Dr. Broadwater talks about an alternative for senior dogs

Joshua Broadwater canine eyelide tumors

Nonhealing corneal ulcers can turn even routine cases into weeks‑long frustrations for practitioners and pet owners alike. In this brief preview of his Fetch Charlotte lecture, Joshua Broadwater, DVM, DACVO, explains why some ulcers refuse to heal and how targeted procedures can finally get them back on track.

: Non‑healing ulcers are a huge part of what we do. That’s part of our bread and butter, because those cases come to us. I’m sure it’s very frustrating for a lot of general practitioners, because these dogs walk in your door and you diagnose a very simple, superficial ulcer. You start on these drops and, for all intents and purposes, it should be healed in a week—but it’s not.

You change medications and they come back, and it’s still not healed. These cases are frustrating for the general vet and for the owner as well, because they see their pet in pain 2 or 3 weeks beyond when healing should have occurred. My goal in this talk is to shed some light on why these ulcers don’t heal. What exactly is the process? Why are they developing in the first place, and why aren’t they resolving with standard therapy? Then, what can we do—or what can general vets do procedurally—to get these ulcers to close?

It also involves proper case selection. A superficial, non‑healing ulcer—what we would term an “indolent” or “refractory” ulcer—is very different from a deep, stromal, infected corneal ulcer. Those have different causes and require different treatments. We need to make sure we select the right cases before considering any procedures designed to stimulate superficial ulcers to heal.

There’s always a lot of controversy around true indolent ulcers—sometimes called “Boxer ulcers” or “refractory ulcers.” Which is the correct way to get these things to heal? A grid keratotomy has long been the gold standard, and I still perform it frequently. My goal with this lecture is to offer more insight on how to perform the procedure correctly.

But there are alternatives. Many clinicians have begun using a diamond burr keratotomy, and we’ll cover that as well. We’ll also talk about feline patients, because cats aren’t just small dogs—they’re practically aliens in how they heal or fail to heal. We’ll discuss which procedures used for dogs are appropriate for cats—and which aren’t—so you can choose the best approach for every patient.

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Videos

Joshua Broadwater, DVM, DACVO, explains why some ulcers stubbornly persist and his approach to dealing with them

When corneal ulcers won't heal

In this video interview with dvm360, shares the clinical signs that could indicate cannabis exposure in patients, plus how to treat these patients

Video interview with Renee Schmid, DVM, DABT, DABVT

Ahead of 4/20 day, Renee Schmid, DVM, DABT, DABVT, sat down with 

 to discuss the clinical signs that pets exposed to cannabis or THC will present with in the clinic, how to treat these patients, and if any secondary concerns are needed if the pet ingested an edible or gummy form of cannabis, such as xyitol or chocolate. As marijuana continues to rise on the list of top yearly toxins at Pet Poison Helpline, recognizing these signs can be crucial, especially if the clients do not want to admit what their pets got into. 

Below is a partial transcript, edited lightly for clarity.

 For cannabis or THC exposures, the biggest things to look at are really clinical signs. There aren't necessarily a lot of diagnostics that are going to be helpful. We're not really a big fan of the urine drug screening either, because those are validated on human urine. And so there's different metabolites. The body breaks it down a little bit differently in humans versus animals. And so a lot of times, if you do a urine drug screen on an animal, you may get a false negative or you may get a false positive. So I really encourage veterinarians to treat based on their clinical signs. And so a lot of the common clinical signs are that kind of lethargy or sluggishness, maybe some ataxia and weakness. They can also have bradycardia. We can see hypotension and hypothermia developing. A very kind of tell-all sign is when they're dribbling urine and so often, if that patient walks in the door and they look a little bit out of it, and they're dribbling urine, but the owner isn't really wanting to say what they got into, or admit to anything, it's probably THC, so probably would want to be treating it in that way. 

Yeah, so for THC and other cannabis products, typically, we want to do a lot of great nursing care, symptomatic and supportive care. So if it's caught early enough, we might be able to induce vomiting and give one dose of activated charcoal, sorbitol. Otherwise, IV fluids might be necessary. Maybe sub q fluids, if they're mildly affected. The really mildly affected cases, might be able to just be monitored at home. I always like to have them be examined by a veterinarian first to help make that determination, because pet owners are not going to be able to tell if they're hypotensive or hypothermic, or, you know, if they're what their heart rate necessarily might be and what their kind of pulse quality is like. So I always like to have an examination there at the veterinary clinic first, and then treating as necessary. If they need some warming, that measure is done because they're hypothermic, if they need anything to help with any potential bradycardia or hypotension, done with them. Fortunately, most cases usually resolve within around 12 to 24 hours. Some might linger for 48 or a little bit longer, depending on how affected they are

Veterinary toxicologist Renee Schmid, DVM, DABT, DABVT, explains clinical signs of cannabis exposure in pets, and how to treat these patients

Managing cannabis exposures in pets

Aaron Shaw, OTR/L, CHT, CSCS talks about making space for life outside the clinic

Managing work-related stress

Aaron Shaw, OTR/L, CHT, CSCS, host of the podcast Healthspan Digest, talks about ways veterinary professionals can manage work-related stress. Shaw explains that although work is an important part of life, it should not consume all of it, and encourages professionals to pursue hobbies and interests outside of work.

