Sweeping student loan changes one step closer to becoming finalized
The U.S. Department of Education has published its notice of proposed rulemaking to implement the changes to the federal student loan program that were enacted last year as part of the One Big Beautiful Bill Act (OBBBA).
The proposed regulations will be open for public comment until March 2. The department will then review the comments, revise as it considers appropriate, and publish final regulations.
New repayment plans
The OBBBA created two new repayment plans to be introduced by July 1: the Tiered Standard Plan (TSP) and the Repayment Assistance Plan (RAP). These will be the only two repayment options available for borrowers with new loans disbursed on or after July 1, according to the department. These repayment options will also be available for current borrowers, should they choose to or be required to change plans in certain situations.
The Tiered Standard Plan is a fixed repayment plan that carries payments for 10, 15, 20, or 25 years based on the amount borrowed. It will offer lower monthly payments for high-debt borrowers by extending the repayment window, but it increases total interest paid if the borrower holds the loan to term. Borrowers may prepay without penalty.
The maximum term length of 25 years is for loan balances of $100,000 or greater. The TSP would replace the current standard 10-year, extended 25-year, and graduated versions of those fixed plans.
The proposed rule specifies that the minimum monthly payment with this plan will be $50. It also confirmed that if a borrower does not select a repayment plan for loans disbursed on or after July 1, they will be automatically placed in the TSP.
The Repayment Assistance Plan is a new income-driven plan created by the OBBBA with annual payments ranging from 1%-10% of adjusted gross income, depending on income level. The 10% level begins at $100,000 of adjusted gross income.
Borrowers who make on-time payments will always see their balance decrease, even if their payment amount does not cover their monthly interest. If the monthly payment is less than the amount of interest accrued, the amount not covered will not be charged. If the monthly payment reduces the outstanding principal balance by less than $50, the principal balance is reduced by up to $50. Monthly payments are also reduced by $50 per dependent.
After 30 years, any remaining balance is forgiven, with the forgiveness amount subject to federal tax at that time. State taxes may vary.
The proposed rule added further detail around the features of RAP, including defining “on-time” for payments, but no notable changes were introduced.
New borrowing limits
New annual and aggregate loan limits for professional students were established in the OBBBA, starting July 1.
Professional students whose first federal loan for their current degree program is disbursed on or after July 1 may borrow up to $50,000 per year in Direct Unsubsidized Loans, with an aggregate cap of $200,000; the aggregate cap includes any graduate borrowing such as for a master’s degree.
The lifetime borrowing limit for these first-time borrowers is $257,500, including any undergraduate borrowing.
The proposed rule would limit the definition of “professional student” to 11 programs, with veterinary medicine included.
Regarding loan limits for dual-degree programs, according to the proposed rule, “If a student is enrolled in a program that awards both a graduate degree and professional degree, the student would be considered a professional student for the purposes of loan eligibility if more than 50 percent of the credit hours in that academic program count toward the professional degree.”
These students would also qualify for the $50,000 annual and $200,000 aggregate loan limit.
Elimination of certain loans and repayment plans
Under the OBBBA, Direct PLUS Loans, including Grad PLUS loans for graduate students, will be eliminated on July 1. These are unsubsidized federal loans that help pay for education expenses up to the cost of attendance after other financial aid is exhausted, including unsubsidized loans.
However, the Education Department proposed a grandfathering provision to this rule for current students: If a student is enrolled in a program at an institution as of June 30 and a direct loan of any kind, including a direct unsubsidized loan, was made to the student before July 1, then that student may borrow a Direct PLUS Loan “during the period of the student’s expected time to credential.” This assumes the borrower still has a direct loan balance as of that date.
This means that current veterinary students may continue to borrow Direct PLUS loans until graduation as long as they have taken out at least one direct loan before July 1.
A notable proposed exception to this provision is for students who are no longer enrolled in a given semester. Even if they later reenroll in their same veterinary college, they will no longer be eligible for Direct PLUS loans.
No more new Direct PLUS Loans will be made as of July 1, 2029, at which time the program will sunset.
Existing borrowers with loans taken before July 1, who do not have any new loans disbursed on or after that date, can stay in their current income-driven plans for now. However, the Pay As You Earn (PAYE) and Income-Contingent Repayment (ICR) plans will be phased out under the OBBBA, and borrowers in those plans must move to another plan no later than July 1, 2028.
In contrast, the income-based repayment (IBR) is a protected plan approved by Congress, so borrowers in IBR with loans taken before July 1 can stay in IBR for the remainder of their loan term. The OBBBA removed the partial financial hardship requirement for IBR, which previously required borrowers’ calculated payment with IBR to be less than the original calculated standard 10-year amount when the borrower first applied for IBR.
The department’s proposed rule provided further clarification for implementation but did not propose any substantive changes to this phase-out plan.
In addition, borrowers whose first direct loan for their current degree program is disbursed on or after July 1 must repay all their loans under the Tiered Standard Pan or Repayment Assistance Plan.
The OBBBA eliminated the Saving on a Valuable Education (SAVE) income-driven plan. However, there is pending court action regarding current SAVE borrowers and forbearance.
Public Service Loan Forgiveness
The Public Service Loan Forgiveness (PSLF) program remains available to borrowers enrolled in qualifying plans, including IBR and RAP. The same is true for those in PAYE and ICR, until July 1, 2028, when borrowers are required to move plans.
The Department of Education emphasized in the proposed rule that the new Tiered Standard plan is not a qualifying repayment plan for PSLF purposes. That means a borrower who is on track to receive PSLF and is currently in a repayment plan scheduled to phase out will need to proactively select a PSLF-qualifying repayment plan by July 1, 2028, otherwise they will automatically be placed in the Tiered Standard plan and their eligibility for PSLF will be paused.
Payment postponement
Deferment and forbearance are two options for temporarily suspending student loan payments, and the OBBBA placed new limits on the use of both.
While the OBBBA removed unemployment and economic hardship deferment options for new direct loans, it preserved them for current borrowers.
For forbearance, current borrowers with loans disbursed before July 1, 2027, would still be eligible for the current forbearance period of up to one year with the option to request a renewal as long as they continue to meet the forbearance criteria.
The OBBBA also addressed loan rehabilitation, a process to remove student loans from default through a series of on-time payments. The OBBBA now allows for two rehabilitations per loan under Federal Perkins Loans, Federal Family Education Loans, and direct loan programs, an increase from previous legislation.
Student loan changes in context
The Education Department says the changes introduced in the OBBBA will result in significant taxpayer savings by reducing “excessive subsidy costs of loan forgiveness and other high-cost terms and conditions.” It estimates that in the past four years, the department forgave $199 billion in student debt because of these provisions, including the PSLF and time-based forgiveness discharges under IDR plans.
For the 2025-26 academic year, the cost for annual in-state tuition ranged from $24,400 to $73,631 among U.S. veterinary colleges and the cost for annual out-of-state tuition ranged from $26,409 to $81,252, according to the annual data report from the American Association of Veterinary Medical Colleges.
The average debt from earning a veterinary degree was $212,499 for the Class of 2025 among those with debt, or $174,484 for all new graduates combined, including those with zero debt, according to data from the 2025 AVMA Graduating Senior Survey.
Specifically, 40% of last year’s graduates owed over $200,000 in educational debt from veterinary college, with 5.9% indicating they owed $400,000 or more.
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Veterinarians, Veterinary Technicians Prioritizing Greater Collaboration to Tackle Challenges
By Malinda Larkin
Published on February 03, 2026
Collaboration among veterinary and veterinary technician organizations has resulted in a renewed focus on strengthening the future of veterinary technician education, credentialing, and support systems across the profession.
In October 2025, leaders from the Association of Veterinary Technician Educators (AVTE), the American Association of Veterinary State Boards (AAVSB), and AVMA convened in person to discuss a number of these issues, including pass rates of the Veterinary Technician National Exam (VTNE).
Making the grade
Veterinary technicians must take the VTNE to become credentialed. These are generally graduates of AVMA Committee on Veterinary Technician Education and Activities (CVTEA)–accredited veterinary technology programs; however, because of changes made by the AAVSB that went into effect in 2024, they can also be on-the-job trained (OJT) and alternate pathway candidates in certain states.
According to Jim Penrod, CEO of the AAVSB, test takers from CVTEA-accredited programs candidates had a 70% average first-time pass rate in 2025. Those from alternative paths, such as non-accredited programs, had a 59% first-time pass rate, and OJT candidates had a 54% first-time pass rate.
The CVTEA implemented a requirement in 2020 that a program’s three-year average VTNE pass percentage for first-time test takers must be 50% or higher.
Veterinary and veterinary technician organizations are working together on a handful of initiatives, including an assessment of accreditation standards for veterinary technology programs and how they align with entry-level competencies for veterinary technicians.
Dr. Beth Thompson, associate director in the AVMA’s Education and Research Division, said, “The hope at that time, while that bar was low, was we would see test scores from programs trend upward and the CVTEA would step up the requirement as that happened. Then we had a pandemic.”
Many veterinary technology programs have struggled to meet the 50% pass rate then and now. As a result, about a dozen veterinary technology programs were put on probationary accreditation in the past few years because of their VTNE pass rates, which can last for two years. Programs can request an extension for a third year, which the CVTEA has largely granted, Dr. Thompson said.
“The committee was tasked with looming problem that we were going to have a number of programs get to end of their third year and not be above 50%,” she said. “Rather than move to voluntarily terminal accreditation, CVTEA needs to take another look.”
The committee suspended the accreditation standard related to the VTNE pass rates at its June 2025 meeting; it is now under review.
“The great news is that this is recognized,” said Dr. Jim Weisman, AVMA chief of academic affairs, research, and accreditation. “We’re excited to advance dialogue and evaluate the assessment process and look forward to outcomes in the next year.”
Factors for success
The AVTE has been looking into this issue and released its report on VTNE performance, “Exploring Success: An Evaluation VTNE Performance Drivers” this past October with support from the AAVSB and the AVMA. The report—based on surveys of veterinary technician educators, graduates, and program leaders—explored the data, experiences, and support systems that shape VTNE outcomes.
The results showed that academic prerequisites alone don’t predict VTNE performance, but stronger entry GPAs are associated with higher odds of passing. That said, programs with higher pass rates are more likely to require college-level math, English, and biology.
Programs with higher pass rates are also more likely to require clinical experience for admission. Students who had active roles—as opposed to only observing—in clinical settings prior to testing were more likely to report feeling prepared and to pass on their first attempt, according to the survey’s authors.
Results from the Association of Veterinary Technician Educators’ report on Veterinary Technician National Exam (VTNE) performance showed that veterinary technician graduates who passed the test on their first attempt were more likely to use school-provided study guides, review sessions, or study groups and take the VTNE while still enrolled in their program.
“There were no meaningful differences in teaching methods, evaluation formats, or remediation offerings between high- and low-performing programs. This suggests that instructional quality and faculty capacity—not format—drive better outcomes,” the report stated.
Regarding graduates, those who passed on their first attempt were more likely to
- Use school-provided study guides, review sessions, or study groups.
- Study consistently, on average 10 to 20 hours per week.
- Rely on a small number of highly effective resources.
- Take the VTNE while still enrolled in their program.
The survey results also demonstrated that prepared students were significantly more likely to report support from professors, academic counselors, and family. Those who lacked this support—particularly academic advising—were more likely to experience delayed passing.
Notably, over 75% of surveyed veterinary technology programs reported an increase in students requiring accommodations, yet very few students actually received them. Program directors called for financial support to provide access to quality VTNE prep tools, resources specifically for review and practice, and stronger consistency from AAVSB, CVTEA, and CVMA on entry-level success requirements.
Communication and commitment
Earlier this year, that work continued immediately prior to the 2026 AVMA Veterinary Leadership Conference, held January 9-10 in Chicago, where the three organizations welcomed the new leadership of the National Association of Veterinary Technicians in America (NAVTA) into the this growing effort.
“At our initial meeting in October, we were encouraged by the spirit of openness, optimism, and shared responsibility that shaped the discussion. That same energy was evident again in Chicago, where we took meaningful initial steps in a joint effort to assess how CVTEA accreditation standards align with the VTNE Job Task Analysis,” according to a joint statement from Dr. Weisman, Penrod, Tricia Gorham, credentialed veterinary technician and AVTE president; and Todd Von Deak, executive director of the AVTE.
CVTEA staff members and volunteer leaders, along with other stakeholders, reviewed what areas need further consideration when evaluating what veterinary technician students are expected to learn and what they are expected to perform in their jobs. Further research will continue this year and the group will meet again at AVMA Convention 2026, taking place July 10-14 in Anaheim, California, where members will discuss potential next steps.
Additional outcomes from the January meeting were an update on AAVSB’s technology review, which will be shared separately with the AVTE community; exploration of potential joint research initiatives focused on increasing understanding of the VTNE, student success, and broader technician utilization; and initial planning for in-person “fireside chats” at each organization’s upcoming conference.
“While our organizations each have unique responsibilities, we are united in our commitment to transparency, continuous improvement, and the well-being of students, professionals, and the public,” according to the joint statement. “… we reaffirm our shared commitment to AVTE’s guiding principle of One Community—to work in partnership, respect each organization’s role, and support the systems that serve veterinary technician education with care and integrity.”
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Trauma-informed veterinary practice: linking emotional labor, moral distress, and occupational well-being
This study explores the emotional and psychological challenges inherent in veterinary practice, a profession situated at the intersection of empathy, ethics, and trauma. Despite its compassionate reputation, veterinary work frequently exposes practitioners to distressing experiences, including euthanasia, caregiver grief, and moral dilemmas, which can culminate in burnout and compassion fatigue. Drawing on a Trauma-Informed Care (TIC) perspective, this study explores veterinary professionals’ lived experiences and understands occupational distress as a systemic and relational experience rather than an individual shortcoming. By moving beyond individual-level burnout models, veterinary distress is reframed as an outcome of cumulative exposure to suffering, moral conflict, and emotionally charged caregiver interactions embedded within organizational contexts. Using a qualitative phenomenological design, semi-structured interviews were conducted with six veterinary professionals, with data collection concluding upon thematic sufficiency, identifying emotional stressors, coping mechanisms, and unmet psychoeducational needs. Findings reveal (1) persistent emotional exposure and moral conflict as key sources of stress, (2) limited institutional support and a prevailing culture of endurance, and (3) strong reliance on informal peer networks for emotional regulation. These findings underscore the need for trauma-informed education, structured debriefing, and peer support systems within veterinary institutions. For stakeholders, veterinary schools, professional associations, and clinics, adopting trauma-informed policies offers a practical route to mitigating compassion fatigue, enhancing psychological safety, and sustaining compassionate engagement in animal care.
