Only 26% of dairy producers and 13% to 42% of veterinarians provide adequate pain management to dairy cattle experiencing mastitis, a recognized painful condition, according to researchers. Mastitis is just one example showcasing the lack of pain control use in the dairy industry.

Pain in Dairy Cattle: A Narrative Review of the Need for Pain Control, Industry Practices and Stakeholder Expectations, and Opportunities

, summarizes common painful conditions and procedures in dairy cattle. It also covers quality assurance programs’ pain management recommendations and the uptake of pain management in practice.

Dairy cattle experience pain during necessary or unavoidable procedures and conditions such as dehorning, castration, abdominal surgery, lameness, and mastitis. Pain can decrease dairy production and increase animal distress, negatively impacting welfare. Quality assurance programs, including Farmers Assuring Responsible Management (USA), proAction (Canada), and Red Tractor (UK), have guidelines on pain management in dairy cattle; however, the industry has implemented recommended strategies inconsistently.

Signs and symptoms of pain in cattle include increased heart rate and cortisol, abnormal gait, reduced feed and milk intake, lethargy, and prolonged lying. If a cow exhibits any of these characteristics, it is crucial to mitigate pain. Appropriate pain alleviation methods recommended for common procedures (e.g., dehorning, castration, abdominal surgery) are local anesthetics and nonsteroidal anti-inflammatory drugs (NSAIDs). Recommendations for common conditions such as (e.g., lameness, mastitis) include NSAIDs, early intervention, and supportive therapy such as corrective hoof trimming and hoof blocks. Preferred NSAIDs in cattle are ketoprofen, meloxicam, and flunixin meglumine.

A standard approach as simple as giving an NSAID can significantly improve industry practice. Regardless, current levels of pain management administration by producers and veterinarians in Europe and North America are low. Only 24% to 35% of producers and 39% to 56% of veterinarians provide NSAIDs/systemic analgesia for dehorning, while 8% to 10% and 25% to 42% for castration; 80% and 60-75% for lameness, 61% to 98% and 61-77% for abdominal surgeries, and 26% and 13-42% for mastitis, respectively. Although these painful procedures and conditions are usual among cattle, pain does not need to be as common. Educating producers and veterinarians on the importance of pain management is the first step to closing the gap.

The study authors conclude further research is needed to identify and overcome barriers to adopting pain management strategies, which are vital to minimizing pain in animals and ensuring productive and sustainable dairy production.

, is a 2025 PharmD candidate from the University of Connecticut School of Pharmacy in Storrs.

Roche S, Saraceni J, Zehr L, Renaud D. Pain in dairy cattle: A narrative review of the need for pain control, industry practices and stakeholder expectations, and opportunities. 

Articles

Current levels of pain management administration by dairy producers and veterinarians in Europe and North America are low.

Take an NSAID at the first sign of pain? Dairy cattle should, too

In this interview with dvm360, Link Welborn, DVM, DABVP, shares how he helps his clinic and clients prepare for a natural disaster, plus their biggest challenges in the aftermath of a disaster.

Video interview with Link Welborn, DVM, DABVP

With natural disasters like wildfires, hurricanes, tornados, and others impacting parts of the United States, clients and clinics need to be prepared for a disaster to strike in their area, but how can they prepare?

, Link Welborn, DVM, DABVP, chief veterinary officer, Covetrus, shared his insights from 40 years of experience as well as a practice owner of 8 AAHA-accredited practices on how to best prepare your teams and clients for a natural disaster before it strikes. 

Below is a partial transcript, edited lightly for clarity

I think one of the biggest challenges is trying to figure out where best to apply the opportunity to be of service. It obviously, there's a lot of sort of chaos and confusion associated with any natural disaster, and in at least in the case of some of them, they're, you know, it's an ongoing challenge, like, for instance, with wildfires, whereas a hurricane may move on to a different area, but wildfires can continue to be a problem in a given area. So often, it's challenging to try and figure out, well, you know, I want to help, but how can I help? What's the best mechanism to be able to be of use? 

