I was recently at a clinic giving a practice management seminar and a conversation about training and education came up. In a very confident, “as a matter of fact” tone, one of the veterinary technicians expressed frustration about career advancement because “those that are experienced prefer not to share their knowledge in an effort to maintain job security.” Has this sentiment ever been raised in your place of employment? Does it sound familiar? Believe it or not, it is quite common.

As a veterinarian who works full-time in continuing education (CE) here at 

, I believe that education is a cornerstone of our profession, and its true value is realized when it is shared rather than hoarded. Veterinary medicine is a dynamic field that constantly evolves with advancements in technology, research, and clinical practices. It is crucial for professionals in our community to actively contribute to a culture of knowledge sharing for the benefit of our patients, clients, and the overall improvement of veterinary care. Look at all the advancement in artificial intelligence, practice management software, and new ways of managing pain in our patients.

Hoarding knowledge within a team or a veterinary hospital is counterproductive and detrimental to the collective growth of the veterinary community. Employees hoard knowledge for a number of reasons. These include personal reasons like fear of competition, an attempt to keep control, or, yes, to ensure job security. I also have found it could be for their own gain like receiving praise or bonuses related to their knowledge or performance. It is something I have been hearing more as I have been chatting with practices around the country. And it truly makes me scratch my head. Collaboration and open communication foster a supportive environment where ideas can be exchanged, experiences shared, and skills enhanced. This collaborative approach not only enhances the quality of care provided but also creates a positive workplace culture, where trust and respect flourish among team members.

One of the best examples of the power of sharing knowledge is witnessed in our brand-new education program, “In the Clinic.” This is a 1-hour CE session in which an entire veterinary team is interviewed about a therapeutic topic with understanding and appreciation for their educational perspective. This innovative program was truly designed to share knowledge across the team. A recent program was on the team approach to veterinary dentistry at Heart + Paw in Lake Hopatcong, New Jersey, with Jan Bellows, DVM, DAVDC, DABVP, FAVD, as our subject matter expert. If you have not seen this webinar, I encourage all of you to view it on demand on our dvm360.com/Flex platform.

Continuing education is paramount in veterinary medicine because of the rapidly evolving nature of our field. New diagnostic tools, treatment modalities, and research findings emerge regularly. By actively participating in ongoing education, veterinarians and veterinary staff stay abreast of the latest developments, ensuring that their knowledge remains current and applicable to the ever-changing landscape of veterinary science. We welcome all of you to have a seat at the education supper table at all our Fetch veterinary conferences (new Fetch Nashville is coming up May 17 and 18, 2024). Investing in employees’ education is the single best investment one can make for the practice and patients.

Moreover, embracing CE promotes a culture of lifelong learning and professional growth. It encourages veterinary professionals to seek out new information, refine their skills, and adapt to emerging challenges. This not only benefits the individual practitioner but also elevates the overall standard of care within the veterinary community.

By withholding information, employees may inadvertently hinder the progress of the team, limit professional development opportunities, and compromise the overall standard of care. Furthermore, it can create a sense of isolation among team members, hindering the establishment of a cohesive and efficient veterinary team. No one wins, including our patients. 

The importance of education in veterinary medicine is best realized when it is shared openly among all our fellow professionals. Embracing a culture of open communication and continued learning ensures that veterinary professionals stay at the forefront of advancements, benefiting the entire veterinary community and the animals under our care. To quote Malcolm X: “Education is our passport to the future, for tomorrow belongs only to the people who prepare for it today.”

Articles

A note on the importance of training and career advancement in veterinary medicine from our chief veterinary officer, Adam Christman, DVM, MBA

Education is best when it is shared, not hoarded

Anaphylaxis is more than just an everyday allergic reaction and being prepared to recognize and treat these pets in a timely manner is crucial. Anaphylaxis is the systemic, immediate hypersensitivity reaction that is mostly caused by the Immunoglobulin E (IgE) mediated immunologic release of mediators from mast cells and basophils. The best way to differentiate an anaphylactic reaction from other simpler Type I hypersensitivity reactions is to characterize it as systemic hypersensitivity reaction involving at least 2 organ systems (dermatologic, respiratory, cardiovascular, and gastrointestinal (GI)).

Anecdotally, it would seem we are seeing more severe, life-threatening anaphylactic reactions in the last 5 years, which may also be due to our improved recognition of the disease. These are often some of the most severely and acutely ill patients we see in practice, and without timely and accurate identification and intervention, mortality can be very high.

