George Robinson, DVM, MSPH, delivers the Day 2 morning keynote at the Fetch dvm360 conference in Long Beach, California on December 2, 2023.

When success seems elusive, you need to pivot and try to reach your goal in a new way. That was the main message shared by George Robinson, DVM, MSPH, founder and vice-chairman of Heartland Veterinary Partners in Chicago, Illinois, during his morning keynote on Day 2 of the Fetch dvm360 conference in Long Beach, California.

Robinson also peppered throughout his talk “the 4 P’s” more commonly associated with achieving success: preparation, persistence, perseverance and passion. He said 

. “I truly believe that failure is not an option,” he said. “I was always prepared to pivot.”

To drive home his point, Robinson shared some of his lifelong experiences with failure and success that led him to pivot as he built a career in veterinary medicine. “It’s an interesting path that’s laced with a lot of success, and laced with a lot of failure,” he said.

Prior to founding Heartland Veterinary Partners, a veterinary support organization for which he is a former CEO, Robinson owned and operated private veterinary practices in Louisiana, and served in leadership positions with National Veterinary Associates in Agoura Hills, California, and the Banfield Pet Hospital organization based in Vancouver, Washington. He is a former political party representative for the state of Louisiana, and currently sits on the board of directors of the Louisiana State University (LSU) System Foundation.

Robinson began walking attendees through his career trajectory with a story about his experience as a Boy Scout. In his quest to earn the coveted Eagle Scout status, he initially failed a weekend-long outdoor skills test when continuous rain presented challenges that he was unable to overcome. “Everything went really, really wrong,” he said.

Denied the Eagle Scout status, Robinson said he was depressed. However, he wanted to try again. “I knew only one thing: failure was not an option,” he said.

Robinson said his community quickly rallied for 6 weeks to help him build the skills would need to pass the outdoor test. He cooked over an open fire in his suburban backyard, he received instruction on how to swim, and a nature professor taught walked with him and taught Robinson about plants, along with others who supported his goal in a variety of ways. “With that combined community effort, I realized that I had to pivot,” he said.

Given the opportunity to test again, the outcome was much different than the first attempt. “I became the first African American Eagle Scout in the state of Louisiana,” Robinson said.

After graduating from the LSU School of Veterinary Medicine in Baton Rouge, Robinson was a graduate student at Howard University in Washington, DC, where he sought approval from the experimental program committee. The process typically took months, he said. However, in a meeting with university’s president of research, Robinson noticed an affiliation with the Boy Scouts and his Eagle Scout status earned him favor. “He approved my study that afternoon,” said Robinson, who went on to earn his degree in only 9 months, crediting preparation and persistence.

He also spoke about struggles as a private practice owner when he learned a hard lesson early on. “I made one of the biggest mistakes I think a lot of us in private practice make… You love everything that you do, but you don’t give your people the respect that they deserve and need, and you’re not patient,” he said.

Robinson said he had been treating his employees without empathy, and acted “fussy” about their work, expecting his entry-level staff to know more about veterinary operations than they did. On Christmas Day, his entire team quit, leaving him to handle many patients without professional support. As a result, he pivoted and persevered. “I changed my attitude about employees. I changed my thought process on their development, and things got better” he said. 

Robinson closed his talk by encouraging attendees to embrace all of the “P’s”, not to be afraid of setbacks, seek out support, react to change with courage, and simply move forward. “And be prepared to pivot,” he said.

Robinson G. The Pivot. Presented at: Fetch dvm360 conference; Long Beach, California. December 1-3, 2023.

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George Robinson, DVM, MSPH, spoke to Fetch dvm360 conference attendees about overcoming failures to reach his goals, in a morning keynote address

Pivoting is key to veterinary leader’s success

Louise S. Dunn delivering her keynote presentation at the Fetch conference in Long Beach, CA.

Louise S. Dunn addressed the room of veterinary professionals attending the Day 1 keynote presentation the Fetch dvm360 conference in Long Beach, California, by asking the simple question: “Would everyone agree that the face of the profession is changing?” Followed by an overwhelming agreement from attendees, Dunn explained that from this change in the veterinary profession, new solutions and protocols may be needed to improve practice operations. But her biggest piece of advice with inevitable change is to be proactive instead of reactive. This can keep your practice ahead, instead of always playing catch up. In her session, “Unlocking Synergy: Mastering the Dynamic Interplay of Clients, Teams, Business, & Technology,” Dunn explained different areas of the profession and how to use change to your advantage.

