Erica Brandt, CVT, VTS (ECC), discusses what Fetch dvm360 Conference attendees can take away from her CE session on "Surviving Triage."

Confronting triage challenges

The ability to accurately and rapidly assessing an patient in an emergency situation makes the difference between a good veterinary technician and an excellent one, according to Erica Brandt, CVT, VTS (ECC), hospital director at WestVet in Meridian, Idaho. 

, her educational session being presented Saturday, March 15, at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina. The session highlights the importance of recognizing a true emergency and immediate interventions.

The following is a transcript of the video:

, what I really want technicians to take away is [that] we've gone through a really rough time with communicating with clients, through the pandemic and those types of things. And I just want to reiterate we are all going through the same types of concerns, and troubleshooting that [what] we're trying to do to reestablish our relationship with clients and get back into those rooms. And then, it's not easy. It's not easy to look at a patient and decide, is this patient truly having an emergency, and what next steps do we need to take? So, I want a big collaborative room, a safe space to say this is a very difficult thing that we do, and here are some tips that I use to make it a little bit easier.

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Erica Brandt, CVT, VTS (ECC), discusses her educational session being presented at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina.

As veterinary medicine advances, the demand for compassionate, holistic care for pets at every stage of life grows. For general practitioners, urgent care, and emergency veterinarians, becoming a Certified Hospice and Palliative Care Veterinarian (CHPV) offers numerous benefits, enhancing both career satisfaction and quality of patient care. Here’s why CHPV certification is a smart move for veterinarians in these fields.

Clients increasingly seek specialized care options, especially for aging or terminally ill pets. They want to ensure their pets have comfort and dignity in their final stages of life, along with support in making difficult decisions. When veterinarians have the CHPV certification, it allows them to provide the compassionate end-of-life care clients are seeking, turning potentially challenging conversations into reassuring, educational moments.

CHPV certification empowers veterinarians to broaden their services to include hospice and palliative care, meeting the growing demand from pet families prioritizing their pets’ quality of life. Integrating these services into practices not only provides a unique offering but also strengthens client relationships as well as opens new revenue opportunities.

Additionally, it’s crucial to meet the expectations of your clients. You can enhance client loyalty and retention by delivering comprehensive care, including compassionate end-of-life services. Various studies show a 14-25% client attrition rate following pet loss- often due to owners feeling dissatisfied with the support they received during their pet's end-of-life care. Offering dignified and respectful end-of-life care addresses the evolving needs of all your clientele, ensuring your practice remains their trusted choice.

 These insights highlight the need for veterinary practices to provide adequate training to their staff in handling pet loss to maintain client trust and satisfaction.

Build skills in compassionate communication

A CHPV-trained veterinarian learns how to navigate sensitive discussions around pet illness, end-of-life decisions, and euthanasia. This skill is particularly valuable in general practice, where routine visits often turn to difficult conversations as pets age, and in emergency care, where emotional support is essential. CHPV certification provides tools and techniques for effectively communicating with pet owners, helping veterinarians support clients through emotionally charged situations.

One of the primary focuses of hospice and palliative care is to maximize comfort, even in the absence of a cure. Veterinarians trained in hospice and palliative care can offer pain management, anxiety relief, and supportive therapies that improve quality of life. CHPV certification empowers veterinarians with the knowledge to assess and treat complex cases, improving patient outcomes and satisfaction.

Dealing with end-of-life care can be emotionally challenging, but CHPV certification helps veterinarians approach it with confidence, empathy, and skill. Many veterinarians find that by offering hospice and palliative services, they experience greater career satisfaction and a renewed sense of purpose.

 Supporting pets and families during the end-of-life journey can be one of the most fulfilling aspects of veterinary practice.

While many veterinarians pursue hospice and palliative care for its profound emotional rewards, it’s also important to recognize its potential to generate additional revenue streams. With growing demand for options that prioritize pets’ comfort and quality of life, clients are increasingly willing to invest in services that align with their values. By incorporating hospice and palliative care, veterinarians can offer a vital service that supports both their patients and their practice’s sustainability.

These services also help bridge a critical gap in emergency cases, where families are often presented with only a few options: high-cost interventions, limited middle-ground treatments, or euthanasia. Providing hospice and palliative care offers families another path that prioritizes their pet's comfort and dignity when other treatments are not viable. This alternative helps alleviate the distress and negativity that can arise when choices feel limited, empowering families to make decisions with greater compassion and clarity.

