Veterinary Vertex

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A splenic mass shows up on ultrasound and the question hits like a brick: benign or malignant? We go straight at the uncomfortable truth behind canine splenic cytology. Even when splenic FNA feels like the “do something now” step, the match between cytology and histopathology is only moderate, and that has consequences for how we advise families, schedule rechecks, and decide when splenectomy is the safest path.

We talk with Drs. Janet Grimes and Matthew Alusio about what their data means in the exam room: why a neoplastic cytology result tends to be more predictive than a non-neoplastic one, and why a benign aspirate does not rule out cancer. We unpack the spleen’s built-in complexity, including extramedullary hematopoiesis, mixed cell populations, and the sampling problem of trying to summarize a large, heterogeneous lesion from a tiny needle sample. We also get specific about the diagnoses no one wants to miss, including hemangiosarcoma and lymphoma, and how tumor exfoliation and overlap with reactive processes can blur the picture.

From there, we shift into action: when cytology is most useful, when serial ultrasound monitoring is a reasonable strategy for smaller, non-ruptured nodules, and when size and rupture risk should move the conversation toward surgery and definitive histopathology. We also dig into the “possibly neoplastic” gray zone and why calling your pathologist can be one of the most practical diagnostic tools you have.

If you work up splenic masses in dogs and want clearer owner conversations, better monitoring plans, and fewer false reassurances, this one is for you. Subscribe, share with a colleague, and leave a rating and review so more clinicians can find the show.

JAVMA article: https://doi.org/10.2460/javma.26.01.0006

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Routine stifle exploration during canine cranial cruciate ligament surgery sounds like common sense, until you ask the uncomfortable question: what if “doing more” doesn’t reliably improve long-term function for most dogs? We sit down with Dr. Dan Low to unpack long-term outcomes after high tibial osteotomy procedures (TPLO and CCWO) performed without routine arthroscopy or arthrotomy and without proactive meniscal evaluation, a real-world approach many clinicians use but rarely see studied in depth.

We break down what high tibial osteotomy actually changes in the cruciate-deficient stifle, then get practical about evidence. Dan explains why this large case series matters, how uncommon events become easier to estimate with bigger numbers, and why validated owner-reported tools like LOAD (Liverpool Osteoarthritis in Dogs) and the Canine Orthopedic Index give us a more standardized view of recovery than vague “good” or “excellent” labels. We also discuss one of the most debated points in veterinary orthopedics: late meniscectomy. When a meniscal sparing strategy produces a low late-intervention rate that looks similar to rates reported in explored joints, it raises a bigger issue about which meniscal lesions are truly clinically meaningful.

We don’t pretend one study settles the debate. You’ll hear the strongest criticisms of this design, the patient groups where exploration still makes sense (uncertain diagnosis, revision cases), and the unanswered research questions that could reshape how we balance morbidity, time, and cost in dog knee surgery. If you treat CCL disease, refer cruciate cases, or counsel owners through surgical options, this conversation will sharpen how you explain risk-benefit decisions without defaulting to habit.

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JAVMA article: https://doi.org/10.2460/javma.25.11.0736

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Rehabilitation isn’t a luxury line item at the end of a case anymore. It’s becoming the difference between “we fixed the lesion” and “this patient truly returns to function.” We’re joined by Drs. Heidi Reesink, Denise Marcellin-Little, and David Levine to unpack a first-of-its-kind JAVMA rehabilitation Technical Tutorial Video supplemental issue and what it signals about where veterinary rehabilitation and physical therapy are headed.

We talk honestly about what makes rehabilitation challenging and exciting in real clinical practice: plans that look totally different for dogs, cats, and horses; chronic cases like osteoarthritis that demand long-term strategy; and the reality that owner goals, time, and cost shape what care can actually happen. You’ll hear why a multidisciplinary rehab team matters, how technicians and assistants help deliver consistent protocols, and why listening to the patient over time can be just as important as any single test.