The COVID-19 pandemic created a huge need for change and those effects are still being used. Dunn explained that telemedicine, curbside services, and digital forms and sign-ins have all been utilized after the pandemic demanded social distancing. However, the effect of this change found that clients valued a lot of these service innovations. Even without distancing protocols in place, some clients still prefer to have some appointments through video for behavioral reasons, or for geriatric/senior patients. According to Dunn, clients also appreciate the convenience of curbside and online forms.

“We have all the different specialties for technicians, [but] are we using [them]? Are you using technicians with special interests? The outlooks are that the majority of practices are not,” Dunn stated. She used a quote from the former dean of the University of Florida College of Veterinary Medicine, James Lloyd, to emphasize her point. Llyod had once said, “The more credentialed veterinary technicians and other non-DVM staff members you have supporting each veterinarian, the more likely it is that your hospital will operate efficiently.” Dunn stated that the rise in pet ownership created the increasing need for more veterinary staff members. Utilizing technicians in the clinic can help with better workload delegation and daily flow. She also stated that proper utilization of all staff members can help them learn and grow in the field.

Dunn also recommended using a work from home model for client service representatives (CSRs). This can allow some positions within the clinic to have a more flexible work schedule. “Did you know that there was a survey—not just in veterinary medicine—where they said you could have a 20% wage increase or you can continue to work from home. The majority of people said they'd rather stay working from home,” Dunn said. CSRs can schedule appointments and follow-up with clients over the phone while at home.

Dunn’s final message reminds attendees of the lasting effects these innovative adjustments will continue to have on the future of veterinary medicine. The pandemic revealed areas of improvement in the business model and offered opportunities for adaptation. However, Dunn also reminded everyone to focus on what their own practice specifically needs, because that can vary from practice to practice.

Dunn LS. Unlocking Synergy: Mastering the Dynamic Interplay of Clients, Teams, Business, & Technology. Presented at: Fetch dvm360 conference; Long Beach, California; December 1-3, 2023.

Louise Dunn underscored the value of being proactive to change during her Day 1 keynote session at the Fetch dvm360 conference in Long Beach, California

Be proactive with your clinic innovation

Experts in canine infectious respiratory disease (CIRD) are urging caution as a mysterious canine respiratory disease continues to make headlines in the United States. As incidences of the mysterious virus are increasingly reported across the country, it is becoming widely discussed among veterinary professionals and their clients. 

The pathogen or virus causing this Canine Infectious Respiratory Disease (CIRD) is unknown. Investigators in Oregon and New Hampshire are among those researching the disease.

In Oregon, more than 200 reports of CIRD cases have been received by the Oregon Department of Agriculture (ODA) since August 2023.

 The ODA is reportedly working to identify the cause of these cases in collaboration with local veterinary professionals at Oregon State University's Carlson College of Veterinary Medicine, the Oregon Veterinary Diagnostic Laboratory, and the USDA's National Veterinary Services Laboratory.

The University of New Hampshire's New Hampshire Veterinary Diagnostic Lab and its' Hubbard Center for Genomic Studies started investigating this respiratory disease in mid-2022. Preliminary findings released in June 2023 showed that investigators were unable to identify any pathogens responsible for the CIDA.

The Colorado Department of Agriculture (CDA) reported calls coming in over a recent period of 2 months from veterinarians experiencing double the typical number of patients with canine infectious respiratory disease in the state than what is normally seen during an outbreak of this type.

Silene St. Bernard, regional medical director for VCA animal hospitals in Southern California, DVM, DACVPM, said they are also seeing an increase in respiratory cases in different locations, in an interview with 

 “Some of those cases are cleanly getting diagnosed with assorted viruses and bacteria that we already know about and can test for. But we seem to have some cases in some locations that are progressing to more serious illness, potentially into a pneumonia, and we don’t have diagnoses for all of them.”

There are more than 10 states, including Florida, Illinois, Massachusetts, and Rhode Island, with similar patterns of CIRD incidence, according to the CDA.

With the rise of attention to this disease through national media and worried clients calling clinics to ask about their pet's risks and health, it is important to understand what is known about this disease.