1 Introduction
The veterinary profession occupies a distinctive position at the intersection of human and animal health, empathy, and crisis (1). Although the field is frequently depicted as emotionally fulfilling, a growing body of research uncovers a far more somber and sometimes ignored reality. Veterinarians frequently encounter considerable psychological stress, ethical dilemmas, and emotional distress arising from their profession (2, 3). These job-related pressures, which include euthanasia, witnessing abuse, having emotionally charged conversations with companion animals’ caregivers, and making ethically constrained decisions, can have a profound impact on mental and emotional well-being (Figure 1). Over time, repeated exposure to such morally and emotionally demanding situations constitutes cumulative occupational strain, increasing veterinary professionals’ risk of burnout, compassion fatigue, depression, and suicide (4–6).
Figure 1. Conceptual intersection of empathy, ethics, and trauma in veterinary practice. The figure illustrates how emotional labor (empathy), moral distress (ethics), and exposure to suffering (trauma) intersect to shape occupational well-being risks in veterinary practice.
From the standpoint of occupational health psychology, the veterinary profession exemplifies work characterized by high emotional demands, ethical complexity, and limited psychosocial resources. Within the Job Demands–Resources (JD–R) framework, such pressures function as persistent job demands which, when not counterbalanced by adequate organizational resources, lead to emotional exhaustion, disengagement, and moral distress (7, 8). Together, JD–R, COR, and a trauma-informed perspective help to understand veterinary distress as a systemic and relational response to emotionally and ethically demanding work environments, rather than as an individual vulnerability.
Veterinary professionals’ experiences further illustrate the burdens of emotional labor, the regulation of emotions to meet professional expectations (9). They are required to deliver medical care to animals while simultaneously supporting distressed or grieving companion animals’ caregivers, thereby assuming a dual caregiver role (10). This dual responsibility produces what has been described as a “relational load,” in which practitioners absorb both animal suffering and caregiver distress. Repeated exposure to emotionally charged encounters, particularly under financial or organizational constraints, contributes to compassion fatigue and secondary traumatic stress (11, 12), with consequences extending beyond individual well-being to professional sustainability and workforce retention.
According to Conservation of Resources (COR) theory (13), such environments foster ongoing resource depletion, as emotional, cognitive, and moral resources are continuously expended without sufficient recovery or institutional replenishment (Figure 2). In this study, COR theory informs both the interview focus (e.g., perceived losses of emotional energy, time, moral agency, and social support) and the analytic interpretation of how veterinary professionals attempt to protect or restore depleted resources.
Figure 2. Refined systemic framework of occupational stress and trauma-informed response in veterinary practice, illustrating the interaction among job demands, insufficient resources, and organizational resilience mechanisms fostering safety, peer support, and empowerment.
This study was conducted in Türkiye and focuses on veterinary professionals working in companion-animal (small-animal) clinical settings, a context characterized by particularly intense relational and emotional demands. Companion-animal practice concentrates key dynamics relevant to a trauma-informed perspective, including frequent end-of-life decision-making, direct exposure to caregiver grief, and time-pressured, emotionally charged communication, making it a high-salience setting for examining cumulative occupational trauma. Türkiye represents a critical empirical context due to the rapid growth of companion-animal ownership alongside limited institutionalized mental health supports within veterinary workplaces; despite the presence of professional associations and informal peer networks, standardized systems for psychological debriefing or trauma-informed supervision remain scarce. Financial constraints and limited insurance coverage further intensify moral conflict and emotional labor. While the empirical focus is small-animal practice in Türkiye, the mechanisms examined, emotional labor, moral conflict, resource depletion, and relational trauma exposure, are theoretically transferable to other veterinary domains and caregiving professions, albeit with contextual variation in triggers and organizational conditions.
The absence of formal mechanisms for emotional processing, peer support, or ethical consultation perpetuates a culture of endurance rather than reflection. As a result, many veterinary professionals rely on improvised individual coping strategies instead of organization-supported interventions (14). This pattern aligns with research showing that organizational climate, particularly psychological safety and perceived support, plays a decisive role in moderating the health impacts of emotional labor (15, 16).
Existing research has documented elevated rates of burnout, compassion fatigue, moral distress, depression, and suicide among veterinary professionals, yet these outcomes have largely been interpreted through individual-level psychological models (4, 6, 14). Relatively little attention has been paid to how trauma accumulates through relational and organizational processes, such as repeated euthanasia, exposure to caregiver grief, and ethically constrained decision-making. This theoretical gap motivates the present study.
TIC, originally developed in human healthcare (17), emphasizes safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. In this study, TIC is analytically integrated with JD–R and COR frameworks to form a unified conceptual model, wherein trauma-informed principles operate as organizational resources that can buffer high job demands and interrupt cycles of resource loss.
Thus, rather than positioning well-being as an individual responsibility, the present study conceptualizes trauma-informed practice as an organizational and relational strategy. This integrated framework guides interview design, analysis, and interpretation, and provides a basis for examining how veterinary professionals perceive, manage, and potentially mitigate occupational trauma within structurally constrained settings.
1.1 The hidden cost of compassion in veterinary medicine
Veterinary practice is characterized by a distinctive dual caregiver role that differentiates it from many other healthcare professions. Veterinary professionals are responsible not only for the medical treatment of animals but also for managing the emotional needs and grief responses of companion animals’ caregivers (10). This relational configuration creates a two-tiered emotional system in which practitioners must regulate their own affect while simultaneously responding to caregiver distress. Previous research describes veterinary professionals as “mediators of suffering,” tasked with alleviating animal pain while absorbing intense human emotions (18, 19).
Euthanasia represents a particularly salient manifestation of this dual burden. Although often medically justified, euthanasia frequently becomes a shared traumatic encounter in which veterinary professionals witness acute caregiver grief, guilt, or anger. Such experiences are repeatedly described as among the most emotionally demanding aspects of veterinary work (12, 20). Sustained exposure to emotionally charged interactions, particularly those involving blame, despair, or moral conflict, has been shown to contribute to secondary traumatic stress and compassion fatigue over time (21). Veterinary professionals are positioned at the intersection of animal suffering and caregiver trauma, often with limited opportunity for emotional processing or recovery.
Professional norms within veterinary settings further intensify this burden. Veterinary professionals are expected to demonstrate empathy while maintaining emotional composure, a requirement that necessitates continuous emotional regulation and contributes to cumulative exhaustion (14, 22). When such emotional labor is combined with structural constraints, such as staffing shortages, ethical dilemmas, and financial limitations, risks of burnout and moral distress are amplified. In Türkiye, these challenges are exacerbated by socioeconomic instability and limited access to affordable veterinary care, frequently placing practitioners in ethically constrained situations where optimal treatment is financially unattainable.
An additional layer of complexity arises from companion animals’ caregivers’ trauma responses, which may include denial, shame, anger, or prolonged grief. Veterinary encounters are often experienced by caregivers as highly distressing events, particularly when illness or death is perceived as the loss of a family member (10). Consequently, veterinary professionals are repeatedly exposed to intense expressions of human grief and, in practice, assume informal counseling roles during moments of acute emotional crisis. This sustained relational exposure constitutes a central yet frequently under-acknowledged source of occupational strain in veterinary medicine.
1.2 Trauma-informed care (TIC): a framework for relational resilience
Building on Figley’s etiological model of compassion fatigue (11), prolonged empathic engagement with suffering and repeated value–treatment conflicts, such as those arising when financial constraints limit optimal care, can culminate in compassion fatigue and moral distress. TIC originally developed in human healthcare, emphasizes safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity as guiding principles for understanding and responding to trauma exposure (17).
Although initially formulated for human service settings, TIC is increasingly relevant to veterinary practice, where both care providers and care recipients may be affected by repeated exposure to suffering, loss, and ethical conflict. In this study, TIC is applied as an analytic lens to interpret how veterinary professionals perceive, manage, and are affected by emotionally and morally demanding interactions with animals and companion animals’ caregivers, rather than as a standalone theory requiring extensive elaboration.
Despite its conceptual relevance, trauma-informed approaches remain unevenly integrated into veterinary contexts. Existing well-being initiatives tend to emphasize individual self-care, with more limited attention to the organizational and relational conditions through which trauma is produced and sustained. This study therefore uses TIC to foreground the organizational and relational dimensions of occupational strain, positioning trauma-informed principles as potential resources for enhancing relational resilience within veterinary practice.
1.3 Gaps in veterinary training and organizational support
Despite extensive evidence highlighting the psychological demands of veterinary work, formal veterinary education continues to prioritize biological sciences and technical competencies over emotional literacy and trauma sensitivity (6, 23). Training related to recognizing trauma responses in companion animals’ caregivers or managing veterinary professionals’ own emotional exposure remains limited, contributing to increased vulnerability to moral distress and compassion fatigue.
At the organizational level, workplace cultures may implicitly valorize endurance and self-denial, discouraging open discussion of emotional strain. Prior research has documented a prevailing culture of endurance and silence around mental health in veterinary and other caregiving professions, often characterized by implicit expectations to “keep going” despite emotional strain (4, 6, 14). The present findings align with this literature, as participants described limited opportunities for emotional disclosure and a normalization of overextension within everyday practice, suggesting that distress is often managed through endurance rather than supported reflection. In the absence of structured supports, such as reflective supervision, peer consultation, or post-event debriefing, emotional burdens are frequently internalized, increasing the risk of burnout and professional disengagement.
Companion animals’ caregivers’ emotional needs are similarly under-recognized within many veterinary organizations. Formal frameworks for grief communication, trauma-informed caregiver management, or referral pathways for distressed caregivers are rarely institutionalized. This organizational omission not only prolongs caregiver distress but also intensifies veterinary professionals’ experiences of isolation and powerlessness. Addressing trauma in veterinary practice therefore requires a dual focus on supporting veterinary professionals and acknowledging caregiver trauma as an integral component of clinical work. The present study directly examines these reciprocal dynamics, situating them within a trauma-informed framework that conceptualizes professional and caregiver well-being as relationally interconnected.
1.4 The case for a needs-based TIC model
This study examines a significant yet underexplored dimension of veterinary practice: the reciprocal dynamics of emotional strain and trauma within veterinary professionals – companion animals’ caregiver interactions. While existing research has documented compassion fatigue and moral distress among veterinary professionals, comparatively less attention has been paid to how companion animals’ caregiver trauma intersects with professional well-being in everyday clinical encounters. Using a qualitative approach, this study explores veterinary professionals’ emotional and psychological challenges alongside the unmet relational needs of companion animals’ caregivers as perceived by practitioners. By situating these experiences within a trauma-informed analytic perspective, the study identifies relational and organizational gaps that may hinder compassionate and sustainable veterinary practice.
The research is guided by the following questions:
- What trauma-related emotional and psychological challenges do veterinary professionals experience in their professional practice?
- What coping strategies and emotional support mechanisms are currently lacking or underutilized?
- How can trauma-informed principles be adapted to meet the needs of both veterinary professionals and companion animals’ caregivers?
2 Methods
2.1 Research context
Türkiye constitutes a pertinent setting due to the rapid growth in companion-animal ownership alongside limited institutional mechanisms for psychological debriefing, ethical consultation, or formal peer-support structures in veterinary workplaces. Additionally, constrained insurance coverage and caregiver financial limitations often lead to ethically constrained decision-making, intensifying moral conflict and emotional labour. Studying this context therefore enables an analysis of trauma-informed needs in environments where emotional demand is high but systemic supports are still emerging. To our knowledge, while informal peer support and professional networks exist, there are no widely standardized, clinic-embedded, or routinely implemented debriefing/supervision pathways across veterinary workplaces; therefore, support is typically ad hoc and uneven rather than systematized. The research team approached the study with awareness of their disciplinary backgrounds in psychology and counseling, which informed sensitivity to emotional and relational dynamics in veterinary work. Reflexive memos were maintained throughout data collection and analysis to document assumptions, emotional responses, and analytic decisions. These memos were used during team discussions to minimize interpretive bias and to enhance analytic transparency.
2.2 Research design
To explore the psychoeducational needs of veterinary professionals regarding TIC, a qualitative needs analysis was conducted by using semi-structured individual interviews. This approach enabled an in-depth understanding of veterinarians’ emotional challenges, trauma-related experiences in their practices, and their perspectives on potential educational support. The study explored how veterinary professionals’ professional and personal experiences shape their emotional resilience, caregiving roles, and perceived need for trauma-informed practices. A qualitative approach was appropriate as it allowed an in-depth exploration of participants’ perspectives, emotions, reflections, and needs. Moreover, it enabled an understanding of interactions with distressed companion animals’ caregivers, ethically challenging decisions, and the emotional impact of animal suffering. The study aimed to capture veterinary professionals’ lived experiences in depth and detail.
The study was not designed as Interpretative Phenomenological Analysis (IPA) in a strict methodological sense. Rather, it employed an inductive thematic content analysis with phenomenological sensitivity, prioritizing participants’ meaning-making and lived experience while generating themes through inductive coding and constant comparison. Accordingly, the terms “interpretive phenomenological stance” and “phenomenologically informed design” refer to the study’s epistemological orientation (attention to lived experience and meaning), whereas “inductive content analysis” describes the analytic procedure used to develop codes and themes. This unified description is methodologically consistent with the analysis steps reported in Section 2.5.
Therefore, a relatively small, information-rich sample was deemed appropriate to ensure analytic rigor and depth (24). Interviews were conducted with the aim of reaching thematic sufficiency (also described as thematic saturation) within a focused scope. Thematic sufficiency was operationalized through codebook stability: after Interview 5, no substantively new codes related to the central analytic domains (trauma-linked demands, coping/resource protection, and support needs) were identified, and Interview 6 served as a confirmatory case. This pattern supported the adequacy of the final sample for the study aims.
