Ahead of his sessions at the Fetch dvm360 Conference in Long Beach, California, 

 spoke to Christopher Lee, DVM, MPH, DACVPM, DACVM (Parasitology); Cert: FFC, CFV, RECOVER-ALS, about a critical, high-stress scenario in general practice: managing vaccine-associated adverse events. Lee highlighted an important knowledge gap and a common protocol pitfall that he believes many veterinarians can address to improve patient outcomes.

Editor’s note: The following questions and answers have been consolidated and lightly paraphrased to fit this interview into a Q&A format.

: You’ve indicated that a significant gap exists in how veterinarians manage the most severe vaccine reactions. Can you elaborate?

: Vaccination is arguably our most powerful tool in preventive care, but the fear of a severe adverse event is real for both vets and clients. In my experience, the biggest gap is in the acute management of anaphylaxis, a Type I hypersensitivity reaction. It’s a high-stress emergency. A dog may come in with a swollen face, urticaria, or in shock. While the intent is right, I find that 9 out of 10 vets do not use the right cornerstone medication in that first, critical moment.

: What is the common therapeutic response, and what’s missing?

: The common response is to reach for diphenhydramine and dexamethasone, along with supportive care. Those medications aren't “wrong,” but they don't address the immediate, life-threatening pathophysiology. The critical drug that’s missing is epinephrine. If you could give one medication, what would that be? It is epinephrine. Think of it this way: For a person with a severe allergy, what do they carry? An EpiPen. It’s not a DexPen or a Benadryl pen. It’s an EpiPen. That’s the direct counter to the systemic vasodilation and bronchoconstriction happening during anaphylaxis.

: You stress the importance of differentiating between hypersensitivity types. Why is that so crucial for practice?

: Because the management and long-term strategy for each type is remarkably different. We need to differentiate type one through 4 reactions. In practice, you might see:

Type I: The immediate anaphylaxis we just discussed.

Type II: Immune-mediated reactions, like IMHA or thrombocytopenia.

Type III: Immune-complex reactions, which can look like a localized vasculitis or little bald spots at the injection site.

Type IV: Delayed-type hypersensitivity, which can cause sterile granulomas or lumps.

Understanding which pathway you’re dealing with is essential for everything from your acute treatment to your plan for future vaccinations for that patient.

: Beyond emergency treatment, you’ve identified a common error in vaccine administration protocol itself. What are you seeing?

: This is a widespread issue that started with a good intention. Decades ago, the concern over feline injection-site sarcomas rightly led to the protocol of giving feline vaccines very low on the body. However, that feline-specific protocol is now being incorrectly applied to dogs. I'm seeing a lot of people putting canine vaccines low on the limbs, and that is problematic. It is not helping out the pet; in fact, it's working against us.

: What is the correct approach for vaccine sites?

: For cats, keep everything low; for dogs, keep everything high. Administering vaccines high on the body in dogs is a lot more comfortable for the patient, and you're going to have fewer problems.

Lee will be presenting on this topic and other preventive medicine strategies at the Fetch dvm360 Conference in Long Beach, California. 

Articles

In a dvm360 interview, Christopher Lee, DVM, MPH, DACVPM, DACVM (Parasitology); Cert: FFC, CFV, RECOVER-ALS, recommends prioritizing epinephrine and species-specific administration to improve patient outcomes.

Put epinephrine first in anaphylaxis management

A new radiation therapy platform is set to enter veterinary medicine in early 2026. The new system, a robotically accelerated conformal beam radiation platform named Sirius, will make its debut at the cancer care center PetCure Oncology in Seattle, Washington.

The technology is being introduced through a partnership between Empyrean Medical Systems, a human and veterinary medical technology company, and Thrive Pet Healthcare, a nationwide network of veterinary hospitals. According to a joint press release from the 2 organizations, the system’s radiation treatment offers human-grade precision.

“This collaboration bridges [2] worlds—human and veterinary oncology—to accelerate innovation that improves lives,” Kal Fishman, president and CEO of Empyrean Medical Systems, said in the news release.

 “Empyrean’s vision is to change radiation oncology for good. Our partnership with Thrive marks an important step toward that mission by opening new frontiers for compassionate, high-performance cancer treatment in veterinary medicine.”