Below is the video transcript, lightly edited for clarity:

So a couple things that somebody on the vet team could do to help manage stress: I think first and foremost, it is really being in charge of your own body—really taking ownership of yourself in a way. And that is really going to be focusing on how you eat, how you sleep, how often you move your body, what kind of social support you have...in the clinic certainly, but definitely outside of the clinic.

I think that people who are the most successful in navigating stressful work environments are the ones who can recognize that work is a piece of their life, but it's not all of their life. And you know, people can step out of the work environment and realize there are more things to do, there are hobbies and activities that they're interested in—it becomes easier to kind of put work in a bucket. And I think that for those of us that are professionals, it’s pretty easy to feel like work, if you're passionate about what you do, is always on our brain to some degree.

But...if work is on our brain to some degree and it's also almost like a weight on us, then we need to have something we can pivot away from, and that is where I want to say real life comes in. I mean, certainly work is real life, but I think a big part of real life is having a hobby and an interest and something you really look forward to once you're done with that stressful day, and really taking the time and energy to engage in that when you do leave the office.

And that can be hard because most of us, when we leave work, we can be pretty tired or feeling kind of beat down. But by saying, you know, ‘It's been a tough day. I'm kind of tired. I'm kind of worn out, but I know that...one of my hobbies is going for a bike ride’ and saying, ‘Yeah, I'm tired, but I have to rally. I'm going to go do this thing.’

And I think when we have hobbies that we're interested in, then once we start doing that, we kind of forget about some of the stresses that may have been preoccupying us and really weighing us down throughout the day and so having a little bit of a mental break from the stress of our job day to day gives our brain a break, gives our body a break. Again, you get all the physiological benefits of exercise, and the mental break, the mental time out from the stress of work.

On April 20 each year, those who enjoy recreational marijuana or take it for its medical benefits celebrate the unofficial cannabis holiday 4/20 day. However, because Pet Poison Helpline receives thousands of calls a year related to cannabis, the team highlighted the case of Gertie the Goose in its most recent installment of 

an unusual cannabis-related call the toxicologists received.

“Although dogs are far more likely to have an accidental marijuana exposure, according to our case data, there was one recent call that gave us goose bumps,” joked Renee Schmid, DVM, DABT, DABVT, a senior veterinary toxicologist and director of Veterinary Medicine at Pet Poison Helpline, in an organizational release.

Carola Schubbel/stock.adobe.com (Not an actual image of Gertie) 

“Earlier this year we received a call from a woman whose pet goose Gertie had quickly gobbled up a joint that accidentally dropped on the floor. The pet owner called us, and after analyzing the situation, we recommended she take Gertie into the veterinary hospital for monitoring and treatment.”

Gertie was then taken to the local animal hospital where the veterinary staff performed a crop lavage with saline. According to the release, a crop is a thin-walled pouch at the base of the esophagus where birds store food before it goes all the way down to its stomach. The Pet Poison Helpline relied on avian data from other birds to develop their recommendations since their the data for geese with this type of exposure is limited. In a scenario where a dog or cat ingests marijuana, they can begin to show clinical signs within minutes to hours depending on the exposure, such as inhalation versus ingestion.

Risks of THC and cannabis products for patients

If a pet is exposed to marijuana, they will present with a dazed expression, lethargy, dribbling urine, incoordination, and slow response signs. Pet Poison Helpline also shared that vomiting and drooling are also common signs, and pets could potentially experience heart rate changes, vocalization, neurological stimulation, hyperactivity or coma. For avian patients specifically, they can have similar neurologic and cardiovascular signs, which Gertie did.

“Even if you don’t use marijuana personally, it can still impact your pets,” Schmid warned.

 “There are currently only 4 states in the country that don’t allow some form of [delta-9-tetrahydrocannabinol (THC)] usage, so the chances of your pet encountering THC are very real. A friend or family member could bring some into your home without your knowledge or your pet could come in contact with THC in a public area such as a park. We also had a case where a dog wandered into a neighbor’s yard and ate a batch of marijuana brownies.”

As more states continue to legalize marijuana either medically or recreationally, there was also more calls to Pet Poison Helpline relating to THC exposures. Pet Poison Helpline saw a 430% increase in marijuana calls from 2019 to 2023, and marijuana made its first appearance on the company’s Top 10 List of Poisons for 2021 coming in at 8

 as of the Top 10 List of Poisons in 2024.

 Schmid and the Pet Poison Helpline team is urging pet parents to be diligent and keep these products out of reach from pets and children. Schmid also warns pet owners and veterinary professionals that currently marijuana products have “significantly more THC as compared to those in decades past.”