: Preformed mediators of the mast cell and basophil. (All figures courtesy of Jayme Hoffberg, DVM, DACVECC, Board Certified Criticalist) 

There are numerous causes of allergic and anaphylactic reactions including insect bites and stings, vaccines, or other drugs though many of our patients will have an unknown trigger. In this article we are going to focus on IgE mediated type I hypersensitivity. 

Our 2 main “bad boys” of anaphylaxis are the mast cell and the basophil (

). Both release histamine and mast cells will also release heparin. These 2 mediators are stored in granules preformed so there is prompt degranulation and release from the cells. This occurs when an antigen (an allergen) attaches to an IgE antibody on the surface of the cells. The release of these granules occurs within seconds to minutes. Then within 5-30 minutes there is downstream activation of the arachidonic acid cascade which releases prostaglandin, leukotrienes, and platelet activating factor. About 2-6 hours post stimulation, there is release of cytokines and chemokines such as interleukins and Tumor Necrosis Factor alpha (TNFalpha).

Histamine makes up about 70% of the weight of the basophils and mast cells so these cells pack a big punch. Histamine levels can be measured in plasma within one minute of an anaphylactic stimulus. The effects of histamine are based on the overlapping effect of the 4 histamine receptors.

 Main histamine driven effects are going to include cutaneous changes, respiratory effects, cardiovascular derangements, and GI and hepatobiliary changes. We will discuss more about the clinical presentation, but overall histamine receptor activation will cause vasodilation, increased vascular permeability, bronchoconstriction, heart rhythm disturbances (often tachycardia), and overall decrease in cardiac output driven by reduced cardiac contractility (inotropy).

The other granule mediator with early effects is heparin. Heparin will decrease clot formation but also can be a component of a hyperfibrinolytic state meaning there is an increase in clot breakdown. This means the animal can form a slower and weaker clot that is more prone to rapid breakdown and an inability to stabilize the clot.

The arachidonic acid cascade occurs after this immediate granule release when phospholipase A2 catalyzes membrane phospholipids to arachidonic acid. Arachidonic acid is then further catalyzed via COX and LOX to prostaglandins, thromboxane, and leukotrienes.

 These are responsible for additional bronchoconstriction, pulmonary and coronary vasoconstriction, and peripheral vasodilation. Slow reacting substances of anaphylaxis SRS-A) are also formed and are 1000x more potent than histamine with a longer duration of action. These cause bronchoconstriction, permeability changes, and chemotaxis. They are likely involved in the more protracted reactions.

 Cytokines and chemokines are also released. These chemotactic factors draw more immune cells to the area which causes further inflammation especially important in some of the later stage effects.

A dog’s shock organ is the GI and hepatobiliary system and this information in conjunction with the knowledge of these 2 main granules will help explain the life-threatening effects seen in canine anaphylaxis. While there is peripheral vasodilation, alternatively there is portal hypertension meaning there is an increase in the blood pressure in the portal system which is the vascular bed to the GI and hepatobiliary system. This portal hypertension occurs due to increased arterial blood flow to the portal system (hepatic arterial vasodilation) but decreased outflow of blood from the liver (increased hepatic venous outflow obstruction).

While increasing blood flow to tissues can be beneficial, when it becomes dysregulated it is detrimental to the tissues perfused causing ischemia and damage. When combined with the vascular permeability changes driven by heparin and the hypocoagulability effects from the heparin the effects are compounded.

Onset of an allergic and anaphylactic reaction are often rapid within 5 to 30 minutes with continued rapid progression. The time of onset and speed of progression are proportional to the severity of immunologic response so a bigger immune stimuli and mediator release will cause a quicker, more rapidly progressive and, therefore, more life-threatening response. There are also delayed reactions and biphasic reactions which can occur. These are often mediated by Ig other than IgE and are beyond the scope of this article, but it is important to note that there is thought that biphasic reactions may increase mortality.

Cutaneous changes such as pruritis, rhinitis, peripheral edema/erythema, facial angioedema, and urticaria are generally thought to be mediated by the H1 receptors but H2 receptors also can cause some of these skin changes which is why they are so common in allergic reactions. These cutaneous signs may be a potential precursor to more severe reactions but are also often delayed or can be completely absent in rapid anaphylaxis.