For veterinarians in all types of practices, CHPV certification represents a chance to enhance their approach to care, expand services, and experience greater fulfillment in their careers. The skills and perspectives gained from CHPV training foster empathy, professionalism, and a commitment to the well-being of every pet, making it a valuable addition for any veterinarian looking to provide comprehensive, compassionate care.

Fernandez-Mehler, P, Gloor, P, Sager, E, Lewis, FI, & Glaus, TM. Veterinarians' role for pet owners facing pet loss. 

Compassion Understood. (n.d.). The impact of pet loss on veterinary Compassion Understood. Vets. Compassion Understood. Accessed March 14, 2025. https://www.compassionunderstood.com/vets

Cooney K, Lewis J. Consider end-of-life care as a career. Veterinary Practice News. Published January 26, 2023. Accessed March 14, 2025. https://www.veterinarypracticenews.com/myvpnplus/consider-end-of-life-care-as-a-career

The Certified Hospice and Palliative Care Veterinarian certification enables veterinarians to be not only healers but also compassionate guides through the final chapters of a patient’s life.

How pursuing a CHPV certification can benefit veterinary teams

Image Credit: © Kriang - stock.adobe.com

Editors note: Quotes have been lightly edited for brevity and clarity.

At Fetch Charlotte 2025, Joya Griffin, DVM, DACVD, kicked off her dermatology series of lectures with 

Treating the itch that won't quit: Diagnostic approach to the pruritic pet. 

One aspect she keyed in on was the fundamental importance of a meticulous history and basic diagnostics in the evaluation of pruritic pets.

“For me, it really is just getting back to basics,” Griffin said, “I'm trying to figure out how do I get the case from looking like a disaster to looking good again and feeling good?” She explained to attendees that focusing on these foundational principles is 1 of the most important pieces of the puzzle for effectively managing complex dermatologic cases.

“All of pruritus is not created equally”, Griffin said. “The history of pruritus sometimes can confuse us. Sometimes that confusion comes from a pet parent, because they can actually know when the disease how it started, but they don't know how it started.”

With the mindset of getting back to the basics, Griffin said that when assessing a dermatologic condition, these are the questions she’s asking and the information she is looking for:

 Determining the age of onset, whether symptoms are intermittent or continuous, and how they have evolved over time.

 Ascertaining if signs were initially seasonal and if pruritus preceded lesions or vice versa.

 Inquiring about the pet's travel history, indoor/outdoor status, and the health status of other pets or human family members.

 A thorough review of past and current medications, including their efficacy, dosage, duration, and consistency of administration.

Asking whether the pet’s bowel movements were solid or diarrhea, and whether there was any vomiting.

: Assessing the type of flea control being used and the consistency and correctness of its administration—especially in atopic dogs, which may exhibit heightened sensitivity to flea bites.

Griffin stressed the importance of cytology, stating, "I do have cytology on the majority of my dermatologic cases because looks can be deceiving." She reminded attendees that you can't truly know if a lesion is bacterial, yeast, or sterile without it. She advocates for its use not only as a diagnostic tool, but also as a means of monitoring response to treatment and to guide decisions on whether to pursue culture and susceptibility testing.

For those who find cytology intimidating, Griffin suggests utilizing available tools such as AI analyzers and online image libraries to improve confidence in sample interpretation. She also shared a tip for improving client compliance. "I like to show pictures when I'm talking about cytology, because it really is just pattern recognition." She added, "If I have a skeptical client, I can bring them back, show them, and say, 'This is what I'm looking for. This is why,' and I can help them understand the importance of the cytology and the importance of the recheck exam."

Griffin also reminded attendees that skin scrapes are essential for detecting superficial and deep ectoparasites. She also shared a tip for improving client compliance, “Another reason to have a camera on your scope is you can bring the pet parents back, and they can show them the mites, and then they will believe that you're not just trying to sell them.”

Griffin said that these in-house diagnostics are not only quick and cost-effective but also integral in prioritizing treatments and determining the necessity of further diagnostics.

Griffin explained that a back-to-basics approach helps prevent overlooking simple diagnoses. A thorough history and basic diagnostics provide a solid foundation for subsequent diagnostic and therapeutic decisions, ultimately leading to more effective management of pruritic pets.

