Sandra Koch, DVM, MS, DACVD, talks about the importance of patience, dedication, and collaboration 

Practicing compassion and spectrum of care with clients and itchy patients

Resources on feline atopic skin syndrome:

Clinical presentations of feline atopic skin syndrome

The challenges of diagnosing feline atopic skin syndrome

Treatment options for cats with feline atopic skin syndrome

Creative solutions for feline atopic dermatitis

In this video from an earlier interview on feline atopic skin syndrome at the 2025 WVC Conference in Las Vegas, Nevada, Sandra Koch, DVM, MS, DACVD, reminds veterinary professionals to be compassionate with clients as they navigate their cat’s skin condition. She also highlights the importance of spectrum of care and collaboration among the veterinary team to achieve an improved quality of life for their patients.

Below is the interview transcript, lightly edited for clarity:

I do hope that we have more research for cats in order to help better understand the disease to provide better treatment options, because we do need better options to help our superior species.

And because managing allergies in cats can be so difficult, can be so challenging for pet parents and veterinarians, it's very important that we practice compassion with our owners because they're going to be frustrated, they're going to be angry, they're going to be upset, right?

Financially, it can be a big burden, so practicing spectrum of care and trying to work with them with something that works for them, not just their cats, and understanding that despite the limitations that we have, if we are persistent and we work together with our clients, we should be able to [help them] get them better. I mean, of course, there are those cases that are nightmare cases, right, that we're all like pulling our hairs out to figure out.

But I think with patience and dedication and working as a team—as a care team with our clients, and in pairing with our nurses and technicians—I think we're able to improve their quality of life, and that's the main goal, right?

And by improving their quality of life, we're also improving the quality of life for their families, because everybody suffers when they’re itchy.

Videos

With chronic hepatitis potentially being more common in cats than believed, according to a feline virologist at the City University of Hong Kong, a group of researchers and specialists are coming together to study the first hepatitis B-related virus found in carnivores. Specifically, their research will center on how the virus affects cats, including its link to liver disease and cancer in these felines.

For the study, Texas A&M Gastrointestinal Laboratory (GI Lab) is partnering with Julia A. Beatty, BVetMed, PhD, FRCVS (Feline Medicine), FANZCVS, GAICD, chair professor of veterinary medicine and infectious disease at the City University of Hong Kong. Beatty will work with Jörg M. Steiner, DrMedVet, PhD, DACVIM (SAIM), DECVIM-CA, AGAF, GI Lab director and regents professor in the Department of Small Animal Clinical Sciences at the College of Veterinary Medicine and Biomedical Sciences (VMBS), and his team.

Hepatitis B is known to be a global health concern in the human world, and animal variants of the virus have been studied for with human health in mind.

However, “the health of domestic cats is the primary driver for our work,” shared Beatty in a Texas A&M report. According to Texas A&M, the recently discovered feline “cousin” of the hepatitis B virus—discovered by Beatty and her team—is the first virus related to hepatitis B that has been found in a carnivore and companion animal

Beatty explained that the team’s goal is to investigate whether the feline cousin of the hepatitis B virus leads to disease in cats like in the same way it does in humans.

In humans, hepatitis A, B, and C can all affect the liver, although the severity varies for each type.

 Hepatitis A is generally food-borne. Although this illness has high transmissibility, the damage it does to the liver is mild.

On the other hand, hepatitis B spreads via contact with infected bodily fluids. Mothers can also transmit the disease to their babies.

 This form of hepatitis, along with hepatitis C, can cause chronic disease and lead to long-term liver damage, cancer, and cirrhosis—a condition in which the liver’s healthy tissue is replaced with scar tissue, permanently damaging the liver.

In humans and cats, hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. In humans, this type of cancer is most often caused by chronic liver diseases like cirrhosis.

“The goal of our study is to determine whether the feline hepatitis B-like virus causes disease in cats like it does in humans,” Beatty said.1 “We have already identified an association between the virus and both chronic hepatitis and...HCC, the most common type of liver cancer in cats.”