A qualitative, phenomenologically informed design was chosen to capture veterinary professionals’ meaning-making around morally and emotionally demanding encounters and to surface practice-proximal needs for trauma-informed supports. This approach is methodologically congruent with our aim to understand how participants experience, interpret, and regulate trauma-linked events in everyday clinical routines, rather than to estimate their frequency.
2.3 Participants
In the present study, there were six veterinary professionals (4 men, 2 women), ranging in age from 25 to 52 years (M = 35.2). Participants were recruited through purposive and snowball sampling strategies to ensure diversity in both professional background and work setting. Occupational roles included veterinary technicians, clinicians, laboratory specialists, and veterinary officers, with professional experience ranging from 4 to 28 years. This variation ensured the inclusion of both early-career and highly experienced perspectives. Furthermore, participants reported personal connections to animals through companion animals’ caregivership, including cats, dogs, and horses. One of the participants told of the recent loss of a horse that highlights the intersection between professional and personal experiences of animal care, which refers to the dual caregiving responsibilities.
Inclusion criteria were: being a licensed veterinary professional currently practicing in a companion-animal clinical setting in Türkiye; routine face-to-face contact with companion animals’ caregivers; and ≥1 year of professional experience. Exclusion criteria were: primary practice in large-animal/agricultural, zoo/wildlife, or laboratory-only roles with no routine caregiver interaction. Participants were recruited from private clinics and diagnostic/laboratory services that support companion-animal care.
Sampling strategy and justification. Purposive sampling was used to ensure heterogeneity of roles (technician/clinician/laboratory/veterinary officer) and career stage (early-career to senior). Snowball sampling then extended access to additional clinics and professionals. A small, information-rich sample was targeted to achieve thematic sufficiency within a focused scope; after six interviews, no substantively new codes pertaining to trauma-linked work demands, coping, or support needs emerged, indicating adequacy for the study aims.
Participants were approached via professional networks and direct contact with clinics (email/telephone), and those who agreed were invited to share the study information with eligible colleagues for snowball recruitment. No incentives were provided. To reduce clustering of experiences, recruitment sought representation across different work settings; participants were drawn from multiple service contexts (private clinics and diagnostic/laboratory services), and no more than two participants were recruited from the same workplace. Gender was not used as a primary sampling criterion; however, the final sample composition (male-dominated) is acknowledged as a potential influence on the reported patterns of emotional labor and is addressed as a limitation in Section 4.6.
Confidentiality was safeguarded by assigning pseudonyms (e.g., P1–P6) and removing identifying information from the dataset. All data were stored securely in password-protected files.
2.4 Data collection
The study received ethical approval from the university’s ethics committee before data collection. Participants received information regarding the purpose of the study, their right to withdraw, as well as how all data will be kept confidential. Before the interviews, each participant gave their informed consent. The ethics approval number and date are provided in the Ethical Approval statement (Approval No: TED University, Human Research Ethics Committee/2024–30; Date: 30.04.2024).
Interviews followed a semi-structured guide piloted with two non-participant veterinary professionals for clarity and face validity. Core domains included: (a) emotionally demanding clinical events (euthanasia, treatment limitation, caregiver confrontation), (b) perceived trauma exposure and moral conflict, (c) resource loss/protection experiences (e.g., depletion of emotional energy, time pressure, moral agency), (d) boundary-setting and coping strategies, (e) availability and gaps in organizational supports (debriefing, supervision, peer networks), and (f) views on trauma-informed training content and delivery. The interview schedule used the same core questions for all participants to ensure comparability; follow-up prompts were flexibly tailored to participants’ roles (e.g., technician vs. clinician) to elicit role-relevant examples while maintaining coverage of the same domains. Interviews were conducted in the participants’ preferred language, audio-recorded with permission, and transcribed verbatim. When quotations are presented in English, they were translated and checked against the original to preserve meaning.
The interviewer maintained a reflexive memo after each interview (context, initial analytic impressions, potential biases) and documented non-verbal cues and interactional dynamics where relevant. Member checking was undertaken by sending each participant a short summary of preliminary interpretations for confirmation or clarification. Given the sensitive nature of discussing distressing experiences, participants were informed that they could pause or discontinue the interview at any time; if any distress arose, they were offered information about available psychological support or referral options through institutional channels.
Interviews were conducted online (e.g., via Zoom) and lasted between 20 and 56 min. Interview protocol included questions on demographic information, self-care strategies, veterinary professionals’ responses to trauma among companion animals ‘caregivers, communication approaches with distressed companion animals’ caregivers, and their views on potential training content related to trauma-informed practice.
2.5 Data analysis
The interview data were analyzed using content analysis, following an inductive approach. Initial codes were independently generated by three experts and then compared to ensure consistency and analytic depth. Themes were identified through iterative coding, constant comparison, and integration with relevant literature. To enhance rigor, two additional researchers reviewed the coding framework and verified thematic coherence across transcripts.
We conducted an inductive, phenomenologically oriented content analysis. Transcripts were read holistically, then open-coded line-by-line to capture actions, meanings, and emotions linked to trauma-related demands. Codes were iteratively clustered into categories and candidate themes through constant comparison within and across cases. The codebook evolved reflexively: two researchers drafted initial code families, a third researcher challenged category boundaries (negative-case probing), and the team resolved discrepancies through discussion, privileging conceptual clarity over mechanical agreement metrics. Analytic materials (memos, code iterations, decision logs) formed an audit trail. Data management and coding were conducted securely using spreadsheet-based matrices. Coding consistency was validated through iterative reconciliation: the three primary coders compared code applications after initial independent coding, discussed discrepancies, refined code definitions, and re-applied the stabilized codebook to earlier transcripts to confirm interpretive alignment.
2.5.1 Trustworthiness
Rigor and trustworthiness were established by adhering to the evaluative criteria outlined by Lincoln and Guba (25): credibility, transferability, dependability, and confirmability. Credibility was established by asking participants for confirmation of results, data, and explanations. Transferability was achieved by using purposive sampling, and veterinary professionals from diverse settings were included. For dependability, three independent coders were assigned to code and represent similar codes. The three coders had professional backgrounds. For the conformability, from the data collection process to analysis, all stages were meticulously recorded in an unbiased manner. Moreover, the interview protocol was reviewed and approved by two external professionals, ensuring expert input. To guarantee theoretical coherence and methodological rigor, the emerging themes were then contrasted with previously published works.
Thick description of context and cases supports transferability. Reflexive memos and an audit trail enhanced confirmability. We actively searched for negative/deviant cases that challenged emerging patterns and explicitly reported tensions (e.g., times when informal peer support was absent or ineffective). Finally, a brief peer debrief outside the core team was used to question premature closure and to test the robustness of thematic boundaries. Dependability was further supported by maintaining a decision log (audit trail) documenting codebook revisions and analytic decisions, and by re-checking thematic boundaries against the full dataset after codebook stabilization.
3 Results
This section presents findings derived from in-depth interviews with veterinary professionals, focusing on their lived experiences and emotional challenges within daily practice. The results are organized into two overarching themes: (1) Veterinary professionals, addressing psychological, emotional, and structural factors influencing professional well-being, and (2) Companion Animals’ Caregivers, reflecting caregivers’ emotional responses and support needs as perceived by veterinary professionals. Together, these findings illustrate the reciprocal emotional dynamics embedded in veterinary care and highlight areas relevant to trauma-informed practice.
3.1 Veterinary professionals
Participants’ accounts revealed a convergence of emotional, relational, and structural stressors characterizing veterinary work. Although no systematic differences emerged based on years of experience or practice setting, financial strain, emotionally demanding interactions with caregivers, and limited institutional support were consistently emphasized. Across interviews, veterinary professionals described ongoing emotional labor and moral strain arising from routine practice, alongside individual efforts to remain professionally functional despite insufficient preparation for the psychological dimensions of their role. The subthemes that come after Sources of Stress, Coping Strategies, and Training Needs show how veterinary professionals’ experiences and ways of being professionally resilient are complex and varied.
3.1.1 Sources of stress
Veterinary professionals’ stress was shaped primarily by sustained emotional and relational demands rather than by clinical complexity alone. Participants consistently described interactions with companion animals’ caregivers as the most emotionally taxing aspect of their work, noting that caregivers’ expectations, anxiety, and emotional reactions frequently transformed routine clinical encounters into emotionally charged situations. These experiences reflected high emotional demands embedded in daily practice, with limited opportunities for psychological recovery. A central source of stress involved expectations of constant emotional availability and blurred professional boundaries. Participants reported frequent non-urgent calls and messages from caregivers, including contact outside working hours, which eroded personal boundaries and contributed to a persistent sense of being “on call.” As one participant noted, “messages keep coming after hours.” Such patterns intensified emotional demands while restricting rest and recovery.
Financial constraints constituted another prominent and structurally embedded stressor. Veterinary professionals described ethically challenging situations in which optimal treatment options were financially inaccessible for caregivers, forcing compromises that conflicted with professional values. One participant summarized this dilemma by stating, “you know the best treatment, but you have to choose cheaper options.” These circumstances generated moral distress and feelings of powerlessness, as practitioners expended emotional energy without the means to resolve these conflicts.
Caregivers’ non-adherence to medical recommendations further amplified emotional strain. Participants expressed frustration when treatments were delayed, medications were not administered, or follow-up visits were missed, often resulting in preventable deterioration in animals’ conditions. One veterinary professional remarked that caregivers sometimes “forgot the medication,” leaving practitioners to manage both worsening clinical outcomes and emotional exhaustion. Such interactions compounded cumulative job demands by requiring additional emotional regulation during already strained encounters.
Strong emotional identification with animals emerged as a double-edged aspect of professional motivation. While empathy for animals sustained commitment to the profession, it simultaneously increased vulnerability to distress, particularly when suffering was perceived as preventable. As one participant reflected, “that love makes it harder.” Repeated exposure to animal pain and loss accumulated over time, contributing to emotional fatigue and gradual depletion of emotional resources.
In addition to external pressures, veterinary professionals described significant internalized stress related to uncertainty, responsibility, and self-doubt. Persistent concerns about treatment outcomes, end-of-life decisions, and professional adequacy extended beyond clinical encounters. One participant articulated this ongoing worry by asking, “What if the treatment plan does not work?” These internal processes sustained emotional engagement and compounded stress outside working hours.
Perceived gaps in caregivers’ knowledge and the influence of misinformation constituted another source of emotional labor. Participants described repeated efforts to correct unrealistic expectations regarding treatment outcomes, preventive care, and recovery timelines. One veterinary professional noted that some caregivers believed “we can do miracles,” which strained trust and complicated communication. The need to continuously justify clinical decisions intensified relational tension and emotional demands.
Finally, participants situated their experiences within broader societal attitudes toward animal welfare. Several veterinary professionals described a general lack of awareness regarding animal needs and rights, which heightened their sense of moral responsibility. One participant summarized this perception by stating, “There’s actually a general ignorance.” This broader context contributed to cumulative stress, as practitioners felt compelled not only to provide care but also to educate and advocate within an already emotionally demanding professional role.
3.1.2 Ways to deal with stress
Veterinary professionals described coping not as the elimination of stress, but as ongoing efforts to manage and contain emotional strain arising from sustained job demands. Participants reported using a combination of interpersonal, behavioral, and emotion-focused strategies to remain functional within an emotionally demanding work environment.
Peer consultation and collegial support emerged as a primary coping resource. Participants described seeking advice from more experienced colleagues not only for clinical decision-making but also for guidance on communicating with caregivers during emotionally charged situations. One participant explained that they consulted colleagues about “how we should tell the pet owner.” Such informal debriefing processes helped reduce feelings of isolation and increased confidence when navigating morally or emotionally difficult encounters.
Boundary-setting was identified as a protective strategy aimed at limiting further emotional depletion. Participants emphasized the importance of establishing flexible but clear limits regarding availability, particularly in response to non-urgent after-hours requests. One veterinary professional noted the need to “set limits and tell them not to call for things that aren’t urgent.” These practices allowed practitioners to preserve personal time and reduce ongoing emotional exhaustion.
Physical self-care practices were described as essential for sustaining attention, emotional regulation, and clinical performance. Participants highlighted adequate sleep, regular meals, and short breaks as necessary for coping with long shifts and irregular schedules. As one participant stated, “sleep is always a necessity.” Such practices supported short-term recovery and helped prevent irritability and fatigue during demanding workdays.
Emotion-focused coping strategies were closely linked to meaning-making and professional identity. Several participants described reconnecting with animals outside of high-stakes clinical decision-making to restore emotional balance and reaffirm their motivation for the profession. One veterinary professional reflected that animals were part of their “rest and happiness.” Rather than eliminating stressors, these strategies enabled participants to sustain empathy and engagement despite ongoing emotional strain. Taken together, these coping strategies reflect efforts to manage and replenish emotional resources, allowing veterinary professionals to continue functioning within a persistently demanding occupational context.
3.1.3 Needs for training
Veterinary professionals described training-related needs not in terms of technical competence, but as gaps in emotional, communicative, and ethical preparedness for daily practice. Participants consistently reported that their formal education emphasized biological and procedural knowledge, while offering limited preparation for managing emotionally complex interactions with caregivers and coping with the psychological demands of the profession.
Communication-related challenges were identified as a central area of unmet training needs. Participants noted that difficulties often arose not from clinical uncertainty, but from conveying unfavorable information, discussing financial limitations, or responding to caregivers’ emotional reactions. One veterinary professional remarked that “nobody teaches us how to deal with a crying pet owner.” Such experiences highlighted a perceived mismatch between academic training and the interpersonal realities of clinical work.
Emotional regulation and self-management skills were also described as insufficiently addressed during professional education. Participants reported difficulty processing emotionally intense experiences, particularly those involving euthanasia or preventable animal suffering. As one participant stated, “you leave an appointment after euthanasia and go right to the next one as if nothing happened.” The absence of structured guidance for navigating these transitions contributed to unresolved emotional strain and cumulative distress.
