Veterinary Vertex

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A single ion is changing how we read the story of canine heart failure. We sit down with cardiologist Dr. Darcy Adin and internist–nephrology researcher Dr. Autumn Harris to unpack why hypochloremia—once dismissed as collateral damage from diuretics—now stands out as a powerful predictor of survival in dogs with stable congestive heart failure. The conversation moves from physiology to practice, showing how chloride levels map to renin–angiotensin activation, diuretic resistance, and risk, and how that knowledge can guide smarter, earlier interventions.

We trace the research arc: early work that spotlighted chloride as more than a bystander, data linking low chloride to advanced disease stages and higher diuretic needs, and the pivotal finding that hypochloremia predicts outcomes even after controlling for other variables. Along the way, we break down renal salt sensing at the macula densa, why chloride depletion ramps up neurohormonal stress, and how this affects real dogs with mitral valve disease and congestive heart failure. If you manage CHF cases, this is practical cardiology and nephrology in lockstep.

Most importantly, we translate the science into steps you can use tomorrow. We talk thresholds and trend-watching, ensuring chloride is on every chemistry panel, covering RAS inhibition, adjusting diuretic strategies to spare chloride, and when to consider chloride supplementation. We also preview active trials targeting chloride to improve diuretic responsiveness, cut hospital time, and lift quality of life. Owners get a clear takeaway too: lab values are not just numbers; they’re signals that help personalize care and extend good days.

If you care for dogs with heart failure—or love one at home—this deep dive reframes a humble electrolyte as a crucial guide. Listen, share with your team, and help push the field forward. Enjoyed the conversation? Subscribe, leave a review, and tell us how you monitor chloride in your CHF workflow.

JAVMA article: https://doi.org/10.2460/javma.25.08.0526

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A spike in feline H5N1 cases has many of us asking the same question: how did bird flu end up in our living rooms? We sit down with author and clinician Dr. Jane Sykes to map the path from migratory birds to household pets, spotlighting the two biggest drivers of risk for cats—predation on infected wildlife and contaminated raw diets. The conversation is candid, practical, and rooted in current data, with clear guidance for veterinarians and pet owners who want to reduce danger without fear or hype.

We break down the clinical pattern that should trigger suspicion: a rapidly worsening illness with fever, lower respiratory signs, neurologic changes like ataxia or seizures, hypersalivation, and even sudden vision loss. Jane shares a step-by-step plan for what to do next: preserve the suspect diet for testing, notify local public health partners, and coordinate diagnostics through NAHLN labs with NVSL confirmation. We also unpack why household cases typically arise from common exposure rather than cat-to-cat spread, and why ending raw feeding across the home is the first and most effective intervention. The oseltamivir question comes up too; Jane weighs the risks, pharmacologic unknowns, and stewardship concerns around antivirals in cats.

Listeners get concise takeaways: cooked diets are safer, indoor life or secure catios cut exposure, and detailed dietary histories matter more than ever because many raw products look like pasteurized foods. We touch on the evolving clade 2.3.4.4b, the possibility of reassortment in cats, and why dogs appear more resistant yet still susceptible to infection. Jane points to the research we still need—serology to find silent infections, better food-chain surveillance, and communication tools that help us talk about diet without blame. Subscribe, share with a colleague or pet-loving friend, and leave a quick review to help more people find evidence-based guidance on companion animal health.

JAVMA article: https://doi.org/10.2460/javma.25.06.0388

Washington Post article: https://wapo.st/49isM8M

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A small structural “bump” on a molecule might be the big breakthrough EPM care has been waiting for. We sit down with researcher and clinician Izabela de Assis Rocha to unpack how bumped kinase inhibitors exploit a tiny difference between parasite and mammalian kinases to hit Sarcocystis neurona where it hurts—motility, invasion, and replication—while sparing the horse. It’s a molecular strategy with practical promise, and the conversation bridges the stall, the lab, and the future of equine neurology.

