A new study has found that although home-prepared diets for canines are often diverse in ingredients, most canines may be lacking key nutrients. Investigators assessed 1726 homemade diets for nutritional completeness as well as how dog owners prepared the dog food.

Diet information was collected through an open-ended survey with responses from owners participating through the Dog Aging Project. The study was a collaborative effort led by the Texas A&M College of Veterinary Medicine and Biomedical Sciences (VMBS) with support from additional institutions.

“We found that only 6% of homemade diets had the potential to be nutritionally complete,” Janice O’Brien, DVM, a PhD student in dog nutrition epidemiology at Virginia-Maryland College of Veterinary Medicine in Blacksburg, Virginia, and a study author, said in a news release.

 “Since our study didn’t include exact ingredient amounts, it’s possible that a smaller percentage than 6% were nutritionally complete.”

The diet information collected for the study was entered into a digital tool, Balance It, which helps owners create nutritionally complete homemade diets for their pets. “Balance It is compliant with both the [FDA] and the Association of American Feed Control Officials’ recommendations for canine nutrition,” O’Brien said.

 “By entering the list of ingredients in each recipe into Balance It, we determined if there were nutrients missing.”

Based on the collected diet information, home-prepared diets were composed of a range of ingredients that may include meat and organs, vegetables, fruits, grains, nuts and seeds, and added oils. “The most common dietary ingredients were meat (90%) and vegetables (65%). Nearly half (45%) of owners added some form of commercially prepared diet or base/topper to supplement the home-prepared ingredients,” according to the study’s authors.

O’Brien previously found that few home-prepared diets are balanced. In a presentation of her research at the 2025 American College of Veterinary Internal Medicine (ACVIM) Forum in Louisville, Kentucky, she shared that about 25% of diets for pets enrolled in the study were partially balanced (1 to 10 nutrient imbalances), and 52% were unbalanced (10 or more nutrient imbalances), while approximately 17% could not be categorized.

Home-prepared diets have seen a rise in popularity among dog owners over the last 2 decades, according to VMBS. Katie Tolbert, DVM, PhD, DACVIM (SAIM, SA Nutrition), an associate professor in the department of small animal clinical sciences at VMBS and an author in the study, noted that dog owners should be aware that there is a responsibility that comes with the choice to prepare their pets’ meals in their homes. The word of caution is based on the study’s results.

“There is a temptation for a lot of dog owners to go off script when preparing meals at home,” Tolbert said in the release.

 “If you decide to formulate your dog’s food at home, be sure to work with a board-certified veterinary nutritionist and stick to the diet exactly as prescribed. Nothing is considered a ‘filler’ that you can leave out.”

interview at 2025 ACVIM Forum that adding vitamins and minerals to home-prepared foods is necessary in the majority of cases. “There's probably some sort of supplement that is going to have to be added, and it needs to be added all the time,” O’Brien said.

Substituting different types of oil can change the nutritional completeness of the diet, for one example, according to the release. As another example, serious problems can occur by omitting a calcium supplement, which is a common addition in home-prepared dog food.

“If your dog’s calcium and phosphate levels get out of balance, they can develop bone health problems, including a condition nicknamed ‘rubber jaw’ where the bone starts to become soft, like cartilage,” Tolbert said.

 “It can also cause problems in the kidneys.”

Dogs with existing illnesses can experience exacerbated symptoms if they do not receive a diet that is specifically formulated to their unique needs, according to Tolbert. Additionally, she recommends avoiding ingredients that are toxic to canines, such as grapes, or ingredients that pose other risks. “Whole bones…are risky because dogs can end up with sharp pieces of bone in their stomach,” Tolbert said.

O’Brien said that pet owners should be closely following the recipes they use for their animals’ meals. “If you have a recipe that's formulated, make sure that you continue doing that exact recipe all the time, because otherwise, if you drift away from what it initially was, that's going to result in changes to the balance of the diet,” she said in the interview.

The study investigators also concluded that veterinarians collecting a diet history for their patients should fully examine the home-prepared foods being reported by owners. A variety of tools should be used to help pet owners choose a maintenance diet, including consultation with veterinary nutritionists that are board-certified through ACVIM.

For pet owners interested in providing home-prepared meals for their companion animals, the investigators recommend consulting with a veterinarian about dietary needs. The next step is to work with a board-certified veterinary nutritionist to ensure a healthy diet plan meets the individual pet’s needs.

Additionally, Tolbert suggested sending a food sample to a laboratory for testing, which can help ensure the diet contains the appropriate nutrients. “It can be helpful to know exactly what is in the food you’re feeding your pet to make sure the recipe is as precise as possible,” Tolbert said.

Price C. Most homemade dog diets lack nutrients; Texas A&M study finds. Texas A&M University. November 21, 2025. Accessed November 26, 2025. 

https://stories.tamu.edu/news/2025/11/21/most-homemade-dog-diets-lack-nutrients-texas-am-study-finds/

O’Brien JS, Lawson E, Dog Aging Project Consortium, Tolbert MK, Ruple, A. Findings from the Dog Aging Project: home-prepared diets for companion dogs feature diverse ingredients, and few are nutritionally complete. 