I think that the best resources for most in most cases, is to rely on the State Veterinary Medical Association. Every state has a Veterinary Medical Association (VMA). They typically work closely with the [American Veterinary Medical Association] that has a disaster response team, and often the state VMA is in a position to be able to know, you know, where resources are needed, and help channel those resources most appropriately

I think one of the most important things is indeed that preparation, particularly for pet owners, because most pet owners don't think about what they need to do until, frankly the disaster is upon them. I obviously live in hurricane country, so we see this year after year and so what we try to do is make sure that pets are microchipped first of all, because if a pet does wind up being separated from their family, the likelihood of that pet being returned to the family is enhanced exponentially if they've got a microchip. If they're not microchipped, it's much more challenging to be able to get that pet back to their owner. And we certainly, we've certainly seen that over and over again, so that's probably the number one preparation that we would encourage.

Videos

Link Welborn, DVM, DABVP, shares his insights and tips on how to better prepare your hospital, clients, and patients for a natural disaster

Disaster preparedness in veterinary practice

Aaron Shaw, OTR/L, CHT, CSCS, emphasizes the importance of coming into the clinic with an emotionally stable state

The impact of mental health on work and daily life

At least 50% of veterinarians report moderate to high levels of burnout, with female veterinarians experiencing a higher risk of burnout compared to males, according to a 2023 study published in the National Library of Medicine.

 The same study also found that younger and less experienced veterinarians as well as those with higher educational debt loans also exhibited higher burnout risk.

With burnout being rampant in the veterinary profession, 

 interviewed Aaron Shaw, OTR/L, CHT, CSCS, occupational therapist, certified hand therapist, strength and conditioning specialist, speaker, mentor, and host of the podcast 

, on the topic of wellness in the veterinary profession. 

 why investing in wellness is important as a veterinary professional, and talked about the concept of “healthspan.” In this new video, Shaw discusses the impact of mental health on work and daily life, emphasizing the importance of emotional stability and stress management.

The following is a transcript of the video: 

Mental health has a huge impact on work and daily life. I mean, the impacts, it's hard to think of like what it doesn't impact. The reality is that our emotional state, our ability to manage stress, to manage the challenges, good and bad challenges, or I should say, positive and negative challenges, that kind of come our way moment to moment really hinges on us being present and engaged, and that has to be on the foundation of managing stress, having a durable emotional sense—emotional well-being sense—of how to make decisions well that will impact patients, that will impact not only the patients themselves—the animals— but also the caregivers, the pet parents.

So, it is absolutely key to come in with a level head, emotionally stable, balanced, and that takes a bit of effort to do, but it's absolutely necessary to have ultimately the best outcomes for patient care.

Steffey MA, Griffon DJ, Risselada M, et al. Veterinarian Burnout Demographics and organizational impacts: A narrative review. 

. 2023;10. doi:10.3389/fvets.2023.1184526

Image Credit: © Khaligo - stock.adobe.com

The American College of Veterinary Anesthesia and Analgesia (ACVAA) small animal anesthesia and sedation monitoring guidelines were last published in 2009. With 2025 comes updated guidelines, and Lydia Love, DVM, DACVAA, shares what that means for practitioners in this interview with 

. The guidelines incorporate advancements in monitoring technology and provide a tiered approach to perioperative care across various clinical settings. Love discusses the rationale behind these changes, challenges in implementation, and their potential to enhance patient safety in veterinary practice.

 Can you introduce yourself and tell us a bit about your background?

I’m Lydia Love. I have served as a veterinary anesthesiologist for 15 years. Prior to my residency, I gained extensive experience across multiple areas of veterinary medicine—from high‐volume spay/neuter procedures with the Humane Society United States in the Appalachian region to small animal and emergency care in Memphis. My exposure to the field has also been through my husband's work as a former large animal veterinarian, now specializing in spay/neuter procedures. For the past 6 years, I have been a faculty member in anesthesia and analgesia at NC State.

 What prompted the need for revising the 2009 guidelines, and what key changes can practices expect in the 2025 update?

First, it is important to emphasize that these guidelines serve as recommendations rather than strict rules, acknowledging that each practice and clinical situation is unique. The original small animal monitoring guidelines were introduced in 1995, updated in 2009, and now, nearly 2 decades later, significant advances in technology and a refined understanding of safe anesthesia management necessitate an update. 