The canines that are at risk have interactions with other dogs through boarding, daycares, parks, and groomers. Although shelters are typically at risk for outbreaks due to crowing, animal shelter animals appear to be less affected by unknown pathogens such as this.

Dogs that are presenting with this disease at clinics typically have an acute cough, sneezing, nasal and eye discharge, fever, anorexia, and lethargy. Carl Osborne, DVM, Chagrin Falls Veterinary Center and Pet Clinic in Ohio, also advises clients whose dogs are coughing to remove their pet's collar. This way, it will not further irritate their trachea or hamper their breathing.

Teams that suspect a patient has this disease can test by swabbing the dog for a PCR test within 4 days of the first clinical signs. When the dogs are tested earlier, veterinary teams can prevent missing pathogens within a short shedding period, including CIV, pneumovirus, and respiratory coronavirus.

The respiratory PCR panels should include 

 bonchiseptic, canine adenovirus type 2, canine distemper virus, influenza A virus, 

 The cultures could be indicated for suspected bacterial infection not responsive to first-line treatment with 3 companies having commercial diagnostic laboratories for respiratory PCR panels: IDEXX Respiratory Disease (CRD) RealPCE Panel Comprehensive Canine (2524), Antech Canine Respiratory PCR Panel Code T995, and Cornell Canine Respiratory PCR Panel (CRPNL).

If the case is mild enough, it can be self-limited without treatment. However, cough suppressants may be used to make the pet more comfortable. Pets may need to be hospitalized for nebulization, intravenous antibiotics, oxygen therapy, and rehydration, and in severe cases, ventilatory support may be required.

Emphasizing the importance of keeping up with vaccinations, including canine influenza, Bordetella, and parainfluenza, to clients can help keep dogs safe from diseases. Because this disease is highly contagious, keeping dogs away from unfamiliar dogs, when possible, can keep them safe. If clinics have infected pets, they should implement a standard isolation and quarantine procedure for dogs and promptly isolate them using personal protective equipment.

Veterinary clinics should let their clients know if they are bringing in a dog that is presenting with respiratory, they should call ahead to let the staff know. This gives teams the chance to assess them outside before bringing them into the clinic to minimize the risk to pets in the waiting room or other exam rooms. Teams should also sanitize all animal areas, fomites, and any other possibly contaminated areas including, but not limited to, desk spaces, doorknobs, and phones.

St. Bernard also said that if they are coming into contact with this illness within their clinic and then going home to pets of their own, changing their clothes at the door and making sure everything is wiped down is a way to not bring this illness into their own home. 

As more information comes to light on this emerging CIRD, 

 will continue to report on important updates.

Canine infectious respiratory disease in Oregon. News release. Oregon Veterinary Medical Association. Updated November 28, 2023. Accessed November 28, 2023. https://www.oregonvma.org/news/reports-of-severe-canine-infectious-respiratory-disease-in-oregon

New Hampshire Veterinary Diagnostic Laboratory. Canine respiratory outbreak. University of New Hampshire College of Life Sciences and Agriculture. November 21, 2023. Accessed November 28, 2023. https://colsa.unh.edu/new-hampshire-veterinary-diagnostic-laboratory/canine-respiratory-outbreak

Canine respiratory disease. Colorado Department of Agriculture. Updated November 22, 2023. Accessed November 28, 2023. https://ag.colorado.gov/canine-respiratory-disease

Canine respiratory outbreak. University of New Hampshire College of Life Sciences and Agriculture. November 21, 2023. Accessed November 28, 2023. https://colsa.unh.edu/new-hampshire-veterinary-diagnostic-laboratory/canine-respiratory-outbreak

Mysterious Respiratory Disease Reportedly Spreading Among Dogs Across the Country. News release. University of Florida College of Veterinary Medicine. November 27, 2023. Accessed November 30, 2023. https://sheltermedicine.vetmed.ufl.edu/2023/11/27/mysterious-respiratory-disease/

Mystery Canine Illness Sweeping the Nation. News release. Chargin Falls Veterinary Center and Pet Clinic. November 28, 2023. Accessed December 1, 2023. 

While this mysterious canine infectious respiratory disease continues to spread across the United States, here is an inside look at what we know. 