. 2025;86(11):ajvr.25.06.0216. doi:10.2460/ajvr.25.06.0216.

O’Brien J, Ruple A, Tolbert K. Abstract NM04: Home-prepared diets for companion dogs are made from diverse ingredients and few are balanced. Presented at: American College of Veterinary Internal Medicine (ACVIM) Forum; June 18-21, 2025: Louisville, KY.

Crossley KC. Study: Few home-prepared diets are balanced. 

. June 20, 2025. Accessed November 26, 2025. 

https://www.dvm360.com/view/study-few-home-prepared-diets-are-balanced

Articles

Investigators with the Dog Aging Project assessed 1726 feeding plans created by pet owners.

Study finds homemade diets for canines often lack key nutrients

Megan Shepherd, DVM, PhD, DACVIM (Nutrition), a veterinary nutritionist at Royal Canin, discusses the benefits of probiotics for pets.

Best practices on talking about probiotics

In this segment of Pet Connections, Megan Shepherd, DVM, PhD, DACVIM (Nutrition), a veterinary nutritionist at Royal Canin, discusses the benefits of probiotics for pets. As Shepherd explains, bacteria-based probiotics are common, but yeast-based probiotics offer unique advantages.

Hi, I'm Megan Shepherd, veterinary nutritionist at Royal Canin, and here are some considerations when talking to pet owners about probiotics:

Probiotics are live beneficial microorganisms. They can be a great complement to a pet's diet when you want to add a layer of GI support. The beneficial microorganisms in probiotics can be bacteria or yeast. While bacteria-based probiotics are most common, yeast-based probiotics are pretty cool due to some unique features.

Saccharomyces cerevisiae is the most common yeast used in food and supplements, and it is used as a prebiotic fiber in some pet food. 

, makes for a pretty cool probiotic due to some key features:

 It survives the gastric environment very well.


 The mannooligosaccharides and beta-glucans, naturally found in the cell wall of 

, have beneficial impacts on the GI microbiome and immune health.


 When you want to add on a layer of GI support to that patient on antibiotics, you can give a yeast-based probiotic like 

 at the same time as the antibiotic dose, making it easier for the pet owner to implement that support.


 Yeast don't have the capacity to transfer antimicrobial-resistance genes.

, specifically the CNCM I-1079, strain, which is used in veterinary medicine. And, Royal Canin’s feline probiotics includes added vitamin B12 ie, cobalamin, and enough to support that cat with hypocobalaminemia.

Final consideration with probiotics: Probiotics are regulated. However, there are surveillance limitations. So, when navigating probiotic options, ensure that they are science-based and be very specific with which probiotic you are recommending to your pet owner.

Videos

Megan Shepherd, DVM, PhD, DACVIM (Nutrition), shares how yeast-based probiotics offer unique advantages over traditional bacteria-based options.

My clients hold their pets’ lives in their hands, yet often miss the mark when making medical choices for them, despite my counsel. What can I do to sway them in healthier directions?

We’ve all tried to pry open those black boxes inside our clients’ heads that explain the eternal contradictions: the owner who adorns her dog with pricey bling, but won’t spring for x-rays to clarify 3 days of vomiting. The one who stockpiles parasite preventives, but declares vaccines unnecessary. Or the pet owner who tags her overweight cat as her BFF, but won’t chisel him down to a healthy weight that might prolong their love.

We offer our clients strings of medical pearls, but our words often fall flat, said Samantha Siess, DVM, PhD, who studies risk perception, communication, and medical decision-making in both human and veterinary medicine. “Communication is as vital as the medicine itself,” she said.

Michele Campellone, VMD, owner of The Visiting Vet, LLC, a mobile veterinary clinic servicing Montgomery County, Pennsylvania, practices this daily.She estimates that only 60% of her clients go with her recommendations on the first pass. But she’s prepared for their reticence—and she prepares them, too. A “no” to wellness diagnostics? “I say, ‘If we’re not going to do it this year, then we’ll definitely do it next year, since he’ll be a year older,’” she explained.

And to the client who can’t say “no” to that hefty cat who wails for food? “I tell them: ‘There’s a 90% chance he is going to become diabetic. It’s better for your cat to be crying for food than for you to be crying because you’re having trouble giving the insulin,’” Campellone said.

Preventive health initiatives, from simple (vaccines, flea and tick prophylaxis, etc) to complex (diet and exercise), vary by time, money, and effort required. They can be a tough sell, Siess said, because they are directed toward healthy-looking animals not yet in need.

“Remind them that their pet doesn’t have to be acting sick to have something brewing,” she suggested. “And that there is benefit to starting treatment when they are still acting fine.”

Wellness blood work, Siess advises owners, might flag problems like climbing kidney values that could be addressed with a renal diet.

 shows that the ‘doom and gloom’ approach is a poor motivator. “People are more likely to respond to, ‘If you give this vaccine, your pet will be healthy’ than ‘If you don’t give it, you risk death for your pet,’” she explained.

“The more threatening a statement, the more likely they are to think, ‘That won’t be me.’”