Dogs with anaphylaxis rarely present with the expected hives/cutaneous signs we would use as signs of an allergic reactions with a recent study showing 57.9% of dogs with anaphylaxis had no cutaneous signs reported.

 When these cutaneous signs occur, they may wax and wane for days.

Cats will likely have more respiratory signs as the lung is their shock organ, but regardless of species, the respiratory tract is affected in anaphylactic reactions in multiple ways. This can be due to pulmonary changes caused by bronchoconstriction, vasodilation, and increased vascular permeability, which causes increased airway resistance, increased fluid leak and pulmonary edema. There can also be increased respiratory mucous production worsening airway resistance and potentially inhibiting gas exchange. Stridor or other signs of upper airway obstructive disease can also occur due to laryngeal and nasopharyngeal edema especially in patients with already compromised airway patency like brachycephalic dogs. Delayed respiratory effects can also occur due to the arachidonic acid pathway and chemokines/cytokines increasing inflammatory cell recruitment, platelet aggregation and damage to the pulmonary endothelium which can cause acute lung injury (ALI).

A recent study found 26.8% of dogs had respiratory signs with anaphylaxis, and respiratory distress was found to be associated with non-survival.

In anaphylactic reactions, the first signs are often severe GI signs. Peracute GI signs including severe vomiting and diarrhea often hemorrhagic in nature are often the presenting complaint. These GI losses will then further contribute to hypovolemic shock. Vascular permeability changes and GI barrier function damage can also allow for bacterial and cytokine translocation and SIRS/Sepsis. Furthermore, as H2 receptors mediate gastric acid secretion, there can be significant 

increases in gastric acid production which can predispose these patients to gastric and duodenal ulceration.

Anaphylaxis can affect coagulation in multiple ways with severe anaphylaxis causing a global hypocoagulable state including decreased clot formation and clot formation, increased clot breakdown, and decreased platelet count.

 The cause of this coagulaopathy is multifactorial and at this time still not fully understood, but one major cause is due to the massive release of heparin. These animals will often have a mild to severe increase in aPTT (proportionally worse than PT). In simplified terms, this is due to the abundant effect of heparin on factor X activation as part of the intrinsic pathway.

Shock occurs due to a combination of causes. One study showed cardiovascular dysfunction in 42.1% of dogs with anaphylaxis.

Hypovolemic shock occurs due to fluid losses notably in the GI tract or due to hemorrhage. Additionally, histamine can decrease cardiac contractility and cause arrhythmias thereby dropping cardiac output causing cardiogenic shock. Vasodilatory or maldistributive shock also occurs due to peripheral vasodilation. There is also metabolic shock due to the cytokine effects on cell function. These animals will often present hypotensive with other signs of severe malperfusion (dull mentation, low temperature, elevated lactate etc) but may have pink mucous membranes.

This peripheral vasodilation in shock is seen in cases of distributive shock like anaphylaxis and sepsis/SIRS as well as other conditions beyond the scope of this article. In addition to all these effects, it is important to note that histamine will also dampen the body’s response to catecholamines normally released in shock to thereby blocking the body’s ability to restore cardiac output, perfusion, and delivery of oxygen.

As there is no anaphylaxis point of care test and these dogs often do not present with telltale cutaneous signs, the necessary rapid identification can be difficult. Other non-specific signs such as rapid onset severe GI signs or shock/collapse should trigger the clinician to start looking for some markers seen in anaphylaxis. Alanine transaminase (ALT) elevation and gall bladder wall edema have been found to be markers of anaphylaxis and when combined with other findings should prompt consideration of the diagnosis.

An increase in ALT is commonly seen in anaphylaxis and often occurs very rapidly.

 ALT increases due to ischemia and hypoxia of the hepatocytes driven by alterations in blood flow as well as direct injury from cytokines to hepatocytes. ALT will generally be high in anaphylaxis with a sensitivity of 95% and specificity of 98%.

 It increases rapidly in less than 12 hours from insult, peaks usually in 1-2 days and will often return to normal in 2-3 weeks depending on the peak value.

A halo or double rim effect to the gall bladder can occur almost immediately after insult due to portal hypertension and vascular permeability changes.

 Sensitivity of this marker is 93% with a specificity of 98%.

Epinephrine is the first line treatment for anaphylaxis. It should always be the first drug reached for when all the above information triggers your suspicion of anaphylaxis.