“In fact, about a quarter of feline HCC cases are positive for the virus. But more work must be done to fully understand how the virus affects cat health,” she continued.

 “These diseases are not incredibly common in cats, but it’s possible that chronic hepatitis is more common than we think.”

According to Texas A&M, the same hepatitis B-like virus has been identified in a limited number of dogs. Yet, no evidence exists that shows dogs can get liver disease due to the virus.

Beatty stated there is also no evidence that the virus can infect humans. This hepatitis B-like virus, however, has been found in large-cat species, such as the endangered Iberian lynx.

Currently, there is no feline vaccine for the hepatitis B virus, and the hepatitis B vaccine for humans is highly toxic to cats, explained Beatty. However, “there are already some new virus treatments that can point researchers in the right direction,” she said in the report.

 “There’s already a lot of knowledge in this area.”

Price C. Texas A&M Gastrointestinal Laboratory collaborates with virologist to prevent liver disease in cats. Texas A&M University. April 9, 2025. Accessed April 10, 2025. 

https://stories.tamu.edu/news/2025/04/09/texas-am-gastrointestinal-laboratory-collaborates-with-virologist-to-prevent-liver-disease-in-cats/?utm_source=newsletter&utm_medium=email&utm_content=Texas%20A%26amp%3BM%20Gastrointestinal%20Laboratory%20Collaborates%20With%20Virologist%20To%20Prevent%20Liver%20Disease%20In%20Cats&utm_campaign=today_04-09-2025

Hepatitis. Penn Medicine. Accessed April 10, 2025. 

https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/hepatitis

Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed April 10, 2025. 

https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis#:~:text=Print%20All%20Sections-,Definition%20%26%20Facts,your%20liver%20begins%20to%20fail

Hepatocellular carcinoma. Mayo Clinic. Accessed April 10, 2025. 

https://www.mayoclinic.org/diseases-conditions/hepatocellular-carcinoma/cdc-20354552#:~:text=Hepatocellular%20carcinoma%20(HCC)%20is%20the%20most%20common,by%20hepatitis%20B%20or%20hepatitis%20C%20infection

Articles

The recently discovered feline “cousin” of the hepatitis B virus is associated with liver cancer in felines

Researchers to investigate new hepatitis B-like virus and its impact on cats

Clemson University reached a new milestone in the construction of South Carolina’s first veterinary school. The Harvey S. Peeler Jr. College of Veterinary Medicine (CVM) in Pendelton recently celebrated its’ continuing progress with a traditional beam signing ceremony on the site of the future animal health campus.

“The signing of this beam represents more than just the progress of a building–it symbolizes a historic step forward for Clemson University and the state of South Carolina,” Robert H. Jones, executive vice president for academic affairs and provost at Clemson University, said in a news release.

 “The Harvey S. Peeler Jr. College of Veterinary Medicine will address a critical shortage of veterinarians and serve as a cornerstone for advancing animal and human health, strengthening our state’s economy and keeping top talent in South Carolina.”

The beam signing came 4 months after the 

 for the new complex of structures that will house future students and educators. Joining university officials for the beam signing were individuals with Turner Construction, LS3P and Flad architects, and Clemson leaders.

Steven Marks, BVSc, MS, MRCVS, DACVIM, founding dean of the the Harvey S. Peeler Jr. College of Veterinary Medicine, adds his signature to the orange steel beam.

Dozens of signatures are marking the orange beam that has been permanently placed at the top of Clemson University's CVM Hub, a facility that is designed to serve as the heart of the animal health campus. However, Steven Marks, BVSc, MS, MRCVS, DACVIM, founding dean of the Harvey S. Peeler Jr. College of Veterinary Medicine, noted the special significance of one of the beam’s signatures: Timothy R Boosinger, DVM, PhD, DACVP.

Boosinger, who died in January 2025, was co-chair of the Clemson CVM Steering Committee, helping to create the blueprint for the new school. In an interview with 

, Marks said Stacia Harris, EdD, director of marketing and communications for the CVM, arranged to have a sticker created with Boosinger’s digital signature. Marks then applied the sticker to the beam during the ceremonial signing event on March 21, 2025.