In the 2025 revision, we have introduced a tiered approach comprising minimum, alternate, and advanced recommendations. For instance, in the cardiovascular monitoring section, oscillometric blood pressure monitoring is designated as the minimum standard; however, in the absence of this technology, Doppler blood pressure monitoring is suggested as an alternative. Additionally, every section now consistently underscores the need for a dedicated, knowledgeable individual to actively monitor the patient, as relying solely on automated monitors is insufficient. New sections have also been added on monitoring the depth of anesthesia, along with quick-reference charts for neuromuscular blockade monitoring and sedation levels to assist practitioners in promptly recognizing and responding to changes in patient status.

 The guidelines mention minimum, alternate, and advanced recommendations. Were these levels designed with access to care in mind, considering potential cost limitations in various practice settings?

Absolutely. The development of these tiered recommendations was driven by the need to accommodate a wide spectrum of practice environments. Our minimum recommendations are based on both the literature and our extensive clinical experience, ensuring essential safety standards. We recognize that resource availability varies widely, whether in shelter medicine, under-resourced areas, or academic institutions. Our goal was to create guidelines that are broadly applicable while still enhancing the standard of peri-anesthetic care.

 What challenges might veterinarians and veterinary technicians face in adopting these new guidelines? Do they need to re-train or abandon previous methods?

Challenges primarily include equipment availability and the requisite training. Many practices have transitioned from purchasing individual instruments to investing in multi-parameter monitors that integrate various recommended monitoring modalities. However, not every practice has access to these modern systems; hence, we have provided alternate recommendations. Training is equally critical. The individual responsible for patient monitoring must be thoroughly trained to interpret each parameter and intervene appropriately. While some indicators, such as low SpO₂, are straightforward, others—such as capnography—provide complex data about ventilation, pulmonary perfusion, and equipment integrity. In situations such as CPR, capnography is arguably the most valuable monitor. Therefore, ensuring that practitioners are well-versed in the nuances of these monitors through appropriate training is essential.

 When updating these guidelines, how did you balance evidence-based criteria with expert consensus? Has new research or a shift in clinical thinking influenced the revisions?

In veterinary medicine, data on perioperative care and outcomes is relatively limited. For example, while pulse oximetry has been associated with reduced mortality, much of our supporting data originates from older human studies. Consequently, many of our recommendations are extrapolated from human studies and our collective clinical experience. We sought input from experts across organizations such as NAVAS ( North American Veterinary Anesthesia Society, AVTAA (Academy of Veterinary Technicians in Anesthesia and Analgesia) and ACVAA, and engaged in focused discussion groups over nearly 2 years. Looking ahead, we may adopt a modified Delphi model and a more structured literature review using a PICO framework to further refine and systematically grade the evidence for future revisions, potentially in 2035.

 When will these revised guidelines be available to the public?

They are currently available as a preprint in Veterinary Anesthesia and Analgesia articles in press. Although the final formatted version is forthcoming, the preprint is open access and 

 Is there anything else you would like to add regarding the updates, particularly concerning monitoring during recovery?

Yes. One critical update is the enhanced detail provided on patient monitoring during recovery. Approximately 50% of veterinary anesthesia-related fatalities occur within the first 3 hours of recovery—a period during which monitors are frequently turned off as the patient is transferred back to its recovery area. We emphasize the physiological vulnerability during this phase and the necessity for continued monitoring. Additionally, I am particularly enthusiastic about the incorporation of strategies designed to facilitate adherence to best practices while minimizing the likelihood of errors. Recognizing that high cognitive load and stressful conditions can lead to mistakes, the guidelines now advocate for the use of cognitive aids, such as checklists for equipment setup and standardized safety protocols, to promote consistent communication and a shared understanding among the team. These measures are intended to preempt errors before they escalate into critical issues.

Lydia Love, DVM, DACVAA, discusses the rationale, technological advances, and training imperatives that underpin the updated 2025 ACVAA guidelines 

What to expect with the updates to ACVAA's small animal anesthesia and sedation monitoring guidelines for 2025

A smaller version of the Vetlen Pouch, an antibiotic delivery system designed to administer antibiotics directly to wounds in animal patients, was recently introduced by Vetlen, the company behind the product’s development. The new version is a 5 mL size, which offers an alternative to the 

“We are excited to offer an alternative to the current options available for local antibiotic therapy in veterinary medicine,” Stephanie Morley, DVM, president of Vetlen, said in a company release.