We break down the science behind CDPK1, the gatekeeper residue that drives selectivity, and why unique parasite structures like the apical complex and apicoplast open new therapeutic lanes. Then we move into what really matters for care: pharmacokinetics and clinical fit. BKI-1708 shows strong systemic distribution that positions it as a prophylactic candidate, while early data on BKI-1553 suggests better CNS penetration and a path toward active EPM treatment. Isabella explains how EPM’s dead-end host biology may lower the risk of widespread resistance, a rare bright spot in the antiparasitic landscape.

Clinical trials are the hard part. With no robust experimental infection model and fewer than 1% of exposed horses developing disease, enrolling enough cases takes patience and teamwork. We talk about building pragmatic, clinician-led studies, harmonizing diagnostics and neurologic scoring, and tracking relapse to find outcomes that matter to horses and owners. The One Health angle also shines through: BKIs show activity against equine piroplasmosis and have potential roles in toxoplasmosis and cryptosporidiosis, linking equine research to human and livestock health.

If you care about evidence-based equine neurology, new antiparasitic strategies, and turning elegant biochemistry into barn-side change, this is your roadmap. Subscribe, share with a colleague who manages EPM cases, and leave a review to help more veterinarians find the show. What question would you ask about bringing BKIs into practice?

AJVR article: https://doi.org/10.2460/ajvr.25.07.0270

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A calmer patient isn’t just a kinder visit—it’s a safer workplace. We sit down with researchers Drs. Gene Pavlovsky and Ellen Everett to unpack new data showing that veterinary teams see decreases in bites and scratches when every staff member completes low-stress handling certification. Partial participation helped culture in pockets, but it didn’t move the needle on injuries. The lesson is clear: safety is a system, not a solo skill.

We trace where stress truly starts, from the parking lot to the waiting room, and why early moments—carrier handling, first touch, body language checks—set the tone for the entire appointment. Gene and Ellen explain how teams identified high-risk scenarios and compare practices that rely on pre-visit medications or sedation to those built on consistent, low-stress workflows. The surprise? More drugs alone did not equal fewer injuries. Instead, shared training and peer accountability turned the tide: a receptionist who redirects a nervous dog to a quiet space, a certified veterinary technician who swaps scruffing for treats and positioning, and a veterinarian who uses “drive-by” sedation for severely fearful patients.

Along the way, we challenge a stubborn myth that heavier restraint makes staff safer. Data and lived experience point the other way—restraint escalates fear, and fear drives defensive aggression. We talk practical tools like Churu for cats, environmental tweaks, and stepwise protocols that protect staff while preserving patient welfare. We also cover the business case: fewer missed days, lower workers’ comp exposure, smoother procedures, and clients who notice the difference and come back.

If you lead a small animal practice, teach vet students, or simply want better outcomes without bruises or burned-out teams, this conversation maps a path from intention to implementation. Subscribe, share with your team, and leave a rating and review—then tell us what’s helped your hospital make low-stress care the norm.

JAVMA article: https://doi.org/10.2460/javma.25.05.0325

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What if the “gold standard” isn’t the only standard that delivers real results? We sit down with guest editor Dr. Emma Read to explore Spectrum of Care, the evidence-based approach that empowers veterinarians to present a range of medically sound options tailored to each client’s budget, lifestyle, and ability to follow through. Instead of treating alternatives as compromises, we show how tiered choices reduce moral distress, expand access to care, and still protect outcomes for pets.

Emma takes us inside the new JAVMA supplemental issue, where educators and clinicians map out how to teach Spectrum of Care so graduates don’t have to learn it the hard way. We dig into student takeaways, from recognizing privilege to practicing clear, empathetic conversations that align treatment with client goals. We also spotlight practical tools like communication frameworks and a Spectrum of Care video toolkit that make it easier to identify options, set expectations, and document decisions without shame or confusion.

Research is the next frontier. Many effective, lower-cost protocols live only in clinics and memories. We talk about turning those real-world methods into published evidence, partnering with veterinary schools to design studies, and building a shared knowledge base that separates tradition from what truly works. Along the way, we touch on business models that support tiered care, strategies to track outcomes, and the mindset shift that helps teams feel capable rather than constrained.