“That probably made the beam signing more special than a normal beam signing,” Marks said. “We wanted him to be a piece of the college. He was such a true gentleman [who] dedicated his whole career to veterinary medicine.”

Boosinger was a US Air Force veteran and veterinary pathologist who also served the animal health community as an academic leader for over 35 years at Auburn University in Alabama. As dean of Auburn’s College of Veterinary Medicine, Boosinger led the initiative that doubled the size of the college’s facilities with 325,000 square feet of new construction that included teaching hospitals. He and later served as the college’s provost and chief academic officer, as well as president of the Association of American Veterinary Medical Colleges and a member of the American Veterinary Medical Association (AVMA) Council on Education.

“Dr Boosinger was both an Auburn and Clemson Tiger…Adding a new college to the Clemson Family is a very proud moment for the CVM team, and we were honored to recognize his contributions,” Marks added in a news release.

Dean and provost emeritus Dr Timothy R Boosinger. Auburn University College of Veterinary Medicine. January 27, 2025. Accessed April 9, 2025. https://www.vetmed.auburn.edu/blog/cvm-news/dean-and-provost-emeritus-dr-tim-boosinger/

Harris S. Building a legacy: CVM Hub beam signing. News release. Clemson University. March 28, 2025. Accessed April 9, 2025. 

https://news.clemson.edu/building-a-legacy-cvm-hub-beam-signing/

Steven Marks, BVSc, MS, MRCVS, DACVIM, founding dean of the Harvey S. Peeler Jr. College of Veterinary Medicine, explained the significance of the traditional beam signing in a 

interview. “That beam signing is kind of a culmination. People don't realize [that] when you're building a building, there's so much that happens before the building actually rises. The beam signing .. is between the architects, the contractors, and then the university and the college itself. So everybody comes together. It was very, very special for us,” Marks said.

The CVM campus is a short drive from the university’s main campus in Clemson, South Carolina; across the road from the Clemson University Equine Center in Pendelton, and adjacent to the Clemson Experimental Forest. Marks noted that the design of the CVM campus buildings take their locations into account for the benefit of students and staff. “So there's a lot of glass, a lot of windows to look out, either onto the forest, or you can look across the street onto the current Equine Center. So it's a quite spectacular site,” Marks said. “Students will be able to take a walk in the woods, and will utilize outdoor space…It's quite beautiful.”

Seven structures will make up the veterinary campus and are in various stages of construction with some steel and exterior framing currently being erected. This includes the CVM Hub, which is expected to be fully enclosed by the end of summer 2025.

 The CVM Hub will contain classrooms, a library, food service, and social spaces for students to relax in, according to Marks.

According to Stacia Harris, EdD, director of marketing and communications for the CVM, April 2025 is a busy month for the campus. Plans have included the start of steel framing for the clinical teaching and research buildings, and site prep work has accelerated for the equine teaching and food animal buildings. Additionally, steel framing is scheduled to being in summer 2025 on the ambulatory building. Meanwhile, the campus’ utility building has its’ framing completed with roofing started and concrete block walls being installed.

The research building will contain offices for faculty and graduate students, and laboratories for work in advancing veterinary science

 while the clinical teaching building will primarily house laboratory and simulator spaces for coursework as well as a community clinic that will allow the public to access veterinary care.

 “That's where we'll teach anatomy, where we'll teach your surgical skills,” Marks said.

Meanwhile, the ambulatory service building will be home to a mobile hospital service being created to primarily care for farm animals, according to Marks. The service will provide fourth year students with clinical rotation experience on local farms.

 “Trucks will be deployed into the community with students and faculty,” Marks said.

A new equine teaching building will be located on the front pasture of the current Equine Center. “Horses will be able to just be trotted down into the teaching building, stay there just long enough for the lab to be taught, and then they'll be returned to the Equine Center,” Marks said.

The farm animal teaching building will be off-site, about a 5-minute drive away, on the university’s current dairy farm. “There will be dairy cattle that'll be moved from the herd into the laboratory teaching setting and then returned to the dairy herd,” Marks said.