But whether diagnostics serve up wellness baselines or sickness workups, they all involve numbers.And numbers are intangible. For an owner whose cat is drenching the couch in urine, an antibiotic offering a potentially quick fix is more appealing than a list of Latin-lettered microbes and minimum inhibitory concentrations on a urine culture.

Though there are possible detriments to empiric antibiotics, Siess said, “they want that tangible.”

Campellone understands this and strives to make amorphous values real for her clients. Every report, once explained, gets emailed to them. She reminds owners that the diagnostic measurements they now have in their possession serve as baselines for future comparison and provide essential data to emergency doctors should the pet ever face a crisis.

According to the 2021 Consumer Expenditure Surveys, veterinary services accounted for just one-third of total spending on pets,

 with the lion’s share going to food, supplies, and ancillary services like grooming and training. If your client would sooner pay for deer antlers and pet psychic readings than blood pressure and urine protein-to-creatinine ratios, it may be a not-so-simple issue of communication.

Practice management consultant Wendy S. Myers, who runs Sarasota, Florida-based Communication Solutions for Veterinarians, says good communication always starts with financials. She said disclosing costs up front helps build trust. But she prefers the term 

 (fees are nonnegotiable quantities, and are linked to professional services) to 

But money is just part of the equation, noted James Morrisey, DVM, DABVP, postdoctoral fellow in veterinary communication at Colorado State University (CSU) College of Veterinary Medicine and Biomedical Sciences in Fort Collins. “We tell owners, ‘This is the test, and this is the cost.’But we don’t explain the value,” he said.

We cannot communicate the value of a visit without learning the pet parent’s agenda for the appointment. Instead, we often resort to what Morrisey refers to as “Spanish Inquisition of questions”: Coughing? Sneezing? Vomiting? Diarrhea?

He said yes-or-no questions like these don’t build the rapport necessary to discover a client’s goals.But open-ended inquiries, such as “What brings you in today?” or “Describe how Maisy’s energy level has changed recently,” draw more information, improve communication efficiency,

In a study examining veterinarian solicitation of client concerns in companion animal practice,

 fewer than half of the appointments saw a veterinarian pose a single question to the pet owner. And of those questions, 1 in 4 was closed-ended.

To compound matters, veterinarians interrupted owners in 55% of their appointments.

 This often led to incomplete replies and owners’ concerns being put off until the last moments of appointments.

If we are trying to influence our clients’ behaviors, Morrisey said, we need to open our ears more. “If clients don’t feel like we’re listening to them, they’re not going to be listening to us.”

The nuances of communication between doctor and pet parent are now part of the curriculum at many US veterinary schools. In programs like those at CSU and Cornell University College of Veterinary Medicine in Ithaca, New York, veterinary students can practice tough conversations through role-playing with simulated clients.

, a trust-builder that prompts the doctor to demonstrate they are listening by repeating back what was said (“I hear you are concerned about Copper’s urinating in the house”). Students also pick up techniques like 

, which employs words and phrases that can help redirect the narrative so that an appointment moves forward in a meaningful direction (“But let’s talk for a minute about Copper’s weight loss”).

Siess said constructive communication can set into motion owner choices and behaviors that are optimal for their pets. But when a pet parent shrugs off your advice, she suggests meeting those hesitations head-on.

What’s holding them up? Do they understand their pet’s condition? Are they concerned about putting their animal through testing or therapy?Are there financial concerns?Is “Dr Google” saying something different?

“Anecdotally, people tend to say, ‘Well, I read this online,’” Siess observed, “rather than take the advice of the clinician in front of them who has seen (the condition) many times and is now applying this knowledge to 

Given that pet owners tend to trust the written word—sometimes more than the spoken—Siess said veterinarians might take a page out of human medicine and populate their clinics with written decision aids. These might include vaccine pamphlets that lay out risk factors and tailor protocols to different pet profiles. Or flowcharts that make chronic health conditions seem more manageable.

Campellone employs visuals heavily to keep her mobile clientele engaged. “I always draw pictures for owners,” she said. “I show them what I’m doing, even if it’s just expressing anal glands. I’m constantly teaching them.”

Siess S, Marziliano A, Sarma EA, Sikorski LE, Moyer A. Why psychology matters in veterinary medicine. 

. 2015;30(2):43-47. doi:10.1053/j.tcam.2015.05.001

Table R-1. All consumer units: annual detailed expenditure means, standard errors, coefficients of variation, and weekly (D) or quarterly (L) percent reporting, Consumer Expenditure Surveys. 2021. US Bureau of Labor Statistics. September 2022. Accessed November 4, 2025. 

https://www.bls.gov/cex/tables/calendar-year/mean/cu-all-detail-2021.pdf

Dysart LM, Coe JB, Adams, CL. Analysis of solicitation of client concerns in companion animal practice. 

. 2011;238(12). doi:10.2460/javma.238.12.1609

Whether the push is for diagnostics, optimal treatments, or solid preventive measures, leading owners to sound decisions for their pets’ health might be the veterinarian’s toughest task. 

