Our staff is missing a team member. Whether it’s a position we can’t fill or a person who calls out unexpectedly, bolts early, or just quits, being down a member of the team creates major rate-limiting steps in our clinic operations. How can we keep our animal hospital adequately staffed?

Like snags in the biochemical reactions that we learned about in veterinary school, staff shortages slow up everything: Appointments have to be rescheduled. Owners are left waiting far too long for wellness visits. And care for sick animals gets denied.

“It’s a systemic issue in our industry,” Andrew Heller, DVM, cofounder of IndeVets, said.

Heller, whose Philadelphia, Pennsylvania–based company supplies hourly doctors to its undervetted hospital clients, recalls a San Diego practice he visited recently that had a waitlist of 30 pets. Because of staff deficits, he pointed out, “veterinarians are leaving money on the table and losing clients.” 

In recent years, the demand for veterinary services and bumped up pet-related spending in general.

The industry has moved in with vigor: From 2009 to 2021, the number of US veterinary hospitals increased 18.5% to 32,634, according to an American Veterinary Medical Association report.

 The US Bureau of Labor Statistics projects approximately 4300 new job openings for veterinarians and more than 15,000 for veterinary technicians annually over the next decade.

 However, more job openings don’t mean there are more candidates.

Academia to the rescue! (Maybe.) With increased veterinary class sizes, 3 new veterinary schools graduating inaugural classes in the past few years, and at least another 10 in various stages of development, many more baby vets are being born.

At least 1 state has tried to address the labor shortfall. Colorado, to much industry consternation, recently passed Proposition 129. This legislation creates the “veterinary professional associate” a midlevel professional with credentials somewhere between a veterinary technician and a veterinarian.

But these efforts might not be enough, Heller said. Experience aside, a new veterinary grad does not equal the retiring Baby Boomer who is accustomed to working long hours. “The new generation wants to work to live,” he explained. “Sometimes you need 2 or 3 new vets to replace the productivity of a retiring vet.”

With insufficient staffing, who has time to properly train newbies? From the client service representatives at the front of the house to the technicians and veterinarians in the back, everyone needs training. Lack thereof leads to frustration.

In an IndeVets survey, 39% of veterinarians moving into the more flexible realm of relief employment expressed burnout.

 CDC data from 2018 show suicide among female and male veterinarians, respectively, to be 3.5 and 2.1 times greater than the general population; most of these veterinarians who died by suicide worked in a small animal practice.

How is this possible in a profession whose workers “play with puppies all day”?

“I feel like our profession gets put on a pedestal, and then people see the reality once they work in it,” Jennifer Schneider, VMD, medical director at Clocktower Animal Hospital in Herndon, Virginia, said.

At every level of the operation, there’s burnout—and burnout leads to callouts. Schneider estimates that her hospital weathers a few employee callouts a week, and as many as 3 on a bad day. “Staff shortages require doctors to get more involved in other things, like blood draws, cleaning rooms, etc,” she lamented. “So sometimes I have to stay at work 2 or 3 hours past closing just to finish my notes.”

When someone isn’t there to do their job, it cuts into the morale of those who do show up, Kemba Marshall, DVM, MPH, SHRMCP, who is CEO of KLMDVM Consulting LLC in St. Louis, Missouri, said. “We cannot allow them to stay because they are the people who drag down the culture. Yet in spite of ourselves, we will take the warm body because we hold out hope that sometimes they will contribute.”

Nathan Peterson, DVM, MBE, DACVECC, an associate clinical professor at Cornell University College of Veterinary Medicine in Ithaca, New York, examined a different problem: how veterinary technicians fare when having to administer futile (or noncurative) therapies to critically ill patients. The study, recently published by the Journal of the American Veterinary Medical Association, found that most participants reported moral despair.

“It is distressing for our technicians to not have any agency in these medical decisions,” Peterson said.

Rather than talking privately with clients, writing up treatment plans, and then walking away—leaving technicians to carry out orders without understanding the decisions—veterinarians should hold tough client conversations in the presence of their technicians, even inviting them to participate in dialogues, Peterson said.

Staff well-being is often overlooked by practice leaders but could improve with better hospital culture. Flexible work hours that allow for improved work-life balance, designated break times, encouraging use of paid time off, and staff recognitions can all help boost morale and motivation.

Schneider recommends that hospitals provide employees at all levels with regular one-on-ones, complete with performance improvement plans, opportunities for cross-training to expand their skills, and career mapping to sort out their goals. “Giving responsibility to people motivates them,” she said.

