collaboration: Tackling the Toughest Cases with Zoetis Specialists By Your Side

Joining us today is Dr. Wolfe's client and patient Lisa Bono and Zahara. How are you, Lisa?

Do you have a little video of your fur baby there somewhere? I understand Zahara's there somewhere?

Here she is. Here's Zahara in all of her glory.

So good to see you. So, tell us about Zahara. And what has your experience been with Zahara and her care through the years with Dr. Wolfe.

Actually, Dr. Wolfe and I started working together just earlier this spring afterZahara’s diagnosis with lymphoma. I had been going to see other vets at her clinic. But then when she got the diagnosis, I was referred over to Dr. Wolfe. So, we've had about half a year of knowing each other. Dr. Wolfe has been amazing. I've always felt like she's been...has Zahara's best interest at heart, and I felt very confident in the care that she's provided for Zahara.

Oh, I love that. So, tell us about her recent health issue that was uncovered.

So, Zahara was, as I mentioned, diagnosed with lymphoma earlier this year, and went to talk to Dr. Wolfe and we began a CHOP protocol for her. She was doing quite well for some time until we hit the doxorubicin in the first round of the CHOP protocol. And she just hit a wall pretty fast with that. Within a few days she had severe, severe diarrhea. This is a Basenji, so she doesn't really drool, and she was just copious drool and fluid from all orifices, shall we say. And brought her into Dr. Wolfe. And she spent some time with her there. And we had to then figure out what was going on for her. And I'm sure Dr. Wolfe can go through some more the details of exactly what we had to do. But basically, we had to figure out what was the problem? Was it liver failure? Was it severe GI distress. And what we were able to do was figure out that it was GI distress, but it was a series of different tests that we had to do to try to narrow it down. And it was quite dire at that time. So, figuring out what we needed to do quickly was a challenge.

Sure. And it sounded like diagnostics and urgency were really important at this time. So how important were those diagnostic tests that resulted that turnaround time for you and Zahara?

So I should just give you a little bit of background for myself. I'm actually a professor of biology here at Texas Tech University. So, I do research for a living. I really like data, right? And the ability to have these rapid diagnostics, right, every day, Dr. Wolfe would call me up, we'd have like, a long conversation on the phone and literally go through all of her numbers. So, Dr. Wolfe had to teach me a little bit about what diagnostics we had access to. But then we could go through all of the data for her day by day and compare it to the previous day, so that we could see where things were going with her. And that allowed us to make evidence-based decisions in a very emotionally fraught situation. So, we could make a call very quickly about are we going to continue with this approach or another approach or do other types of tests?

I love this. It sounds like it was so collaborative together.

It was absolutely collaborative. I really appreciated it.

Yeah. So having those diagnostic tests made available quickly seemed very helpful for both of you and for Zahara so you can come together for the greater good of our treatment plan it sounds like.

Yes, as she mentioned, we did those diagnostic tests daily. And there was a there was a moment a few days into her hospitalization that we were deciding together if we were going to move forward with her care, or if if what would be more appropriate to stop treatment. And it was having those diagnostics rapidly available that helped me determine that this was GI distress and not some other type of chemotherapy complication.

She's doing quite well. She brings me toys in the evening. She wants to play with that. She goes with us to our local breweries and likes to hang out with people and dog watch with that. And absolutely, without these diagnostics at that moment, I do not think that she'd be with us here today. And we're actually getting ready to celebrate her 11th birthday in a few weeks. Honestly, when I got this diagnosis, I really wasn't sure that we were going to see her 11th birthday, so I'm pretty excited right now.

Oh, that's wonderful, happy early birthday to her. What would you like other pet parents to know about your experience with Dr. Wolfe and how she uses that as diagnostics.

So one thing that was really helpful for me is that we live in West Texas and what may not be obvious to many of your viewers is that this is a fairly remote part of the country. I grew up in New Jersey, and in the northeast, so I was used to, you know, you go to your vet, and if you need to go see a specialist, you can go down the road. And within an hour or less, you can get to see somebody that will know how to handle these situations. But here in West Texas, Lubbock is the largest thing in any direction for five and a half hours. So, if I needed to go see somebody, see a specialist, we would have to actually drive five and a half hours, right. And that would be really limit the type of care that we could have gotten for Zahara, and to have all these things in house and so fast. I mean, like, you know, again, I love fast data, right? So, we could get these results for her within very short periods of time and make these decisions rather than me having to drive five and a half hours and go see somebody for some of this type of equipment, as we would have, you know, back in the day before this kind of equipment was available. So, it really made it you know, accessible, rather than being cost prohibitive and time prohibitive to do these things.

A pet owner and veterinarian share their story of how they used Zoetis’ Vetscan Imagyst® and Virtual Laboratory to diagnose and treat a dog with lymphoma

Zahara’s Story

Jb Minter, DVM, MS, DACZM, shares what he hopes attendees takeaway from his session at the Fetch Charlotte conference

Takeaways from a zoo medicine session

Jb Minter, DVM, MS, DACZM, director of Animal Health at the North Carolina Zoo, will be speaking at our upcoming Fetch conference in Charlotte, North Carolina and told 

 in an interview, about what he hopes attendees can learn from his session. He aims at underscoring the similarities between zoo medicine and small- and large-animal medicine so that zoo medicine appears more accessible for any veterinary professional. 

Dr Minter will be speaking tomorrow, March 15, at the Fetch Charlotte conference.