The CVM was named for Harvey S. Peeler Jr, a senator in the South Carolina General Assembly and a graduate of Clemson University.

 “He is a dairy man at heart. His family is in a dairy industry. It just so happens that he moved throughout his career into a leadership role…He's been embedded in agriculture, and we know how important agriculture is to the state of South Carolina and how important it is to Clemson. It's quite the honor to have his name on our college,” Marks said.

Clemson plans to have the new CVM opening to its’ first students in fall 2026, pending approval from the American Veterinary Medical Association (AVMA) Council on Education. Marks said the university is continuing to work through the process of earning accreditation and is currently on track to make its’ goals. The next step is a comprehensive visit from the AVMA Council on Education scheduled for June 2025.

The terraced CVM Hub building is designed to be the heart of the the Harvey S. Peeler Jr. College of Veterinary Medicine campus.

The ceremonial beam is hoisted into place atop the CVM Hub building.

The site of the future the Harvey S. Peeler Jr. College of Veterinary Medicine is shown under construction on April 7, 2025.

Harris S. Building a legacy: CVM Hub beam signing. News release. Clemson University. March 28, 2025. Accessed April 9, 2025. https://news.clemson.edu/building-a-legacy-cvm-hub-beam-signing/

Harris S. Building a legacy: March 2025 construction update. News release. Clemson University. March 17, 2025. Accessed April 9, 2025. 

https://news.clemson.edu/building-a-legacy-march-2025-construction-update/

Clemson breaks ground on Harvey S Peeler Jr College of Veterinary Medicine. News release. November 22, 2024. Accessed April 9, 2025. https://news.clemson.edu/clemson-breaks-ground-on-harvey-s-peeler-jr-college-of-veterinary-medicine/

The Harvey S. Peeler Jr. College of Veterinary Medicine recently celebrated with a beam signing ceremony

Clemson University's future veterinary school is making progress

As a veterinarian, I have dedicated my life to understanding and alleviating the pain of my patients. However, nothing could have prepared me for the moment I truly became one of them. It wasn’t by choice but by circumstance. In the blink of an eye, I found myself walking—or rather, struggling to walk—in their paws. I became a dachshund.

Earlier this year, many of you saw me at VMX in a scooter and using a cane, and many of you know how much I love to work out. I have been exercising since I was 20 years old and found great joy in the love of staying fit and finding my crew of fellow gym buddies over the years. But severely herniating L4-L5 in my spine brought me right down to the ground—like a dachshund. At first, I thought I was going to be OK. I had received 2 epidurals to manage the pain, but unfortunately, it didn’t help. At VMX, my incredible friends were there to support me and literally bring me up when I was down for the count. To those of you who were there, thank you!

Adam Christman, DVM, MBA, with his dogs.  

As you know, dachshunds, with their long backs and short legs, are notorious for their predisposition to intervertebral disc disease (IVDD). It’s a condition I’ve diagnosed, treated, and even wrote a book about—

Honey, Have You Squeezed the Dachshund? A Guide for Dachshund Owners Who Are Terrified of IVDD

. I’ve counseled pet owners countless times and watched their beloved companions yelp in pain, drag their hind limbs, and tremble with fear as they faced an uncertain road ahead. I’ve seen it in my own dachshunds. I also follow my own advice to clients about ramps. If you’ve been following me on social media, you’ve seen how many custom-built ramps are in my house; it’s like 

It wasn’t until I personally experienced the searing agony of nerve pain, the crushing weight of immobility, and the unrelenting frustration of ineffective treatments that I truly understood the depths of their suffering. Sleeping 30 minutes maximum a night was my average. And yet, I woke up, went to work, and put on my game face.

Pain is a thief; it robs you of movement, peace, and sleep. It consumes every moment, turning even the simplest tasks into insurmountable obstacles. It took me close to 30 minutes just to put 1 sock on. I, too, found myself trapped in this relentless cycle. What you also don’t know is that I had soft tissue surgery earlier this year as well—a postop recovery that I care never to remember. Additionally, I still had (and currently have) my herniated disk. Standing up was an exercise in courage. Walking was an act of defiance against the pain that threatened to pull me down. Every nerve in my spine seemed to scream with a fire I couldn’t extinguish.