And motivated employees are more likely to “people” their animal hospitals and contribute meaningfully.

Pet owners report spending more on their pets post-COVID. American Pet Products Association. January 9, 2024. Accessed May 21, 2025. https://americanpetproducts.org/blog/pet-ownersreport-spending-more-on-their-pets-post-covid#:~:text=APPA%20Team,in%20the%20past%2012%20months?%E2%80%9D&text=While%20the%20COVID%2D19%20pandemic,during%20this%20time%20of%20recovery.

Leech R. 2025 economic state of the veterinary profession: trends and opportunities for your practice. 

. April 2, 2025. Accessed May 19, 2025. https://www.dvm360.com/view/2025-economic-state-of-the-veterinary-profession-trends-and-opportunities-for-your-practice

Veterinarians. In: Occupational Outlook Handbook. US Bureau of Labor Statistics. Updated April 18, 2025. Accessed May 19, 2025. https://www.bls.gov/ooh/healthcare/veterinarians.htm#tab-6

Veterinary Technologists and Technicians. In: 

. US Bureau of Labor Statistics. Updated April 18, 2025. Accessed May 19, 2025. https://www.bls.gov/ooh/healthcare/veterinary-technologists-and-technicians.htm#tab-6

Larkin M. US veterinary colleges increase seats at accelerating rate. American Veterinary Medical Association. September 26, 2023. Accessed May 19, 2025. https://www.avma.org/news/us-veterinary-colleges-increase-seats-accelerating-rate#:~:text=From%202018%2D19%20to%202022,125%20veterinary%20students%20each%20August

Green EM. The push for new schools in an evolving world. 

. February 1, 2025. Accessed May 19, 2025. https://todaysveterinarybusiness.com/veterinary-college-viewpoint-020725/

Midlevel practitioner proposal secures enough votes in Colorado. American Veterinary Medical Association. November 7, 2024. Accessed May 19, 2025. https://www.avma.org/news/midlevel-practitioner-proposal-secures-enough-votes-colorado#:~:text=Colorado%20voters%20have%20approved%20a,licensed%20veterinarians%20in%20the%20state

Veterinarian burnout survey. IndeVets. 2024. https://indevets.com/wp-content/uploads/2024/08/IndeVets-Burnout-Survey-2024.pdf

New study finds higher than expected number of suicide deaths among U.S. veterinarians. CDC. December 20, 2018. Accessed May 19, 2025. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/media/releases/2018/p1220-veterinarians-suicide.html

Kogan LR, Rishniw M. Veterinarians and moral distress. 

. 2023;261(5):1-7. doi:10.2460/javma.22.12.0598

Articles

Understanding the problem can help practices develop solutions.

Overcoming understaffing

Urinary tract infections (UTIs) are a common health problem in dogs and cats. Veterinarians often treat these infections with antibiotics, but over time, this widespread use contributes to antimicrobial resistance (AMR). As resistant bacteria become harder to kill, both animal and human health face growing risks. A recent study published in 

 highlights the importance of responsible antibiotic use, guided by international treatment guidelines, in slowing this dangerous trend.

In this study, researchers evaluated hundreds of bacterial samples from dogs and cats with UTIs. They focused on identifying the bacteria involved, measuring antibiotic resistance, and tracking multidrug resistance (MDR), which is a more severe form of AMR where bacteria resist multiple types of antibiotics. Almost half the patients had recurrent or upper UTIs, and many infections involved 

, a common pathogen in both pets and humans.

The findings raised serious concerns. Seventy-five percent of the bacterial isolates showed some resistance to antibiotics, and more than one-third qualified as multidrug resistant. Many of these bacteria resisted first-line antibiotics, including penicillins and fluoroquinolones, which veterinarians often use to treat UTIs. These trends show how quickly bacteria adapt and why current prescribing habits must change.

To combat this problem, the hospital adopted treatment guidelines from the International Society for Companion Animal Infectious Diseases. These guidelines promote evidence-based decisions when diagnosing and treating UTIs. Instead of automatically reaching for antibiotics, veterinarians first perform tests to identify the infection and choose the most effective, narrow-spectrum drug when necessary. They avoid overusing powerful drugs meant for more serious infections.

After applying these guidelines for 30 months, the hospital saw real progress. Rates of MDR dropped significantly over time. Cases involving prior antibiotic use, especially fluoroquinolones and broad-spectrum penicillins, showed the strongest links to MDR. As veterinarians prescribed these drugs less often and used them more selectively, they reduced the pressure that drives resistance.