Approximately 12 million cats and dogs in the United States are diagnosed with cancer each year, making it the leading cause of death in dogs and one of the leading causes of death in cats, alongside chronic kidney disease.

According to Empyrean Medical Systems and Thrive, the system is designed to deliver photon augmented wave stereotactic radiation therapy, combining robotic beam positioning, Monte Carlo–based treatment planning, and real-time image guidance to target tumors with high-dose radiation therapy while “sparing healthy tissue and critical organs.”

The technology’s accuracy and adaptability allow veterinary professionals to provide faster, safer, and more effective care, the organizations said.

 They added that the system’s initial installation in Seattle will give pets and their families in the Pacific Northwest region greater access to lifesaving treatment.

“Facing a cancer diagnosis is one of the hardest moments a family can experience. Through this partnership, we’re helping make those moments easier with human-grade precision and compassionate care,” Scott Milligan, group vice president for Thrive Pet Healthcare, said in the news release.

 “By bringing the Sirius system to PetCure Oncology in Seattle, we’re advancing our vision for the future of pet well-being—one built on medical excellence, innovative technology, and collaboration across teams and partners who share our commitment to helping pets live longer, better lives.”

“This cutting-edge technology represents a major leap forward in veterinary radiation therapy, enabling us to deliver precise, noninvasive treatments with minimal adverse effects,” concluded Neal Mauldin, DVM, DACVR, DACVIM (Oncology), DACVIM (Internal Medicine), chief medical officer of PetCure Oncology.

Thrive Pet Healthcare and Empyrean Medical Systems partner to bring human-grade precision to veterinary cancer care with the Sirius advanced radiation platform. News release. Empyrean Medical Systems. November 20, 2025. Accessed December 1, 2025. 

https://empyreanmed.com/thrive-pet-healthcare-and-empyrean-medical-systems-partner-to-bring-human-grade-precision-to-veterinary-cancer-care-with-the-sirius-advanced-radiation-platform/

Cancer research – looking back, moving forward. Morris Animal Foundation. Updated June 29, 2023. Accessed December 1, 2025. 

https://www.morrisanimalfoundation.org/article/cancer-research-looking-back-moving-forward

The system is designed to deliver photon augmented wave stereotactic radiation therapy

Human-grade precision radiation therapy technology to debut

) is once again an active threat in the Americas. Cases in Mexico have increased, and detections are approaching the US border. Meanwhile, federal agencies and veterinary groups have released guidance for clinicians on identification, laboratory submission, reporting, and therapeutic options.

Below are the most common and practical questions clinicians are asking, with concise answers and links to supporting resources and the US Department of Agriculture (USDA)/Centers for Disease Control and Prevention (CDC) guidance where appropriate.

What is NWS, and how does it present clinically?

NWS larvae cause primary myiasis by burrowing into and feeding on living tissue. Affected animals often present with foul-smelling, expanding wounds with visible, active maggots. Mucosal infestations of the nose, mouth, or ears can also occur and are especially destructive. For clinicians, larvae are typically oriented head-down (posterior spiracles exposed), and wounds can expand quickly if not treated.

Read more about identification and clinical signs:

Screwworms: When the larvae don't care about boundaries

 reports, NWS detections in Mexico have surged, with cases now detected within approximately 70 miles of the US border. The USDA reported that the parasite is actively moving northward and that border-proximate detections have increased concern. That proximity prompted US trade and surveillance actions earlier this year.

Read more about the current status and risk:

New World screwworm detected less than 70 miles from the US-Mexico border

Watch now to hear an expert break down the latest on NWS: 

As screwworm nears the border, an expert explains how it spreads and what it means for the US

Dr. Lee breaks down the current NWS situation

 are obligate parasites that infest and consume the living flesh of warm-blooded hosts, which causes facultative myiasis.

 Confirmed cases have been reported within approximately 70 miles of the US border.

 USDA is working on sterile fly production/dispersal facilities and has stepped up surveillance; the sterile insect technique is central to eradication.

 Emergency use authorizations were issued for lotilaner (Credelio) in dogs on October 24, 2025, and cats (Credelio CAT) on November 21, 2025.