 “Traditional methods, such as antibiotic powders or antibiotic-loaded beads, are often ineffective long before full healing has been achieved. While systemic therapies like oral or injectable antibiotics are an option, they don’t always deliver the necessary concentration at the site of infection, particularly when dealing with biofilm-related infections.”

Intended for implantation in surgical or wound sites, the Vetlen Pouch provides localized, high-dose antibiotics over an extended period with a syringe-based replenishing system.

 The pouch also includes a rate-controlled membrane for diffusing antibiotics gradually and consistently.

According to Vetlen, treatment is customizable, with veterinarians having the ability to adjust the antibiotic medication being administered according to individual patient needs. The pouch can be easily removed once the treatment is complete, similar to a surgical drain.

Suitable for a range of non-food animal patients, the device can deliver continuous medication for up to 30 days. According to Vetlen, the pouch was originally designed for antibiotic delivery. Still, other small-molecule medications, such as those approved for intramuscular or subcutaneous injection, can be administered with the Vetlen Pouch. However, these medications must be less than 2,000 g/mol and water-soluble.

“The Vetlen Pouch...provides a unique solution by delivering the right antibiotic directly to the site of infection for an extended period, ensuring optimal drug levels. This localized delivery promotes faster healing by allowing patients to focus their energy on tissue repair, rather than fighting an infection,” said Morley in the release.

The 10 mL Vetlen Pouch was released in November 2024, during which more than 500 veterinarians received the original-sized pouch. According to Morley, the decision to develop a smaller-sized Vetlen Pouch was driven by feedback from small animal general practitioners and equine veterinarians. “The feedback we received from veterinarians following the launch of the 10 mL Vetlen Pouch was overwhelmingly positive,” she said.

 “Through extensive voice of customer research, we learned that small animal general practitioners and equine veterinarians, especially for distal limbs, were seeking a smaller pouch that could be used for a broader range of cases. In response to this need, we’re pleased to introduce the 5 mL Vetlen Pouch.”

According to Vetlen, there are plans to expand Vetlen Pouch’s technology into human medicine. Last year, the US Food and Drug Administration (FDA) recognized the antibiotic delivery system as a breakthrough technology for its potential to treat open fracture-related infections that are complicated by biofilms.

“We believe our breakthrough local antibiotic delivery technology will dramatically improve wound healing in veterinary medicine,” said Morley in an earlier news release.

Vetlen announces the launch of the 5 mL Vetlen Pouch: A revolutionary local antibiotic delivery service. News release. Vetlen. March 12, 2025.

Bautista-Alejandre A. New device delivers antibiotics directly to wounds in dogs and horses. 

. October 29, 2024. Accessed April 7, 2025. https://www.dvm360.com/view/new-device-delivers-antibiotics-directly-to-wounds-in-dogs-and-horses

The device received an FDA breakthrough device designation last year

Vetlen launches 5mL pouch for targeted antibiotic therapy in animals

The mass firing that took place at the US Department of Health and Human Services (HHS) on April 1, 2025, resulted in a striking number of personnel cuts from the CDC, FDA, and NIH. The layoffs were set into motion as part of a "dramatic" restructuring as part of President Donald Trump’s executive order “Implementing the President’s Department of Government Efficiency Workforce Optimization Initiative,” according to the American Veterinary Medical Association.

In a HHS press release sent out on March 27, 2025, Health Secretary Robert F. Kennedy Jr. pledged he would cut 10,000 workers across the agencies under HHS, which would reduce 82,000 full-time employees to 62,000, when combined with other efforts including early retirement and voluntary buyouts.

 According to the department, this will allegedly save taxpayers $1.8 billion per year.

The cuts began during the first week of April with many being placed on administrative leave or offered reassessment, but thousands of others were terminated, including senior leadership. Among those cuts were over 140 leaders and staff members at the FDA’s Center for Veterinary Medicine, many being veterinarians.

 Other veterinarians are beginning to feel this impact across other areas within the FDA, including the including the Human Foods Program, the Office of Inspections and Investigations, the Center for Drug Evaluation and Research, the Center for Devices and Radiological Health, and the Center for Biologics Evaluation and Research, along with those working with CDC and the NIH.