This shift demonstrates the power of antimicrobial stewardship by choosing antibiotics carefully and only when truly needed. By following guidelines, veterinarians not only improved care for their patients but also helped protect the effectiveness of antibiotics for the future. This approach mirrors strategies used in human medicine, especially for infections like UTIs that frequently lead to antibiotic prescriptions.

The study also emphasizes the connection between pet and human health. Because dogs and cats live in close contact with people, they can carry and share resistant bacteria, especially strains like MDR 

. Reducing resistance in animals helps limit the risk of transferring these dangerous bacteria to humans. This forms part of the broader One Health initiative, which recognizes that human, animal, and environmental health are deeply interconnected.

This approach requires time, teamwork, and consistency. At the hospital, clinicians and microbiologists worked together to guide treatment choices and educate staff about the risks of AMR and the importance of guideline-based care. Although not all veterinary settings may have this level of coordination, the study shows that change can begin in one hospital and expand outward. By following science-based antibiotic guidelines, veterinary teams can protect their patients and the public, reduce unnecessary antibiotic use, and preserve treatment options. As resistant bacteria continue to pose a global threat, efforts like these show that responsible prescribing can make a meaningful difference, not just for pets but for everyone.

 is a 2026 PharmD candidate studying veterinary pharmacy at the University of Connecticut in Storrs.

Scarpellini R, Piva S, Monari E, et al. Antimicrobial resistance in companion animals: a 30-month analysis on clinical isolates from urinary tract infections in a veterinary hospital. 

. 2025;15(11):1547. doi:10.3390/ani15111547

Responsible antibiotic use can help improve outcomes.

Fighting antimicrobial resistance in pet UTIs 

Elanco Animal Health Incorporated announced today that its Canine Parvovirus Monoclonal Antibody (CPMA) has become the first US Department of Agriculture conditionally approved treatment that targets canine parvovirus (parvo). This conditional approval means the CPMA can be used for passive immunity to prevent parvo in puppies that have been exposed to the virus, which will expand the potential of protecting dogs from this disease that affects more than 330,000 puppies annually.

“We understand that pet owners and veterinarians are navigating rising costs and financial uncertainty right now, which is why we’re focused on making CPMA even more accessible to every puppy that needs it,” Chris George, DVM, infectious disease expert at Elanco Animal Health, said in the organizational release.

 “The label expansion to include passive immunity, in addition to our $200 rebate program, and sampling programs to shelters and clinics in high parvovirus areas further advances our mission to defend puppies and defeat parvo, delivering value and peace of mind to veterinarians and pet owners alike.” 

According to the release, the expanded product label means that the dogs that have been exposed to the deadly virus can be protected, including environments where resources can often be constricted, such as shelters. In a study conducted by Elanco, when dogs 8 weeks or older were given a prophylactic dose, CPMA was 100% effective in the passive immunity of these healthy dogs.

Some of the puppies treated by CPMA in Florida (Image courtesy of SPCA of Brevard) 

A shelter in Florida recently treated and saved the lives of 27 parvo puppies through CPMA, the largest recorded group to be saved through the monoclonal antibody treatment to date, according to Elanco.

 Some of the puppies in the litter are now up for adoption and are "thriving" in the shelter.

Through its Defend Puppies. Defeat Parvo. campaign, Elanco shared that it expanded CPMA’s availability by donating more than $3 million worth of the product to 2300 clinics and shelters located in high-parvo areas across the US. This program reportedly helped shelters, veterinary professionals, and clients get better access to the lifesaving treatment. Through the expanded label, CPMA now has the potential to save thousands of puppies from parvo.

“We understand that pet owners and veterinarians are navigating rising costs and financial uncertainty right now, which is why we’re focused on making CPMA even more accessible to every puppy that needs it,” George said.

“The label expansion to include passive immunity, in addition to our $200 rebate program, and sampling programs to shelters and clinics in high parvovirus areas further advances our mission to defend puppies and defeat parvo, delivering value and peace of mind to veterinarians and pet owners alike.”

Elanco announces milestones expanding access to Canine Parvovirus Monoclonal Antibody (CPMA) to veterinarians and shelters across the country. News release. Elanco Animal Health Incorporated. June 26, 2025. Accessed June 26, 2025.

New data reveals Elanco’s Canine Parvovirus Monoclonal Antibody treatment significantly improves puppy survival rates and relieves operational stress in veterinary clinics. News release. Elanco Animal Health Incorporated. October 15, 2024. Accessed June 26, 2025. 

https://www.elanco.com/us/newsroom/press-releases/new-data-reveals-elanco-canine-parvovirus-monoclonal-antibody-treatment-significantly-improves-puppy-survival-rates

This approval means that CPMA can be used to prevent canine parvovirus in puppies exposed to the virus.