 Foul odor, expanding wound, visible larvae oriented head-down. Preserve larvae in 70% ethanol for lab identification.

Who do I notify, and how do I submit specimens if I suspect NWS?

USDA guidance is to immediately notify your state animal health official and your regional Animal and Plant Health Inspection Service (APHIS) office. APHIS has a dedicated NWS response resource with standard operating procedures (SOPs), reporting flows, and a Stop Screwworm information hub for clinicians. The CDC also provides clinical guidance for human cases. Follow APHIS SOPs for quarantine, movement restrictions, and premises for disinfestation if a confirmed case occurs.

As for submissions: According to APHIS, preserve larvae in leak-proof containers with 70% ethanol (or ≥ 70% isopropanol or 5-10% formalin if necessary). Aim to submit multiple larvae in various stages. Follow your state animal health office and APHIS SOP for sample submission and chain of custody. If possible, photograph the lesion and preserve live larvae separately (if the lab requests live specimens).

Read more about reporting and get specimen guidance:

What are the current treatment options for infested animals?

Treatment is primarily the mechanical removal of larvae coupled with wound debridement, topical care, and systemic support. In 2025, the FDA issued emergency use authorizations (EUAs) allowing lotilaner (Credelio) for dogs and lotilaner chewable tablets (Credelio Cat) for cats as therapeutic options under EUA conditions; follow FDA EUA and local regulatory guidance when using these products for NWS. Also use standard wound care, antibiotics if indicated, and reexamine lesions within 24 to 48 hours to ensure no live larvae remain.

FDA grants emergency use authorization for lotilaner to treat New World screwworm in dogs

Antiparasitic receives FDA emergency authorization to treat New World screwworm in cats

What should I tell clients about prevention and protection of pets and livestock?

Advise owners to promptly treat and protect open wounds, practice routine wound checks, and keep companion animals on year-round effective parasiticides when risk is high. Christopher Lee, DVM, MPH, DACVPM, DACVM (Parasitology), has recommended isoxazoline class products as one protective measure to kill larvae acquired by pets. For livestock, emphasize wound management, good husbandry, minimizing fly attraction, and rapid reporting of suspicious cases.

Watch now to learn more about client education and prevention:

Vet Watch update: Do you have normalcy bias?

According to APHIS, update your clinic’s wound management protocols and specimen submission checklists, brief staff on identification and personal protective equipment for handling larvae, and have contact info for your state animal health official and APHIS accessible. Consider stockpiling recommended topical/systemic wound care products and have an isolation/quarantine plan for affected patients. Additionally, review recorded USDA/CDC webinars for staff training.

Are there One Health or human health concerns I should be aware of?

According to the CDC, human infestations are uncommon but possible. Clinicians should counsel clients that NWS can rarely infest humans when there are exposed wounds or mucosal lesions. If there is potential human exposure, notify public health authorities and follow CDC clinical guidance. Collaboration between veterinary and public health agencies is a core part of the federal response.

New World screwworm myiasis. CDC. September 10, 2025. Accessed December 1, 2025. 

https://www.cdc.gov/dpdx/newworldscrewwormmyiasis/index.html

Mexico confirms case of New World screwworm in Nuevo Leon. News release. USDA. September 21, 2025. Accessed September 22, 2025. https://www.usda.gov/about-usda/news/press-releases/2025/09/21/mexico-confirms-case-new-world-screwworm-nuevo-leon 

Bautista-Alejandre A. New World screwworm detected less than 70 miles from the US-Mexico border. 

. September 22, 2025. Accessed December 1, 2025. 

https://www.dvm360.com/view/new-world-screwworm-detected-less-than-70-miles-from-the-us-mexico-border

Standard operating procedure for possible detections of New World screwworm in animals. USDA. Accessed December 1, 2025. 

https://www.aphis.usda.gov/sites/default/files/aphis-sop-detection-nws-in-animals.pdf

Bautista-Alejandre A. FDA grants emergency use authorization for lotilaner to treat New World screwworm in dogs. 