Griffin J. Treating the itch that won't quit: Diagnostic approach to the pruritic pet. Presented at: Fetch Charlotte 2025; Charlotte, North Carolina. March 14-16, 2025.

Joya Griffin, DVM, DACVD, reminds Fetch Charlotte 2025 attendees to maintain a strong foundation when it comes to diagnosing itchy pets

Quick diagnostic tips for evaluating pruritic pets

Dechra shared earlier this week that it has officially launched its terbinafine and betamethasone acetate otic gel (DuOtic; Dechra) for canine patients. The product received FDA approval in March 2024 and is a first-to-market treatment for canine otitis externa associated with 

 Because DuOtic is an antibioitic-free solution, it gives professionals a new tool to combat canine otitis externa with antimicrobial stewardship in mind.

“We are proud to equip veterinarians with a dedicated solution for yeast-driven otitis externa that is aligned with our antimicrobial stewardship goals," said Laura Olsen, president, North America at Dechra, in an organizational release.

 "DuOtic is a game-changer for ear infection care that builds on Dechra’s extensive otic portfolio, giving veterinarians the confidence and ability to treat ear infections with the right treatment at the right time.”

The medication is a fixed combination of terbinafine, an antifungal commonly used to treat athletes’ foot in humans, and betamethasone acetate, a gluccorticosteriod with anti-inflammatory activity.

 The product works by the otic gel dissolving into the earwax and is then slowly eliminated from the pet’s year to fight yeast infections for up to 45 days. DuOtic is only available by prescription from a veterinarian and administered by a veterinary professional.

To administer DuOtic, veterinary professionals should clean and dry the patient’s external ear canal prior to administering the initial dose. One dose is 1 tube per affected ear and administration should be repeated for 7 days, and the pets ear canal is not cleaned for 45 days after the initial administration, allowing contact of the gel with the ear canal.

“It’s exciting to have an antibiotic-free otitis externa product specifically designed for Malassezia infections,” expressed Rusty Muse, DVM, DACVD.

 “As a profession, we have had to use antibiotics in ears that don’t need them for too long. Now, with DuOtic, we don’t have to.”

Duotic comes with premeasured dosing, gentle, alcohol-free gel formulation, and a flexible tip applicated to make the process more comfortable to these patients. They product was also made with compliance in mind because a veterinarian or veterinary technician administered regimen could improve compliance, and help the pet get the full course of treatment as well as follow-up care.

The FDA did state that DuOtic could cause eye injury or irritation in people or dogs and encourages them wear eye protection and the pet be restrained to minimize post-application head shaking.

 This product should also not be used on feline patients or dogs with known tympanic perforation.

The product will be available through veterinary distributors in 2-count and 20-count packages.

Dechra Launches DuOtic®: The First Antibiotic-Free Otitis Externa Treatment for Dogs. News release. Dechra. March 12, 2025. Accessed March 14, 2025.

dvm360 staff. FDA approves drug for treating canine yeast ear infections. March 15, 2024. Accessed March 14, 2025. https://www.dvm360.com/view/fda-approves-drug-for-treating-canine-yeast-ear-infections

FDA Approves Treatment for Yeast Ear Infections in Dogs. News release. US Food and Drug Administration. March 15, 2024. Accessed March 14, 2025. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-approves-treatment-yeast-ear-infections-dogs?utm_medium=email&utm_source=govdelivery

DuOtic received FDA approval March 2024 to treat canine patients

Dechra launches antibiotic-free otitis externa treatment

The history of the Morris Animal Foundation and the Golden Retriever Lifetime Study

For more than 75 years, Morris Animal Foundation’s (MAF) mission has been to bridge science and resources to advance the health of animals. It remains one of the world's largest nonprofit animal health research organizations, funding nearly $167 million in more than 3,000 critical animal health studies across a broad range of species. Thanks to the generous support of individuals and corporate partners, our research has impacted over 20,000 different species of animals, from dogs to dolphins.

In 2012, MAF launched a new project –the Golden Retriever Lifetime Study (GRLS), one of the most comprehensive prospective canine health studies in the United States. Its purpose is to identify the nutritional, environmental, lifestyle, and genetic risk factors for cancer and other diseases in dogs. The MAF team collects, with the help of veterinarians and dog owners, health, environmental, and behavioral data on 3,000+ enrolled golden retrievers.