Canine Parvovirus Monoclonal Antibody receives conditional USDA approval for passive immunity

Feline cholangiohepatitis syndrome (CCHS) and hepatic lipidosis are 2 of the most common feline hepatopathies.

 Signs of both conditions are mostly varied and nonspecific.

 In these conditions, icterus results from decreased clearance of bilirubin, diarrhea results from portal hypertension or cholestasis, and vomiting results from decreased toxin clearance or direct vagal stimulation.

Hepatic encephalopathy (HE) occurs either from portosystemic shunting

 or is caused by hepatic lipidosis from amino acid imbalance. HE manifests as ptyalism, dullness, ataxia, and/or seizures.4 Polyuria/polydipsia may result from medullary washout (low urea), dehydration, or HE. Dysuria may be noted from ammonium biurate urolithiasis.

 Anesthesia intolerance may result from decreased hepatic metabolism of GABAergic drugs (benzodiazepines). Gastrointestinal bleeding can be seen with portal hypertension or coagulopathy.

The minimum data base should include a complete blood count (CBC), chemistry profile, urinalysis, coagulation testing, and diagnostic imaging. Liver function testing (serum bile acids; ammonia level) is redundant with icterus. CBC may reveal target cells and/or acanthocytes caused by altered lipoprotein or cholesterol synthesis and transport. Leukocytosis and/or inflammatory leukogram may be present relative to primary pathology. Heinz bodies are common, with hepatic lipidosis as a result of oxidative stress and glutathione deficiency. Elevated aspartate aminotransferase (AST)/alanine aminotransferase (ALT) are seen with hepatic damage, and elevated alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) are seen with cholestasis. Decreased synthetic function can result in hypoalbuminemia, hypocholesterolemia, hypoglycemia, decreased blood urea nitrogen, and hyperbilirubinemia. Hyperbilirubinuria precedes hyperbilirubinemia and can be an earlier indicator of decreased hepatic function in the cat. Urinalysis may also reveal ammonium biurate and/or bilirubin crystalluria, and lipid droplets are common with hepatic lipidosis.

Subclinical coagulopathies are common, especially with cholestatic hepatopathies like hepatic lipidosis that result in decreased enterohepatic circulation and relative vitamin K deficiency.

Abdominal radiographs may be useful to assess liver size or look for choleliths, but abdominal ultrasound is more sensitive to assess hepatic parenchyma, biliary tree, gall bladder, and adnexal structures.

CCHS has been classified by the World Small Animal Veterinary Association Liver Standardization Project into 4 categories: neutrophilic cholangitis, lymphocytic (non-neutrophilic) cholangitis, destructive cholangitis, and chronic cholangitis associated with liver fluke infestation. CCHS can occur in cats of any age, often with vague signs, acute to chronic, including weight loss, anorexia or polyphagia, lethargy, vomiting, fever, jaundice, hepatomegaly, polydipsia, ptyalism, pallor, nonregenerative anemia, poikilocytosis, and elevated liver enzymes, with or without neutrophilic leukocytosis. It is often seen in conjunction with pancreatitis and enteritis, in which case the term triaditis is used.

Neutrophilic CCHS commonly occurs in younger cats with more acute signs. Biliary/pancreatic inflammation is common, ie, triaditis. CBC reveals neutrophilia with or without left shift. Chemistry profile can reveal a moderate increase in ALT, AST, and GGT; variable increases in ALP and bilirubin; and normal cholesterol unless there is concurrent extrahepatic bile duct obstruction (EHBDO) or diabetes mellitus. Diagnostic imaging may reveal mineral densities, choleliths, regional ileus, sternal lymphadenopathy, biliary tree thickening, biliary sludge, and/or pancreatitis. Primary bacterial infection is common. E coli is the most common isolate, but many bacteria have been implicated.

 Bacteria can be seen on cytology more commonly than histopathology, so cytology of liver tissue imprint and bile may be helpful in addition to histopathology and cultures. Neutrophilic CCHS may transform into lymphocytic CCHS.