Like my dachshund patients, I learned to adapt. I shuffled instead of walking. I used a scooter, just like they use a cart. I hesitated before taking the stairs. I feared sudden movements that might send electric jolts of pain radiating through my body. I cried during a cough or a sneeze. I experienced the frustration of treatments that didn’t provide relief and the heartbreak of feeling helpless in my own skin. I knew what it was to lose trust in my own body.

Now I know how my patients feel. I thought of them, curled up in their crates at night, whimpering in discomfort. I thought of the pet parents who sat beside them, stroking their fur, feeling powerless to ease their pain. I understood them in a way I never had before. The nights are the hardest—when the world is silent, you are left alone with the echoes of your suffering, and everyone is resting while your mind is as active as a marathon runner.

Finding the right pain protocol was a journey of trial and error. What worked for one patient did nothing for me, and what gave brief relief often came with intolerable adverse effects. I gained a newfound appreciation for the complexity of pain management, not only the science of it but also the deep, personal impact it has on every patient’s quality of life.

Dachshunds with IVDD face a similar battle. Whether it’s steroids, nonsteroidal anti-inflammatory drugs, gabapentin, acupuncture, rehabilitation therapy, or laser, there’s no one-size-fits-all solution. The patience required to navigate this process is exhausting. Yet my doctors never gave up on me, just as we would never give up on our patients. The willpower to keep trying when nothing seems to work is nothing short of heroic. I now recognize that our patients don’t just need treatment; they need our compassion, persistence, and unwavering belief that relief is possible. And to me, the best medicine I could receive is TLC. Being home with my dogs and my husband and being surrounded by friends, coworkers, and family who relentlessly checked in on me to make sure I was following the doctor’s orders meant more to me than anything.

As I write this, I am heading toward surgery. I’m nervous and scared but also excited to be the Adam Christman I want and need to be. Social media never showed how I truly felt as I didn’t think my platform was suitable for this, so this is the first time I’m sharing my journey. I know my profession would understand the synergy behind our personal battles and the battles our patients experience. They, too, need to be surrounded by TLC, their family, and loved ones.

Pain has a way of changing you; it deepens your empathy, sharpens your awareness, and shifts your perspective. As veterinarians, we pride ourselves on our medical knowledge, but true understanding comes from lived experience.

I now speak to my clients with a different kind of authority—not only as a veterinarian but also as someone who has felt the very pain their pets endure. I understand the urgency in their voices and the desperation in their eyes. I recognize the silent suffering of a pet who is too stoic to show how much they’re hurting. When I went down, I thought I was permanently down. Imagine what that is like for people and our pets. It was absolutely terrifying, but one thing is for certain: I have received my strength from my dogs and patients over the years. They still manage to wag their butt, purr next to you, and greet you at the door regardless of any physical ailment they may have. They have inspired me to be strong throughout my own personal journey.

To my fellow veterinarians, I urge you to see beyond the clinical signs and feel beyond the science. When a pet yelps in pain, know their suffering extends far beyond that moment. When a client worries about their dog’s future, recognize the deep, emotional toll of that fear. Walk in their paws—not only in theory but also in spirit. Pain is a universal language. And because of this journey, I now speak it fluently.

If there’s one thing I’ve learned, it’s that suffering is not just a physical experience, it’s also emotional, mental, and deeply personal. My journey through pain and healing has made me a better veterinarian, a more empathetic healer, and a stronger advocate for those who cannot speak for themselves.

To my dachshunds out there: I see you. I feel you. I am you.

To my colleagues: Let us remember that we are not just treating conditions, but we are also treating souls. Let us be relentless in our pursuit of relief, patient in our understanding, and unwavering in our compassion. Use your intuition, for it is stronger than you know.