 I think the biggest thing I want people to take away from this session is that zoo medicine is not that scary. It sounds scary because again, most of you don't learn about a lot of the critters that we have here. And I'm going to use a term zoological medicine in a much broader sense, because people think zoological medicine—to them that's bears and lions and elephants and rhinos. But there are there are going to be patients that people are going to potentially see in private practice. Take fish, for example, take snakes for example, or birds for example, those kind of fit under the umbrella of zoological medicine. So I want people that are in small- and large-animal medicine, not to be fearful of those animals. They are a little bit different, but I think we all have that basic understanding of veterinary medicine, and how veterinary medicine works. We have a basic understanding of just anatomy and physiology.

There are some nuances, and it may take some additional continuing education or a book or some journals to read, but it's still medicine and I think everybody has the skill set to practice for that.

Jb Minter, DVM, MS, DACZM, shares what he hopes attendees takaway from his session at the Fetch Charlotte conference

Mars Veterinary Health announced that it created a Medical Affairs Science Team that will focus on outcomes-based health care as well as clinical trials to leverage partnerships and the broad spectrum of data-driven insights. The goal of the team is to help veterinary professionals improve the lives of their patients through better ways to diagnose, treat, and predict patient conditions.

“We feel a responsibility to leverage our knowledge and reach to positively impact the future of veterinary care,” said Molly McAllister, DVM, MPH, chief medical officer, of Mars Veterinary Health, in an organizational release.

 “The formation of our Medical Affairs Science Team demonstrates our commitment to advancing the veterinary profession for the health and wellbeing of people, pets, and the planet.”

Led by Dottie Brown, MS, DVM, DACVS, vice president of science and healthcare innovation, the Medical Affairs Science Team consists of experienced veterinary scientists in both research and clinical care, who will focus on a client-centered health care delivery that prioritizes patient outcomes.

 The Medical Affairs Science team will also focus on the design, execution, and management of a high-quality and efficient clinical study. This will allow Mars Veterinary Health to contribute to the advancements of clinical science and research for the profession, according to the company.

The team will utilize partnerships with academic and industry institutions to gain data-driven insights and knowledge from across the 70,000 associates and 3,000 veterinary clinics within Mars Veterinary Health across the globe. The Medical Affairs Science Team hopes to enhance the lives of pets while also revolutionizing profession-wide care.

“As a purpose-driven, global organization at the forefront of veterinary care, we have the special opportunity to harness our knowledge, reach, and data-driven insights to lead industry-changing research and science,” said Brown.

 “This new team marks another step forward in our pursuit to advance veterinary medicine and ultimately make A Better World for Pets.”

Mars Veterinary Health doubles down on scientific focus with the formation of Medical Affairs Science Team. News release. March 14, 2024. Accessed March 14, 2024. 

https://www.marsveterinary.com/mvh-doubles-down-on-scientific-focus/

Articles

The team will focus on clinical studies and outcome-based health care to improve the lives of pets. 

Veterinary care provider launches Medical Affairs Science Team 

Joya Griffin, DVM, DACVD, explains what role technicians can play in dermatological cases

Effectively utilizing your technicians in dermatology cases

Joya Griffin, DVM, DACVD, shared how she utilizes her technicians and what tasks they can take on to make patient visit run more smoothly. Teamwork in these cases can help with workload distribution and allow for maximized efficiency through coordinated efforts.

Dr Griffin will be speaking at the Fetch conference in Charlotte, North Carolina on Saturday, March 16, 2024.

 So dermatology cases can be very challenging and I think they take a lot of time. So, in my practice, I utilize my staff very heavily. There's things that they do to make my day run smoother. 

They're highly trained and very effective in having a kind of a comprehensive approach to each of the cases. My lecture is about how you can utilize your staff in general practice to make your derm cases go more smoothly.

A lot of it starts with using the staff members to collect thorough derm histories, which are very specific to skin cases. They can be very long and kind of exhaustive. But my staff will send those history forms out before the appointment and then when the client comes in, they go over those histories again, and try to glean from the pet parent the important information about that specific case.

, our host Adam Christman, DVM, MBA, joins Whitney Miller, DVM, DACVPM, chief veterinarian at Petco, to learn more her journey into veterinary medicine and the work she does with Petco. She also describes how AI can be a beneficial tool for veterinary professionals, specifically with radiology cases.

 From both a personal and Petco standpoint, we made a huge commitment at the beginning of this year, and we rolled out to all of our full service general practices the AI radiology technology. So that's really where we're kind of—I don't know if 'dipping the feet in' is the right term since we went big scale at the start, but definitely, we're still learning a ton and how to apply that to the day to day case workup for our veterinarians. 

You know, when you're working with cases you're taking those radiographs, typically, if you want or would like a expert review, [and] you're sending it off. During COVID-19, we saw super long lead times to get the radiologist's review back. Some of those are improving but this [AI technology] is an almost instantaneous read on that radiograph that our doctors can look at and leverage, again, as another tool in the toolbox. So I think kind of trying to allay that fear of AI is going to come in replace specialists, replace our diagnostic capabilities as veterinarians. That is not something that we advocate or even think is really going to happen.

Probably a lot of general practitioners out there, emergency practices, are looking at AI cytology. There's other things that are out there around AI within anesthetic monitoring, or other applications. I think that folks are still really learning what's going on there.

Learn more about Whitney Miller, DVM, DACVPM and how artificial intelligence can be used for veterinary radiology