Veterinary Vexations: Collaring good choices

 podcast, host Adam Christman, DVM, MBA, sits down with Bonnie D. Wright, DVM, DACVAA, to unpack practical, evidence-based approaches to multimodal analgesia. They explore how acupuncture, shockwave, laser, pulsed electromagnetic field (PEMF), and guided motion complement pharmacologic therapies for both acute and chronic pain, as well as  how clinicians can translate these tools into accessible, cost-sensitive treatment plans owners can participate in.

Below is a partial transcript, edited lightly for clarity and flow:

What do you know about multimodal analgesia in veterinary medicine? I know we've covered different aspects of this, but we have never had the one and only Dr Bonnie Wright in the house to talk to us. Welcome, my friend. Thank you. I'm glad I'm sitting down. I'm honored that I'm sharing the screen with you right now. Is really what it is.

Here, really. Thank you for all the great work that you do. And to the listeners, just get a listen of just a little bit of the wonderful work that our colleague has done. Dr Wright, was born and raised in Albuquerque, New Mexico, and she accomplished her DVM at Colorado State University and a residency in anesthesia and critical patient care at the University of California, Davis. She's lived in Colorado since 2001 and part time in Hawaii since 2017. She's board certified in veterinary anesthesia and analgesia, and she's earned her certificate in medical acupuncture, veterinary pain practitioner, canine rehabilitation practitioner, canine rehabilitation therapist and advanced training in canine musculoskeletal imaging and regenerative medicine. My goodness, she practices and teaches in the areas of anesthesia, pain medicine, the sciences of nonpharmaceutical pain medicine, evidence-based acupuncture, regenerative medicine and rehab, balancing love of both teaching and practice. She constantly learns from both her patients and her students. She's on the lead faculty for the evidence-based veterinary acupuncture program, which we're going to talk more about. And she also has two adult sons, several wonderful dogs, a fabulous horse, and an unknown number of wild hogs and turkeys. She spends time exercising and building her off grid Hawaiian farm with her wife and scent-trained service dogs. Oh, my goodness. How do you balance all of this? I'm exhausted. I love it. Well, let's, let's go into a little bit of the pain management, because I'm really excited to learn more about this, and I want to kind of back up a little bit—what's involved in being an integrative pain management specialist?

I think with the word integrative, it is multimodal — beyond just what we think of pharmacologically as using different drug classes, but really recognizing that in most forms of complex pain, you need both pharmacologic and nonpharmacologic tools, and you are integrating those in a way that optimizes both and neglects neither.

I'm curious what got you involved in that.

Well, as an anesthesiologist, we're always asked to help with pain cases, but at the time, I was much better at the pharmacologic side, because that's what I was taught. And I found myself struggling when it came to chronic pain, because a pharmacologic tool by itself tends to not be a big enough toolbox. And so, the first thing I learned was medical acupuncture, and started becoming fascinated by how it worked and how it was using the same neurotransmitter systems, and I realized we needed a voice in our world that could speak scientifically about what nonpharmacologic modalities were doing. And so, I went running down that road.

I love it, fantastic. And let's tell a little bit about that, about the science behind [nonpharmaceutical] therapies. What do we know about that?

You know we know a lot of things physiologically. So, a lot of models that look at a particular system, and if you modify that system, what happens more globally in the body. What we have less of is the more comprehensive, randomized, controlled clinical trial in our species of interest for a variety of reasons. And one is that with complex interventions, like a lot of the nonpharmacological things, where you're modifying homeostasis, it is harder to measure that in a predictable, evidence-based way with a good placebo control. And so, it really limits the way we were used to getting our science for a number of things that are more complex than simply giving a drug or doing a surgery and immediately looking at outcomes—it's harder to measure.

Yeah, excellent. Okay, so you touched a little bit about acupuncture. We know there is plenty of evidence-based medicine and the use of acupuncture for multiple cases, so share with us a little bit of best use cases and any stories that maybe you have witnessed along your wonderful career.

I think that the way to see acupuncture is as a modifier of homeostasis. Bodies, when we're young and healthy, have a pretty normal homeostasis, but as you deal with sickness and injury, you can form homeostatic loops that are less functional or less comfortable. And acupuncture is a way of bringing those homeostatic loops back to something closer to where they were when you were a healthy individual. And so, it's really tapping into the neurochemistry of the body, which means, if it's a homeostatic system, acupuncture is going to be pretty good at it. And so, pain is the obvious one—an important homeostatic system that, with multiple things that happen over a lifetime, can spiral in a way that creates worsening pain after an event, but also very much as we age and we accumulate multiple events. So pain, I would say—I quote—things that aren't based on, like a study about how often I think acupuncture will help a particular thing, and pain is up in the 95% plus category; we can almost always influence pain, and we actually have, you know, Medicare coverage for things like low back pain in people now for acupuncture, as you said, sort of helping to buoy up that concept. I think some of the other homeostatic systems that are pretty clearly affected are the function of nerves. So, when you have neuropathies, a spinal cord disease and changes in the nervous system, acupuncture is also—because of that homeostatic system—really successful at that as well.