From there we get practical and tech-forward. We dig into objective gait analysis using wearable sensors and motion capture, the stubborn underuse of goniometry despite validation, and how ultrasound-guided injections and arthroscopy support both diagnosis and treatment while enabling longitudinal monitoring. We also explore major modalities clinicians ask about every day, including shockwave therapy and underwater treadmill aquatic therapy, plus what we still need to learn to tighten protocols. Finally, we tackle orthobiologics and regenerative medicine evidence, why big studies are so hard in veterinary patients, and how video tutorials can bridge the gap between research and day-to-day rehabilitation outcomes.

If you care about better mobility, clearer measurements, and more predictable recoveries, listen now, share it with a colleague, and subscribe so you don’t miss what’s next. After you listen, leave us a rating and review and tell us: which rehabilitation tool has changed your practice most?

JAVMA editorial: https://doi.org/10.2460/javma.264.s1.s3

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We sit down with Dr. Lynn Pezzanite to explore a promising angle on aging-related equine osteoarthritis (OA): cellular senescence, the pro-inflammatory state where cells release a senescence-associated secretory phenotype (SASP) that can amplify damage inside tissues over time.

We walk through why horses are such a valuable One Health model for osteoarthritis research and why this team compared synovial fluid cells from the joint with peripheral blood mononuclear cells from circulation. Using single-cell RNA sequencing, the study teases apart immune and cellular heterogeneity that bulk methods can blur. One of the most striking takeaways is the compartment split: senescence-associated pathways can be down in peripheral blood yet up in synovial cells, suggesting the joint environment may create a more intense, specialized senescent phenotype.

We also dig into the immune cell story, including why dendritic cells and gamma delta T cells keep showing up as important across both chronic natural OA and early post-traumatic OA work. Then we shift to what this could mean clinically: the promise and cautions around senescence-targeted therapies and the practical case for local intra-articular delivery. Finally, we talk translational hurdles like equine-specific dosing and safety, plus the next research steps to connect senescence burden with OA pain and treatment response.

If you care about equine lameness, osteoarthritis biomarkers, and the future of disease-modifying OA therapy, subscribe, share this with a colleague, and leave us a rating and review wherever you listen.

AJVR article: https://doi.org/10.2460/ajvr.25.09.0343

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Botox for the equine hoof sounds like a punchline until you learn the science behind it. We sit down with Dr. Kali Slavik and repeat guest Dr. Andrew van Eps to explore a simple but high-stakes question in equine biomechanics: what happens when you inject botulinum toxin into the deep digital flexor (DDF) muscle, the muscle-tendon unit that helps control the rotational forces acting on the horse’s foot and distal phalanx (P3)? 

We walk through the anatomy in plain terms and then get into the study design, using healthy horses with one treated limb and one control limb to reduce variability. Kali explains how they used wireless pressure sensor membranes to quantify ground reaction forces at different hoof regions and track center of pressure during stance and at the walk, a powerful alternative to traditional pressure plates when you want more real-world movement data. Andrew shares what he expected to see and what surprised him once the numbers came in. 

Then we dig into the findings that matter most for equine laminitis: reduced toe force during breakover and a meaningful palmar shift in center of pressure, including changes seen even when the horse is just standing still. We also cover the practical realities, including the short-lived effect (about two weeks), who this may best help (think acute onset laminitis tied to SIRS or hyperinsulinemia), why it is less suited to chronic or support-limb cases, and the big barriers of cost and technical ultrasound-guided injections. We close with study limitations and the next research step: a blinded placebo-controlled trial that also looks at P3 rotation outcomes. 

If you care about laminitis treatment options, hoof biomechanics, and how veterinary research turns measurements into better decisions, listen now and share this with an equine colleague. Subscribe, leave a rating and review, and tell us what question you want answered next.