Lymphocytic CCHS most commonly occurs in middle-aged to older cats who have been ill more than several weeks and who usually have a predisposing condition such as inflammatory bowel disease, primary cholangitis, pancreatitis, EHBDO, cholelithiasis, cholecystitis, neoplasia, chronic extrahepatic or systemic bacterial infection, or chronic trematode infection. CBC reveals inconsistent anemia, poikilocytosis, and/or lymphocytosis. Chemistry profile and diagnostic imaging findings are similar to those with neutrophilic CCHS. Lymphocytic CCHS requires liver biopsy with histopathology for diagnosis. Samples reveal lymphocytic or lymphoplasmacytic inflammation around the portal triads with fibrous tissue deposition over time. Chronic disease can result in lymphoproliferation, which can evolve into lymphoma, or immune-mediated destruction of the bile ducts, which can cause complete biliary tree occlusion.

Treatment of CCHS should center on management of the underlying concurrent disease if present. Broad-spectrum antimicrobial therapy should be given for 3 to 6 months for neutrophilic CCHS and until biopsies return and based on clinical signs for lymphocytic CCHS. Empiric antimicrobial therapy should include coverage for gram-negative and anaerobic bacteria. Biochemical abnormalities should normalize if disease and bacteria are eradicated. If there is failure to improve, the clinician should consider whether the underlying condition was adequately treated, whether there is chronic infection somewhere, whether there is transformation to lymphocytic CCHS, or whether there is concurrent hepatic lipidosis.

Lymphocytic CCHS is often treated with prednisolone for immunosuppressive and anti-inflammatory effects, but full remission is rare with monotherapy. Concurrent metronidazole can be helpful to modulate cell-mediated immunity and decrease endotoxin. Chlorambucil may be effective in some cases. Methotrexate is used for biopsy-confirmed sclerosing cholangitis. It is important to maintain adequate nutrition to prevent secondary hepatic lipidosis. Fluid therapy should ensure supplementation of B vitamins and maintenance of normal serum potassium. Ursodeoxycholic acid should be given after extrahepatic biliary duct obstruction has been ruled out. Antioxidant therapy with vitamin E and/or SAMe (S-adenosylmethionine) should be implemented.

CCHS can have a very long remission or cure with chronic medical management. The disorder commonly spontaneously cycles, and clinical flare-ups can occur. There are no long-term prospective studies on treatment efficacy. Death is most commonly due to biliary cirrhosis or progression to lymphoma or related to progression of underlying primary pathology (ie, enteropathy).

Hepatic lipidosis is an acquired cholestatic disorder resulting from excessive accumulation of triglycerides in hepatocytes (> 80%). It typically occurs secondary to another disease such as other hepatopathies (ie, cholangiohepatitis), pancreatitis, gastrointestinal disease (ie, irritable bowel disease), diabetes mellitus, respiratory disease (ie, asthma), septicemia, neoplasia (ie, lymphoma), renal/lower urinary disease, cardiomyopathy, hyperthyroidism, anemia, neurologic disease, and/or trauma.

Clinical signs are varied and can include vomiting, anorexia, weakness and/or cervical ventroflexion, history of weight loss, icterus, hepatic encephalopathy, bleeding, diarrhea, hepatomegaly, dehydration, and/or pallor. CBC may reveal poikilocytosis (63%), nonregenerative anemia (22%), Heinz bodies, acute hemolysis, hyperbilirubinemia (95%), elevated ALP (80%), ALT (72%), AST (89%) with normal GGT (if idiopathic/no primary pathology), hypokalemia (30%), hypophosphatemia (17%), hypomagnesemia, prolonged clotting times (25% to 60%), elevated bile acids, hyperammonemia, or elevated serum β-hydroxybutyric acid.

 More than 80% of hepatocytes are vacuolated and lipid filled on cytology. Cytology is important to rule out lymphoma and decrease the odds of significant neutrophilic inflammation, but histopathology may be needed for definitive diagnosis and an optimal long-term treatment plan.

Cats have a unique metabolism, which informs us of certain nutritional supplements in the treatment of hepatic lipidosis. Cats continue to use protein for the production of energy even with low protein availability. They depend on dietary intake of arginine, taurine, methionine, and cysteine; are adapted for a low-carbohydrate diet; have an increased requirement for dietary B vitamins compared with other mammals; and require vitamins A and D from animal tissues. Taurine stabilizes membranes and can reduce hepatic lipid content. Carnitine is an essential cofactor of fatty acid metabolism, urea cycle, and GSH synthesis. Vitamin E protects against oxidative damage. SAMe, a carnitine and glutathione precursor, protects the liver against oxidant injury and is an important cofactor in many reactions. Vitamin B deficiencies may be one of the causes and consequences of hepatic lipidosis, as they are necessary for the synthesis of carnitine and SAMe.