Love it. I'll share with you I had back surgery earlier this year, you know, awful with, like that, worst pain I've had, and recovery, they recommended acupuncture. So I went, and I got to tell you, like, it definitely helped speed the recovery. And, you know, less pharmaceutical for sure. And you know, I don't know if you know, I have dachshunds, so insert wherever you'd like, right? But my gosh, it's, it's a, it's a nonnegotiable, is what I say to my patients too, when we talk about especially for the back dogs…For many years post op, they recover. I'm curious to get your experience on this too. But they definitely recover beautifully, more comfortably, and they're back to normal function, I would say, much better before I was doing acupuncture on them. So, what are your thoughts on that?

I think that's great, and I love the fact that you're talking about it not as a replacement, but as something that works with it. And sometimes, when we add something on to something else, you don't know which one made the biggest difference—was that the surgery? It was faster; certainly, when you're forced to use it by itself, like if surgery isn't an option, or once a surgery has failed and that patient isn't doing well, the fact that we can even see acupuncture working in those settings is really good. But again, I love the idea that you're presenting this as this integrative approach.

Yeah, and I'm seeing a lot more in practice. I'll tell you this over—I think I would say post-COVID, the past five years, it's not been like, "well, here's your option." It's like, "this is the treatment plan," and it's already embedded within the plan. And pet owners love it. Dr Wright, love it. They're like, "Oh, thank you. I've been reading up on this. I've been asking my neighbors about this. I was in Facebook groups about this," and I love that we're already talking about, which we're going to go into in a moment. But like shockwave therapy, laser therapy—they really enjoy and appreciate that.

Well, I think that when we give pet owners the ability to do things that they are more integral in, which is multiple physical medicine things, and acupuncture is one. Because even though they're not doing the needling, they're usually there. They're seeing the effects. We're training them as to how to see what might occur over the days after we give acupuncture. It, in a way, helps reduce caregiver burden. It's another cost, and that's one of the aspects of caregiver burden, but there's this very positive relational piece of it with the owner and the animal, as well as the acupuncturist and the animal, that is often really rewarding on each level—for the practitioner, the patient and then the pet owner, right?

Yeah, I think pet owners want to be involved a lot more nowadays than they did beforehand, and some of these modalities that you can easily do at home, which is great, especially for I call them our frosted face patients or gray muzzles. Yeah. And so, okay, so we have other modalities as well. So, we, in addition to wonderful use of acupuncture, we got things like Shockwave, laser, TENS/PEMF — electrical modalities, what are some of those things with indications for and I think as general practitioners or new graduates, sometimes they get a little confused on what they should be reaching for. So, what does that look like?

Yeah, I think that's a great point, and some of what you reach for will be what's available in your world. I'm grateful that, like, laser was kind of maybe the first non-pharma thing that really got promoted and helped people realize that there were nonpharmacologic approaches that could be added in. What I want people to think about is metered application of any form of energy to tissue can help modify that tissue. And so, when we're dealing with nonpharmacologic treatments across the board, we're dealing with a way of applying energy safely to tissue that will help that tissue to heal and to be more homeostatically balanced. And so, you can use light waves or photons—okay, are they light or particles? Doesn't matter. It's energy in the tissue that is influencing both the substrate of the fascia and the mechanoreceptors and those mechanical fields, as well as modifying the nerves. The same thing with adding waves of sound. So sound waves are going to create energy fields within a tissue, going to induce mechanotransduction, and that is going to lead to cascades like acupuncture that modify both the nervous system and also the myofascial planes that occur around those nerve endings to improve the overall pain, but also often tissue healing. Same thing with PEMFs — pulsed electromagnetic field therapies. It's using electricity in that field. With acupuncture, especially in neurologic cases, we will actually put electrical stimulation across our needles, and that can really help with some of the neurologic recovery. And so, for each of them, I would say, just think about that fact that you're using a metered application of energy, and then exercise—and exercise is an awfully easy thing to add back in. You know, even getting a weekend course in some methods of exercise and motion kind of helps reverse some of our early training that you should like put something in a cage and not let it do anything when it's injured, and can actually have huge differences that are pretty easy to institute pretty quickly. When I lecture, I try to give people a tool they can use right away. And a lot of the things require either a machine or more training, but not some of those really basic concepts that have to do with the animal creating motion in itself through things that are exercise or active stretching related.

Yeah, fascinating. Do you find it a little bit confusing for vet students and veterinarians when you're combining both pharmacologic and nonpharmacologic? In other words, you're worried about potential adverse reactions. If I'm using opioids versus, you know, some of the traditional—well, some of the nonpharmaceuticals, such as shockwave laser, do they get worried that there might be some adverse reactions that can occur?

I suspect there's some worry about that. I also think that we do a much better job of teaching this cellular, physiologic pharmacologic approach in veterinary school. And so as soon as people start trying to add some of the nonpharma, it feels more foreign. And I think some of the schools are coming around more with some sports medicine, but in general, we're still stuck a little bit in the way we were teaching. And so, then people feel insecure adding something that wasn't talked about very much in vet schools, but I do see a number of vet schools changing that. So, I think with that insecurity and maybe that feeling that they're oppositional to each other, which has been, I think maybe sometimes perpetuated in the past, and of course, I don't think is true, I think that's where some discomfort comes from.