Epinephrine is a mixed adrenergic receptor agonist. Among its effects, vasoconstriction increases blood pressure and decreases airway mucosal edema. Its positive inotropic and chronotropic effects increase cardiac output and blood pressure as well while its beta 2 effects cause bronchodilation. It will also suppress inflammatory mediator release by stabilizing the mast cell and basophil granule release and provides relief from urticaria.

Epinephrine has a short duration of effects and can cause arrhythmias, hypertension, anxiety, tremors, or pallor but side effects are generally very mild especially when given IM or as a CRI. Dose recommendation is 0.01mg/kg IM with a max dose of 0.3 mg in patients <40 kg or 0.5 mg in patients >40kg.

 The dose can be repeated every 5-15 minutes as needed to help relieve signs. The author will give an immediate IM dose on suspicion for anaphylaxis. If shock or a hemoabdomen is identified, then a second IM dose is given before starting a CRI titrated to normalize blood pressure starting at 0.05 mcg/kg/min.

The author also treats other allergic reactions with epinephrine IM even if there are no “anaphylactic cues” as anecdotally it seems to help relieve hives sooner in these patients but there is currently no evidence to support this in canine patients.

Commercial epinephrine pens are usually not used as the needle is too short if a patient is obese (SQ injections are not recommended), you cannot dose <15 kg accurately, there is a short, labeled shelf life of 12-18 months, and they are very expensive.

Antihistamines are considered a second line drug in people and administration should never cause a delay of administration of epinephrine. Even though it is not a first line drug, blocking histamine is very important as part of treatment. Since there are overlapping effects from different histamine receptors consider blocking both H1 and H2 by pairing Diphenhydramine (2.2mg/kg IM, SQ, or PO every 8 hours) and famotidine (0.5-1mg/kg IM, SQ, or PO q 12 hours). We generally recommend continued antihistamine medications for 3-5 days as the lasting effects of the histamine release can cause wax and wane signs for a few days, especially the skin effects.

Glucocorticoids may have a couple purposes in allergic reactions, but their use is controversial in human medicine to treat anaphylaxis. Steroids do not generally have direct effects on the early symptoms of anaphylaxis such as dermatologic changes but their direct physiologic benefit in anaphylaxis is more directed in down regulating the late-stage response mediated by arachidonic acid and cytokines/chemokines or may help limit a biphasic reaction. The onset of action is about 4-6 hours regardless of route so again these are likely not helping as much as we may believe in the acute treatment. They can be useful in animals with upper airway swelling causing obstructive changes.

The author uses steroids in severe anaphylactic patients and simple allergic reactions in patients who are brachycephalic and have signs of upper airway obstructive disease regularly but does not use them in most other simple allergic reactions. Dosing may change based on clinical preference, but the author generally will start with a 0.1mg/kg dexamethasone dose IV, SQ, or IM then a tapering dose of prednisone depending on the clinical picture of the patient.

There are many factors that cause the potential for high mortality in anaphylactic patients if not treated correctly. The patients that have had the worst morbidity and mortality in the authors experience are those with severe hemoabdomen. Remember, these dogs have portal hypertension and this change, vascular permeability alterations, and coagulopathy will all set a perfect stage for intraabdominal bleeding.

Interestingly, not all dogs with hemoabdomen have been found to have coagulation testing abnormalities again confirming this is a multifactorial cause which can complicate treatment.

 Hemoabdomen ranging from mild to severe and rapidly fatal can occur and need to be the addressed immediately as the more an animal bleeds, the worse their coagulopathy will become further impeding our ability to treat. If there is evidence of an anaphylactic reaction and hemoabdomen, clotting times or viscoelastic testing should be evaluated but waiting on these tests may not be feasible to prevent worsening morbidity and mortality.

: Ultrasound images of hypoechoic liver masses identified on dog diagnosed with anaphylactic reaction.

Rapid administration of the above epinephrine dose should be given along with plasma transfusion starting with 20ml/kg of fresh frozen plasma should be considered. These dogs often rapidly stabilize after epinephrine and plasma, but some need a larger volume of plasma, red blood cells, platelets, or fresh whole blood transfusions and prolonged epinephrine CRI to stabilize. If blood products are not available, the IM epinephrine recommendations should be followed immediately while looking for rapid transfer to a facility with blood product availability.

: Recheck ultrasound of same dog as figure 2 one week later showing resolving masses.