The cornerstone of treatment for hepatic lipidosis is nutrition. Once the patient is stable, feeding tube placement should be considered. It is important to monitor for refeeding syndrome, which occurs from insulin release and intracellular shifting of electrolytes like potassium and phosphorus. Fluid therapy should be supplemented with potassium, magnesium, and phosphorus as indicated, and lactated or acetated solutions avoided. Other therapies should include vitamin K, vitamin E, vitamin B complex, vitamin B12, L-carnitine, SAMe (or N-acetyl cysteine for acute crisis), taurine, and omega fatty acids.

Negative prognostic findings include older age, dullness, weakness, ptyalism, hypoproteinemia, hypoalbuminemia, elevated creatine kinase, hypocholesterolemia, hepatic failure at presentation, anemia, hypokalemia, and lack of aggressive nutritional and supportive care. Survival ranges from 50% to 85%. Decrease in serum β-hydroxybutyrate during hospitalization is associated with survival.

 Hepatic lipidosis is considered frequently fatal without intervention and treatment.

Hepatic sampling is important for diagnosis. Ultrasound-guided liver aspirate and cytology can reveal lipidosis, vacuolar change, or diffuse hepatic neoplasia like lymphoma. Bleeding can be seen from coagulopathy, especially with cholestasis secondary to hepatic lipidosis. Stabilization of the patient and treatment with 2 to 3 doses of vitamin K1 is recommended prior to liver aspiration.

Cholangiohepatitis cannot be diagnosed with liver cytology and requires liver biopsy and histopathology. Ultrasound-guided biopsy has approximately 50% discordance compared with surgical and laparoscopic biopsies, according to the results of one study, and may not give enough tissue to reveal accurate diagnosis or quantitate copper. Surgical biopsies or laparoscopy allow for obtaining large biopsies and assessment of other organs. Liver samples should be submitted for histopathology, cultures (aerobic/anaerobic) with or without quantitative copper analysis, special stains, immunohistochemistry, and/or molecular testing as indicated.

, is vice president of medical excellence and education at Thrive Pet Healthcare, with over 20 years of veterinary experience. A graduate of Colorado State University’s veterinary program in Fort Collins, she completed a small animal rotating internship at Cornell University in Ithaca, New York, and an internal medicine residency at The Ohio State University in Columbus, earning board certification as a small animal internal medicine specialist. Cairns is an adjunct faculty member at Lincoln Memorial University College of Veterinary Medicine in Harrogate, Tennessee, and serves on several boards, including the Chicago Veterinary Medical Association. A dedicated member of the Feline Veterinary Medical Association for 20 years, she has specialized in feline internal medicine, building a subpractice that drew patients from across the US. Cairns is passionate about advancing veterinary education and supporting the profession’s well-being.

Bayton WA, Westgarth C, Scase T, Price DJ, Bexfield NH. Histopathological frequency of feline hepatobiliary disease in the UK. 

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Understanding feline cholangiohepatitis syndrome and hepatic lipidosis

The icteric cat: diagnosis and treatment of common feline hepatopathies

On this special Pride Month episode of The Vet Blast podcast presented by dvm360, our host welcomes Jennifer Scanlon, LCSW, to talk about the human-animal bond, especially for those in the LGBTQ+ community

From snouts to souls: Celebrating the spectrum of love

This podcast is sponsored by VCA Animal Hospitals.

 readers! To celebrate and recognize Pride Month, this episode of the 

, welcomes Jennifer Scanlon, LCSW, to the show to talk about the importance of the human-animal bond for those in the LGBTQ+ community. Throughout the episode, Scanlon and our host, Adam Christman, DVM, MBA, share personal stories on the impact pets have on emotional well-being, a pet that has had a profound impact on their lives, and how pets can facilitate social interactions and bridge social gaps for LGBTQ+ individuals.

Below is a partial transcript, edited lightly for clarity.

 I think what some of the listeners and...viewers may not know is...we all have a special bond with our pets. We know that they're our companions, or our world. And...the LGBTQ+ community is very, very bonded to them. So, let's chat about that and...[how] pets serve as companions for the community, especially during times of social isolation or even discrimination. We know pets serve as vital sources of our emotional support, connection, and identity affirmation. So, what does that look like from your perspective?

Pets just create a nurturing environment. [LGBTQ+] individuals can truly be themselves, and pets just offer such a comforting and...nonjudgmental presence. The 2 most common words I hear from pet owners that our pets give to us is...unconditional love. So this bond is especially important during difficult times and even very vulnerable times. That companionship actually helps combat those feelings of isolation, discrimination, and even loneliness, and the bonds we have with our pets [are] genuine, right? They're very genuine, and it creates a sense of belonging. 