Yeah, and I think continuing education is doing a really good job in bringing that front and center, because, I think to certain generations of veterinarians, it's been many, many years, and obviously the science changes, and that's what I like about this podcast, is we're talking about evidence based multimodal analgesia, and I think it's kind of our due diligence as educators, all of us around, educate each other a little bit about some of the peer reviewed literature that's out there, showing the science and the mechanism of action to see how it works. I think tPEMF, for instance, just showing how nitric oxide uses its own body for those things, for healing and shock wave therapy, the different modalities versus use of laser. So, I do see a lot in continued education, which is great that it's really front and center. And you'll love this—it’s popular—those sessions, really?

Yeah, they are. Are very popular. And I know I mentioned this earlier about pet owners, but I really do think going to where their needs are, and we're in a time too. Dr Wright, we're talking a lot about spectrum of care, access to care, and what does this look like when we have all these different types of modalities out there, and some are like, well, what is this going to cost me? Is this going to be cost effective? What are your thoughts on that?

I think that you know, cost is part of that equation, and caregiver burden, and so it is an important piece of it. That said, a lot of the modern drugs are actually quite expensive as well. So, it's both—that the cost financially is there and does it work or not? I think a lot of what is presented to clients has to be done in a way that is circumspect. You know, this is modifying homeostatic physiology, and it may or may not work in this patient. Here's the number of events that I think we should give this an opportunity to work. And if it hasn't by then, then we need to regroup. I often speak to clients about treating pain, in particular, as a ladder approach, where, you know, we might be doing some non-pharma and some pharma, but we're not going up all the rungs yet. We're not throwing the whole kitchen sink at somebody. We're going to decide based on this individual what is possible, and that is sometimes based on their socioeconomic position as well, in terms of what can or cannot be afforded. And then from that you can add to it when you fall short.

Yeah, absolutely. And we have both acute and chronic pain management that we deal with. And where do we fall in when we're talking about integrative multimodal analgesia? Are there differences that you would use one versus the other?

I think with acute and chronic pain, there's a pretty significant importance of adding the integrative piece. So, for acute pain, we do have better control often with our drugs, but we've also realized that opioids are maybe creating a lot more long-term damage than we realized, because they're neuroinflammatory. And so as veterinary medicine moves away from using opioids as heavily as it did in the past, it becomes more important to manage pain more globally, and so you'll see more reliance on drugs like ketamine. We've always had a good reliance on the nonsteroidals, I think, but adding things like ice therapy and some laser therapy into the perioperative period, I think are really critical and not that expensive, and people are really wrapping their brains around that, especially as people like me are out there teaching about the actual physiologic effects of those interventions. It just makes sense. So that's different tools than you might be adding for your chronic cases, where I think the reliance is probably even more important on some nonpharma, but I think that even in the acute pain setting, where our drugs do work better, we are able to titrate them better and do a better job by incorporating some of those tools.

Yeah, excellent. And where do you see the future of pain management in veterinary medicine heading in, say, like, 5–10 years, what does that look like?

You know, I just think that we're well on our way to people really understanding the physiologic effect of nonpharmaceuticals, because myself and a lot of other people are talking about it, especially as sports medicine grows. I think that that conversation will just become more smooth as it is more widely taught in vet schools, and as more practitioners are familiar with it. I think sometimes our non-pharma is also—I don't want to say polluted, but promoted by people that are selling a unit of some sort, PEMF or a laser, and once people are talking about it in a more academic setting, there will be less of the confusion based upon people that are selling a particular product. And so, I think that's going to help too. So rather than a big change in direction, I see it as being a lot bigger wave.

Yeah, and you mentioned sports medicine—is there a difference where this might probably be a dumb question, because I don't know too much about sports medicine, but from a general practitioner's perspective, with sports medicine, what are the hot kind of modalities that you use a lot more in sports medicine than in, you know, non-sports medicine areas?

Motion. Exercise. Motion. I mean motion is so healing. There are papers across species that talk about the hypoalgesic or analgesic effects of motion applied by an individual moving through space. And so, sports medicine does a lot of that, and then a lot of the other parts of sports medicine where they are creating better comfort in joints or in tissues have an end goal of that piece of motion. And so, there's a huge overlap between pain medicine and sports medicine, because that's really what you're doing in a bigger way, because you're also trying to keep them moving through space and doing their jobs.

I got to give a big shout out to Dr Leilani Alvarez. She was our keynote speaker a few weeks ago, and she talked about motion—just you got to move. And between that that resonated with me, and then also shout out to Dr Betsy Charles—we talked about our well-being, about movement, movement in general just feels so good to move. And when you have those down days, just keep moving and keep swimming is what she was saying.

Right all the time, it's so overused, but motion in so many ways.