Participants further emphasized the lack of formal support mechanisms for reflecting on emotionally demanding cases. Several veterinary professionals described relying on trial-and-error learning to manage emotional burden, noting limited exposure to structured debriefing or supervised reflection during training. This absence was perceived as contributing to ongoing emotional exhaustion rather than facilitating adaptive coping.
Finally, participants identified limited training in animal behavior and caregiver psychology as an additional source of strain. Misinterpretation of animal stress signals and caregiver reactions was reported to exacerbate clinical tension and emotional difficulty. One participant observed that “a scared animal may be misinterpreted,” highlighting how gaps in behavioral understanding could intensify already challenging interactions. Taken together, these findings indicate that veterinary professionals perceive their training as insufficiently aligned with the emotional and relational demands of practice, contributing to sustained stress and reliance on informal, self-directed learning processes.
3.2 Companion animals’ caregivers
This theme focuses on companion animals’ caregivers as emotionally active participants in veterinary encounters whose reactions significantly shape clinical interactions. Veterinary professionals described a wide range of caregiver emotions, including apathy, anger, guilt, anxiety, and grief, reflecting the strength of the human–animal bond. Participants emphasized that responding to these emotional reactions constituted a substantial part of their daily work and contributed to the reciprocal emotional dynamics of veterinary care. The two subthemes; Responses and Support provided, exemplify how veterinary professionals perceive, manage, and respond to companion animals’ caregivers’ suffering, underscoring the emotional reciprocity intrinsic to veterinary care.
3.2.1 Responses
Veterinary professionals interpreted caregivers’ reactions largely as grief-related responses shaped by attachment, loss, and perceived responsibility. Participants reported observing diverse emotional and behavioral patterns, ranging from avoidance and indifference to anger, remorse, and intense anxiety. While understanding these reactions was viewed as important for effective communication, managing them was also described as one of the most emotionally demanding aspects of practice.
Caregiver behaviors perceived as neglectful were frequently interpreted as avoidance-based coping rather than intentional disregard. Participants described situations in which delayed visits, missed follow-ups, or ignored recommendations reflected caregivers’ difficulty confronting the possibility of animal suffering or loss. One participant noted that caregivers sometimes “avoid coming to the clinic until it’s too late.” This avoidance complicated veterinary professionals’ emotional responses, creating tension between empathy and frustration.
Expressions of anger and hostility were commonly described in cases involving unfavorable outcomes or limited treatment options. Participants reported that such anger was often directed toward veterinary professionals, particularly when caregivers experienced fear, loss of control, or financial stress. As one veterinary professional stated, “the anger is directed at us.” These interactions heightened emotional demands and contributed to anticipatory stress during difficult consultations.
End-of-life decisions elicited particularly intense emotional reactions. Veterinary professionals described caregivers’ panic, guilt, and self-blame during discussions of euthanasia or terminal illness. One participant observed that caregivers repeatedly questioned whether they had done something wrong. These encounters positioned veterinary professionals at the intersection of clinical responsibility and shared emotional vulnerability, requiring continuous emotional regulation while maintaining professional functioning. Taken together, caregivers’ responses constituted a complex emotional landscape that veterinary professionals were required to navigate alongside clinical decision-making.
3.2.2 Support provided
Veterinary professionals described providing emotional support to caregivers as an integral part of routine practice. Participants reported offering reassurance, empathy, and guidance alongside medical treatment, particularly during moments of acute distress. This support was framed as a practical response to caregivers’ emotional needs rather than as a separate or optional aspect of care.
Clear and transparent communication emerged as a primary strategy for supporting caregivers. Participants emphasized using simple language and visual explanations to reduce uncertainty and help caregivers understand diagnoses and treatment options. One veterinary professional explained that showing test results “makes it easier for them to accept the situation.” Such practices were perceived as facilitating trust and reducing anxiety during emotionally charged encounters.
Emotional regulation by veterinary professionals functioned as a stabilizing element in interactions with distressed caregivers. Participants reported consciously maintaining calm and composed behavior in response to anger, fear, or grief. One participant noted, “If I lose my calm, they lose theirs.” This approach helped de-escalate tension and maintain communication, though it required sustained emotional control.
Empathic presence and validation were also described as central components of support. Participants emphasized listening without judgment and acknowledging caregivers’ emotional experiences, particularly during moments of loss. One veterinary professional stated that simply expressing understanding “makes a difference.” Validation was perceived as helping caregivers feel recognized and supported during vulnerable moments.
In some cases, support extended beyond the immediate clinical encounter through brief follow-ups or additional guidance. While participants described these actions as meaningful for strengthening relationships with caregivers, they also acknowledged the emotional effort involved. As one participant reflected, “You give a piece of yourself every time.” These accounts illustrate how support provision, while central to veterinary practice, contributed to ongoing emotional demands.
4 Discussion
This study examined veterinary professionals’ experiences of occupational stress, emotional strain, and coping and offers an exploratory, context-bound interpretation of these experiences through the framework of TIC. The findings suggest that veterinary practice is characterized by persistent moral and emotional demands, limited opportunities for recuperation, and uneven organizational support structures. Drawing on the Job Demands–Resources (JD–R) model (7) and Conservation of Resources (COR) theory (13), the findings indicate that sustained empathic engagement and moral conflict function as salient job demands that deplete emotional and cognitive resources, while limited social and institutional resources constrain recovery. Rather than making generalizable claims or positioning prior work as insufficient, this discussion proposes a conceptual framework for understanding how trauma-informed organizational practices may support resilience and psychological safety in veterinary contexts. These interconnections are summarized in Figure 3.
Although prior occupational health research has documented burnout and emotional exhaustion among veterinary professionals, much of this work has emphasized individual experiences and coping, while also acknowledging broader organizational and structural contributors to varying degrees. Consistent with qualitative and quantitative findings across caregiving professions, the present study suggests convergence with evidence from emergency medicine, palliative care, and child protection, where repeated exposure to death, grief, and ethical conflict is conceptualized as occupational trauma. Rather than redefining the field or challenging existing systemic perspectives, this study conceptualizes veterinary distress as sharing structural similarities with trauma-exposed caregiving work, extending JD–R and COR models toward a trauma-informed occupational perspective. In this sense, the contribution is theoretical and integrative rather than demonstrative.
4.1 Emotional and moral demands as persistent occupational stressors
Veterinary professionals’ accounts depict a work environment marked by continuous exposure to animal suffering, caregiver grief, and ethically constrained decision-making. These findings align with existing literature on compassion fatigue and moral distress in caregiving professions (11, 14). Within the JD–R framework, such experiences function as hindrance demands that consume energy without fostering growth. Participants’ descriptions of euthanasia, financial constraint, and caregiver conflict reflect moral incongruence between professional values and feasible action, a pattern previously linked to moral distress and burnout (8, 26).
What is theoretically noteworthy is not the presence of stressors per se, but their cumulative and relational nature. Veterinary professionals’ “dual caregiver” role intensifies emotional labor (9), as they manage both animal suffering and caregiver emotions. This finding converges with work in palliative and emergency care, where relational exposure is a key driver of occupational strain. COR theory helps explain how repeated moral and emotional demands initiate loss cycles that, without institutional replenishment, escalate into chronic strain.
4.2 Resource depletion, endurance, and organizational silence
Participants described a workplace culture that normalizes overextension and emotional self-reliance. Rather than interpreting this as individual resilience, the findings suggest the presence of a structural culture of endurance, comparable to patterns reported in other healthcare settings (15). From a COR perspective, the absence of formal recovery mechanisms perpetuates resource depletion, increasing vulnerability to burnout.
A trauma-informed interpretation offers a different reading: distress disclosure is constrained not by personal weakness but by insufficient psychological safety. TIC reframes recovery as an organizational responsibility, shifting attention from individual coping to structural interventions such as reflective supervision and debriefing. This does not replace JD–R or COR models but complements them, specifying how resources can be operationalized through trauma-sensitive practices (27).
4.3 Peer support as an informal but fragile resource
Peer consultation emerged as a critical relational resource, consistent with research highlighting social support as a buffer against emotional demands (28, 29). Participants’ narratives of shared meaning-making illustrate how collective sensemaking mitigates isolation and moral uncertainty. However, the informal nature of this support renders it uneven and dependent on personal initiative, limiting its protective capacity.
From a TIC perspective, peer support is a core principle that requires institutional scaffolding. This study suggests, rather than proves, that formalizing peer support mechanisms could transform an existing informal resource into a sustainable organizational practice, aligning relational resilience with occupational health objectives.
4.4 TIC as a complementary occupational health framework
TIC differs from traditional stress models by conceptualizing repeated exposure to death, grief, and moral conflict as trauma-related rather than merely stressful. Emerging veterinary literature has begun to acknowledge trauma-informed approaches, although applications remain limited and fragmented. The present study does not claim to introduce TIC to veterinary medicine but offers a contextualized application that integrates TIC principles with established OHP frameworks.
The six TIC principles, safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity (17), map closely onto constructs such as psychological safety and participatory climate (15). This convergence suggests theoretical compatibility rather than novelty, positioning TIC as a lens that deepens understanding of how organizational resources operate in trauma-exposed work.
4.5 Türkiye context and analytic transferability
The Türkiye context is characterized by rapid growth in companion-animal ownership, financial constraints, and limited institutional mental health supports. These contextual features likely intensify moral conflict and emotional labor, shaping how stress is experienced and managed. While some findings, such as financial constraint and informal coping, may be context-specific, others (euthanasia-related distress, caregiver grief, reliance on peer support) appear analytically transferable to other veterinary and caregiving contexts.
Accordingly, the findings should be interpreted as conceptually rather than statistically generalizable, offering insights into mechanisms that may manifest differently across cultural and institutional settings.
4.6 Limitations and future directions
This study is exploratory and based on a small, purposive sample, which limits statistical generalization. The male-dominated sample may underrepresent gendered dimensions of emotional labor, and participants who volunteered may have had heightened awareness of occupational stress, introducing selection bias. Accordingly, the findings should be interpreted as analytically transferable rather than context-specific, as the mechanisms identified, such as emotional labor, moral conflict, resource depletion, and relational trauma exposure, are theoretically relevant to veterinary practice beyond Türkiye and to other caregiving contexts, including large-animal and mixed clinical settings. However, policy-oriented implications derived from this study should be interpreted with caution, as governance structures, professional regulation, and occupational health responsibilities differ substantially across countries and veterinary sectors. Accordingly, trauma-informed policy recommendations are intended as adaptable principles rather than uniform prescriptions, requiring alignment with local regulatory frameworks and institutional capacities. Future research should examine trauma-informed interventions longitudinally and across diverse cultural and institutional contexts and include caregiver perspectives to further test and refine the transferability of these mechanisms.
5 Conclusion
Veterinary practice is a high-demand occupation that exists at the confluence of compassion, ethics, and trauma. This study illustrates that veterinary professionals’ discomfort is not only an individual inability to cope, but rather a foreseeable outcome of systematic exposure to moral and emotional pressures without sufficient resource replenishment. This study proposes a reconceptualization of TIC as an organizational-level occupational health paradigm, therefore expanding existing models of workplace stress to include the emotional dimensions of caring labor.
A trauma-informed workplace culture that fosters safety, trust, and cooperation may alleviate burnout, increase compassion satisfaction, and maintain professional engagement. Ultimately, caring for veterinary professionals as professionals who have been exposed to trauma on the job is not only a question of psychological care, but also of moral and organizational duty.
Data availability statement
The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.
Ethics statement
The studies involving humans were approved by TED University Human Research Ethics Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
Author contributions
BS-Y: Data curation, Methodology, Conceptualization, Validation, Project administration, Investigation, Supervision, Resources, Software, Formal analysis, Writing – review & editing, Writing – original draft. SO: Formal analysis, Validation, Resources, Project administration, Data curation, Supervision, Writing – review & editing, Methodology, Software, Conceptualization, Writing – original draft, Investigation. HI: Writing – original draft, Visualization, Conceptualization, Funding acquisition, Methodology, Writing – review & editing.
Funding
The author(s) declared that financial support was not received for this work and/or its publication.
Conflict of interest
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declared that Generative AI was not used in the creation of this manuscript.
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Reduce administrative bottlenecks with payment automation
January 22, 2026
By Randy Modos
Veterinary clinics are under more pressure than ever. As client expectations rise and caseloads grow, veterinarians and front desk teams are being stretched thin—not just by patient care, but also by the administrative systems that support it. Around two-thirds of practices report struggling to meet demand,1 primarily due to staffing shortages and operational inefficiencies.
Payment automation can offer relief. By streamlining billing, reconciliation, and other back-office processes, automation eases the unsustainable burden on overworked staff, allowing clinics to focus more on patient care and less on paperwork.
The burden of manual payments
A busy front desk is the heart of a veterinary clinic, but it is often rife with administrative bottlenecks. Many practices remain stuck with outdated manual billing systems that hinder their operations. For teams already operating at capacity, the workload is not manageable.
Because disconnected payment systems do not sync information with practice management software, staff are forced to spend valuable time manually transferring data between the two. This leads to duplicate work, missed payments, and reconciliation tasks that consume already packed schedules.
These inefficiencies not only slow down workflows, but can also erode morale, pulling staff away from more meaningful work and stretching limited resources even thinner.
How payment automation streamlines workflows
Modern payment automation tools are designed to alleviate the back-office burden and help practices thrive. Here’s how automation streamlines veterinary clinic workflows:
1) Simplify payment operations
With a digitized front office, teams can quickly request and process payments after services are rendered, reducing bottlenecks and delays.
A centralized system ensures consistency and transparency across all transactions. Staff can also leverage built-in features that simplify invoicing and reduce the need for manual follow-up.
For example, payment automation software enables practices to securely store and recharge client payment details, eliminating the need to collect the same information repeatedly and reducing time wasted chasing unpaid invoices. Look for a platform that relies on tokenization (a process that replaces sensitive data with unique, non-sensitive tokens) to maximize security.
Automated systems make it easier to manage billing across channels by sending digital invoices via email or text, enabling phone-based payments and supporting recurring billing. These automated workflows support omnichannel experience, reducing the need for manual follow-up, helping staff save time and giving clients more convenient ways to pay.