The president of the AVMA, Sandra Faeh, DVM, said in an AVMA statement that while the AVMA supports efforts to thoughtfully improve government efficiency, “as the work is done to achieve that, essential functions must be preserved.”

“The offices impacted by this recent reduction-in-force work on issues such as drug availability, antimicrobial resistance, animal and human food safety, disease control (including, but not limited to, avian influenza), international trade, and much more. The work done by our veterinarian colleagues in these offices is critical to the safe and effective practice of veterinary medicine, and–ultimately–the protection of animal and public health,” Faeh continued.

In the HHS release, the restructuring plan is to consolidate 28 divisions into 15, reduce regional officers from 10 to 5, and centralize human resources, external affairs, information technology, policy, and procurement. This restructuring means the FDA will ultimately lose 3500 full-time employees, the CDC will decrease by 2400, and the NIH by 1200 employees.

These cuts were made after consulting with HHS’s 13 operating division leaders, according to a memo that the AVMA news obtained, which also cited examples of “wasteful administration” including 1400 external affairs officers, 100 communications officers, and dozens of information technology and human resources departments. Currently, there are no additional cuts planned, but the department will continue to look for further ways to streamline its operations and agencies.

Over 100 public health leaders including former US Secretaries of HHS, a former US Surgeon General, former CDC directors, former governors, retired state health directors and commissioners of health as well as corporate and nonprofit leaders wrote an open letter to Congress on April 2, 2025.

 The letter urged Congress to "take immediate action to protect and strengthen the American public health infrastructure.”

Organized by For Our Health, an initiative of the American Public Health Association, the letter was released in response to the reduction in force as well as the HHS announcing the restructuring of CDC functions and transferring some core responsibilities to a newly created Administration for a Healthy American. According to public health leaders, this move will compromise the nation’s ability to prevent and respond to health emergencies.

“The US faces multiple escalating public health threats, including an avian influenza outbreak affecting livestock. This outbreak has severe economic repercussions, driving up egg prices and threatening farmers’ livelihoods. CDC staff, with their expertise and dedication, work tirelessly alongside the US Department of Agriculture and state health departments to contain this crisis. Yet, Secretary Kennedy recklessly suggested to ‘let the animals develop natural immunity’ which would be catastrophic. His refusal to listen to leading veterinarians and animal health researchers delays necessary interventions and puts workers who handle these animals at serious risk,” according to the letter.

The National Association of Federal Veterinarians estimates that up to 3200 veterinarians are part of the federal workforce, excluding 1000 veterinarians in the military, with the largest proportion working for 2 USDA departments, the Food and Safety Inspection Service and the Animal and Plant Health Inspection Services. Both of these groups employ about 650 and 600 veterinarians.

Among those affected by these layoffs include federal workers responding to the highly pathogenic avian influenza outbreak, engaging in mitigation planning for pandemics, caring for animals involved in agency research, and more.

“The situation is fluid right now, and we want to work with Congress and the administration to ensure that key positions and personnel are restored and that the many critical and essential functions of these federal offices, which protect the health of both humans and animals, are maintained,” Faeh concluded.

The AVMA shared that it will continue to advocate on behalf of federal veterinarians. It is currently unclear how many veterinarians have been affected by the mass layoffs.

Larkin M. Veterinarians among those cut in extensive layoffs at HHS. American Veterinary Medical Association. Published April 4, 2025. Accessed April 7, 2025. 

https://www.avma.org/news/veterinarians-among-those-cut-extensive-layoffs-hhs

HHS Announces Transformation to Make America Healthy Again. News release. US Department of Health and Human Services. March 27, 2025. Accessed April 7, 2025. 

https://www.hhs.gov/press-room/hhs-restructuring-doge.html

For Our Health’ Strongly Opposes HHS Cuts to Public Health Funding and Workforce Reductions and Calls for Congressional Oversight. April 4, 2025. Accessed April 7, 2025. 

https://www.forourhealth.org/news/for-our-health-stands-in-solidarity-with-public-health-workers-amid-harmful-cuts-and-layoffs

Over 10,000 employees from the FDA, CDC, and NIH, could be let go due to restructuring plans