Breaking down the mysterious canine infectious respiratory disease

explained how laser therapy can be beneficial for reducing pain

How laser therapy can be effective in pain management

, Leslie Gallagher McMahon, CCMT, CCRT, CEO and founder of Two Hands Four Paws in Los Angeles, California, explained just how effective laser therapy can be for pain management. She also shared her tips for expressing the benefits of laser to clients and how it can be a real benefit to painful patients.

Gallagher McMahon will be delivering a joint lecture on laser therapy at our Fetch Long Beach conference tomorrow, December 2nd. Check out all our 

The following is a partial transcript of the video.

So we use laser on probably most of our clients. I think it's the rare dog—I mean just the dogs with cancer that we don't laser, but we mostly use it for pain relief. And in any of the post-op dogs, we use it for tissue healing. You can also use it for otitis media, you can use your ear infections, you can use it for skin infections. But that tends not to be our focus here. What our number one concern of our clients here is pain management. So rehab laser is always going to be addressing the pain that these dogs are either the geriatrics that have severe osteoarthritis or the dogs recovering from surgery that have an awful lot of pain of post-op pain. Laser has been just miraculous in healing for us to get these dogs better. It's really been a game-changer.

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Fetch faculty member Leslie Gallagher McMahon, CCMT, CCRT, explained how laser therapy can be beneficial for reducing pain

Students from more than a dozen veterinary schools were presented with scholarship awards totaling $530,000 during the American Association of Equine Practitioners' (AAEP) 69th Annual Convention in San Diego, California. The scholarships were awarded by The Foundation for the Horse, a nonprofit organization that aims to improve the welfare of horses, and funded in partnership with other organizations. 

The 29 scholarship recipients are pursuing careers in equine practice. Their awards included 4 new scholarships totaling $75,000 as well as ongoing scholarship programs.

These scholarships reward veterinary students at colleges of veterinary medicine in the United States, Canada, the Caribbean, and Europe for their academic excellence, leadership in their school and in an AAEP student chapter, and their long-term goals in equine practice. Applicants apply during their second and third year of veterinary school and are required to have documented support of AAEP members and their clinical instructors.

Recipients of the foundation's ongoing scholarship programs including the following awards:

Four students received $75,000 Coyote Rock Ranch Scholarships:

Megan Elcombe, University of California, Davis

Ten students received $10,000 Zoetis Foundation Scholarships:

Amanda Ayers, University of California, Davis

Briana Blackwelder, North Carolina State University

Nicole Gonzales, University of California, Davis

Angela Mangine, University of Pennsylvania

Five students received $5000 Merck Animal Health Scholarships:

Alexandra Bettencourt, Texas A&M University

Scarlett Loya, University of Pennsylvania

Lauren Obermeyer, The Ohio State University

Harrell Phillips III, Kansas State University

Five students received $5000 Oakwood Foundation Scholarships:

Madeleine Edwards, North Carolina State University

James Ford III, Lincoln Memorial University

Additionally, Claire Long from Texas A&M University received the $5000 Dr. Bill Rood Leadership Scholarship. New scholarship program awards are as follows:

Hannah Quail from the University of Florida received the $50,000 Ellen DiBella Memorial Scholarship.

Annie Gerding from The Ohio State University received the $10,000 Richard & Anne Stirlen Foundation Scholarship Honoring Dr. Gus Abuja.

Meghan Poth from University of California, Davis, received the $10,000 Richard & Anne Stirlen Foundation Scholarship Honoring Dr. Laura Javsicas.

Tessa Beiter from Cornell University received the $5,000 Hagyard Equine Medical Institute Scholarship.

Established in 1994, The Foundation for the Horse annually awards more than $1 million annually in scholarships and grants to impact equine health and well-being throughout the US and developing countries. 

The Foundation for the Horse awards record $530,000 in scholarships. News release. November 30, 2023. Accessed December 1, 2023. https://aaep.org/node/38172

The 29 recipients were recognized during the American Association of Equine Practitioners' annual convention in San Diego, California.

Veterinary students awarded $530,000 in scholarships from The Foundation for the Horse

Minneapolis, Minnesota--(Newsfile Corp. - November 27, 2023) - One day in 2009, Dr Emily Stein, a microbiologist and postdoctoral fellow in rheumatology and immunology at Stanford University, was waiting for her grandmother, who was living in a care facility in Wisconsin, for their daily game of online scrabble. When her grandma didn't go online, she started to become worried. She then learned from her mother that her grandma had suffered a major stroke after having a tooth extraction the previous day.

