The Cone of Shame Veterinary Podcast

Dr. Alex Sigmund, DVM, DACVO, a board-certified veterinary ophthalmologist and the face behind The Vet Eye Guy, is here to call us out on something I may or may not be guilty of: reaching for NeoPolyBac every time a dog shows up with a red eye! We're digging into why that approach can lead to missed diagnoses, how to recognize serious conditions like glaucoma and dry eye, and the essential ophthalmic diagnostics every general practice should have in its toolbox. From tonometry tips to empowering veterinary technicians, Alex shares practical ways to improve eye care, practice better antibiotic stewardship, and catch problems before they become emergencies. Gang, let’s get into this episode!

The Vet Eye Guy: Follow Dr. Alex Sigmund on Instagram, TikTok, and Facebook (@TheVetEyeGuy).

The Vet Eye Team: Dr. Alex Sigmund's veterinary ophthalmology practice in Atlanta, Georgia.

Dr. Ryane Englar is joining me on the podcast today to tell her unique story: What happens when you go blind as a veterinarian? Dr. Englar takes us through the journey, from her first symptoms, to diagnosis, to treatment and transplant, to learning to move through the world differently with a disability. Dr. Englar is extremely open, honest, and insightful in this episode, and she shares some really powerful messages that apply to us all. Definitely do not miss this one!

Dr. Ryane Englar's new book, " Postcards from Life's Passenger Seat: Reflections on Sight, Identity, and Belonging"

All books by Dr. Englar

Email Dr. Englar: [email protected]

Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) graduated from Cornell University College of Veterinary Medicine in 2008. She practiced as an associate veterinarian in companion animal practice before transitioning into the educational circuit as an advocate for pre-clinical training in primary care. She debuted in academia as a Clinical Instructor of the Community Practice Service at Cornell University’s Hospital for Animals. She then transitioned into the role of Assistant Professor as founding faculty at Midwestern University College of Veterinary Medicine. While at Midwestern University, she had the opportunity to teach the inaugural Class of 2018, the Class of 2019, and the Class of 2020. While training these remarkable young professionals, Dr. Englar became a Diplomat of the American Board of Veterinary Practitioners (ABVP). She then joined the faculty at Kansas State University between May 2017 and January 2020 to launch the Clinical Skills curriculum.

In the 420th episode of the Cone of Shame Veterinary Podcast, Dr. Andy Roark talks with Steven Satal about the state of cannabinoid medicine in veterinary care after the early surge of interest 8–10 years ago. Satal clarifies terminology and legal distinctions between hemp (≤0.3% THC) and cannabis/marijuana (>0.3% THC), noting the 2018 Farm Bill definitions may change. They discuss how the field has plateaued but become more normalized, with over 40 PK/PD dosing studies across species and increasing specialist referrals for cannabis consults focused on harm reduction, dosing, and product selection. Satal emphasizes cannabinoids are not a silver bullet; his main uses are chronic pain, epileptic disorders, and canine cognitive dysfunction, with some evidence for itch reduction in dermatology. He typically starts dogs/cats at 2 mg/kg CBD twice daily and adjusts, stresses variable product quality, cites brands with supporting studies, and outlines cautions with sedating drugs and liver monitoring; he does not recommend cannabinoids for pre-visit anxiety.

Stephen Niño Cital holds a Masters in veterinary anesthesiology and is a veterinary technician specialist (VTS) in research anesthesia among other credentials. He has a passion for anesthesia, pain management, and integrative medicine. Stephen has authored numerous peer reviewed articles and contributed to several textbooks- including acting as the lead editor for the first veterinary cannabinoid medicine textbook and more recently a second edition of a pain management textbook. He has many exciting professional highlights but some of his favorites include being part the scientific team that discovered acidic cannabinoid forms are absorbed more efficiently than decarboxylated forms, discovered a common drug used in anesthesia causes a serious complication known as methemoglobinemia in monkeys, invented a smaller and more practical blood filter for animals during blood transfusions, and helped gain title protection for veterinary technician specialists. Stephen is a lab manager for HHMI at Stanford University in the department of neurobiology, and the Chief Veterinary Nursing Officer and director of the pain and cannabinoid medicine services at Remedy Veterinary Specialists. Additionally, he is the COO of the Veterinary Anesthesia Nerds, LLC., and Executive Director of the Academy of Laboratory Animal Veterinary Technicians and Nurses, and president of the California RVT Association. His current pursuits include completing another acupuncture certification and a VTS in neurology.