Curious how to bring Spectrum of Care into your practice or your classroom? Press play, then subscribe, share with a colleague, and leave a review to help more veterinarians find these tools and stories.

JAVMA editorial: https://doi.org/10.2460/javma.263.s3.s4

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Think draft horses “do worse” with colic? We put that belief on trial and let the data speak. With equine practitioner and researcher Dr. Jennifer Burns as our guest, we unpack why survival isn’t about breed status—it’s about when the horse arrives and how quickly we act. Drafts are famously stoic, which can mask early pain and delay referral. By the time they reach the hospital, heart rate, lactate, and abdominal protein often paint a sicker picture. The takeaway is both practical and hopeful: intervene early, educate owners on subtle signs, and don’t let draft status stop a surgical plan when it’s indicated.

We walk through the study’s design, the variables that could and couldn’t fit the model, and the nuance behind “more complications” without worse overall outcomes. Jennifer shares the conversations she has with clients who fear that surgery is a Hail Mary, and we spotlight a compelling number—60% of admitted horses were discharged—that reframes expectations. From clear displacement cases to managing two-thousand-pound athletes, we connect field realities with hospital strategy and discuss where targeted anesthesia, fluid plans, and postoperative monitoring might chip away at complication risks.

You’ll also hear candid stories from the road, the lessons that stuck, and the research questions we’re chasing next: is delayed care driven by recognition, logistics, or cost, and how can we fix it? If you care for draft horses—or love one—this conversation offers a sharper lens for spotting trouble sooner and a stronger voice when advocating for timely referral. If this episode helps you rethink colic in stoic breeds, follow the show, share it with a fellow horse person, and leave a quick review to help others find us.

JAVMA article: https://doi.org/10.2460/javma.25.05.0320

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We sit down with award-winning equine researcher Dr. Charlie Barton to unpack a controlled randomized trial from Colorado State University that challenges the tradition of fasting horses before general anesthesia—and the results are hard to ignore. Horses allowed hay before anesthesia passed manure much sooner post-op, often within three hours, while fasted horses took up to eight. Even better, careful intraoperative monitoring showed no difference in oxygenation or other key anesthesia parameters.

We walk through how the team designed the study and learn how the data point toward a protocol change with real-world benefits: faster GI recovery, shorter hospital stays, lower exposure to hospital pathogens, and calmer patients who aren’t fighting muzzles or playing in water buckets out of boredom. Along the way, Charlie shares surprises in the data, how behavior can skew water measurements, and why aligning practice with species biology can be helpful.

This conversation also opens the curtain on collaborative research in a busy hospital—how a residency project became a catalyst for protocol change and sparked interest from other clinics reevaluating their feeding plans. We close with practical takeaways for veterinarians, clear guidance for horse owners, and a few personal notes about career pivots, coffee before rounds, mountain trails, and the joy of seeing horses munch hay on their way to safer, smoother recoveries.

If you care about equine anesthesia, postoperative colic risk, and evidence-based protocols, you’ll want to hear this. Subscribe, share with your surgery and anesthesia teams, and leave a review to let us know your hospital’s approach—and whether you’re ready to feed before general anesthesia.

JAVMA article: https://doi.org/10.2460/javma.24.04.0235

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Horses and anesthesia make for a high stakes mix, and the numbers prove it. We open the barn door on a new study of oral trazodone in healthy adult horses that boosted sedation but, at a low dose, unexpectedly increased xylazine requirements at induction. Our award-winning guest, Dr. Emmett Swanton, walks us through the why behind the work, what the data actually say, and how to turn mixed results into smarter, safer protocols.

We dig into the global context first: equine perioperative mortality remains several times higher than in small animals, with most disasters happening during recovery. That’s where behavior, physiology, and pharmacology collide. Could a preoperative oral sedative soften the edges—calmer handling, smoother transitions, less panic? The study offers a nuanced yes: trazodone clearly increases calm, but clinicians shouldn’t assume an alpha-2 sparing effect at low dose. Instead, we talk practical use cases where trazodone shines today—pre-visit anxiolysis, postoperative stall rest—and where the next wave of research should go, especially recovery scoring and dose-timing strategies that might translate sedation into fewer complications.