Every moment they're having with their pets together is just a source of joy and emotional support. So, in a world that can sometimes feel unaccepting, pets serve as allies. And with the work that I do within the community, I often hear...that their pets are often their first allies in their lives. That is powerful, and it just reminds us [of] the importance of pets and how they provide us with love, connection, and acceptance. I just feel like...we can always find light in our pets' presence, and that's just a wonderful thing.

Explore how pets can provide unconditional love and acceptance to clients and veterinary professionals in this special episode of the Vet Blast Podcast.

Pruritus is a frequent presenting complaint in small animal primary care practice. Allergic dermatitis, a common cause of pruritus,has been the most common cause for canine pet insurance claims for over a decade.

 This is inflammation in the skin caused by any allergen and may include hypersensitivity to fleas, cutaneous adverse food reactions, and atopic dermatitis. Atopic dermatitis is a reaction to environmental allergens and can affect up to 15% of dogs.

Pruritus negatively impacts the quality of life of both pets and their family. Because of the numerous potential underlying causes and the complications of secondary infections, these cases can be frustrating for both the veterinary team and clients. Determining the underlying cause, while controlling symptoms and treating secondary infections, can take multiple visits, which requires an investment of both time and finances.

Controlling pruritus is an essential part of the treatment plan, which is often multi-modal. Finding an effective, safe medication to control itch is essential to maximize patient comfort. Compliance is improved when medications work quickly and are cost-effective, especially those needed for long-term use.

Introducing an Option for Canine Pruritus Control

 (ilunocitinib tablets) is a once daily oral medication for the treatment of pruritus associated with allergic dermatitis and contr of atopic dermatitis in dogs over 12 months of age. It breaks the itch-scratch cycle by interrupting inflammatory cytokine signaling pathways through the inhibition of Janus kinase (JAK) enzymes.

In a double-blind, placebo-controlled, randomized, multi-site field study of 268 dogs with atopic dermatitis, owner-reported pruritus was measured using the Pruritus Visual Analog Scale (PVAS) and skin lesions were measured by veterinarians using the Canine Atopic Dermatitis Extent and Severity Index (CADESI-4). Patients receiving Zenrelia had significant improvement in PVAS and CADESI-4 scores at day 28 compared to placebo.

Zenrelia has a boxed warning which veterinarians should read and understand prior to using the product. It’s well-tolerated at label dosages, and its safety for long-term administration at label dose has been demonstrated across multiple studies. The most common adverse effects reported in clinical field trials include vomiting, diarrhea, and lethargy. Laboratory abnormalities identified in the clinical field studies included thrombocytopenia, leukopenia, neutropenia, lymphopenia, eosinopenia, monocytopenia, and decreased RBC count.

Zenrelia has not been studied with concurrent use of corticosteroids, cyclosporine, or other immunosuppressant medications, or in pregnant or nursing dogs.

 Due to JAK inhibitors having the potential to cause immunosuppression, Zenrelia is not recommended in dogs with concurrent severe infection.

How Does Zenrelia Compare to Oclacitinib?

A multi-site, randomized, controlled, blinded, head-to-head study was performed to compare the efficacy of Zenrelia to oclacitinib in 338 atopic dogs. Zenrelia was administered once daily, and oclacitinib was administered twice daily for 14 days then reduced to once daily administration, per label dosing instructions for each drug.

Similar reductions in itch were noted between treatment groups over the first 2 weeks (days 1-14). Zenrelia was as effective as oclacitinib at the primary study endpoint, day 28, based upon improvement in both PVAS and CADESI-4 scores. The rate of adverse events reported were similar between groups. In an optional continuation phase through day 112, Zenrelia showed promising results for pruritus reduction and the potential for clinical remission.

Because Zenrelia does not require a loading dose and is administered once daily, Zenrelia may help improve owner compliance and can be cost effective* for pet owners. Additionally, when oclacitinib dosing is decreased from twice-daily to once-daily dosing, a transient increase in pruritus has been reported, called rebound pruritus.

 Because Zenrelia is dosed once daily from the start, it avoids rebound itch.

The Zenrelia label contains a boxed warning that states: “Based on the results of the vaccine response study, dogs receiving Zenrelia are at risk of fatal vaccine-induced disease from modified live virus vaccines and inadequate immune response to any vaccine. Discontinue Zenrelia for 28 days to 3 months prior to vaccination and withhold Zenrelia for at least 28 days after vaccination.”