Soon after the incident with Stein's grandmother, a study of thousands of US Medicaid claims was released, showing an increased risk of stroke/heart attack up to four weeks after a tooth extraction or dental implant surgery, which was something researchers had been looking at for quite some time. The invasive procedure creates an opportunity for microbes in the mouth, which are normally blocked by healthy gums, to enter the bloodstream and cause trouble somewhere else in the body. This is also why many people wind up with transient bacteremia (or bacteria in the blood) after a tooth cleaning procedure.

Stein was determined to find a solution to her grandmother's predicament, so she flew to Wisconsin to take oral samples from her grandmother and set up a miniature laboratory back in her apartment in California.

"I studied her oral microbiome, doing a high-throughput screening of any naturally safe ingredient I could give her," Stein said. "I was trying to find a way to prevent the microbes in her mouth from causing any further problems. So that's what I did for several years - I literally biohacked my grandma."

This incident was one of the reasons why Stein founded 

, a company that seeks to combat and rehabilitate oral dysbiosis, or an imbalance in the mouth's microbiome. However, another incident a few years later added another dimension to her work.

In 2012, Stein adopted a dog named Tinzley, a 10-year-old female Cocker Spaniel from a rescue organization in Washington State. She had been told that the dog needed dental cleaning, and, on the long drive home to the Bay Area, Tinzley became distressed and lethargic. Stein rushed her to an emergency vet and it was determined that her gum disease had progressed into a bloodstream infection. A total of 21 teeth had to be removed, plus a course of IV and oral antibiotics to clear out the infection, resulting in a vet bill of $6,000. Statistics show that 

, which could result in them losing up to 1/3rd of their lifespan.

According to Stein, current antibiotic and antiseptic approaches are ineffective in curbing the harmful microbes in the mouth, and these may contribute to antimicrobial resistance, creating more "superbugs" in the future. The incidents with her grandma and with Tinzley have inspired Stein and Primal Health to take a different approach to oral health for both humans and pets through its human brand 

Both brands focus on the importance of having a strong and properly aligned oral microbiome for both humans and pet dogs and cats. With billions to trillions of cells, microbes, bacteria, viruses, and fungi inside the mouth, maintaining balance in that environment improves overall health and well-being.

Daily Dental Care's pHossident lozenge uses a combination of ingredients generally recognized as safe (GRAS) by the FDA to help prevent acid and oral biofilm (plaque) production, as well as limits the growth of disease-causing bacteria associated with cavities, gum disease, and bad breath. It also helps create conditions conducive to the growth of beneficial bacteria that are essential for dental health.

Teef for Life offers three types of drinking water additives, Protektin42 (for dogs), Protektin30 (for cats), and Protektin42+K (for both dogs and cats), made from plant-derived ingredients that are gentle on pets' digestive systems. These naturally remove plaque and tartar, prevent smelly breath, and extend the benefits of teeth cleaning at the vet.

Put simply, both product lines bathe the bacteria in the mouth with nutrients that shift them to a keto diet, stopping the microbes from consuming carbohydrates and sugars and switching them to processing proteins, creating less harmful byproducts. Combined with proper diet and toothbrushing, these result in better oral health and lower risk of gum disease.

"Through personal experiences and my study of microbiology, immunology, and rheumatology, I've learned how important having a strong oral microbiome is to the general health of both humans and pets," Stein said. "Over millions of years, we evolved alongside numerous microbes inside and outside our bodies. Most antibiotic/antiseptic methods are toxic and do more harm than good. Instead, we subject microbes in the mouth to a nutritional 'carrot and stick' method, applying dual pressure points to steer the whole community away from pathogenic behaviors towards a more beneficial existence."

 is spent annually on oral healthcare worldwide, and with 1 in 2 people suffering from some form of dental disease, it's clear that the current status quo is inadequate. Stein aims to change that as she continues to innovate in the oral healthcare landscape.


Name: Angelic Brown
Email: Angelic.Brown@PrimalTx.com

Dr Emily Stein shares how her grandmother's stroke and the health struggles of her rescued dog led her to develop a way to restore balance to the oral microbiome of both humans and pets.