Dr. Andy Roark, host of The Cone of Shame Veterinary Podcast, flips the script and lets Kelsey Beth Carpenter run the show for the launch of a brand new six part miniseries, Cone of Shame Canada. The topic on the table: human pharmacies have entered the veterinary pharmacy business north of the border, and Andy walks through why that regulatory change is rattling Canadian practices, what the US already learned from its own online pharmacy shakeup years ago, and the three things he thinks matter most right now, protecting client trust, talking openly with the team, and evolving the business model in manageable phases rather than panicking. By the end, listeners get a clear-eyed roadmap for navigating pharmacy disruption, plus a sneak peek at the lineup of guests still to come in the series. Gang, lets get into this episode! This episode is brought to you ad-free by Boehringer-Ingelheim Canada! Kelsey Carpenter is a Registered Veterinary Technician with over a decade of experience working in emergency hospitals across California. She currently works as the Social Media Manager for DrAndyRoark.com and a Content Specialist for the Uncharted Veterinary Conference. Some of Kelsey’s passions include the open hospital concept, the power of creativity and humor, the overlap of science and art, and sharing lessons learned from living life with chronic illness. Kelsey is probably most known for two of her favorite hobbies: writing and performing comedic songs about veterinary medicine and acting as a full time stage mom for her Chihuahua mix, Birdie.

I’ve got Dr. Jules Benson on the podcast today and we’ve got a doozy of a topic for ya: The sad, sad state of research in vet medicine (my words, not his!) I am bothered by what seems to be a tidal wave of crappy, biased, cherry-picked research lately, and I ask Dr. Benson to get into it with me. How do we get our information in vet med? What do we believe and what do we not believe? How do we actually incorporate data and research into a future that’s feeling more cynical and less trusting? Let’s get into it!

Dr. Jules Benson is the Principal at Tapetum Lucidum Consulting and the 2025 Chair at the Veterinary Innovation Council (VIC). With over two decades as a practitioner, industry executive, strategist, and data and technology leader, his focus lies in identifying and applying innovation that can improve the lives of pets, pet families, and veterinary healthcare teams.

Dr. Andy Roark welcomes Dr. Isaac Bott, an Utah practice owner and theriogenologist who works with reindeer, to discuss his run for AVMA president (election July 2027) and the profession’s sustainability challenges. They explore how rising cost of care intersects with the need to pay living wages and retain veterinarians, technicians, and support staff, arguing vet medicine is not overpriced even if care can be unattainable for some clients. Bott emphasizes retention through sustainable workplaces, burnout reduction, and clear development pathways that let team members fully use their training, including technician specialization and continued growth for veterinarians. They discuss burnout drivers such as student debt, emotional strain, call burden, and workplace dynamics, and advocate for unity through organized veterinary medicine so veterinarians keep a strong voice amid regulatory and industry changes.

Dr. N. Isaac Bott was raised in the small town of Castle Dale, Utah. He is a 2009 graduate of Washington State University’s College of Veterinary Medicine. He owns and operates Mountain West Animal Hospital, a mixed animal veterinary facility in Springville Utah. He currently serves on several national and state veterinary boards. He is a past president of the Society for Theriogenology, an international group of veterinarians with expertise in animal reproduction. In 2023, he was Awarded the Dr. John Steiner Award for Practitioner Excellence. In 2024 he was given the Utah Veterinarian of the Year award. He has also served as a council member and chair of the American Veterinary Medical Association’s Council on Veterinary Service. He also has served as the co-chair of the Utah Veterinary Medical Association’s Legislative Committee. He currently serves as the American Veterinary Mecidcal Association (AVMA) delegate for the Society for Theriogenology. He also serves on the board for the AVMA Political Action Committee, the dean’s advisory board at Utah State University’s College of Veterinary Medicine, and as a member of Theriogenology Foundation board. He has extensive experience with strategic planning, legislative process and organizational leadership. He has also authored over a dozen peer-reviewed scientific articles, a dozen textbook chapters, and has traveled the globe providing theriogenology services for camelids and cervids. He is the proud father of three children: Kaycee, Kayden and Kendyn.