It is important to note that if ultrasound is performed on these patients, mass like hematomas have been noted especially in the liver due to the intraparenchymal bleeding (

). It is a clinical judgment call based on all the information of the case that will help you determine if this is a patient with a hemoabdomen due to a primary bleeding mass that needs surgical stabilization or if this is an anaphylactic patient with hepatic hematomas who needs rapid medical stabilization. These mass like lesions, if they are hematomas, should resolve over time on recheck ultrasounds (

As the treatment of these patients is so crucial, at the authors hospital we utilize a flow chart (

) in our training to help aid diagnostics and treatment.

: Flow chart utilized at the author's hospital for treatment and diagnostic recommendations for an anaphylactic hemoabdomen.

General care for shock for these patients is instituted including fluid therapy, epinephrine CRI as needed, or dobutamine if there is continued hypotension and evidence of poor inotropy. Monitoring and correction of cardiac arrhythmias may be necessary. GI support is also important such as supported enteral nutrition via a nasogastric tube. Monitoring of organ function, hematologic variables, and other hemodynamics will vary based on the case presentation.

 is Head of Emergency and Critical Care at Thrive Pet Healthcare Specialists in Hoffman Estates, a suburb of Chicago. She earned her Bachelor of Science degree and then her Doctor of Veterinary Medicine with high honors from the University of Illinois. She went on to complete a three-year residency in emergency and critical care at the Veterinary Teaching Hospital of Michigan State University before becoming an assistant clinical professor at the University of Wisconsin. Hoffberg has spent the last 10 years developing emergency and critical care departments and house officer training programs at multiple large private specialty hospitals. She finds excitement watching the quality of medicine and job satisfaction improve across an entire team when training and education is prioritized. Clinically, Hoffberg’s main interests are in extracorporeal therapies, polytrauma, and hematologic and coagulopathic conditions. Hoffberg is also a published author and co-author of multiple veterinary journals and publications.

Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update [published correction appears in J Allergy Clin Immunol. 2010 Dec;126(6):1104]. 

. 2010;126(3):477-80.e842. doi:10.1016/j.jaci.2010.06.022

Shmuel DL, Cortes Y. Anaphylaxis in dogs and cats. 

. 2013;23(4):377-394. doi:10.1111/vec.12066

Smith MR, Wurlod VA, Liu CC. Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity. 

 2023;33(6):648-655. doi:10.1111/vec.13345

Fosset FTJ, Lucas BEG, Wolsic CL, Billhymer AC, Lavergne SN. Retrospective evaluation of hypersensitivity reactions and anaphylaxis in dogs (2003-2014): 86 cases. 

. 2023;33(5):577-586. doi:10.1111/vec.13319

Quantz JE, Miles MS, Reed AL, White GA. Elevation of alanine transaminase and gallbladder wall abnormalities as biomarkers of anaphylaxis in canine hypersensitivity patients. 

. 2009;19(6):536-544. doi:10.1111/j.1476-4431.2009.00474.x

Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. 

. 2020;145(4):1082-1123. doi:10.1016/j.jaci.2020.01.017

Hnatusko AL, Gicking JC, Lisciandro GR. Anaphylaxis-related hemoperitoneum in 11 dogs. 

. 2021;31(1):80-85. doi:10.1111/vec.13017

Summers AM, Culler C, Cooper E. Spontaneous abdominal effusion in dogs with presumed anaphylaxis. 

. 2021;31(4):483-489. doi:10.1111/vec.13070

Identifying culprits of this allergic reaction to help veterinary teams save their patients’ lives

Navigating canine anaphylaxis 

The World Veterinary Association (WVA) announced that this year’s World Veterinary Day will celebrate veterinarians as essential workers in their communities. The official theme, “Veterinarians are essential health workers” honors veterinarians and all do to keep their communities safe and protected.

“This dimension of the veterinarians’ work often remains invisible to the society but protecting and improving the health of people and their communities is an essential part of the vet profession,” the WVA shared in an organizational release.

 “All graduated veterinarians have undergone comprehensive medical training, and regardless of their professional area of practice, are responsible, for promoting public health and food safety and security.”

In 2000, the WVA created World Veterinary Day to celebrate the veterinary profession and it takes place each year on the last Saturday of April. Each year, the WVA and the Health for Animals, a global health care industry association, present the World Veterinary Day Award.

 The award is presented to whomever is promoting the theme to the highest degree. The winning campaigns can be campaigns local to communities, educational seminars, new research, media campaigns, and more. If selected, the winner will receive $5,000.