Daily? Yep, yes, it's like the WD-40 to our joints and to our soul. I'll tell you that, right? Yeah, I just love that, the fact that that's the benefit of the human-animal bond too, especially with our dogs—we got to move and we got to move together. So might as well have good exercise and have them moving. And even to your point about some of these great exercises that you do in sports medicine, we can replicate them when we learn them at home, whether it be in cushions or pool noodles and things like that. But I just think there's such value, because again, in my world, I see a ton of dachshunds, and nothing is more heartbreaking. Those of you know, you know to see a dog that wants to move but can't, and when they have that ability to move—whether it be a cart or whatever that might be—they're like, whoa, back to the zoomies. I go—

Huh? Yeah, yeah, yeah. And, you know, you mentioned application of these things at home, and mentioned, like, pool noodles and things, but I want to be really clear that it can be so much simpler than that. You know, I live in Colorado and Hawaii. Both places are big hiking places, and there's this thought, "Oh, well, we can't hike anymore because of X, Y or Z." And I really disagree. I think you have to titrate it carefully, but getting out and moving through space, hiking on a leash is actually, in most cases, a fairly safe activity. They're not running, they're not jumping, and they're stepping over things, and they're going around things, and so it doesn't even have to be as boring and deliberate as learning PT exercises at home—there's a lot of ways to apply motion within safe limits with guidance that are even fun.

Yeah, I call it a safari—you take him for a hike—and there's wonderful substrates that they're getting involved in. And I let the leash go a little bit more for them and be more patient. I'm not on my phone, you know, I'm present. There's something to be said about then, right? Yes, you know. And I see that happening people or they're pulling away from something. I was like, "Wait, this is their motion. This is their way of scrolling through social media." Is letting them sniff. Yeah, totally, yeah. So, I love this. This is wonderful. So, Dr Wright, where can we learn more? Where would you recommend listeners to go?

Well, you could go to Mistral Vet, but I'm pretty boring, so I would suggest that you go to Evidence-Based Veterinary Acupuncture, where I am just one of a very fantastic team that puts together that group. And that's really where you'll see the excitement—I am just one small sum of many parts.

Oh, I'm telling—and by the way listeners, she's not boring. Let's listen to her bio. My goodness, you can definitely head on over to her website, and we'll put that in the show notes as well. Dr Bonnie Wright, thank you for all the great work that you've done for our profession. Continue to do, keep shining and keep moving.

Everyone, thank you for listening to the Vet Blast podcast with me, Dr Adam Christman. Tune in next time. Remember, take care of your animals and always stay pawsome.

Podcasts

A practical guide to evidence-based, integrative pain management that combines drugs and nonpharmacologic modalities to improve outcomes, reduce caregiver burden, and keep animals moving.

Advancing pain management through integrative and multimodal approaches

Lindsay Hallman, CVT, CCMT, VTS (Oncology), and Katelyn McDonald, CVT, VTS (Oncology), discuss what oncology patients may experience in a dvm360 interview.

Managing adverse effects of chemotherapy

Chemotherapy administration can pose challenges for the veterinary team, clients and patients. In a 

 interview, Lindsay Hallman, CVT, CCMT, VTS (Oncology), and Katelyn McDonald, CVT, VTS (Oncology), veterinary technician specialists at Mount Laurel Animal Hospital in New Jersey, discussed adverse effects of chemotherapy that patients may experience. In this video, showing part of the interview, they also address medications that can help alleviate these effects.

The following is a transcript of the video, lightly edited for clarity:

: What adverse (or side) effects of chemotherapy typically occur with chemotherapy administration in companion animals?

Lindsay Hallman, CVT, CCMT, VTS (Oncology): 

Only about 20% of pets actually have side effects to chemotherapy. The ones that do, it's generally about 2 to 3 days after they receive their chemotherapy. And usually people say, “they wake up in the morning, they're a little bit lethargic, they don't really want to eat breakfast,” but, generally by the evening time, they're completely back to normal. We do send people home at the beginning of their [pet’s treatment] protocol with a little goodie bag of antinausea medications and sometimes some antidiarrhea medications, depending on which chemotherapy they're going with.

We usually tell people [they] can either choose to give an antinausea medication, like ondansetron or meropenem. You can give that for the next 4 or 5 days, just because, if your dog is one of the 20% and you never have to find out. So a lot of people end up just holding on to it, using it as needed. And we have a lot of people who come back at the end of their [chemotherapy] cycles and say, “we never actually ended up using any of these medications.”

We also do have a lot of different chemotherapy options. So if they get sick on, let's say, an injectable chemotherapy, we can always switch them to maybe a less aggressive form of an oral chemotherapy, or we can a metronomic chemotherapy, which is a low dose, steady instead of a spike of an [intravenous] higher dose that they tend to react with better. So, there we have tons of options of where we can go if a pet does happen to have side effects.

The other thing that we do keep in mind, and we always explain to owners, is if you have the 1 in a million pet that really doesn't read the rule book and has a terrible time with chemotherapy—because there are outliers that on a rare occasion we will see that —owners are not under any obligation to continue forward with chemotherapy. 

Once it is started, it is always up to the owner whether they want to continue forward down that path. If an owner ever says, "we've done this, we tried, we're done," then we are here to continue to support them as the care goes on going forward without necessarily administering chemotherapy to that pet. So, at that point, it then becomes a conversation of, how do we keep your pet as happy and comfortable for while their remaining time with us is now.