For busy teams managing high appointment volumes or urgent cases, streamlined billing logistics reduce stress and keep workflows moving, allowing staff to stay focused on patient care rather than dealing with administrative bottlenecks.
2) Reduce errors and improve reporting
With outdated payment systems, manual data entry can result in costly errors. Whether it is a mistyped amount, a missed charge, or a duplicate transaction, manual processes leave your practice vulnerable to errors that not only slow down reconciliation and confuse staff but can also cost your practice precious revenue.
Automated systems can reduce that risk by syncing payments directly with your practice management software, ensuring transactions are tied to the correct patient record and service. Instead of manually entering transaction details, data is synced between your payment system and practice management software automatically for all forms of payment, reducing the risk of errors.
The same solutions also streamline accounting processes. Real-time transaction logging, automated end-of-day reconciliation, and error alerts help staff identify discrepancies promptly and prevent missed revenue. To support smoother reconciliation, additional features, such as automatic batch settlement, support for custom batches, and real-time reporting, ensure confident and accurate daily closeouts.
Often, manual data entry leaves clinics juggling spreadsheets and disconnected systems, making it hard to get a clear picture of payment activity. With payment automation, clinics gain real-time visibility into their financial performance, utilizing cleaner data and built-in reporting tools. This allows practices to make faster, more informed decisions about daily operations and long-term planning.
3) Enable recurring charges for routine service
Besides streamlining everyday billing, the ability to securely store client cards on file can be beneficial for your practice. In particular, you can more easily offer ongoing or subscription-based services, such as wellness plans, prescription refills, and preventive care packages.
With scheduled payments in place, you can ensure timely collection for recurring payments without sending separate invoices or relying on clients to remember due dates. The system will automatically process payments on schedule, with optional reminders or receipts sent to clients for transparency.
Beyond improving consistency, this kind of automation brings greater predictability to financial operations. Practices can better anticipate revenue from month-to-month and maintain a steady cash flow, which is critical for budgeting, staffing and long-term planning.
4) Improve client convenience and retention
Automation not only simplifies internal workflows, but it also enables practices to deliver more consistent and professional experience that clients can rely on.
When payment processes are automated, routine tasks such as invoicing, follow-up charges, and payment scheduling occur reliably and on time, without delays or missed steps. This consistency reinforces trust with clients and reduces the likelihood of billing errors, unexpected charges, or delayed communications, making the financial side of a visit feel seamless and dependable.
Over time, that reliability becomes a key factor in what keeps clients coming back.
5) Support sustainable growth without adding overhead
As veterinary practices expand, whether by increasing patient volume, offering new services, or opening additional locations, administrative demands grow just as quickly.
Without automation, scaling often means hiring more staff to handle billing, invoicing, and reconciliation tasks. Payment automation helps practices grow efficiently by absorbing that workload without requiring additional headcount.
Automated systems can handle higher transaction volumes, manage scheduled billing across multiple services, and maintain accurate financial records at scale. This allows clinics to take on more patients, streamline multi-location operations, or introduce wellness programs without overwhelming staff.
Additionally, automation helps keep overhead costs in check, even as caseloads grow. Tools that support compliant surcharging enable practices to offset rising credit card processing fees by automatically applying a surcharge when a client pays with a credit card. Built-in card detection ensures the surcharge is only applied when appropriate, and automated disclosures help keep your practice compliant while maintaining transparency with clients.
Less admin, more care
When administrative tasks are automated, teams gain time, accuracy, and peace of mind. That means more attention can be directed to what matters most: patient care.
By embracing tools like automated end-of-day reconciliation and recurring billing, veterinary clinics can eliminate bottlenecks, reduce staff burnout, and provide a more professional experience from check-in to checkout. It’s a win for clients, teams, and the health of the practice.
Randy Modos is the president and co-founder of PayJunction, where he provides vision and leadership for the company as it pioneers payment technology and delivers operational efficiencies for businesses.
Reference
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What Is a Stay Interview? 13 Questions to Ask.
Plus, best practices for administering productive stay interviews.
Written by Kate Heinz
Brennan Whitfield | May 10, 2024
In the fight for talent, recruiters and hiring managers can’t wait until an employee is out the door to figure out why they left. That’s why some companies conduct stay interviews, which is when they ask for feedback from a current employee that can inform an organization’s approach to retaining top talent.
What Is A Stay Interview?
A stay interview is a conversation with a high-performing employee with the goal of discovering what they like about their role, and what they would like to change. Stay interviews are an opportunity to both uncover what motivates that employee and to also build trust with them as a manager.
Incorporating stay interviews into your retention and employee engagement strategies can help you learn what matters to your team members and what they’d like to see improve — long before they decide to find another opportunity.
Read on to learn what a stay interview is, why it’s valuable and the best questions to ask.
The Importance of Stay Interviews
A stay interview is just as, if not more, important than an exit interview. Stay interviews are conducted with enough time to identify and correct a problem. Exit interviews, on the other hand, occur when an employee is headed out the door.
When done correctly, stay interviews can have an extremely positive impact on your employee retention rate. The key is to use the information you collect from stay interviews. Failing to act on what your employees have to say will make you appear disingenuous and cheapen the value of stay interviews. Your team members took the time to share their honest feedback, and it’s your responsibility to try to make improvements.
How to Conduct a Stay Interview
Use the following guidelines when scheduling and conducting your stay interviews to ensure they’re productive.
Who Should Conduct Stay Interviews?
Stay interviews should be led by the employee’s direct manager. This helps cultivate a strong relationship founded on trust and open communication, and an employee’s relationship with their manager significantly influences their decision to stay. One survey showed that less than one-third of employees “trust that their managers actually care about their career progression.”
Who Should Receive Stay Interviews?
Your most tenured, high-performing employees should be the primary focus of your stay interview program; they’ve been with your company the longest and clearly there’s something that’s kept them coming back.
Unlike exit interviews, when you’re less interested in understanding why disengaged employees choose to leave, stay interviews should be conducted across the board for all employees. Why? Because people stay for different reasons. To prevent employees from walking out the door, you need to learn what makes your company valuable to each individual.
When Should You Conduct a Stay Interview?
A stay interview should not occur right after an employee starts, nor should it coincide with an annual review. The employee should be fully settled into their role and accustomed to the environment in order for the stay interview to yield useful results. Aim to conduct a stay interview annually for each employee, but ensure it’s not included as an add-on to a performance review.
Conduct all stay interviews within a few days or weeks of each other. That way, you can promptly act on the data you’ve collected so employee feedback is not left unaddressed for a long period of time.
Stay Interview Best Practices
Prioritize Two-Way Communication
There is one caveat to stay interviews and it has to do with your company culture. In order for stay interviews to be productive and yield honest feedback, employees need to trust management. If your type of organizational culture prioritizes hierarchy and separation between senior leadership and employees, face-to-face interviews are probably not the best method of collecting feedback. Until two-way communication is a core value and staple of your culture, stay interviews will not be productive.
Choose a Comfortable Location
Much like an exit interview, you want to make the employee as comfortable as possible so they’re more inclined to share honest feedback. If possible, ask the employee where they’d like the interview to take place and be flexible with the location — they may ask to get out of the office and take a walk or visit a nearby coffee shop, so adapt to their requests when you can.
Take as Long as You Need
A stay interview can take anywhere from 20 minutes to an hour. Unlike an exit interview where you have a set list of questions to get through, a stay interview should be more carefully tailored to the individual. Again, employees stay for different reasons, so take as long as you need to understand the individual’s satisfaction and frustrations.
Benefits of Stay Interviews
Leads to Insight for Employer Branding Strategy
Stay interviews are valuable to your employer branding strategy as they provide the insight you need to create an employer brand that will draw in new talent.
Improves Employee Engagement
Moreover, stay interviews are a useful engagement strategy. By identifying pain points before they become full-blown problems, you can improve your work environment to retain great employees. When done correctly, stay interviews can have an extremely positive impact on your employee retention rate. They are a beneficial engagement tactic coupled with employee engagement surveys and other tools for tracking engagement.
Proactive About Heading Off Employee Churn
A stay interview gives you the chance to avoid recurring problems, which is better than having to learn from your mistakes after the fact. Stay interviews also let managers gauge employees’ professional and personal wellness — and how much balance there is between the two. In doing so, management can get perspective on whether they need to intervene if an employee who’s been putting in a lot of work might be headed for burnout. Being proactive about fending off burnout — rather than reacting when it’s too late — is another way to encourage employees to stick around and make sure they enjoy showing up for work each day.
Cost-Effective (Compared to Recruiting)
Because stay interviews cost no more than the time it takes for managers and employees to have a conversation, they’re a cost-effective method for improving the workplace. That’s especially true in comparison to the costs associated with recruiting and hiring or the productivity lost when someone leaves the team because they were unhappy in their job.
Helps Uncover New Opportunities
Stay interviews don’t need to focus just on the negatives. Sure, it’s a time for employees to be open and honest about problems they’ve encountered in the workplace or elements of the culture that are hurting their productivity. But it can also be a chance to gain insight on where employees are looking for room to grow. Or what additional opportunities they’d like to see in terms of training and professional development.
Challenges of Stay Interviews
Can Involve Difficult Discussions
A stay interview can involve some vulnerable discussions about what the employee truly enjoys — or dislikes — about their job. Grievances could be brought up about their role, the company, other colleagues or management themselves, which can be difficult to navigate for both the employee and manager in the interview. It’s worth the discomfort though.
Can Feel Intimidating
Conducting a stay interview, especially with an employee who has never been in one, can be daunting. The employee may feel they are being questioned about their commitment to the company, or feel resistant to speaking openly about their feelings of the job. This can lead to a lack of usable feedback for both the manager and the employee present.
Require Acting on Feedback
Actually implementing the feedback gathered in a stay interview takes a lot of work. Understanding and addressing employee concerns means being accountable and taking initiative as a manager. While this can require effort, fixing employee issues as soon as possible tells your workforce that you respect their input and encourages them to stay for the long-term.
13 Stay Interview Questions to Ask
Use the following questions to start collecting valuable employee feedback during stay interviews. To convey your appreciation for the candidate and their value to the company, you must actively listen to what they have to say and ask thoughtful follow-up questions.
- What Do You Look Forward to at Work Every Day?
Dive right in and get to the heart of what motivates and excites employees about their role, your office and their work life.
- What Do You Dislike About Work Every Day?
The goal of a stay interview is not only to figure out what your people like about working for you, but to uncover any grievances they have that could compel them to look elsewhere for employment.
- What Do You Think of the Way Employees are Recognized?
When asked which factors were most important to them in a job, 37 percent of employees answered that they valued employee recognition above all else. To keep people around, you need to recognize them in a way that resonates with each individual. Asking this question in stay interviews can help you understand how comprehensive your employee recognition program is and identify different methods of acknowledgment.
- How Would You Rate Our Work-Life Balance? How Could It Be Improved?
In addition to employee recognition, work-life balance is a huge retention factor. When companies provide their employees with a healthy work-life balance, they’re more likely to retain their employees. If employee’s typically come in early, stay late and work into the wee hours of the night, work-life balance must be improved. Consider implementing a work-from-home policy to offer employees more flexibility.
- What Do You Enjoy About the Professional Development Services Offered? What Do You Dislike?
No one wants to feel stagnant in their role. In addition to clearly outlining career paths and providing opportunities for growth, it’s important to make employee development a central aspect of your company culture. In fact, employees who have internal mobility within their companies stay at those companies twice as long as those who experience no mobility.
- Within the Past Year, What Was a Day That Caused You Anxiety or Frustrations?
Answers to this question will help identify standout and serious problems for your team members. Then, ask if the employee can explain the source of their frustration within the situation. Once they’ve explained the cause, ask them about the solution: Can you pinpoint what eventually occurred to help alleviate your stress? This series of questions will target what might make employees want to leave and what keeps them around.
- Within the Past Year, What Was a “Good Day”?
As an alternative to the previous question, asking about a recent good day at work will provide insight into what the employee enjoys about their job. They may define a good day as when they were recognized for their success on a project, when they could work from home or didn’t have to interact with a particular employee. Ultimately, an answer to this question should clue the manager into what aspects of work have a positive impact on the employee’s day-to-day.
- What Does Your Dream Job Look Like?
Since this is a broad question, employees will have to answer it in whatever way is most meaningful and impactful to them. For example, if an employee describes their dream job as one they can leave in the office at the end of the day, they probably don’t have that luxury right now and you should take note to evaluate and improve your work-life balance. Or, an employee may say their dream job is a cross-functional role that involves regular communication with employees meaning they are probably feeling siloed in their current position.
- What Did You Love About Your Last Position That You No Longer Have?
Get down to the nitty-gritty of the employee’s role and responsibilities. What don’t they enjoy about their current position? What do they wish they could carry over from their previous role? Answers to this question will help managers understand how they can improve the day-to-day experience of their direct reports.
- What Did You Love About Your Last Job That You No Longer Have?
Answers to this question will likely account for your company culture, flexibility, office environment, as well as employee perks and benefits. Aggregate responses to establish a holistic representation of your shortcomings as a potential employer. You can then begin to address the most common qualms and make impactful improvements to your office.
- What Do You Think About on Your Way to Work?
A response to this question will help illustrate the employee’s shift in mindset when they’re headed into the office. Ideally, if they’re happy at work and excited about their job, their thoughts will be positive. Or, they may not even think about work. A cause for concern is when the employee has negative thoughts or a sense of dread while headed to work.
- What Do You Think About on Your Way Home From Work?
Similarly, the employee’s response would ideally suggest a positive sentiment about work, but not necessarily about leaving work. Of course, people are generally excited to get back to their life outside of the office by the end of the day, but you don’t want the five o’clock whistle to be a prolonged sign of relief. Furthermore, you don’t want employees to leave irritated or annoyed by the day’s events.
- What Can I Do to Make Your Experience Better?
Again, a stay interview should be conducted by a direct manager since they are in the best position to enact change for the employee.