AJVR article: https://doi.org/10.2460/ajvr.25.12.0452

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Zero re-obstructions sounds almost too good to be true, so we wanted to understand exactly how the data got there and what it means for everyday feline practice. We are joined by study author Dr. Kelly Tart to talk about a prospective, double-blinded, placebo-controlled trial evaluating lorazepam for recurrence prevention after feline urethral obstruction in male cats, one of the most common and life-threatening urinary emergencies we treat.

We start with the “why”: feline urethral obstruction can rapidly cause azotemia, hyperkalemia, acidosis, and fatal arrhythmias, and recurrence often hits within the first couple of weeks after discharge. Kelly explains the key anatomic detail that drives the whole hypothesis: the male feline penile urethra contains both smooth and skeletal muscle, and plugs often lodge distally where skeletal muscle dominates. Many past pharmacologic approaches have focused on smooth muscle pathways, which may help explain inconsistent results in recurrence studies. Lorazepam, a benzodiazepine with skeletal muscle relaxant effects, offers a mechanism that better matches where the problem happens.

We also dig into what strong evidence looks like in veterinary medicine and why prospective enrollment, standardized care, placebo control, and double blinding matter when owners and clinicians are judging outcomes in nonverbal patients. You will hear practical discharge details including timing, dosing approach, a 30-day course to cover the highest-risk window, approximate cost, and what adverse effects to monitor such as sedation and ataxia. We close with the clinical “so what”: how this could change post-obstruction management, which cats we would avoid based on prior benzodiazepine sensitivity, and the research questions this opens for lower urinary tract signs beyond true obstruction.

If you found this helpful, subscribe, share the episode with a colleague, and leave us a rating and review on Apple Podcasts or wherever you listen.

JAVMA article: https://doi.org/10.2460/javma.26.01.0045

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What if the IV catheter your hospitalized dog already has could spare them multiple needle sticks a day without sacrificing lab accuracy? We sit down with Dr. Bryan Welch to challenge a common assumption in small animal emergency and ICU care: that venipuncture is the only reliable way to get serial bloodwork. We talk through a validated push-pull blood sampling technique that uses a peripheral IV catheter to collect repeat samples while aiming to reduce stress, preserve veins, and lower the risk of oversampling and hospital-acquired anemia. 

Bryan breaks down the method step by step: flushing with sterile saline, drawing blood back, returning it to the patient, and repeating to clear dead space and reduce dilution. Then we dig into the results that matter to practicing veterinary teams, including how peripheral IV catheter samples compare with venipuncture right after placement and after at least 24 hours of continuous IV fluids and medications. We also clarify a point that trips up a lot of clinicians, statistically significant versus clinically relevant differences, using real examples of when a number changes but your treatment plan should not. 

We also cover the practical concerns that drive hesitation, hemolysis, clot formation, turbidity, and smear changes, plus what the study did and did not evaluate. Bryan shares where he would be cautious, including interpreting sodium potassium ratios for suspected hypoadrenocorticism, and offers simple implementation tips for teams trying the technique for the first time. If you want evidence-based ways to improve patient comfort and streamline hospitalized dog bloodwork, hit play, then subscribe, share with your ICU team, and leave a rating and review.

JAVMA article: https://doi.org/10.2460/javma.25.09.0635

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A dog with chronic diarrhea or vomiting might also be telling you something else. That’s the core thread we pull on as we explore the gut-brain axis in dogs and why chronic enteropathy (CE) can’t be fully understood through GI signs alone.

We’re joined by Drs. Ulrika Ludvigsson and Sarah Heath to unpack how chronic enteropathy is defined (GI signs lasting more than three weeks) and why emotional health has historically been sidelined in veterinary care. Then we get concrete about measurement. Sarah explains how a validated canine PANAS tool can capture emotional bias. We also dig into displacement behaviors like yawning, lip smacking, and shaking off in odd moments, using the Heath model “sink” analogy to show how high arousal can overflow into visible behavior.

