Nutrition expert Karen Shenoy, DVM, provided advice for veterinarians about talking with clients about weight management in a dvm360 interview.

Tips for discussing weight management with veterinary clients

Karen Shenoy, DVM, US chief veterinary officer at Hill’s Pet Nutrition, spoke about weight management, in an interview with 

 at the 2024 Veterinary Meeting & Expo (VMX) in Orlando, Florida. In this segment, she provides advice for veterinarians about discussing a pet’s weight with clients and addressing a case of obesity with animal owners.

The following is a transcript of the video.

: When veterinary professionals are talking to pet parents about their pets, there are 3 general things that I would have them consider. One is how you can have the conversation in as proactive a manner as possible. So that would first mean that as soon as the pet is starting to show any signs of weight gain that you're having that conversation early before it's to the point of the pet being completely obese. That's really in the best interest of the pet’s health anyway, and it's just going to be easier to scale back and focus on eating the right food in the right amounts and things early on, before you have a real serious problem. Even better, you're having the weight conversation when the animal is a puppy or a kitten, when they're first acquired, before they're even overweight. [You’re] talking about what to look for, how much to feed, and kind of heading off any of those issues with the pet being overweight before they even occur.

The second thing I would say is that we all know people show love through food. We do it with our human families, and we do it with our pets. And so, making sure that you recognize that behavior and that desire, and work into the feeding plan the fact that people are going to want to continue some degree of behavior showing their pets love. So that could be things like incorporating a feeding regimen that includes, maybe, both dry and canned food and an appropriate amount so they can kind of top dress with some canned food that's still healthy and nutritious and helping with the weight loss but is something they enjoy feeding their pet. You can work in some treats or feeding some of the kibble as treats. [There are] lots of different tricks that help them continue to show love to their pet throughout the day, but in a healthy manner.

The third point that I would then make is that it's important to normalize the weight conversation. It's easy for a pet parent to feel judged and we just need to kind of have a candid but very kind conversation with pet parents. And we know that only 1 in 3 pet parents actually recognize that their pet is overweight. So, the first part is kind of helping them to truly recognize the concerns with their animal. And you know, as you do that, again, keep it very positive. It's okay to give some examples of other patients or maybe a situation you yourself were managing [such as] one of the weight issues with one of your own pets, helping normalize it and just having them feel like it's okay and it's not an uncommon problem, but that you're there to help is very important.

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Karen Shenoy, DVM, US chief veterinary officer at Hill’s Pet Nutrition, provided advice for veterinarians about talking with clients about obesity and proper nutrition in an interview at the 2024 Veterinary Meeting & Expo.

Tips for discussing weight management with pet owners

This article was updated on January 29, 2024.

Kobe, a 14-year-old tabby cat, was diagnosed with chronic kidney disease (CKD), which causes a cat’s kidneys to slowly lose function, last summer.

 Among the many different kidney diseases that may affect cats, CKD is the most common.

 According to Texas A&M School of Veterinary Medicine & Biomedical Sciences, most cats with the disease only survive a few years after showing symptoms, which can make the diagnosis extremely distressing for pet owners. It is also a slowly evolving disease that worsens as it progresses, negatively impacting a patient’s quality of life.

“He may be 14, but he’s so active. We’ve even been working this last year to get his weight down, and I’m proud to say that it’s gone really well,” said owner, Gabrielle Sakel in an organizational release.

Kobe was a participant in Texas A&M’s new clinical trial designed for cats with stage 2 to stage 4 kidney disease. The trial uses Porus One, a powdery material, to draw toxins from the intestinal tract so they don’t enter the bloodstream. 

An oral absorbent, Porus One is a unique material that is classified as a supplement, according to a Dechra spokesperson. Each tiny particle is an intricately tunneled sphere, giving each daily dose a huge surface area, comparable to the size of a tennis court.

“The Porus One is not absorbed by the cat’s digestive system at all,” said Audrey Cook, BVM&S, Msc Vet Ed, DACVIM, DECVIM, DABVP (Feline), a professor in the department of small animal clinical sciences who is co-leading the trial with Genna Atiee, DVM, DACVIM (SAIM), a clinical assistant professor. “It just passes through and grabs onto the toxins that we don’t want to get into the bloodstream. Then, the cats poop it all out.”

Although similar products have been used successfully in humans with kidney disease, there hasn’t been much research on their effect in cats.

“Kidney disease is very common in older cats, so Kobe’s veterinarians had been keeping an eye on his blood levels,” Sakel said. “During one visit, they noticed that he had stage two kidney disease. At the time, it just so happened that I was working at Texas A&M’s Gastrointestinal Laboratory [and was told] about the new trial.”