Each month, Pet Poison Helpline releases a new installment of 

 to educate pet owners and the veterinary community on the types of poisonings that are out there impacting pets inside and out of their homes. Each pet selected to be featured in the installments has been successfully treated and fully recovered from the poisoning.

Pet Goose Accidentally Ingests Marijuana Joint. News release. Pet Poison Helpline. April 16, 2025. Accessed April 18, 2025. https://www.prnewswire.com/news-releases/pet-goose-accidentally-ingests-marijuana-joint-302429343.html#:~:text=%22Earlier%20this%20year%20we%20received,hospital%20for%20monitoring%20and%20treatment.%22

Top 10 Pet Poisons of 2024. News release. Pet Poison Helpline. January 8, 2025. Accessed April 18, 2025. https://www.prnewswire.com/news-releases/top-10-pet-poisons-of-2024-302339363.html

Articles

As 4/20 day approaches, Pet Poison Helpline used its most recent Toxin Tail to warn veterinary professionals and pet parents ahead of the unofficial cannabis holiday 

Gertie the Goose accidentally consumes marijuana joint 

Margo Mosher, global head of sustainability for Mars Veterinary Health, discusses the company’s use of wind farming and other sustainability initiatives in an interview with dvm360. 

Powering veterinary medicine with renewable energy

A farm with wind turbines for generating renewable energy in an undisclosed location.

Margo Mosher, global head of sustainability for Mars Veterinary Health, discussed the company’s renewable electricity initiatives such as wind farming to power clinics around the world, an interview with 

. The interview was recorded at the North American Veterinary Community’s 2025 Veterinary Meeting & Expo (VMX) in Orlando, Florida, where Mars Veterinary Health presented an educational session, “How to Practice Sustainable Veterinary Medicine,” that addressed the company’s sustainability initiatives such as renewable energy and efforts made to reduce blood banking waste.

The following is a transcript of the video:

: One of our main sustainability initiatives has been focused on climate change, given it's an urgent, pressing environmental and social issue, and one of our biggest impact areas is the electricity that we use in our clinics around the world. And so a big focus early on in our sustainability journey was to find ways to source renewable electricity. So we're really proud that in 2021, as part of Mars Incorporated, we signed on to a power purchase agreement to source and really fund the building of a large wind farm in Ford Ridge, Illinois, in the US. And as part of that, we therefore have been able to source renewable electricity for our 2000 pet hospitals across the US, and that's including Banfield, Blue Pearl and VCA [networks]. They are all now sourcing clean renewable electricity, and that's helped to reduce a good portion of our greenhouse gas emissions. And then we're also really excited that we've brought online all of our Linnaeus clinics in the UK with renewable electricity as well.

Our last bit for this year is focusing on sourcing renewables for all of our AniCura hospitals across Europe. And then we'll have achieved the goal that we had set, which was sourcing renewables for all of our clinics across Europe, UK and the US, by the end of 2025. This has been a really important part of our sustainability journey and our climate change initiatives. And we're also really happy to be part of Mars Incorporated who has a ambitious target related to climate change, achieving net zero emissions by 2050 and so our renewable electricity for our pet hospitals has really helped us be part of that and contribute to that work.

Powering veterinary medicine with renewable electricity

The most common adverse effects are gastrointestinal, says Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM)

Common adverse effects of SGLT2 inhibitors in cats

In this interview, Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM), a consultant at Veterinary Information Network, discusses the adverse effects associated with sodium-glucose cotransporter-2 (SGLT2) inhibitor use in cats, specific to 

Senvelgo (velagliflozin oral solution) and Bexacat (bexagliflozin tablets)

. She discusses gastrointestinal symptoms, ketosis and diabetic ketoacidosis (DKA), hypoglycemia, and more.

Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM):

 As far as side effects, the most common are gastrointestinal. And right now there are 3 published papers, 2 on Senvelgo, one on Bexacat. And in those papers, the 2 most common side effects were soft stool and vomiting.

Which was number 1 and which was number 2 actually differs between the studies, and I don't think that's any real difference between Bexacat and Senvelgo, I think that was the luck of the population.

If you read the package inserts, it says that diarrhea was the side effect, and it really makes it sound a lot scarier than it is. The use of diarrhea was an FDA-mandated term, and it was 

 loosening of the stool and owners were told to watch the litter box like a hawk and report anything, so I don't know that it's really real-life. The incidence, though, of soft stools was somewhere between about 30% and 50% which again, sounds scary, and it's not that scary.

If it happens, it typically happens in the first week, it's self-limiting, and it goes away. There were a couple cats that had diarrhea that was severe enough that the owner stopped the drug. But that was an exception, rather than the rule by far.

Vomiting happened once or twice, typically. It was random, it's not associated with anything. You're giving an oral medication to a cat, so of course, they're going to vomit randomly—they're cats. So, vomiting I don't think was out of the realm of what you would expect with a cat getting an oral medication...