It is important to note that this warning is based on a single study of post-vaccine antibody titers that included 8, 10-month-old beagles with concurrent illness (Coccidia) receiving the drug at 3 times the label dose.

Additional studies are needed to investigate serologic response to vaccination in healthy adult patients receiving the label dose of Zenrelia.

Because Zenrelia does not require a loading dose and is administered once daily, Zenrelia may help improve owner compliance and can be cost effective* for pet owners.

Remi was evaluated by her veterinarian following a longstanding history of dermatitis, which started when she was approximately a year or two old. Clinical signs included persistent pruritus and excessive licking of the abdominal area, resulting in raw and irritated skin. Previous therapies failed to deliver adequate control of her symptoms.

According to her veterinarian, Remi is “an example of one of the most frustrating cases” he manages, as available treatment options had consistently failed to resolve her condition. He ultimately prescribed once daily Zenrelia.

During a follow-up evaluation 8 weeks later, Remi’s owner reported that Remi’s itch was effectively under control. Remi’s owner expressed peace of mind in having finally identified an effective treatment, ending the ongoing search for alternatives.

Missy began showing clinical signs of frequent itching and gnawing, particularly around her tail and leg. Suspecting the symptoms were allergy-related, she was evaluated by her veterinarian, who prescribed once daily Zenrelia.

During a follow-up exam 2 months later, Missy’s veterinarian reported that her condition had fully resolved, confirming remission. On evaluation, there was no evidence of active inflammation or skin redness. Her itch level was rated at 0—consistent with that of a healthy dog—and her skin score was also 0. According to her veterinarian, Missy is a “rousing success” on Zenrelia.

Zenrelia is indicated for control of pruritus associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age.

Read the entire package insert before using this drug, including the Boxed Warning. For full prescribing information call 1-888-545-5973 or visit 

WARNING: VACCINE-INDUCED DISEASE AND INADEQUATE IMMUNE RESPONSE TO VACCINES.

Based on results of the vaccine response study, dogs receiving Zenrelia are at risk of fatal vaccine-induced disease from modified live virus vaccines and inadequate immune response to any vaccine. Discontinue Zenrelia for at least 28 days to 3 months prior to vaccination and withhold Zenrelia for at least 28 days after vaccination

. Dogs should be up to date on vaccinations prior to starting Zenrelia. Do not use in dogs less than 12 months old or dogs with a serious infection. Monitor dogs for infections because Zenrelia may increase susceptibility to opportunistic infections. Neoplastic conditions (benign and malignant) were observed during clinical studies. Consider the risks and benefits of treatment in dogs with a history of recurrence of these conditions. The most common adverse reactions were vomiting, diarrhea and lethargy. Zenrelia has not been evaluated in breeding, pregnant, or lactating dogs and concurrent use with glucocorticoids, cyclosporine, or other systemic immunosuppressive agents has not been tested. 

For full prescribing information see package insert

Davis K. Skin allergies, gastrointestinal disease among most common conditions that prompt veterinary visits nationwide. April 24, 2024. Accessed November 16, 2024. https://news.nationwide.com/ most-common-conditions-that-prompt-veterinary-visits-2024/

Collins B. Atopic dermatitis (atopy). Cornell University College of Veterinary Medicine. Accessed November 16, 2024. https:// www.vet.cornell.edu/departments-centers-and-institutes/ riney-canine-health-center/canine-health-information/ atopic-dermatitis-atopy

Forster S, Boegel A, Despa S, Trout C, King S. Comparative efficacy and safety of ilunocitinib and oclacitinib for the control of pruritus and associated skin lesions in dogs with atopic dermatitis. Vet Dermatol. 2025;36(2):165 176. doi: 10.1111/vde.13319

Olivry T, Lokianskiene V, Blanco A, et al. A randomised controlled trial testing the rebound-preventing benefit of four days of prednisolone during the induction of oclacitinib therapy in dogs with atopic dermatitis. Vet Dermatol. 2023;34(2):99-106. doi:10.1111/vde.13134

*At label dose the average price for a monthly supply of Zenrelia is less than Apoquel. Cost may vary depending on a dog’s weight. [2024 Zoetis Petcare Products Veterinary Price List vs. 2025 Elanco Zenrelia Veterinary List Price] 

Zenrelia, Elanco, and the diagonal bar logo are trademarks of Elanco or its affiliates. PM-US-24-2203.

Finding an effective, safe medication to control itch is essential to maximize
patient comfort. Because Zenrelia does not require a loading dose and
is administered once daily, Zenrelia may help improve owner compliance and
can be cost effective* for pet owners