. October 24, 2025. Accessed December 1, 2025. 

https://www.dvm360.com/view/fda-grants-emergency-use-authorization-for-lotilaner-to-treat-new-world-screwworm-in-dogs

FDA issues emergency use authorization for New World screwworm drug for dogs. News release. FDA. October 24, 2025. Accessed December 1, 2025. 

https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-new-world-screwworm-drug-dogs

Bautista-Alejandre A. Antiparasitic receives FDA emergency authorization to treat New World screwworm in cats. 

. November 21, 2025. Accessed December 1, 2025. 

https://www.dvm360.com/view/antiparasitic-receives-fda-emergency-authorization-to-treat-new-world-screwworm-in-cats

. August 6, 2025. Accessed December 1, 2025. 

https://www.dvm360.com/view/vet-watch-update-do-you-have-normalcy-bias-

New World screwworm outbreak. CDC. Updated December 9, 2025. Accessed December 9, 2025. 

https://www.cdc.gov/new-world-screwworm/situation-summary/index.html

A concise Q&A for veterinarians summarizing the identification, reporting, treatment, prevention, and practical next steps as the New World screwworm approaches the US border.

Tips for passing the DEA inspection

In this interview, Jack Teitelman, CEO and founder of TITAN Group, a regulatory consulting firm specializing in Drug Enforcement Administration (DEA) compliance in animal and human health care, shares key points from a lecture he presented on DEA compliance at the New York Vet Show in New York City. Teitelman, a retired DEA supervisory special agent, emphasizes that proactive management is essential for passing DEA inspections. Key points covered in this video include conducting consistent cycle counts and reconciliations, being aware of contractual obligations with drug distributors, and more.

Below is a partial transcript, lightly edited for clarity and cohesion.

 Those that are proactive and get involved in managing their program,...that are consistent with doing reconciliations and having consistent cycle counts for [the DEA] to work off of, will be successful and will pass a DEA inspection. That was the key [point] that [attendees] needed to get out of that hour talk. You can't sit back and rely on who you've delegated the responsibilities to and hope that they're doing the job right. You have to take the time to sit down with them once a week—I mean, it depends. In the methadone clinics that we work with, at the beginning of the shift we have a reconciliation count and at the end of the shift we have a reconciliation count, with 2 nurse managers involved. You can see how it can get very intense.

So if you as a veterinarian have just been delegating this responsibility to your staff, and you have never talked to them about how you order, you don't even understand what Vetcove is and that Vetcove is one of the largest platforms out there that people are using—I'm telling you, some of the drug distributors aren't happy with the way Vetcove works because they can’t track purchases effectively on contract...

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Rachel Westcott, PhD, BSc BVMS, (right) and partner Emilis Prelgauskas with the Mobile Care Center in South Australia.

A new Mobile Care Centre vehicle in South Australia is set to bolster veterinary emergency management of bushfires and other disasters. The fully air conditioned, custom-built truck is a multipurpose resource designed to care for the carers by supporting South Australian Veterinary Emergency Management (SAVEM) volunteer veterinarians and veterinary nurses with a safe and secure base.

“This fantastic new mobile facility can be set up close to a SAVEM air shelter field hospital so that the SAVEM incident management team and the duty veterinarian can operate alongside one another and be on-site 24/7, greatly increasing response effectiveness and efficiency during disaster responses,” Rachel Westcott, PhD, BSc BVMS, SAVEM coordinator and Mobile Care Centre project manager, explained to 

“During the recovery phase of a response, the Mobile Care Centre becomes a ‘curbside’ point of contact for an affected community to access resources. A SAVEM response usually extends well into the recovery phase of other agencies, especially in a wildlife-centric response. This enables SAVEM to be ideally placed to be a visible signpost to a community, reminding them response agencies remain to help. In past emergencies, SAVEM’s visible presence over many weeks has been greatly valued by impacted people,” Westcott said.

When it's not being deployed for emergency responses, the Mobile Care Centre will be used for community outreach, education, and information about prevention and preparedness for animal owners and at-risk communities. “The Mobile Care Centre has a 6 x 4 Isuzu cab chassis, is about 11 meters long, and is of maximum road legal height. It has a 5-station incident management team room, bathroom, kitchen, a safe, a pharmacy, fridges, and 2 full-sized bunk beds. It is fully air conditioned, the roof is covered with solar panels, and [it's] equipped with a Starlink dish for internet connectivity,” Westcott said.