MAF is about to celebrate the study’s 13th anniversary. Sadly, just over 1,000 dogs remain enrolled, with most other participants deceased or withdrawn. The oldest study participant just reached the ripe age of 14-years-old and the youngest is nearly 11 years old.

Cancer was identified as the cause of death for roughly 63% of all deaths in the cohort, with hemangiosarcoma the most common diagnosis. As the study enters the final phase, the MAF team is collaborating with other researchers to comb through the data. Several teams are analyzing DNA from study dogs–with and without cancer–to look for genes associated with increased risk, both as a prelude to new diagnostic test development and as potential therapeutic targets.

In addition to bench researchers, the MAF team is working with epidemiologists to comb through our cancer data to identify risk factors for disease. It is in the early stages of analysis but MAF hopes it will answer questions about genetic, environmental, and other factors influencing cancer development.

Understandably, as the cohort ages, end-of-life questions top the list of concerns we hear from our participant owners, and we’re grateful to Caring Pathways for helping us guide our study families through this difficult process.

Caring Pathways has been a proud supporter of the MAF for many years, united by a shared commitment to advancing animal health and well-being. Through donations, Caring Pathways has been honored to contribute to their groundbreaking research, which has had a profound impact on the veterinary community and the pets and families we serve.

However, the partnership goes beyond financial contributions—it reflects Caring Pathway’s belief in the importance of evidence-based care and the value of investing in the future of veterinary medicine. Supporting MAF’s mission aligns seamlessly with Caring Pathway’s goal of providing compassionate, end-of-life care to pets while supporting their families through difficult transitions.

Offering targeted support of the golden retriever lifetime study

As the GRLS continues to yield critical insights into canine health, Caring Pathways has evolved its support to directly assist this groundbreaking initiative.

Caring Pathways has dedicated targeted donations to help sustain the GRLS, recognizing the importance of this longitudinal study in identifying risk factors and improving health outcomes for dogs. These contributions ensure that this vital research can continue to make strides in understanding complex diseases like cancer and osteoarthritis.

To further support GRLS participants, Caring Pathway’s offered discounted TeleAdvice services to help pet owners navigate their dogs’ care in the later stages of life. These consultations provide owners with access to professional advice tailored to their pets’ specific needs, empowering them to make informed decisions about pain management and quality of life.

Education is at the heart of what we do, and we’ve extended this commitment to GRLS cohort owners through a series of webinars. These sessions, focused on topics such as pain and quality of life, osteoarthritis, and canine cognitive dysfunction syndrome are designed to provide owners with practical tools and knowledge to enhance their dogs’ comfort and well-being.

Reflecting on the partnership with MAF, Caring Pathways is filled with gratitude for the opportunity to contribute to their transformative work.

At Caring Pathways, we truly believe MAF’s mission to advance animal health through science and remain committed to being a part of this journey. Together, we can ensure that pets live healthier, happier lives while supporting families through every stage of their beloved companions’ lives.

, earned her Doctor of Veterinary Medicine degree from Colorado State University. Her diverse veterinary career includes completing a small animal internship, working as an emergency and general practitioner, serving as an in-home end-of-life care veterinarian, and working in the pet food industry as a veterinary consultant for a leading company. This unique blend of experiences prepared McGivney for her role as General Manager at Caring Pathways, where she leads a dedicated team of at-home, end-of-life specialists. Her deep passion for the human-animal bond allows her to combine her professional expertise with her love of veterinary care to support families during some of life’s most tender moments.

received her DVM from the University of Tennessee and started her practice career in a bustling emergency clinic in New Jersey. After one year in emergency practice, Diehl completed an internship at the prestigious Animal Medical Center in New York City. Following her internship, Diehl moved west, completing a residency in small animal medicine at Colorado State University. After finishing a 3-year NIH postdoctoral fellowship at National Jewish Health, Diehl joined the staff of the Veterinary Referral Center of Colorado as the co-owner of the internal medicine section. After 14 years, Diehl left private practice to pursue a career in science communication and joined Morris Animal Foundation in 2013. Diehl is a board-certified small animal internal medicine specialist with an interest in gastroenterology and immunology. She lives in Colorado with her husband, 2 children, 2 cats, too many fish to count and a very lovable Labrador retriever.