Genna Atiee, DVM, DACVIM (SAIM), a clinical assistant professor in the Texas A&M University School of Veterinary Medicine & Biomedical Sciences, examines Kobe. (Photo credit: Jason Nitsch ’14, Texas A&M University Division of Marketing and Communications)

“Cats with chronic kidney disease have trouble eliminating certain kinds of toxins, which start to build up in their blood, because their kidneys are not working properly,” said Cook. “Some of these toxins are created in the intestinal tract. When they are absorbed into the bloodstream, they make the patient feel unwell and also worsen the disease. Porus One is [given] to kidney disease patients that we anticipate will help break that cycle.”

For Kobe, a diagnosis came early, and with the addition of being a participant in this trial, researchers have seen successful results. The 14-year-old has been reported to have more energy, running and jumping like he had been before CKD.

“[CKD] is the No. 1 fatal disease for geriatric cats,” Cook said. “Because it’s something every veterinarian sees, we really wanted to find a way to slow down the disease progression and help feline patients feel better.”

Kobe has completed the trial and he will continue taking Porus One to manage his disease. Although his success bodes well for the clinical trial, Cook and Atiee still need more cats to participate.

“We’re still looking for applicants,” Cook said. “Cats must have chronic kidney disease and be at least 7 years old to participate. They also need to like wet food and be able to make a total of five visits to the Small Animal Teaching Hospital in College Station.”

For more information about applying to the clinical trial, cat owners can contact Lisa Even, manager of the office of Veterinary Clinical Investigation, or visit the trial’s “Study Pages” website.

Texas A&M veterinary clinical trial gives tabby cat with chronic kidney disease a second chance at life. News release. Texas A&M School of Veterinary Medicine & Biomedical Sciences. January 23, 2024. Accessed January 26, 2024. 

https://today.tamu.edu/2024/01/23/clinical-trial-gives-cat-with-kidney-disease-a-second-chance/

Chronic kidney disease. Cornell University College of Veterinary Medicine. Accessed January 26, 2024. 

https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/chronic-kidney-disease

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The American Association of Veterinary Medical Colleges (AAVMC) announced that its chief executive officer, Andrew T. Maccabe, DVM, will step down after serving 12 years in the position. Maccabe will continue to be the CEO of AAVMC until he officially steps down in June 2024.

“Dr Maccabe’s many years at the helm of AAVMC helped ensure a close relationship between our two organizations, and enhanced the AVMA’s strong collaboration with veterinary schools and programs,” said Rena Carlson, DVM, American Veterinary Medical Association’s president, in an organizational release.

 “Under his leadership, the AVMA and the AAVMC have partnered on many projects that have greatly benefitted the profession, including initiatives that have promoted One Health, wellbeing, and diversity, equity, and inclusion. We are grateful to Dr Maccabe for the ongoing commitment and dedication he has for students, veterinary teams, and the profession.”

Maccabe earned his veterinary degree from Ohio State University in 1985 and began his career in Jefferson, Ohio, where he worked in mixed animal patients focusing on dairy herd health. Then in 1988, he was commissioned as a public health officer in the US Air Force and would serve for 24 years as an active military and reserve officer service before returning in 2017. As he was serving in the Air Force, Maccabe completed his master’s in public health in 1995.

Andrew T. Maccabe, DVM, will step down as CEO of AAVMC in June 2024. (Image courtesy of the American Veterinary Medical Association)  

He then went on to work as a liaison for the Center for Disease Control and Prevention (CDC) where he coordinated programs and policies between the FDA and CDC before beginning his career at AAVMC.

“Serving as CEO of AAVMC has been the greatest privilege of my career. I have had the pleasure of working with an incredibly talented, highly professional, and diverse staff and I am in absolute awe of the amazing work done every day by the dedicated educators and administrators at our member institutions as they prepare the next generation of veterinarians to serve societal needs,” expressed Maccabe.

AAVMC retained Sterling Martin to help with the search for a new CEO and any inquiries should be directed to David Martin, CEO and founder, at dmartin@smartinsearch.com.

Maccabe to step down from AAVMC after 12 years as CEO. New release. January 19, 2024. Accessed January 26, 2024. 

https://www.avma.org/news/maccabe-step-down-aavmc-after-12-years-ceo

Andrew T. Maccabe, DVM, will leave his position as the organization's CEO by the end of June 2024

AAVMC chief executive officer steps down after 12 years 

Climate change involves long-term changes in temperatures and weather patterns. Certain shifts can be natural, including changes in the sun’s activity or major volcanic eruptions, however, since the 1800s, human activities have been a main contributor of climate change. This is primarily because of the large amounts of burning fossil fuels like coal, oil, and gas. The burning of these fuels releases greenhouse gases that act like a blanket, trapping the sun's heat and causing a rise in temperatures.