“The underfloor battery bank is backed up with a large generator. Two expandable ‘pods’ extend the available room in the incident management team area and in the sleeping quarters when on location. The sophisticated energy system is simple to use and is monitored remotely,” Westcott added.

The project was funded through the Australian Government’s Disaster Ready Fund, and Westcott explained that SAVEM’s Mobile Care Centre will change the way veterinary emergency management occurs in South Australia. “It will enable SAVEM to be fully resourced and in situ in a response, whilst providing SAVEM volunteers with a safe, custom-built space where hot debriefs can happen effectively and personnel can take breaks, greatly improving fatigue management,” Westcott said.

“It will greatly enhance communications, including enabling telehealth between field teams and the Mobile Care Centre, which will mean more animals can be managed or monitored in situ or as outpatients, improving prognoses and freeing up hospital space.”

Two veterinarians have developed a suicide prevention initiative for the veterinary profession, with VetHerd being a multifaceted approach built on evidence-based principles with the goal of creating a peer-supported network of safety. “Many in the veterinary profession know that suicide is a serious issue in our sector; however, knowing about a problem isn’t the same as knowing how to help. It’s a bit like learning all about a disease in vet school but never being taught how to manage or treat it,” Alena Gadoury BVSc (Hons I) BScN, cofounder of VetHerd, said to 

“Our vision is simple but powerful—the veterinary community working together as a herd to protect each other from suicide. Suicide is preventable, and everyone can play a role. VetHerd offers awareness and education to reduce stigma; LivingWorks skills training to help people recognize, ask, and help a person [who] is having thoughts of suicide; along with community connection and a network of safety, so whether they are needing support or helping others, no one feels alone in navigating these challenges,” Gadoury said.

Alena Gadoury, BVSc (Hons I) BScN, and Kat Williams, BVSc (Hons), BPsySc, co-founders of VetHerd

VetHerd also incorporates research that supports suicide prevention in the veterinary profession. Gadoury has commenced a PhD project as a structured way to build a clearer picture of suicide risk and prevention in Australian veterinarians. “Collectively named the AUSVETS Study, my PhD research combines quantitative and qualitative methods and is coproduced with a lived experience advisory group, ensuring the voices of those directly affected are central to the work. By analyzing survey data on the prevalence of suicidal thoughts among Australian veterinarians, we can begin to quantify the magnitude of the problem and the need for resources and interventions,” Gadoury said.

“Identifying the risk and protective factors allows us to identify psychosocial hazards in veterinary workplaces, which can then guide practice and policy changes. Evaluating the LivingWorks Applied Suicide Intervention Skills Training [ASIST] within the profession offers a practical, evidence-based approach to equip veterinary professionals with skills that may help prevent suicide,” Gadoury added.

Gadoury said that although a lot of positive progress has been made in raising mental health and well-being awareness, talking about the topic isn’t the same as translating that awareness into meaningful and sustainable action. “Suicide is a complex issue, and the research consistently shows it’s never caused by a single factor. The same is true for our profession: The role of a veterinarian is incredibly complex, and mental health challenges are often layered and may be shaped by the culture, stigma, resources, access to support, and systemic pressures. So when we ask, ‘How big is the problem?’ we need to look beyond just the prevalence rates and consider how well equipped we are as individuals and as a profession to recognize, respond, support, and prevent the challenges we face in the workplace,” Gadoury said.

“That said, there is a passion of efforts across the sector, from independent clinics to corporate groups, charities, associations, government bodies, and beyond. However, when these initiatives happen in isolation, combined with the heterogeneity in the available data, it’s difficult to fully understand the problem or measure the impact of what’s being done, what should be considered, and where we can go to next. That’s where the outcome of my research aims to play a role, hopefully helping us move from siloed insights to a more evidenced-informed picture,” Gadoury added.

Gadoury’s involvement in mental health, well-being, and suicide prevention stems from several deeply personal experiences. She explained that although the VetHerd initiative is only recent, it has already made an impact.

“This journey has been shaped by personal and professional experiences with the drive to create both a top-down and a bottom-up approach to suicide prevention. To move from silence and stigma toward understanding, connection, and action,” Gadoury said.