Caring Pathways and Morris Animal Foundation share more information on their partnership through the Golden Retriever Lifetime Study

Advancing compassion and science

When a patient is infected with heartworm, it can cause devastating and irreversible damage in dogs. Because of this, compliance is critical in the battle against heartworm and heartworm resistance in veterinary practice. So, how can we improve compliance?

Heartworm Surveillance: Staying Ahead of Resistance with New Research

 at the 2025 WVC Annual Conference in Las Vegas, Nevada, Chris Adolph, DVM, MS, DACVM (Parasitology), shared the latest research on heartworm resistance surveillance to educate attendees on new data and help improve compliance.

“We're going to talk a little program study in the next few minutes, and I'm going to give you some new updates on what's really going on out there. Heartworm is maybe different than the last time you thought about it, and it makes a difference in which prevention you use, for sure,” Adolph kicked off his lecture with.

According to the American Heartworm Society (AHS), most cases of heartworm medication failure can be attributed to compliance issues. Even missing or delaying just one preventive dose can leave an animal vulnerable to infection.

Once a patient is infected with heartworm, the damage is often severe and irreversible. When diagnosing heartworm, veterinary teams typically determine that if a pet is unprotected, it is susceptible to infection. However, when a patient is taking medication as prescribed and still tests positive for heartworm, it signals an evolution in the parasite’s resistance over the past 40 years.

Adolph presented prevalence maps from the American Heartworm Society comparing data from 2001 to 2022, demonstrating the rise of heartworm resistance in the United States. He addressed skeptics—whom he referred to as “heartworm resistance deniers”—pointing out clear patterns emerging across the country.

Adolph also explained that the transportation of dogs across the country for adoption has contributed to the spread of resistant heartworms. Pet owners may unknowingly introduce heartworm-infected animals to regions where resistance was previously uncommon.

“How many of y'all live somewhere other than here, but you see dogs that their book started their life down there. Maybe you guys see these dogs. We're moving them all over the country. When you adopt a dog, guys adopt its parasites, okay, its package deal, right? And if they are resistant heartworms, they get in your ecosystem. And that's the ball game. Okay? Now they live there, right?” Adolph explained.

Between 2013 and 2016, results from a AHS survey on the incidence of adult heartworm infections in adult canine patients in the US showed a 21.7% increase. A study followed the release of the survey results to determine if heartworm testing results available from the Companion Animal Parasite Council aligned with the findings, and whether change in heartworm preventive dispensing accounts for the increase.2

Between 2013 and 2016, results from an AHS survey on the incidence of adult heartworm infections in US canine patients showed a 21.7% increase. A follow-up study examined whether heartworm testing results from the Companion Animal Parasite Council (CAPC) aligned with these findings and whether changes in preventive medication dispensing contributed to the rise.

Researchers analyzed 7-9 million heartworm antigen tests reported annually to CAPC and compared them with the AHS 2016 survey. A state-by-state analysis focused on the southeastern US, where heartworm prevalence is particularly high. National heartworm preventive dispensing data were obtained from Vetstreet LLC and analyzed. The study included oral, topical, and injectable heartworm preventives, with injectable moxidectin counted as six doses.

The results showed a 15.28% increase in positive antigen tests from 2013 to 2016, aligning with the AHS survey. In the southeastern US, the increase was 17.9%, compared to 11.4% in the rest of the country. Nine of the 12 states studied had an increased positive test frequency greater than 10%. Additionally, the findings revealed that two-thirds of canine patients in the US received no heartworm prevention each year.

“I see a lot of low hanging fruit here. I see a tremendous opportunity to have that conversation, and when they say, No, I don't really want to do this and [can I explain for a little bit] why this is super important, and just don't take that person. No, I don't really want any harm or okay, I'm on my 25th patient today. I don't have any gas in the tank for this, but they deserve the best, even if you're on the 25th appointment of the day,” said Adolph.

Taking the time for education and trying to get that third of a third giving their pets preventatives, it can help continue the battle against heartworm resistance and improve the lives of pets across the US.

Adolph C. Heartworm Surveillance: Staying Ahead of Resistance with New Research. Presented at: WVC; Las Vegas, NV. March 2-5, 2025.

Drake J, Wiseman S. Increasing incidence of Dirofilaria immitis in dogs in USA with focus on the southeast region 2013-2016. Parasit Vectors. 2018;11(1):39. Published 2018 Jan 17. doi:10.1186/s13071-018-2631-0

Understanding recent heartworm research will help professionals stay ahead of resistance 