For example, on 2021, the American Veterinary Medical Association (AVMA) won the award for the theme “Veterinarian response to the COVID-19 Crisis resource center. The AVMA kept the center up to date throughout the COVID-19 pandemic to make sure veterinarians across the world had access to these resources to better serve their communities. The resource center included scientific summaries, short videos, risk assessments summaries, online tools, blogs, and other resources.

World Veterinary Day - World Veterinary Association. World Veterinary Association. Published March 18, 2022. https://worldvet.org/activities/world-veterinary-day/

World Veterinary Day celebrates veterinarians as essential health workers. News release. American Veterinary Medical Association. March 11, 2024. Accessed March 11, 2024. https://www.avma.org/news/world-veterinary-day-celebrates-veterinarians-essential-health-workers

AVMA wins World Veterinary Day Award 2021 recognizing the veterinary response to the COVID-19 crisis. News release. American Veterinary Medical Association. July 30, 2021. Accessed March 11, 2024. https://www.avma.org/news/press-releases/avma-wins-world-veterinary-day-award-2021-recognizing-veterinary-response-covid#:~:text=%E2%80%9CIn%20the%20U.S.%2C%20the%20work,2021%20World%20Veterinary%20Day%20Award.

The 2024 World Veterinary Day theme honors veterinarians as essential workers 

World Veterinary Association announces 2024 World Veterinary Day theme 

Inventory Ally was made to optimize inventory costs, reduce shortages, and decrease the amount of time spent managing inventory. The system leverages a clinic’s order history to streamline weekly cycle counts and prioritize items by value and sales volume. It provides precise recommendations for ordering based on your clinic’s counts, offering a comprehensive solution to enhance confidence and improve your bottom line.

Veterinary Formula has added Ear Therapy Wipes and Tear Stain Wipes to its line of medicated solutions for dogs and cats. The ear wipe formula targets bacterial, yeast, and fungal infections, and is made with ingredients like lactic acid, ketoconazole, benzoic acid, and salicylic acid. It helps owners remove dirt and debris from their pet, while combating odors and keeping ears free of wax buildup. The tear stain wipes provide a gentle and convenient way to clean and soothe pets’ eyes, and are made with green tea, chamomile, and valerian extracts. These wipes help remove discharge that causes stains, itching, and irritation.

Aimed to boost efficiency and optimize financial management for veterinary businesses, iVET360 has created a new bookkeeping service developed and led by financial experts who tailor each service to your practice and specific financial goals. iVET360 ensures that its bookkeeping services can provide accurate “apples-to-apples” financial comparisons for veterinary practices, data-driven expertise, and a personalized solution.

SwiftPaws has created a hands-free game of chase controlled by a remote and powered by a battery. The chase kit can be set up in a backyard or open grass area for dogs to chase a ball that runs along a wire. The original kit has speeds up to 30 mph and can cover 300 sq ft of distance for dogs to run around. The original home kit comes with “SwiftPaws Home” main unit, remote control, 3 pulleys, battery, charger, flags, line, line winder, stakes, tethers, and tote bag.

ALLFLEX CleanVax nozzles and shields provide a sanitary, quick way of administering intranasal vaccines to cattle. From Merck Animal Health, CleanVax features shorter nozzles that are less intrusive than traditional cannulas. Additionally, it includes disposable clear plastic shields that can be swapped between animals or groups, ensuring a more hygienic administration process. This product is designed to be calf-friendly and hygienic with an added layer of protection in the shield. The atomizer tips ensure even distribution across mucosal surfaces and reduce product drip.

The ElleVet Sciences CBD + CBDA product line includes soft chews, softgels, oils, paste, and situational/emergency chews. The regular-use dog chews and oils are effective for joint discomfort and mobility, as well as stress, skin, neurological, and cognitive issues. The Calm & Comfort emergency chews are for dogs needing help during highly stressful events such as fireworks, thunderstorms, grooming, or separation anxiety. The softgels have all the benefits of the chews but are a great option for dogs with sensitive stomachs. The CBD + CBDA paste was designed specifically for cats.