Along the way, Emmett shares candid career lessons from residency to journal recognition and makes a compelling case for bridging small animal best practices to equine medicine without copy-pasting expectations. If you manage anxious horses, plan elective procedures, or obsess over safer recoveries, you’ll find concrete takeaways to test in your own barn: when to reach for trazodone, how to think about xylazine titration, and why the recovery phase deserves as much design as induction.

If this conversation helped you rethink your protocol, follow the show, share it with a colleague, and leave a quick review. Your feedback helps more veterinarians and horse owners find evidence-based strategies that keep horses safer.

AJVR article: https://doi.org/10.2460/ajvr.24.07.0185

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Ever have a client drop a “by the way” just as their hand hits the doorknob? We tackle the fix: agenda setting that captures every concern upfront, keeps appointments on track, and strengthens trust without adding time. With guests Drs. Jane Shaw, Kat Sutherland, and Natasha Janke, we map the science and the steps behind a small change that delivers big wins for veterinary teams and clients alike.

We walk through the practical anatomy of a better visit: start with a solid introduction, gather the client’s full list using open-ended questions, resist premature problem solving, summarize the agenda aloud, then triage together. You’ll hear how this approach anchors relationship-centered care, improves client satisfaction, and supports adherence—key predictors of better outcomes. Our guests explain how to insert the veterinary agenda transparently for topics like dental care, weight management, behavior, and nutrition, all without sidelining what the client values most.

From classroom to clinic, we cover training that sticks: scripting that sounds natural, team roles that share the workload, and habits that prevent doorknob disclosures. We unpack common pitfalls—closed questions, one-and-done lists, and diving too deep too soon—and offer simple replacements you can try today. Plus, we spotlight current research, where the evidence is strong, and what’s next for measuring appointment efficiency, client and veterinarian satisfaction, and late-rising concerns.

Ready to try it? Start every appointment with a complete agenda, confirm it, and choose what fits today. Subscribe for more conversations that sharpen clinical communication, share this episode with your team, and leave a quick review to help others find the show.

JAVMA article: https://doi.org/10.2460/javma.25.06.0377

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Ever wondered what’s actually inside a “homemade” dog diet—and whether it truly keeps dogs healthy? We sat down with researchers Drs. Janice O'Brien and Audrey Ruple from the Dog Aging Project to pull back the curtain on what owners are really feeding, what the data reveals, and how to make home-prepared meals complete and balanced without guesswork. The conversation starts with a major survey upgrade: moving from simple checkboxes to detailed free-text responses that capture real ingredients, supplements, and routines. That shift exposes a surprising truth—most DIY bowls contain nine to ten ingredients, far beyond chicken and rice, yet many still miss key nutrients for maintenance.

We walk through the practical and the personal: how to take a smarter diet history in the exam room, what owners should ask before they shop, and which tools can reliably build balanced recipes. Instead of fear or food wars, we focus on action. Consulting a board-certified veterinary nutritionist, using validated recipe platforms, and leveraging commercial base mixes can transform care and confidence. We also explore the long game. Do incomplete diets quietly shape future health risks? Which deficiencies matter most over time? Longitudinal data from the Dog Aging Project aims to turn those open questions into guidance that protects joints, skin, metabolism, and longevity.

There’s another layer that deserves attention: diversity among human owners. While our canine cohorts are broad, our human samples often aren’t. Culture, income, education, and access influence feeding choices, shopping habits, and follow-up care. Broadening who participates in pet nutrition research makes our recommendations more realistic and more fair. By the end, you’ll have a clearer view of where homemade feeding succeeds, where it stumbles, and how to build a plan that meets your dog’s needs today and supports health tomorrow.

If this conversation helped you think differently about dog nutrition, subscribe, share with a friend who home cooks, and leave a quick review—your feedback helps more pet owners find science they can use.

AJVR article: https://doi.org/10.2460/ajvr.25.06.0216

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