The objective of a stay interview is three-fold. Learn what employees enjoy about your company. Figure out what employees dislike about your company. Reinforce two-way communication between management and employees. This question targets all three objectives, allowing the employee to express what they want in their role, what currently dissatisfies them and encourages them to establish trust in their manager.
Implementing a Stay Interview Action Plan
Once stay interviews are complete, it’s time to take thoughtful action on the feedback that’s been gathered. To foster trust and confidence between employees and management, it’s important to make sure employees feel their concerns are being heard and that managers are responding appropriately.
Managers should determine what people or resources are necessary to accomplish the tasks laid out and then set a reasonable timeline for getting them done. Those elements should then be communicated to their direct reports and any other stakeholders involved in potential changes.
Managers should be clear about any expectations for employees, such as new or changing responsibilities, as well as any steps being taken at the management or leadership level. That communication shouldn’t happen just once. There should be follow-up on the progress of the action plan. In the case of long-term initiatives, for example, it might be a good idea to check in again three to six months down the road. By taking the time to implement these plans, you are not just telling employees their time and candor is valuable, but demonstrating it through concrete action.
Frequently Asked Questions
How do I prepare for a stay interview?
For employees, think about what you’re satisfied with in your job (role growth, responsibilities), what you feel could be improved in your job, how you feel about your work and the company culture and what you feel the company could do to better support you in your career.
For managers or employers, determine what issues your employees potentially face at work and frame questions around them, and note what company resources are available to employees if certain issues arise. Additionally, establish when, where and how often stay interviews will be conducted.
What is another word for stay interview?
Stay interviews may also be referred to as retention interviews or stay conversations.
What does a stay interview look like?
A stay interview is often a one-on-one conversation between an employee and their direct manager or an HR team member. Stay interviews are structured by manager questions, and can take about 20 minutes to one hour to complete.
Sunny Betz and Rose Velazquez contributed reporting to this story.
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4 Ways to Fill Your Schedule
January 20, 2026
By Wendy S. Myers, CVJ
The 2026 economic outlook for veterinary practices is concerning, with visits, client numbers, and revenue trending downward.1 Veterinary appointments reportedly declined by 2.8 percent during the last 12 months.2
Because full schedules ensure healthy profits, experts advise aiming for an appointment fill rate of 85 percent.3 Exceeding 90 percent capacity could lead to less same-day appointment availability for sick patients, turn away new clients who can’t get timely care, and risk team burnout. Fill rates below 80 percent will hurt profits and limit employee wages. To calculate your appointment fill rate, take the number of appointments seen divided by the number of available appointments.
If your appointment fill rate drops below 85 percent, use these four strategies to fill empty slots:
1) Schedule progress exams at the end of visits
When acute issues, chronic diseases, or procedures require follow-up care, schedule progress exams as you wrap up each appointment. You will have more appointment availability and ensure timely care.
Say “progress exam” and never “recheck”
Clients may misinterpret “recheck” as optional and free care. The word “progress” shows you are moving forward in resolving the health concern and reiterates that follow-up care is medically necessary.
Book follow-up care in exam rooms
In dental practices, hygienists have greater success with pre-appointing patients than scheduling coordinators at checkout.4 By the time clients reach the checkout counter, they want to leave and may dismiss staff attempts to schedule. To improve compliance with follow-up care, have technicians book progress exams in exam rooms. If you don’t have computers in exam rooms and clients must schedule appointments at the front desk, put alerts in patient records so client service representatives (CSRs) know to schedule progress exams.
Lead clients to schedule
Pick the same weekday and time or use the yes-or-yes technique when booking follow-up care. Share benefit statements, such as getting the first appointment choice. Use the action word “needs” to indicate follow-up care is medically necessary instead of the wiggle word “recommend.” Book with the same veterinarian for exam efficiency and continuity of care.
Say, “Dr. needs to see in 10 days for a progress exam for the ear infection. Does this same time on fit your schedule?” Another opportunity is the yes-or-yes approach. Say, “Dr. has progress exams available on <date, time 1> or <date, time 2>. Which do you prefer?”
Contact clients who don’t book
Enter a medical callback or automated text. In this ear infection scenario, call the client or send a text three days later when seven days remain before follow-up care will be due, ensuring appointment availability
2) Offer online booking—especially for new clients
New clients account for eight percent of practice revenue but were reportedly down 8.6 percent in 2024.5 Offering online scheduling is a key strategy to attract new clients. Veterinary practices’ utilization of online booking grew 87 percent in 2025.6 New clients made 23 percent of online appointment bookings, and 37 percent of all online appointments were scheduled after business hours.
“Direct Booking has paid for itself. Being able to generate more appointments with new clients has been a benefit,” says Vincent Mancini, DVM, owner of Bonita Veterinary Hospital in Bonita Springs, Fla.
Millennials have digital-first preferences
As the largest segment of pet owners (33 percent), millennials overwhelmingly prefer online scheduling and forms.7 As the first generation to grow up with the internet, they find digital tools more convenient and efficient than traditional methods like phone calls and paper forms.
Send confirmations with digital forms upon booking
Your client communications platform can automatically send text and email confirmations with new client forms. This lets you set up the medical record and request records from a previous veterinarian or adoption paperwork in advance.
Enjoy faster check-ins
New clients can share patient details, including breed, birthdate, vaccine status, reproductive status, and more, through online forms—avoiding paperwork that could take up to 15 minutes during the appointment.
3) Move patients up to fill openings
Shifting patients up in the schedule to fill empty slots is known as “schedule optimization.” This strategy improves efficiency, resulting in fewer schedule gaps and more consistent patient flow. A veterinarian saw an average of 15 patients per day in 2024.1 Let’s say the doctor has seven empty slots on Tuesday. Look for sick pet appointments on Wednesday and Thursday that could be rescheduled for Tuesday. This fills empty slots, prioritizes scheduling for ill patients, and enhances client satisfaction.
Keep a wait list of clients who want to be seen sooner. Fill cancellations or no-shows from your wait list. Text will be the fastest way to reach clients about newly available appointments.
4) Forward book wellness appointments
Wellness appointments account for 24 percent of visits and are falling behind 2.9 percent.9 When a client visits for a pet’s wellness appointment, book the next care six or 12 months in advance, filling your future schedule. An American Animal Hospital Association (AAHA) report found that increasing forward booking appointments from 5 percent to 10 percent could grow revenue by three percent.10
Build your schedule 12 to 18 months out
Don’t worry if veterinarians’ schedules change. Doctors will request time off in advance for vacation and conferences, especially when booking travel. Simply contact clients with forward-booked appointments that need to be moved.
Pre-block wellness appointments
These wellness appointments are strategically placed as the first appointment of the day, before lunch, after lunch, and the last appointment of the day. These wellness pre-blocks help keep your schedule on time and ensure your team goes home at closing time, reducing overtime and stress.
Lead clients to forward book
Say, “Just as your dentist has you schedule your next appointment at checkout, we do the same to proactively manage your pet’s health. By scheduling today, you will get your first choice of doctor, date, and time. Dr. can see your pet on <date, time 1> or <date, time 2>. Which do you prefer?”
Have your hospital manager track appointment fill rates monthly. Adjust the schedule to respond to trends, such as adding more urgent care pre-blocks during busy summer months. Knowing fill rates also lets you tweak staffing levels and identify whether it is time to hire another veterinarian to meet appointment demands.
References
- Larkin M. Benchmarking Data Plus Elevating Efficiency Equals Practice Productivity. AVMA News. https://www.avma.org/news/benchmarking-data-plus-elevating-efficiency-equals-practice-productivity. Accessed Nov. 18, 2025.
- Veterinary Industry Tracker. Vetsource. October 2025 compared to October 2024. https://vetsource.com/products/data-services/veterinary-industry-tracker/. Accessed Nov. 18, 2025.
- Suiter A. Stop-Gap Measures. Today’s Veterinary Business. https://todaysveterinarybusiness.com/stop-gap-measures. Accessed Nov. 18, 2025.
- Faustino A. How to Improve Dental Recall with These Tips. https://capforge.com/how-to-improve-dental-recall-with-these-tips/. Accessed Nov. 18, 2025.
- Larkin M, Nolen RS. Less Foot Traffic at Veterinary Practices Spells Declining Revenue. AVMA News. https://www.avma.org/news/less-foot-traffic-veterinary-practices-spells-declining-revenue. Accessed Nov. 18, 2025.
- Beyond the Bark: Communications That Transform Clinic Success. Otto. https://otto.vet/client-engagement-2025/. Accessed Nov. 18, 2025.
- Megna M. Pet Ownership Statistics 2025. Forbes. https://www.forbes.com/advisor/pet-insurance/pet-ownership-statistics/. Accessed Nov. 18, 2025.
- How Brodheadsville Veterinary Clinic’s Staff Helps More Clients in Less Time with Flow. Available at: https://otto.vet/how-brodheadsville-vet-clinics-staff-helps-more-clients-in-less-time-with-flow/. Accessed Nov. 3, 2025.
- Gilmartin S, Yost B, Zirkle K. Behavior Shift: Implications of today’s pet owner trends on veterinary medicine in 2025. Vetsource. https://assets.vetsource.com/m/3e5197539521d838/original/DataServicesWhitePaper.pdf?&target=_blank. Accessed Nov. 18, 2025.
- Forward Booking: How Forward Booking Leads to Better Patient Care. AAHA. AVMA. https://www.aaha.org/wp-content/uploads/globalassets/04-practice-resources/Forward-booking. Accessed Nov. 18, 2025.
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DVM360 I Q&A: Set nutrition before surgery to improve outcomes
Author(s)Bob Alaburda, Associate Editorial Director, Vicky Ograin, MBA, RVT, VTS (Nutrition)
January 2, 2026
Good nutrition before and after surgery may improve healing and reduce complications.
In this dvm360 interview, Vicky Ograin, MBA, RVT, VTS (Nutrition) explains why the nutritional plan before surgery is important and how the microbiome fits into perioperative care.
What do you tell owners about diet before and after elective surgery?
Ograin: I like to broaden this beyond recovery and think about the before. Are they eating a complete and balanced diet. If a patient is malnourished it will make recovery harder. For elective procedures I want them in a good nutritional plane before anesthesia. If the gut is working after anesthesia, we should use it. In the hospital I give a light meal as they wake up and send them home with small meals to start. If we are going to recommend something bland like chicken and rice, I explain that it is not balanced and is only for the very short term. I prefer sending clients home on a highly digestible GI diet that is complete and balanced, so the patient gets the nutrients needed for healing.
How do you collect a diet history and act on it when a pet is coming in for surgery?
Ograin: For an elective case take a thorough history so you know what they are eating and why. If the diet is not supporting recovery, we can change it before surgery when the timing allows. For emergencies we do what we must, but when we can delay an elective procedure, it is often worth improving nutrition first, so the animal has a better chance to heal.
How do you respond when an owner arrives convinced by Dr Google or other online advice?
Ograin: Do not judge. Owners love their pets and are often trying to do the right thing. A confrontational response shuts them down. Acknowledge their concern, explain what is incorrect, give clear, compassionate rationale, and check their understanding. Most pet parents accept the recommendation once they see the why behind it.
What role does the microbiome play in surgical recovery?
Ograin: The GI microbiome is a major part of the immune system. Estimates are that 70 to 80 percent of immune activity is gut related. A healthy microbiome supports immune function and healing. Prebiotic fiber feeds beneficial bacteria. Ingredients like FOS, MOS, and beet pulp in proper amounts help maintain that healthy state. Some clinicians also use probiotics. Many commercial foods now incorporate prebiotic fibers so you can help build a healthy microbiome before surgery.
Is nutrition an optional extra or a critical part of treatment plans?
Ograin: Nutrition is critical. It is the basis of everything. For conditions like cancer or recurrent uroliths proper diet supports healing and can help manage disease long term. Improving nutrition can reduce recurrence and improve quality of life and longevity. If we want the best surgical and medical outcomes nutrition must be part of the plan.
One quick tip vets can share with clients?
Ograin: Take a diet history before surgery. If the patient is not on a complete and balanced diet, consider changing it before the procedure. Use small, digestible meals as the patient wakes up and send home a GI diet that is complete and balanced rather than an unbalanced bland home mix.
Anything else you are working on that clinicians should know
Ograin: I am focusing on new pet food label regulations and how to help pet parents interpret labels. Packaging and labeling rules are changing and may be confusing. My goal is to educate veterinary professionals so they can guide owners through the new information.
https://www.dvm360.com/view/q-a-set-nutrition-before-surgery-to-improve-outcomes
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Protecting Veterinary Staff from Rabies I What Every Vet Team Should Know
Rabies remains a fatal but preventable viral disease transmitted through the saliva or nervous tissue of infected mammals. Veterinary professionals are at the front lines of exposure risk — especially when handling unknown, injured, wild, or unvaccinated animals. Fortunately, there are clear steps to protect yourself, your team, and your practice.
1. Pre-Exposure Vaccination (PrEP)
Who needs it:
Veterinarians and veterinary staff who routinely work with animals — especially those that could carry rabies — should receive rabies pre-exposure prophylaxis. This includes veterinarians, technicians, assistants, students, and anyone who may handle high-risk species.CDC+1
Vaccine schedule:
The standard human pre-exposure vaccination involves a series of three injections given intramuscularly on days 0, 7, and 21–28. This stimulates protective antibody levels and simplifies follow-up care if an exposure occurs.nwcphp.org
Why it matters:
- Makes post-exposure treatment simpler and less intense.
- Provides defense in cases of unrecognized exposures.
- Recommended for high-risk occupational groups even where rabies is rare.nwcphp.org
2. Post-Exposure Protocol
If you are bitten or significantly exposed to saliva or nervous tissue:
- Immediate wound care: Wash thoroughly with soap and water.
- Seek medical care: Follow CDC and public health guidance for post-exposure prophylaxis (PEP) — usually involving rabies immune globulin and additional vaccine doses.
- Report and document: Notify your practice supervisor and occupational health team immediately.Los Angeles County Public Health
Exposure does not always mean a rabies infection, but prompt action can be lifesaving.