Here's our regular rundown of new and notable veterinary products

dvm360® product report: Inventory system, plus cattle vaccines, and more

Koche, a 7-year-old American Paint Horse was brought to Texas A&M College of Veterinary Medicine and Biomedical Sciences Large Animal Hospital after his owners noticed he was in pain (Image courtesy of Texas A&M College of Veterinary Medicine and Biomedical Sciences)

Cedrick Harvey brought Koche, a 7-year-old American Paint Horse, to Texas A&M College of Veterinary Medicine and Biomedical Sciences after Koche started to experience flareups of colic. According to Harvey, Koche had been healthy for her entire life up until March 2023 when the family began noticing she was presenting with signs of pain. Koche holds a special place in Harvey's heart because of her family history with the family.

“Her grandmother was an amazing Paint horse named Apache that grew up within our family,” said Harvey, in an organizational release.

 “We really wanted to keep her bloodline alive, so we bred her and got Cody, who was Koche’s father. So, I’ve had Koche since her birth.”

Koche was brought to her local veterinarians to try and determine what was causing her pain, but the doctor was unable to diagnose her but recommended her to the Texas Texas A&M College of Veterinary Medicine and Biomedical Sciences Large Animal Teaching Hospital (LATH). Here, she was able to be treated with more advanced equipment to help diagnose and treat her pain.

“[Horses with colic] do what I call the ‘no-pants dance,’” said Dustin Major, DVM, DACVS (LA), a VMBS clinical assistant professor of large animal surgery.

 “They circle around and posture like they’re about to lay down, but then they never do. Koche was doing that little dance and kicking at her belly, so we knew she was in pain.”

According to the release, colic is a general term used for abdominal pain in horses that can have a wide variety of causes, but each horse experiencing it tends to have the same reaction.

 When Koche arrived at LATH, she was given medication to reduce her pain and she received what is commonly known as the colic workup. Major began a physical exam, checked for gastric reflux with a nasogastric, and a rectal exam to palpate her internal organs. The team determined that she did not have reflux, and all Major could feel on her rectal palpation was some feed in her large intestine, which he explained was nothing out of the ordinary. After the colic workup, the team found nothing that would cause her to show the signs of pain she was presenting with.

The X-ray of the cantaloupe-sized stone found in Koche’s colon and the stone next to a one-inch needle 

Major then performed an abdominocentesis and an abdominal x-ray, but both provided no answers as well. With no other options, he decided that he needed to go for the final option, colic surgery. Major studied her abdominal organs during the procedure to look for what was causing her pain, and the answer became clear, she had a tone the size of a cantaloupe inside her large colon.

 The stones, known as enteroliths, are formed in the horse's right dorsal colon, the section designed to contract and pack things together. Major explained that this is common in horses in California, but is relatively rare in Texas, which could be why it was tricky to diagnose.

“It’s sort of like making a pearl; the horse ingests a piece of wood, gravel, or something else and then the colon compacts minerals around it, layer upon layer upon layer,” explained Major.

 “The stone then goes down to the transverse colon, where it lodges and backs everything up. The stone can come back out of the transverse colon and then lodge in it again, which is why these horses can be intermittently painful.”

Major was able to remove the 5-pound stone during the colic surgery and after discussing with Harvey, they determined that the enterolith was caused by a high diet of alfalfa combined with high calcium content in the water in Crosby, the town they are from. X-rays were performed on the stone to see if they could determine what was at the center, but the results came back inconclusive.

Her successful treatment was accredited to her local veterinarian, the LATH team, and Harvey’s pushing for someone to help find the source of her pain. Horses that do not receive treatment for their source of colic, including enterolith like Koche, can be at risk of death.

“If you have a horse with colic and it’s not getting better, it’s better to go ahead and be aggressive on the front end,” explained Major.

“You’ll spend less money and have a better chance of having a successful outcome. Especially from a surgical perspective, the earlier we get into the abdomen, the better. Literally, minutes count.”

Koche stayed at LATH for a week before returning home to her family.

Megan Myers. Texas A&M veterinarians leave no stone unturned in diagnosing horse’s mysterious colic. Texas A&M College of Veterinary Medicine and Biomedical Sciences. Published March 5, 2024. Accessed March 11, 2024. https://vetmed.tamu.edu/news/press-releases/koche/

An American Paint Horse was brought to Texas A&M after he began experiencing recurring stints of colic 

Texas A&M veterinarians diagnose cause of mysterious colic 

A new vaccination shows successful treatment of canine cancer after a golden retriever, Hunter, has no evidence of bone cancer after therapy. In early 2022, Hunter was diagnosed with osteosarcoma, a prognosis of 70% of patients not living longer than 12 months after developing the disease.