Because, in the end, we are not so different from the patients we serve. We are all walking—sometimes stumbling—on this journey together. And some of us, like me, are officially dachshunds. And to me, I think it’s 

I’m a dachshund. And I’m proud of it.

From the CVO: I'm officially my dogs

In this week's episode, Madonna Livingston, BVMS, MRCVS, shares her top tips on handling exotic pets, plus more about her recently published book

The Vet Blast Podcast presented by dvm360: 4 best practices on handling exotic pets

Madonna Livingston, BVMS, MRCVS, and our host Adam Christman, DVM, MBA, sat down to chat about all things exotic on this week's episode of The Vet Blast Podcast presented by 

 to talk about ways veterinary professionals can better handle exotic pets in their clinic, her new textbook, and how she self taught herself to be an exotics veterinarian when resources were limited. 

When I went to vet school, there was virtually nothing on exotics. I think I got 2 hours in 5 years. When I first qualified from Glasgow vet school, there was no certificate, there was no pathway for specialization. So I'm self-taught. I bought all the species-specific textbooks. I sat in on a Friday night quite happily reading my Douglas Mader, medicine, surgery, Vet textbook, and did as much extra courses, extra studying that I could do.

Once I'd been qualified, a few years [later] a certificate became available, but it was in England, and I am a homebody. I, by that point, developed clients, a client base, because the clients would come to me and I would say, 'Look, I've maybe never seen this species before. This condition, you've got 2 options: I can try to refer you somewhere, or I can do research into it.' And where I worked wasn't initially, wasn't a particularly affluent area. So for a lot of owners, referral was out [of] the realms of their reach financially. So they would say to me, 'Madonna, could you try.' So I did, and then I built up the reputation doing that way and but I didn't. So I didn't want to move to England. I was settled in my homebody. I had my support network. I asked if I could sit [in] the exams. They told me no, because...understandably, they wanted the money from the tuition. I get it. Then, [by] the time a certificate became available in Scotland, I was already lecturing.

Do you think that in your years of experience, has the interest of exotics for the vet students, has it gone up? Stayed the same, decreased like, what does that look like in your area?

: It's definitely gone up. Definitely gone up.

: I think so too, why do you think that is?

Podcasts

On this week's episode of The Vet Blast Podcast presented by dvm360, Adam Christman, DVM, MBA, and Madonna Livingstone, BVMS, MRCVS, discuss how to handle exotic pets, plus how the human-animal bond is not species-specific

4 best practices on handling exotic pets

Aaron Shaw, OTR/L, CHT, CSCS, discusses what “off-field” practices can help veterinary professionals prepare for the challenges inside the clinic 

Coping with stress in veterinary practice using an athlete's mentality

In this interview, Aaron Shaw, OTR/L, CHT, CSCS, host of the podcast 

, offers strategies that veterinary professionals can use to cope with the stress that the veterinary medicine profession may bring. As Shaw explains, key strategies will involve exercise, nutrition, and sleep.

Below is a partial interview transcript, lightly edited for clarity:

The best way to cope with the daily stressors of vet medicine is to be prepared and in order to be prepared, that has to happen before going into the office, before going into the clinic. And my analogy that I always think of is that of an athlete, and athletes, when they go to game day, or when they go to perform, they are capable of a really high level of performance. You know, physical performance, emotional performance, and focus.

But that doesn't happen just because they walked onto the field that day. It happened from what they did off-field. It's what they did in practice. And I think that with providers in the vet team, what really is key is taking the time outside of the office to prepare for the challenges that are inside the office, to build that resilience.

And the key ways to do that really come down to exercise, nutrition, sleep. We need those 3, just to kind of leave it at those 3 for now, like those 3 have an absolute physiological impact on a person's ability to make decisions—the, you know, cognitive clarity to make decisions, to make challenging decisions, to have the physical stamina to engage in the very physical career of vet medicine, and sleep.

Sleep really enables us to recover from the wear and tear of, you know, the previous day, both the physical challenges and the emotional challenges, and only when all of these things come together, can a provider, can somebody on the team, show up and be resilient to the stresses that are inevitable in practice.