A Cornell University–led clinical trial is enrolling client-owned cats to evaluate AKS-562c, a once-weekly GLP-1 Fc-fusion candidate developed by Akston, for safety and efficacy as an adjunct to nutritional management of excess body condition. Pending trial results, the therapy could become a practical pharmacologic adjunct to multimodal weight-management plans in feline patients.¹

RELATED: Therapeutics company announces partnership to combat animal obesity

Surveillance by the Association for Pet Obesity Prevention (APOP) found that 61% of evaluated US cats were classified as overweight or having obesity in 2022, underscoring the prevalence of the problem in clinical populations.

 Owner recognition of unhealthy body condition appears to be improving, but remains imperfect. In APOP’s 2024 Pet Weight & Nutrition Opinion Survey, 33% of US cat owners categorized their cats as overweight or having obesity (up from 28% in 2023), and many owners remain unfamiliar with formal body condition scoring tools.³

These prevalence and perception data may point to an ongoing need for evidence-based interventions that work in the real world, especially those that reduce owner burden for dosing and feeding management.

Clinical consequences of excess adiposity in cats

Excess adiposity in cats is linked to multiple pathologies, most notably insulin resistance and type 2 diabetes mellitus, orthopedic disease, and decreased physiological reserve. Recent veterinary reviews summarize the epidemiologic risk factors and associated pathologies of feline overweight and obesity and emphasize that obese cats are 7 times more likely to develop diabetes and other metabolic disturbances.⁴

"Feline obesity is one of the most common yet least effectively treated health issues in veterinary medicine," Todd Zion, PhD, co-founder and chief executive officer of Akston, said. "By advancing a once-weekly GLP-1 therapy, we're addressing a real unmet need and aiming to give cats the chance at longer, healthier lives."

GLP-1 receptor agonists reduce appetite and slow gastric emptying via central and peripheral pathways that increase satiety and reduce caloric intake. In human medicine, these agents have demonstrated clinically meaningful weight loss with an acceptable safety profile when used within appropriate monitoring frameworks.⁵

Akston (the product developer) and the Cornell University College of Veterinary Medicine in Ithaca, New York, have initiated a clinical study to evaluate AKS-562c, an Fc-fusion GLP-1 candidate, in client-owned cats. The study is intended to assess both efficacy (weight loss) and tolerability in a real-world population of owned animals. The trial’s headline parameters include an ~11-week treatment period, an enrollment target of 70 cats with an option to expand to 140, and leadership by Patrick Carney, DVM, PhD.¹

Quantify weight change associated with once-weekly AKS-562c administration in client-owned cats.

Describe the incidence and character of treatment-emergent adverse events.

By enrolling owned animals and assessing owner-reported and clinic-based outcomes, the study design supports direct translational relevance to small-animal practice, according to an Akston press release.¹

In the release, Akston reports preclinical data from laboratory cats at Cornell indicating reductions in voluntary food intake without adverse effects or “unanticipated events.” The company said pharmacokinetic analysis supported once-weekly dosing in those studies. The drug is built on Akston’s proprietary Fc-fusion platform, which the company says can extend duration of action and streamline development of long-acting protein therapeutics.¹

"Feline obesity is one of the most common yet least effectively treated health issues in veterinary medicine," Zion said. "By advancing a once-weekly GLP-1 therapy, we're addressing a real unmet need and aiming to give cats the chance at longer, healthier lives."

Akston is also advancing a related GLP-1 program for dogs using the same Fc-fusion platform, which is approximately 6 months behind the feline program.¹

Akston. Akston Initiates Clinical Trial of Once-Weekly GLP-1 Weight-Management Therapy for Cats. PR Newswire. Nov 25, 2025. Accessed November 25, 2025. 

https://www.prnewswire.com/news-releases/akston-initiates-clinical-trial-of-once-weekly-glp-1-weight-management-therapy-for-cats-302625679.html

Association for Pet Obesity Prevention. 2022 State of US Pet Obesity Report. 2022. Accessed November 25, 2025. 

https://static1.squarespace.com/static/6425ec5d33eaaa634113b2d4/t/6454f61c0cad164860799c8f/1683289630779/2022%2BState%2Bof%2BUS%2BPet%2BObesity%2BReport.pdf

Association for Pet Obesity Prevention. 2024 Pet Weight & Nutrition Opinion Survey (Executive Summary). Accessed November 25, 2025. 

https://www.petobesityprevention.org/2024-survey

Saavedra C, Pérez C, Oyarzún C, Torres-Arévalo Á, et al. Overweight and obesity in domestic cats: epidemiological risk factors and associated pathologies. 

 Surg. 2024;26(11):1098612X241285519. doi:10.1177/1098612X241285519.

Collins L. Glucagon-like peptide-1 receptor agonists. In: StatPearls. StatPearls Publishing; 2024. Accessed November 25, 2025. 

https://www.ncbi.nlm.nih.gov/books/NBK551568/

Cornell University is enrolling client-owned cats in an 11-week trial of AKS-562c, a once-weekly GLP-1 Fc-fusion candidate designed to reduce appetite and produce clinically meaningful weight loss while closely monitoring safety and tolerability.