3. Personal Protective Equipment (PPE)
When handling animals that might be infectious — especially wildlife or symptomatic mammals — use proper PPE:
- Gloves (latex or nitrile)
- Eye protection (goggles or face shield)
- Mask (N95 or equivalent)
- Smock or lab coat
This minimizes contact with saliva, nervous tissue, or other potentially infectious materials.CDC
4. Practice-Wide Safety Measures
✔ Encourage vaccination of all staff members who handle animals — including front-desk and support personnel who may occasionally have contact with animals.AAHA
✔ Educate your team on recognizing clinical signs of rabies in animals (e.g., abnormal behavior, excessive salivation, paralysis).CDC
✔ Document exposures and injuries — including bites and scratches — in accordance with practice policies and OSHA guidelines.CDC Stacks
✔ Create clear protocols for handling potentially rabid animals, including when to use additional PPE and when to involve public health authorities.CDC
Key Takeaways
- Rabies is preventable with vaccination and proper precautions.
- Do not rely solely on observation or guesswork — pre-exposure vaccination is a cornerstone of occupational safety.
- Prompt post-exposure action saves lives — both human and animal.
- Safety begins with education and ends with consistent, practice-wide implementation.
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AVMA News I CVTEA announces accreditation decisions
Published on December 24, 2025
The AVMA Committee on Veterinary Technician Education and Activities (CVTEA) released its most recent accreditation decisions from its meeting, held November 6-8 at AVMA headquarters in Schaumburg, Illinois.
Currently, there are 217 CVTEA-accredited veterinary technology programs. Of these, 85% have full accreditation, 10% initial accreditation, 4% probationary accreditation, and 1% voluntary terminal accreditation.
This latest accreditation decisions saw the awarding of initial accreditation to Southern Union State Community College in Valley, Alabama, effective this past September.
The AVMA Committee on Veterinary Technician Education and Activities is the primary accrediting body for veterinary technology programs in North America.
The AVMA Committee on Veterinary Technician Education and Activities is the primary accrediting body for veterinary technology programs in North America.
Additionally, the CVTEA made the following determinations on veterinary technology programs it reviewed during the meeting: 83 will continue on full accreditation, one—YTI Career Institute in York, Pennsylvania—was returned to full accreditation, seven will continue on initial accreditation, and five will continue on probationary accreditation.
Voluntary terminal accreditation, effective November 8, was granted to Edison State Community College in Piqua, Ohio, and Stautzenberger College in Brecksville, Ohio. Continued voluntary terminal accreditation was granted to Ashworth College in Norcross, Georgia, while accreditation was withdrawn from San Joaquin Valley College in Fresno, California, effective October 18.
The CVTEA also voted to continue the emergency conditions policy on avian skills in its Accreditation Policies and Procedures Manual until June 2026, when the policy will be reviewed.
The committee’s next meeting is April 23, 2026.
https://www.avma.org/news/cvtea-announces-accreditation-decisions
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TVP | Shifting Our Mindsets to Spectrum of Care Practice
Veterinary teams that embrace spectrum of care practice are curious, creative, and compassionate and prioritize clear communication to maximize outcomes for their patients and clients.
Kate Boatright, VMD
December 10, 2025
Despite years of discussing ways to improve access to veterinary care, the most common barrier to care for pet owners—finances—continues to grow. The 2025 Lifetime of Pet Care Study by Synchrony found that lifetime costs of care increased significantly for both dogs and cats between 2022 and 2025 (11.65% and 19.4%, respectively).1 Additionally, the number of pet owners reporting unexpected veterinary expenses that caused financial concern increased from 1 in 3 to nearly 1 in 2.1
PetSmart Charities and Gallup surveyed pet owners in late 2024 and early 2025 and found 52% of pet families reported declining recommended veterinary care in the past year.2 Of those pet owners who took their pet to the vet but declined care, cost was the reason given in 71% of cases.2 But what may be more concerning from an access to care perspective is that the majority of these pet owners (73%) reported that they were not offered a lower-cost alternative.
The data show that our work to improve access to veterinary care is far from finished. While the ultimate solutions will require collaboration between multiple stakeholders and systemic change in the animal health industry, there are changes that can be made by individual veterinarians and their teams that can help support clients who struggle with cost and other barriers to care.
The Need for a Spectrum of Care
Costs of veterinary care have risen rapidly over the past decade, up around 60% since 2014.3 This rise outpaces inflation and is driven by many factors, including rising costs of goods, supplies, and equipment as well as increased staffing costs.4 Additionally, veterinary medicine continues to evolve in complexity—with increased specialization, advanced technology, innovative drugs, and novel therapeutic options—which influences costs of care and the recommendations that veterinarians make for their clients.
It is essential that veterinarians and their teams remember that despite ever-advancing technology and treatment options, there remains a wide range of diagnostic and treatment options for most conditions. This range of options has become known as the spectrum of care (SOC) or contextual care.5-7 Veterinary teams that embrace SOC practice are curious, creative, and compassionate and prioritize clear communication to maximize outcomes for their patients and clients. See FIGURE 1 for an algorithm outlining the SOC approach.
Evaluating Curiously
Practicing SOC requires veterinarians to consider both the humans in the room as well as the patient. While we must advocate for our patients’ welfare with our recommendations, we should consider the individual barriers that a client may be facing.8,9 In fact, the 2024 update to the Principles of Veterinary Medical Ethics now includes offering contextual care to clients.
While many start the SOC conversation with finances, there are a wide range of barriers that may alter the diagnostic and treatment plan for a given patient. These can be broken down into several categories8,9:
- Patient factors, including temperament; fear, anxiety, and stress levels during transport and in the clinic; and medication tolerance.
- Client factors, including financial limitations, transportation, scheduling limitations for follow-up appointments and medication administration, personal goals and values, other caregiving responsibilities, past experiences, medical knowledge level, physical limitations, and caregiver burden.
- Veterinarian and veterinary team factors, including experience; knowledge of available options; personal comfort levels, morals, and ethics; education and training; and skill level.
- Clinic factors, including proximity to a specialty hospital, scheduling availability, equipment, staffing, and payment options.
It is essential that veterinary teams take the time to engage in goals-of-care conversations with their clients and identify barriers that could be a factor in each appointment. This is achieved through open-ended inquiries, which invite clients to share their stories, perspectives, concerns, and opinions.11 Veterinary professionals must not only ask these questions but stop and listen to the client’s response without interruption. These basic communication skills lay the foundation for building a partnership with the client, which is essential for maximizing outcomes in SOC practice.
Beginning this dialogue early in the appointment can help veterinary teams anticipate potential barriers. This can help the veterinarian customize the options presented, but the information should not be used to make assumptions about what a client might choose or limit which options are discussed. Dialogue about the client’s goals and potential barriers should continue throughout the appointment as more information about the patient’s condition is learned through the physical examination and diagnostic testing.
Thinking Creatively and Critically
Developing a range of diagnostic and treatment options requires a combination of creative and critical thinking on the part of the veterinarian. Integrating the patient’s history, signalment, and physical examination findings to create a differential diagnosis list is the first step to creating diagnostic recommendations.
The diagnostic tests that can be pursued in any given case are most often limited by finances, equipment availability (e.g., advanced imaging), and patient cooperation. Veterinarians should carefully evaluate their diagnostic recommendations, considering the goal of each test. Testing that provides information that is unlikely to alter the treatment plan should be limited. Additionally, consider if there are other ways to obtain information that may be more cost effective (e.g., a PCV and blood smear instead of a CBC, a smaller chemistry panel). In some cases, diagnostics may not be feasible at all. Instead, an empirical treatment trial may be started.
When considering therapeutic options, veterinarians should keep in mind the client’s ability to adhere to the treatment plan as well as the likelihood of patient compliance. Ask clients about their comfort with administering medication by different routes, their past experiences with medicating the patient, and if their schedule allows them to medicate the pet at the planned frequency. Requirements for monitoring and follow-up should also be discussed. Treatment plans may need to be adapted based on the responses to these questions.
Evidence-based medicine should be used as much as possible to guide diagnostic and therapeutic recommendations. In the current literature, there is often more evidence to support the traditional “gold standard” approach to case management, which can make some veterinarians uncomfortable proceeding differently. Thankfully, there is a growing body of evidence to support SOC options in veterinary medicine. As more data are published, veterinarians will have more confidence discussing alternative options and can more clearly communicate anticipated outcomes to clients.
Communicating Options Compassionately
Successful SOC practice requires clear communication with clients. This allows veterinarians to determine what barriers to care need to be considered and to engage in shared decision making with the client. Shared decision making is preferred by veterinary clients and improves client satisfaction when it is used. This style of decision making has 3 components11:
- Team talk, during which the partnership between veterinary team members and client is established
- Option talk, where each option is presented along with associated risks, benefits, and costs
- Decision talk, when all parties engage in a dialogue to determine the best plan
The order in which options are presented to a client can affect the decision that is made and how the client feels about that decision. Clients are often biased to believe that the first option they are offered is the best.12 If veterinarians always present options from the most to least expensive or intensive, even if a client has expressed a limitation that would prevent them from pursuing the most expensive option, the client may feel shame or guilt for not choosing the first option.4,12 In reality, the best choice for a pet will vary based on the individual patient and client context.
Options should be presented with empathy and in a way that tries to minimize judgment. This may look like presenting an option starting with what seems like the best fit for the client based on the initial goals-of-care conversation followed by the alternatives. For example, a veterinarian might say, “Based on what you shared earlier about your concerns for medicating Fluffy, we could try [option A]. A more aggressive approach would be [option B]. Or a less aggressive approach would be [option C].”
Veterinarians should invite clients to share their thoughts, questions, and concerns about the options, as well as the final plan, using open-ended inquiries such as, “What other questions do you have about these options?” or “Tell me how you’re feeling about the plan we’ve developed today.”
Documenting Thoroughly
Some veterinarians express concerns that pursuing plans that differ from the traditional textbook approach increase their risk of complaints and board discipline or lawsuits. In truth, as long as the minimum standard of care is met, informed consent is obtained, and all conversations are documented completely, there is no increased risk of liability.12,13 While this does not mean that complaints won’t be filed by clients—the best protection against this is clear and compassionate communication—it does mean that SOC practice does not inherently increase liability risk when it is done well.12 In fact, not informing clients of a full range of options may open veterinarians to liability as well.
Obtaining informed consent is essential to meeting the requirements of the regulatory boards and protecting oneself from liability. The key components to obtaining informed consent are communicating the options, including the risks, benefits, and possible outcomes, in a way that the client understands and obtaining the client’s permission to move forward with the agreed-upon diagnostic or treatment plan.12 It is important that all options discussed are documented in the medical record, which is the best protection against liability in the event a complaint occurs. Additionally, veterinarians must remember that informed consent must be reestablished as the case progresses, particularly if the owner’s circumstances or patient’s status changes or if new information is learned that changes the available options or potential outcomes.
The Future of Veterinary Medicine
It is more important than ever that the veterinary profession practices SOC as pet families face a growing number of barriers to care. Remaining blind to these barriers will only increase the number of patients going without care and risk eroding the trust that the veterinary profession has historically held. By engaging clients in goals-of-care conversation to identify barriers to care, presenting diagnostic and therapeutic plans that are based in evidence and responsive to these individual barriers, and discussing options in a way that educates clients and invites them to be an active participant in their pet’s care, veterinarians will master the art of SOC, which is, at its core, what veterinary medicine was meant to be.
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AVMA News I NAVLE will undergo independent audit
Published on December 12, 2025
The 2024-25 testing cycle for the North American Veterinary Licensing Examination (NAVLE) saw a record-number of 9,301 examinations administered, a 51% increase over the past five years. The test has been administered by the International Council for Veterinary Assessment (ICVA) since 2000, and is developed in cooperation with the National Board of Medical Examiners (NBME). It is offered at Prometric computer testing centers throughout North America and certain international locations during three annual testing windows: October-November, March, and July-August.
The ICVA issued a statement on December 1 saying it has agreed to initiate an audit of the examination.
“The North American Veterinary Licensing Examination (NAVLE) is the cornerstone ensuring veterinary excellence across North America and all of us at the ICVA are committed to ensuring that all members of the veterinary community feel confident in the exam’s rigor and impartiality.
Person reading a book at a desk
The North American Veterinary Licensing Examination is a nationally standardized test that consists of 360 multiple-choice questions. In addition to being a requirement for licensure in the U.S. and Canada, it is a North American standardized test designed to assess entry-level private clinical practice.
Recently, members of the veterinary community have raised questions around how the NAVLE is developed, administered, and scored. To ensure the NAVLE continues to be a fair and impartial assessment of candidates’ entry-level knowledge, skills and abilities, we have made the decision to initiate an audit of the examination.
We are in the early stages of the process and will continue to keep the veterinary community updated.
We remain committed to all members of the veterinary community as we continue to ensure veterinary excellence that puts the welfare of all animals first and foremost.”
The ICVA, in its 2024-25 Annual Report, noted that it conducts practice analyses periodically and that previous ones were completed in 2003, 2010, and 2017. The ICVA does this to “identify the knowledge and tasks critical for safe and effective veterinary practice. The findings are then used to update the NAVLE blueprint, keeping the assessment aligned with the skills and competencies expected of newly licensed veterinarians,” according to the report.
https://www.avma.org/news/navle-will-undergo-independent-audit
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Vet Record I Development of a proptosis model as a surgical training tool for veterinary students and practitioners
Oren Pe’er, Lionel Sebbag, Ron Ofri
December 2, 2025
INTRODUCTION
Proptosis, or forward displacement of the eye beyond the eyelid margins, is a frequent and critical emergency in companion animals that necessitates immediate intervention to preserve ocular function and prevent permanent vision loss.1-4 This condition, often resulting from trauma (e.g., vehicular accidents, dog bites), is particularly prevalent among brachycephalic breeds owing to prominent ocular anatomy.5 The prognosis for vision and globe retention depends not only on the extent of the trauma but also on the timeliness and accuracy of the surgical intervention, specifically repositioning the globe and performing a temporary tarsorrhaphy.1, 2, 4 Thus, early and effective training in proptosis management is crucial for practitioners, given the acute nature of the emergency and the potential for serious long-term sequelae if improperly managed.1
Despite the importance of proptosis management skills, practical opportunities to train veterinary students and early-career practitioners in this procedure are often limited. Proptosis cases occur sporadically in most clinical settings, and ethical concerns restrict the use of cadavers or live animals for training purposes.6, 7 Consequently, many veterinarians may enter practice without hands-on experience or adequate confidence in managing such emergencies. This gap in training underscores the need for alternative methods to simulate proptosis cases, allowing students and practitioners to develop both technical skills and decision-making abilities in a controlled, anatomically representative environment. Synthetic models have gained traction in veterinary education as a solution for ethical and effective skill acquisition in various surgical procedures. Models are increasingly recognized for their ability to simulate specific aspects of animal anatomy, enabling repetitive practice and skill mastery without the disadvantages associated with cadaver training.8-16
The purpose of this study was to develop a novel synthetic model replicating key anatomical features and mechanics of the canine eye. By allowing trainees to practice proptosis management, including proper temporary tarsorrhaphy techniques, this model aims to improve both technical competency and confidence in handling proptosis emergencies.