The conversation turns to what their findings suggest: dogs with CE show higher protective bias and more frequent high-arousal signals than healthy dogs, even when GI disease activity seems well controlled. We talk about what that means for clinical decision-making, when to consider referral to a veterinary behavioral medicine specialist, and how co-management can support welfare. You’ll also hear practical owner steps that connect canine gut health and emotional stability, from fiber-forward diets and microbiome-friendly habits to sleep quality (yes, many adult dogs need 14 to 18 hours daily), environmental adjustments, nutraceuticals, pheromones, and medication when appropriate.

If you care about chronic GI disease, canine emotional health, and better outcomes through whole-dog treatment, this one is for you. Subscribe, share this episode with a veterinarian or dog-loving friend, and leave us a rating and review wherever you listen.

JAVMA article: https://doi.org/10.2460/javma.25.09.0623

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Metronidazole has been the reflex prescription for canine acute diarrhea for years and that habit is hard to break. We sit down with Dr. Erin Frey to unpack what the data actually says about outcomes in mild to moderate acute diarrhea, including cases with bloody stool, and why supportive care often matches antibiotics for speed of recovery. Along the way, we get honest about the real reasons “we know better” doesn’t always translate into “we do it” when a worried client is sitting in front of us. 

We walk through what uncomplicated acute diarrhea looks like in practice and what supportive care really means: hydration plans, a highly digestible diet, smart fiber use, and when probiotics may fit. Erin also explains why the gut microbiome is now central to the conversation, and how antibiotic-associated dysbiosis can linger for weeks to months, with special concern for puppies and kittens. If you’ve ever prescribed “just in case” because you feared missing something, this conversation gives you a clearer risk-benefit frame grounded in randomized controlled trials and day-to-day clinical reality. 

Then we zoom out to the culture of prescribing. Peer expectations inside a hospital, mixed standards between clinics, client demand for instant gratification, and the challenges faced by newer grads or relief doctors all shape decisions. Erin shares practical tools for behavior change, including practice-wide talking points, team alignment from front desk to exam room, and a concrete starting point using the AVMA antimicrobial stewardship checklist. 

If you want a clearer, evidence-based approach to treating canine acute diarrhea without unnecessary antibiotics, listen now, share this with a colleague, and leave us a rating and review on Apple Podcasts or wherever you listen.

JAVMA article: https://doi.org/10.2460/javma.25.10.0686

AVMA veterinary checklist for antimicrobial stewardship: Veterinary-Checklist-Antimicrobial-Stewardship.pdf

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Guinea pigs don’t read the dog-and-cat neurology textbook and that’s exactly where clinicians get into trouble. We sit down with Dr. Vishal Murthy to unpack what a truly species-specific neurologic examination looks like for guinea pigs, why so many “standard” tests can be misleading, and how prey-species stress can flatten reflexes and hide both normal function and real disease. If you’ve ever felt unsure interpreting postural reactions or reflex testing in small mammals, this conversation gives you a clearer baseline for what normal actually is. 

We dig into the practical realities that make exotic pet neurology hard in the exam room: freezing, shutdown behaviors, and the ways restraint and stress can change responses. Vishal shares the most surprising findings from their work, including why a gag reflex attempt can quickly become a chewing response, and what that means for brain and spinal cord lesion localization. We also talk about differences between client-owned and research guinea pigs, and why handling style may explain pelvic limb tactile placing changes. 

To make this useful at 2 a.m. in ER as well as in specialty practice, we walk through a guinea pig specific checklist designed to emphasize feasible, more reliable exam elements and reduce unnecessary handling. The goal is better diagnostic accuracy, faster decision-making, and improved welfare for a prey species that experiences exams differently than cats and dogs. Subscribe for more veterinary neurology conversations, share this with your zoological companion animal colleagues, and leave a rating and review wherever you listen.

JAVMA article: https://doi.org/10.2460/javma.25.12.0823

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