The rise in global surface temperatures has seen a 2º F increase since the 1800s. this might not seem like a huge difference, however Margo Mosher, global sustainability director, Mars Veterinary Health, explains how significant this can really be. In her joint session with Jo Ann Morrison, DVM, MS, DACVIM (SAIM), director of veterinary science at Banfield Pet Hospital, Mosher stated, “Two degrees Fahrenheit may not sound like a lot, but if you think about it similar to the context of our body temperature when you have a fever—so our typical temperature is maybe around 98.6º F, if we increase that just 2 degrees up to 100.6º F, we’re probably not feeling very well. And so, we can think of this similarly with climate change and really the significant impact that just a couple of degree change can have.”

Therefore, when the earth temperature rises, the following could be at crucial risk:

The world’s healthcare systems account for 4% of all greenhouse gas emissions, and veterinary medicine is a portion of that 4%.

 Providing care for pet patients has a carbon footprint from using electricity, anesthesia, medical supplies, and even veterinary professionals and pet owners driving to the clinic. According to IVC Evidencia, a European veterinary care provider, medical supply and pharmaceutical purchases used for veterinary practices is one of the leading contributors to the veterinary carbon footprint.

 This is the area in which veterinary professionals can have the most impact in reducing their carbon footprint.

 Dr Morrison explained how commuting to work and travel for conferences can add to a veterinary professional’s carbon footprint. She suggested attending virtual meetings, however, “If an in-person meeting is necessary, then is there a more sustainable option, rather than flying? Is there an option for things like rail or train travel or electronic vehicles? If flying is necessary, what are the most sustainable options to consider here? There’s direct versus connecting flights, and these have different carbon footprints.”

 Morrison also posed the option of taking public transportation to work if that is a viable option. However, she did mention that this can also be a personal choice for each individual. “The first thing to do is have some discussions with your teams. Investigate what is available in your area and see what people would consider in changing with commuting to the practice…maybe there is a fun or creative way to encourage biking to work—again, in areas where that is feasible and that will vary from place to place,” she said.

 Offering telehealth can also offset clients commuting to the clinic. This can be beneficial even if just a portion of appointments can switch to an online format. Telehealth can also reduce the use of medical supplies, which has a large impact on the overall veterinary footprint.

 Another small change practices can make is reminding associates to reduce electricity around the practice when possible. Turning off lights when a room is not in use or unplugging equipment that does not need to be on can be simple efforts made daily.

 Anesthetic gases used for procedures have different environmental impacts. Mosher recommended prioritizing the needs of the patient first, but to consider using lower impact gases, such as sevoflurane, and using lower flow techniques to reduce the impacts anesthesia has on climate change.

Because medical supplies can be a major contributor to veterinary medicine’s carbon footprint, Mosher suggested selecting suppliers who demonstrate a commitment to sustainability (when possible) and consolidating orders and deliveries.

 Waste management can be tackled by starting with prevention as the most preferred method, and when that is not an option, going down the line of reusing, recycling, recovery, and disposal being the last option remaining if necessary. For veterinary medicine, consider what in your practice that can be eliminated, reused, or recycled. For example, reducing paperwork and going digital with patient records can be an option in preventing waste.

Mosher and Morrison’s overall advice for reducing your practice’s carbon footprint is to discuss with your team and see what will work within your means. Engage your team and get everyone involved so each member of the team is making a difference. If certain members of your team are more passionate about climate change than others, let them take some of the lead and lean into their personal interests in improving the practice’s efforts. Celebrating small wins in the progression and becoming more sustainable is also important to recognize on this climate journey. Combating climate change is a collaborative endeavor.

Before wrapping up, Mosher shared a way to calculate your practice’s carbon footprint by using the “CoolClimate Network” website powered by the University of California, Berkeley. This can also share more tips for reducing your footprint. If interested, veterinary professionals can also access resources on Banfield or Mars Veterinary Health’s website.

What is climate change? United Nations. Accessed January 25, 2024. 

https://www.un.org/en/climatechange/what-is-climate-change

Mosher M, Morrison JA. Climate change and the veterinary profession. Presented at: Veterinary Meeting & Expo; Orlando, Florida; January 13-17, 2024.