 Osteosarcoma is the most common primary bone tumor in dogs, representing 85% to 98% of all bone tumors.

 Appendicular osteosarcoma is the most common malignant primary canine bone tumor and is typically found in large to giant dog breeds. When treated by amputation or tumor removal alone, median survival times do not exceed 5 months, with the majority of dogs suffering from metastatic disease.

After undergoing treatment from Yale researcher, Mark Mamula, PhD, Hunter now has no evidence of cancer. The vaccination treatment is a form of immunotherapy that is currently under review by the US Department of Agriculture. The vaccine has also been tested in clinical trials

 and has demonstrated promising results for the vaccine, showing its effectiveness in hundreds of dogs, including Hunter.

Mamula is currently a professor of medicine (rheumatology) at Yale School of Medicine and has been working on this research development for years. "Dogs, just like humans, get cancer spontaneously; they grow and metastasize and mutate, just like human cancers do,” said Mamula in a Yale university release.

 “If we can provide some benefit, some relief — a pain-free life — that is the best outcome that we could ever have.”

Much like in humans, researchers have discovered that dogs with various cancers, such as colorectal cancer, breast cancer, and osteosarcoma, exhibit elevated levels of proteins called epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2). The typical treatment for humans with these cancers involves monoclonal antibodies, which are proteins that can attach to and influence EGFR and/or HER2 function. However, patients often build resistance to these antibodies, diminishing their effectiveness over time.

To create a new treatment approach, Mamula and his team took am innovative route. While monoclonal antibody treatments are derived from a single immune cell and target specific parts of EGFR/HER2 molecules, Mamula and his team aimed to trigger a polyclonal response. This means generating antibodies from multiple immune cells rather than just one, enabling them to bind to various parts of the EGFR/HER2 molecules instead of a single area. The goal is to reduce the likelihood of resistance development, theoretically enhancing the treatment's effectiveness.

The first clinical trial was conducted in 2016 and more trials are still ongoing at 10 locations in the US and Canada. Over 300 dogs have now been treated with the vaccine. The vaccine induces the production of antibodies capable of targeting and binding to tumors, which then disrupt the signaling pathways responsible for tumor growth. The research team currently reports a notable improvement in the 12-month survival rates of dogs with varying types of cancers, at approximately 35% to 60%. Additionally, many dogs undergoing the treatment experience tumor shrinkage.

 While exploring the vaccine's effectiveness in humans through clinical trials is a potential future step, the current focus for Mamula is obtaining USDA approval for the vaccine's use in dogs and its broader distribution.

“I get many emails from grateful dog owners who had been told that their pets had weeks or months to live but who are now 2 or 3 years past their cancer diagnosis,” Mamula said. “It’s a program that’s not only valuable to me as a dog lover. Witnessing the happiness that successful therapies provide to families with dogs is incredibly rewarding.”

Hunter had his front limb amputated and after the vaccine treatment, he has been cancer free for 2 years. He used to work alongside his owner, Deana Hudgins, as a search-and-rescue dog, helping find victims of building collapses and other disasters. After his cancer diagnosis, he no longer performs those duties, but now, at 11-years-old, Hunter helps Hudgins train other dogs.

Mamula told Yale that once this vaccine is approved and available on the market, it will be free for working dogs like Hunter.

Locklear M. Novel cancer vaccine offers new hope for dogs — and those who love them. News release. Yale University. March 5, 2024. Accessed March 11, 2024. 

https://news.yale.edu/2024/03/05/novel-cancer-vaccine-offers-new-hope-dogs-and-those-who-love-them

Dernell W, Straw R, Withrow S. Tumors of the skeletal system. In: Withrow S, MacEwen E, eds. 

Liptak JM, Dernell WS, Ehrhart N, Withrow SJ. Canine appendicular osteosarcoma: diagnosis and palliative treatment. 

Boerman I, Selvarajah GT, Nielen M, Kirpensteijn J. Prognostic factors in canine appendicular osteosarcoma - a meta-analysis. 

. 2012 May 15;8:56. doi: 10.1186/1746-6148-8-56. PMID: 22587466; PMCID: PMC3482154.

Doyle HA, Gee RJ, Masters TD, et al. Vaccine-induced ErbB (EGFR/HER2)-specific immunity in spontaneous canine cancer. 

. 2021;14(11):101205. doi:10.1016/j.tranon.2021.101205

Developed by a Yale researcher, this cancer treatment can offer a new solution for canines