“Having cofounded VetHerd with veterinarian Kat Williams, BVSc [Hons], BPsySc, who has shared a similar journey, it’s been wonderful for us both to have already heard of the impact of our efforts and the training, with participants using the skills to support friends, colleagues, and clients,” Gadoury concluded.

Australian vet-tech company Vedi has launched a veterinary artificial intelligence (AI) scribe, Sidekick, which integrates directly with a veterinary clinic’s practice information management system (PIMS) through Vedi’s existing health record infrastructure. “Sidekick is different from other AI scribes because it doesn’t work in isolation; it works within Vedi’s universal health record. Most AI scribes simply transcribe what is said in the consult and replace it with an AI-generated summary. They only see a snapshot in time. Sidekick does the opposite,” Ross Wyness, CEO of Vedi, explained to 

“Because Sidekick runs inside Vedi, it has access to clinical context that stand-alone tools simply can’t see—including notes written by any team member in the last 24 hours, recent diagnostics and history, all records tied to the pet’s microchip for accuracy and traceability, and PIMS data—for supported systems,” Wyness added.

Wyness said that the way Sidekick has been developed allows the AI scribe to generate summaries that reflect the whole patient story, not just the consult conversation. “It gives vets richer insights, better continuity of care, and fewer gaps or misunderstandings between team members. Other AI scribes help you generate consult notes faster, but Sidekick helps your entire clinic work smarter because it’s powered by the only platform built to unify veterinary health data, not just record it. It's also built for collaboration. Every note your team records for the patient in the last 24 hours—from quick nurse observations to more detailed vet notes, whether spoken or typed—is automatically collated into 1 summary,” Wyness said.

“And because Vedi keeps the original transcription and the generated summary fully accessible to all clinic staff, nothing is ever lost or overwritten. Every word remains accessible for transparency, continuity, and audit purposes, giving clinicians full trust in the record. Sidekick ties each summary to the pet’s microchip, ensuring accuracy and preventing mix-ups between patients. Whether you’re using a mobile device or working from your desktop, you can capture consults effortlessly and get back to caring for the animal in front of you,” Wyness continued.

For veterinary clinics using supported PIMS platforms, Sidekick can automatically surface the most recent data from the pet’s record, such as patient profile information and diagnostics. “This means Sidekick doesn’t operate in isolation; it works from the full clinical picture, not just what was said in the room, allowing it to generate summaries that are richer, more accurate, and more clinically useful,” Wyness said.

Vedi’s goal is a fully connected veterinary ecosystem where data flow securely between the people who need it, reducing administration, improving clinical decisions, and creating better outcomes for pets. “For clinics using other PIMS systems, Sidekick still functions as part of Vedi’s universal health record. Vedi keeps a time-stamped record of all notes entered in the platform, and Sidekick uses this to produce contextual summaries that support continuity of care, team collaboration, and cross-platform consistency. Clinics can then simply copy and paste the summaries into their PIMS or send them directly to other veterinarians, referral specialists, or pet parents,” Wyness added.

dvm360’s Australian correspondent Phil Tucak, BSc, BVMS, also provides updates on the suicide prevention initiative VetHerd and veterinary AI scribe Sidekick.

Veterinary Scene Down Under: Mobile care truck set to respond to Australian disasters

Photo: Walter L. Brown Jr, BS, RVTg, VTS (ECC)/dvm360

Veterinary professionals attend the 2024 Fetch dvm360 Conference educational session in Long Beach, California.

Note that many of the upcoming industry events are being held in person or via a combination of live and virtual learning. Please visit individual event websites for details.

https://registration.dvm360.com/fetch-long-beach-2025

American Association of Equine Practitioners Annual Convention

Hosted by the American Veterinary Medical Association

https://www.avma.org/events/ veterinary-leadership-conference

Hosted by the North American Veterinary Community (NAVC)

https://www.viticusgroup.org/wvc-conference

Hosted by the Ohio Veterinary Medical Association

https://registration.dvm360.com/fetch-charlotte-2026

Veterinary Orthopedic Society Annual Conference

https://www.vosdvm.org/vos-2026-conference

Upcoming industry events for earning continuing education credits.