Climate change: 5 charts from the IPCC report that show why every increment of warming matters. World Economic Forum. March 23, 2023. Accessed January 25, 2024. 

https://www.weforum.org/agenda/2023/03/climate-change-ipcc-emissions-risks-net-zero/

Protecting the planet and its people: healthcare's climate action roadmap. World Economic Forum. June 2, 2021. Accessed January 25, 2024. 

https://www.weforum.org/agenda/2021/06/healthcare-climate-action-roadmap/

The positive pawprint: Sustainability report 2023. IVC Evidencia. 2023. Accessed January 25, 2024. 

https://ivcevidensia.com/getmedia/70832551-51b0-4fd2-9651-b0e2d5eac222/IVC-Evidensia-Sustainability-Report_2023.pdf

Veterinary experts discuss how this profession can have an effect on the environment and what you can do to help prevent global warming 

The veterinary profession and its impact on climate change

Beyond Diagnostics

These are all great in-house diagnostics that we have Dr. Hann, and what is Zoetis doing differently that's allowing them to do this great medicine?

Yeah, so we obviously have the artificial intelligence available. But knowing that there are certain cases that are pretty cut and dry, like yes, there's giardia. The dog's having diarrhea, giardia, then you usually have a pretty straightforward treatment plan. But there are a lot of cases that are more complicated, or you get a result from the artificial intelligence. But it's a more complex case of how, what now, and so that's maybe not always as clear as a step. So, Zoetis also has a consultation service that is fairly easily accessible on the platform where veterinarians can request consultations by email or set up Zoom consults, which can be either dial in or Zoom video, and the variety of specialties. And they can either do an email consult where they can send it in at any time, and the specialists will get to it as soon as they can. Or they can set it up at a specific time that works for them and their practice. And then we can provide that extra step of okay, yeah, you have the AI that's helping, but doesn't always put the pieces together. So, we still need that level of additional step for certain cases where specialists on the consultation service can work with general practitioners to come up with a plan for if we have a diagnosis, but it's a more complicated diagnosis, or certain...like with the blood smear review, sometimes that gives you information but not the full diagnosis. And so then, you know, using the specialty service to kind of figure out okay, what other diagnostics do we need in this situation? What do we ideally need, but what works for your practice and your patient and your pet owner? And so we really do try to both offer kind of the gold standard approach, but also individualize that for that particular case so that you can actually institute a reasonable plan for that pet.

I love that modern medicine with progressive communication. This is fantastic. Thank you doctors.

Now what? Learn how the Zoetis’ consultation services can provide expert guidance on diagnostics and individualized treatment plans for all of your cases

Beyond diagnostics: How Zoetis’ specialty consultation services supports the veterinary healthcare team

Vetscan Imagyst

I love what you were just talking about with compliance. I'm curious to get your thoughts Dr. Wolfe on this about compliance and adherence. Do you find that pet parents are more likely to do such things knowing that they have Imagyst and digital cytology available in your clinic?

I do, to reiterate to Dr. Clary’s point. I don't think we realized that we had the Giardia that we have in West Texas, and so they may come in it may be that they're coming in for diarrhea, or maybe they're coming in for immunizations, and they also have diarrhea. And when you have that, the Imagyst has an iPad, and you can take that iPad into the room. And you can actually show the client in the examination room that this is why, you know, hookworms or whipworms or giardia. And rather than just watching and waiting, they'll go ahead, and they'll begin to treat in that moment there. And with ear infections, for, example too now that they've moved to skin cytology, which can include ear cytology, is if we have the Imagyst in the exam room and show this is the yeast or the bacteria on your pet skin or in your ears, then they're more compliant to not only agreeing to allow us to perform these cytologies, but also to their acceptance of treating. And then it helps me know specifically what medication to treat with as well. So I think that the visualization really helps to see we get to point to the bacteria and point to the yeast and point to the giardia. I love that matching the bug to the drug early.

Same way. It just increases compliance, and also that turnaround time. What I love is that client comes in, they have a problem, we diagnose it, they go home with the solution, not two days from now. I don't have to do phone calls. I don't have to worry about them picking the medicine back up. People are busy. They don't have time to keep coming back and forth to the clinic. And I think it also helps with costs because maybe we haven't, if we diagnose it correctly, we haven't tried three drugs that didn't work and then finally end up with one that works. We're more pinpointed, directed to the actual disease.

That's great. And I think it's better medicine as well, because I can tell you that we practice better fecals because they provide you the kits. So, we're using the appropriate solution. We're centrifuging it and I feel confident too, when I'm treating a diarrhea, that a negative is more likely to be a negative, as opposed to having my technician perform the fecal flotation and maybe not waiting the appropriate amount of time or spending at the appropriate amount of time. So, I feel like artificial intelligence has really made me trust those results more, that a positive is a positive and negative could potentially be a negative.

Understand how AI-driven tools are allowing veterinarians to match the bug to the drug early