Dr. Chad R. Brown, DVM (Purdue), executive director of the Lloyd Veterinary Medical Center at Iowa State University, joins Dr. Andy Roark to tackle a gut-punch truth in veterinary medicine: good decisions do not always equal good outcomes, and outcome-based judgment can be brutal on clinicians. They unpack how hindsight bias and outcome bias trick us into “judging our past self with our future self’s information,” rewarding lucky medicine and fueling shame after tough cases. Chad argues for de-emphasizing outcomes and emphasizing decision-making processes we can control, like communication, diagnostics, anesthesia monitoring, and checklists, especially when training students, interns, and residents. They also discuss how outcome fixation can break good clinicians through overcorrection or apathy, and how focusing on process can reduce burnout and support spectrum-of-care thinking.

Dr. Steve Deels, a New Zealand emergency veterinarian and career coach, joins Dr. Andy Roark to tackle a familiar gut punch: "you can save a life at 2:00 a.m. and still get a one-star review because the wait was too long." They dig into dark humor as a healthy coping tool, the unrealistic expectations placed on vets as jack-of-all-trades clinicians, and how Steve’s early mixed-animal work and later corporate clinic burnout pushed him toward life coaching and practical strategies like daily journaling (three successes and one gratitude). You will walk away feeling validated, more resilient, and better equipped to spot the 90 percent that is good, not just the 10 percent that drains you, plus a preview of Steve’s upcoming book 'Bite Marks and Burnout'. Gang, let’s get into this episode.

Dr. Ivan Zak, DVM, entrepreneur and former CEO of SmartFlow and Galaxy Vets, joins Dr. Andy Roark to dig into one of the spiciest topics in vet med, whether production pay is actually “bad,” and what happens when salary-only pay gets weaponized as burnout prevention. They unpack Ivan’s experience switching Galaxy Vets to straight salary, watching productivity and hours drop, and realizing the business risk of blocked schedules and reduced case acceptance. Ivan shares how that led to Galaxy Vets’ shared production approach in Canada, where vets earn 25% based on total organization revenue divided by shifts, paired with employee ownership and core values like owner’s mindset and big picture thinking to drive teamwork, accountability, and cost awareness. Ivan also discusses leadership transitions, culture as a selection tool, and his new Serenity Vet mission to reduce labor costs. Gang, let’s get into this episode.

Ivan "Zak" Zakharenkov, DVM, MBA

Dr. Ivan Zak is a veterinarian, entrepreneur, and operator. His startups include SmartFlow, the first workflow optimization system (acquired by IDEXX), Galaxy Vets, an employee-owned group of urgent care clinics, and, most recently, Serenity Vet, an operating system for relief management and labor optimization.

Ivan is passionate about bridging the gap between clinical excellence and strong business outcomes — building veterinary organizations where vets don't have to choose between being great doctors and understanding the enterprise they're part of.

Dr. Zak graduated from the Atlantic Veterinary College and holds an MBA in International Healthcare Management. He lives in Saint John, New Brunswick, with his wife and two kids.

Tabitha Kucera, VTS (Behavior) and founder of Chirrups and Chatter, joins Dr. Andy Roark to unpack what "keep them quiet" actually means after surgery. Using real cases like a beagle mix post-abdominal surgery and a cat post-PU, Tabitha shares low-mobility enrichment options such as snuffle mats, frozen Kongs, and scent work that support recovery without heavy sedation or strict confinement. The result: better client guidance, stronger outcomes, and stronger relationships.

Episode Links:

chirpsandchatter.com

small-paws.ca

@chirpsandchatter

Tabitha Kucera is an Elite Fear Free Registered Veterinary Technician, Veterinary Technician Specialist (Behavior), Certified Cat Behavior Consultant, and Karen Pryor Academy Certified Training Partner. She owns Chirrups and Chatter Cat and Dog Behavior Consulting and Training and is the animal behavior technician at The Gentle Vet in Ohio. Tabitha lectures at both regional and national levels, enjoying the opportunity to help people better understand and connect with animals. Additionally, Tabitha is a Fear Free certified speaker and coach, a Fear Free Practice Certification and Implementation Consultant, and the host of the podcast, Tails from a Vet Tech.

Tabitha offers organizational consulting and education for veterinary clinics and animal shelters, focusing on best practices that address both the emotional and physical needs of animals. She specializes in behavior and training programs and handling skills. Tabitha has contributed to the development of training and behavior programs for numerous veterinary hospitals and shelters and continues to provide ongoing support to these organizations through her consulting work.