METHODS
Model design
The synthetic proptosis model in this study was developed based on clinical and educational experience of board-certified veterinary ophthalmologists who are faculty members in a veterinary teaching hospital, aiming to mimic key anatomical and mechanical features of the canine eye relevant to globe replacement and tarsorrhaphy. Rather than relying on formal material trials, the design process involved iterative evaluation by experienced veterinary ophthalmologists to identify materials that balance realism with practicality in a teaching context. The structure is composed of components chosen for their durability, ease of handling and tactile response, aiming to provide a functional and accessible training platform for repeated practice.
At its core, a smooth wooden sphere serves as the ocular globe, offering stable resistance and a curved surface suitable for needle penetration and suture handling. This ‘eye’ is placed within a Lycra pouch, selected for its elastic properties, which realistically simulate eyelid retraction and closure dynamics. The Lycra margins are marked with small white dots, visually representing meibomian gland openings, thereby guiding accurate placement of temporary tarsorrhaphy sutures.
The globe-in-pouch assembly is seated within a gauze-lined plastic cup, functioning as an orbital cavity that supports consistent positioning of the ‘globe’. A base of modelling clay beneath the cup provides structural anchoring and allows for customisable orientation. The entire unit is affixed to a non-slip, rigid platform, facilitating secure manipulation during simulated procedures.
While the model accurately simulates globe replacement and tarsorrhaphy, its design does not allow for procedures involving other orbital dissection, such as lateral canthotomy, which requires dynamic soft tissue compliance and periocular anatomic planes not represented in this model.
Participants and training
Sixteen participants, comprising 14 veterinary interns and two final-year veterinary students, were recruited for the study. Participants had no prior experience with proptosis management except for three of 14 interns who were each involved with one proptosis surgery in a dog. The study was reviewed and approved by the Human Subjects Institutional Review Board of the Hebrew University of Jerusalem (AGHS/May-18.22).
Each participant underwent a standardized training session consisting of a lecture on ocular proptosis and surgical repair according to Foote and Sebbag,2 followed by pre- and post-session surveys to evaluate skill acquisition, confidence levels and the model’s perceived realism. Participants were paired, with each taking turns practicing on the proptosis model under close supervision by board-certified ophthalmologists (O.P. and L.S.). Standard surgical instruments, including needle holders, Adson’s forceps, Allis forceps, suture scissors, stents and 4-0 nylon suture with a cutting needle, were provided. The surgical steps for correcting proptosis using the model, which closely resembles the clinical procedure, are shown in Figure 2. A dynamic visual guide to the technique is also available (Supporting Information S1). The initial step involved repositioning the wooden ball, representing the globe, into the ‘orbit’ before suture placement. This positioning was essential to facilitate suture passage through the eyelid margins while minimising the risk of accidental trauma to the globe during needle insertion. Once the globe was correctly repositioned, two to three partial-thickness horizontal mattress sutures were placed using non-absorbable 4-0 nylon suture with stents, positioned to appose the upper and lower eyelids. Careful suture placement was critical: the needle was guided through the white dots representing meibomian gland openings, avoiding the inner Lycra material that mimicked the palpebral conjunctiva. To further clarify, the needle was passed through the ‘stroma’ of the Lycra pouch and directed to exit at the level of the white dots simulating the eyelid margin—that is, the anatomical mucocutaneous junction of the eyelid where meibomian gland openings are located. This visual landmark on the model was used to guide suture passage in a way that reflects clinical practice. Sutures were tightened sufficiently to ensure that no gaps remained between the upper and lower eyelids.
Stepwise procedure of globe repositioning and temporary tarsorrhaphy using the synthetic proptosis model. (a and b) High-density wooden globe, encased in a Lycra pouch that simulate the eyelids, is initially positioned to protrude from the eyelid margin, representing proptosis. (c–e) Initial step involved repositioning the globe (wooden ball) in the ‘orbit’ before suture placement to facilitate precise suture passage through the eyelid margins while minimising the risk of accidental trauma to the globe during needle insertion. (f–i) Placement of two to three partial-thickness horizontal mattress sutures using non-absorbable 4-0 nylon, with IV tubing stents to align and secure the upper and lower eyelids (see video in Supporting Information S1).
Survey and data collection
Participants completed pre- and post-training surveys to assess their confidence in performing proptosis surgery (Supporting Information S2), as well as the model’s anatomical realism and ease of use. Responses were recorded on a visual analogue scale (VAS) ranging from 0 to 10. Changes in confidence levels before and after training were analysed using Student’s t-test, with statistical significance defined as p-value less than 0.05.
RESULTS
Sixteen participants (14 interns and two final-year students) completed pre- and post-training surveys assessing self-confidence, model realism and procedural understanding. The group included three interns with minimal prior experience (one case each), while all others were naïve to the procedure. Survey results are presented in Table 1. A statistically significant increase in self-confidence was observed following model-based training, with VAS scores rising from a mean of 4.3 ± 2.5 to 8.1 ± 1.6 (p = 0.0005). Participants rated the model highly in terms of anatomical realism (8.3 ± 0.7), ease of use (8.4 ± 1.8) and educational value across key procedural steps (e.g., suture placement: 9.1 ± 1.2).
When asked about potential improvements to the model, eight participants indicated that they would not make any changes. One participant expressed a preference for using live animals, while another suggested adding features such as nerves and blood vessels to enhance anatomical realism. Additional suggestions included using alternative fabrics, decorating the model to increase visual appeal, and improving its adherence to the table for greater stability during procedures. Two participants, both veterinary interns, reported challenges in performing the procedure correctly and expressed a desire for further practice with suturing to enhance their proficiency.
DISCUSSION
The development of this high-fidelity synthetic proptosis model represents an important advancement in veterinary surgical training, particularly for emergency ophthalmic procedures where cadaver use poses ethical and logistical challenges.1, 6, 17 Synthetic models provide an ethical, standardized training platform that allows for repetitive hands-on practice, ultimately enhancing both confidence and competence among veterinary students and practitioners.9, 11-13 This is further demonstrated by a recent meta-analytic study reporting the superior effectiveness of simulation-based instruction compared to traditional training methods in veterinary education.18 Unlike cadaver-based training, which requires access to preserved biological tissue and presents challenges related to variability and availability, our synthetic model provides a uniform and reusable alternative. It enables early-stage learners to develop critical surgical skills—such as eyelid manipulation and temporary tarsorrhaphy—using a high-fidelity platform without the ethical or logistical burdens of cadaver use. While cadaver heads remain important for advanced anatomical dissection in specialist training, and pig eyes have been used in some training settings to simulate proptosis,2 these approaches are limited by biological variability, tissue degradation and ethical considerations. In contrast, the synthetic proptosis model presented in this study offers a reproducible, accessible and standardized solution for veterinary students and other trainees engaging in foundational ophthalmic procedures. Although veterinary students represented a small proportion of participants in this study, the model demonstrated substantial educational value across all training levels, including interns with limited clinical experience in proptosis correction.
A key component of any educational model is its ability to accurately replicate real-life conditions.19 The synthetic proptosis model in this study was carefully designed to mimic the anatomical and mechanical properties of a canine eye during a proptosis event. Participants rated the model’s effectiveness in teaching proptosis repair with a mean score of 9.5 out of 10, underscoring its utility as a high-quality training tool. Similarly, the anatomical realism of the model received high scores (8.3/10), demonstrating its capability to provide an accurate and immersive experience that closely mirrors clinical situations. Although not objectively evaluated, qualitative observations during training sessions supported these quantitative findings; as participants repeated the tasks, there was a noticeable increase in dexterity, precision and comfort with the surgical instruments, especially when performing critical steps such as temporary tarsorrhaphy. Real-time supervision and feedback were particularly beneficial, allowing participants to make adjustments during practice, which further accelerated skill acquisition and confidence.20, 21
Participant confidence to perform proptosis replacement surgery increased significantly from 4.3 ± 2.5 pre-training to 8.1 ± 1.6 post-training (p = 0.0005). This confidence boost is crucial,22 as self-assuredness is essential in high-stakes surgical scenarios such as proptosis repair, where practitioners must remain calm and precise under pressure. This aligns with previous studies that developed synthetic models across various veterinary procedures, such as canine castration,11 ovariohysterectomy9 and blood vessel ligation,12 all of which have shown to significantly enhance students’ skills and self-assurance in handling clinical cases.
While self-reported confidence is a valuable outcome, it represents only one dimension of clinical readiness. Incorporating objective assessment tools could substantially enhance the educational rigor and validity of simulation-based training. Structured evaluation systems—such as Objective Structured Assessment of Technical Skills, task-specific checklists and global rating scales—have been shown to improve inter-rater reliability and provide standardised criteria for procedural competence.11, 23 Moreover, such tools may help mitigate cognitive biases, including overconfidence and premature closure, by offering externalised and consistent feedback. Future iterations of our training model may benefit from integrating these objective metrics to allow for benchmarking of skill acquisition and longitudinal performance tracking.
Although the VAS offered a practical and intuitive means of capturing trainees’ perceptions and self-assessed confidence, it may have limited the depth of insight into the learning experience. In future studies, combining VAS scores with Likert-scale items,24 procedure-specific performance checklists11 and open-ended qualitative questions25 could yield a more comprehensive and nuanced evaluation. These additional tools may help capture a broader range of trainee feedback—from technical difficulties and perceived realism to reflective learning processes and critical thinking development. Despite the synthetic model’s success, there are limitations that future iterations should address. While the materials used provided effective simulation, they do not fully capture the biological variability and tactile feedback inherent to living tissue. For example, pronounced retrobulbar oedema in clinical proptosis cases often complicates globe replacement, occasionally necessitating a lateral canthotomy—an aspect not simulated by this model. Future versions might benefit from incorporating materials that can better emulate the soft tissue resistance and anatomical variability of live patients. Advanced materials, such as silicone-based or biomimetic compounds, could offer more nuanced feedback, thereby increasing realism.
The study’s sample size, although effective in detecting a statistically significant increase in confidence levels, was limited and may affect the generalizability of the findings. Larger sample sizes in future studies could help determine if the confidence and skill improvements observed are consistent across a broader cohort. Additionally, while the majority of participants were interns with limited surgical experience, some had more exposure to similar procedures, which may have influenced self-assessed confidence and performance scores. Evaluating the model with users across a wider range of experience levels, including experienced veterinarians, could provide a comprehensive assessment of the model’s effectiveness and identify specific training benefits for different skill levels.
In addition to its role in foundational training, the model may also serve as a valuable refresher tool for experienced clinicians returning to practice after extended absences due to illness, parental leave or career transitions. Its ability to simulate a critical emergency procedure in a low-risk, high-fidelity setting makes it ideal for re-entry training programmes and continuing professional development. More broadly, simulation has emerged as a key strategy for maintaining surgical competence, reinforcing rarely used skills and promoting clinical confidence throughout a veterinarian’s career. Importantly, recent studies have also demonstrated the role of simulation in reducing cognitive biases by encouraging structured reflection, deliberate practice and feedback-driven improvement.26-28 These elements foster sound clinical judgment and align with educational paradigms that prioritise cognitive resilience and lifelong learning.
While our cohort was composed mostly of interns, future studies should consider stratifying participants by experience level and directly comparing outcomes of novice, intermediate and advanced users. Such stratified analysis would allow for the identification of specific learning curves and gaps in procedural proficiency of the different trainee groups. A relevant example can be found in human ophthalmology, where the EyeSi surgical simulator has been widely adopted not only for training but also for standardised assessment of ophthalmic surgical skills across different learner stages.29 This reflects a broader trend in ophthalmic education, where simulation-based surgical training and assessment are increasingly validated and integrated into curricula.30 Applying a similar framework in veterinary education could help validate the model’s utility as both a formative and summative assessment tool, and allow the development of tailored simulation curricula for trainees at various stages of experience, ranging from undergraduate education to continuing professional development.
Expanding this model to simulate other ophthalmic conditions offers promising educational potential.31 Developing synthetic models for additional eye conditions such as adnexal masses, entropion and corneal ulcers could broaden the scope of hands-on training available in veterinary education, equipping practitioners with essential skills across a range of ophthalmic procedures. Likewise, modern three-dimensional printers can be used to model orbital fractures and other pathologies, enhancing the anatomical fidelity and versatility of future training tools without use of cadavers.
CONCLUSION
The synthetic canine proptosis model presented in this study may serve as a valuable and practical training tool, providing an ethical and effective alternative to cadaver training. By facilitating high-fidelity, repeatable practice, the model significantly enhances the surgical confidence and competence of veterinary students and early-career practitioners, helping to establish a high standard of care in veterinary general practice when dealing with traumatic ocular proptosis.
https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.5924
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DVM 360 | Top questions on New World screwworm: What every veterinarian should know
December 1, 2025
Author(s)Bob Alaburda, Associate Editorial Director
Fact checked by: Abi Bautista-Alejandre, Assistant Editor
A concise Q&A for veterinarians summarizing identification, reporting, treatment, prevention, and practical next steps as New World screwworm approaches the US border.
New World screwworm (Cochliomyia hominivorax) is once again an active threat in the Americas. Cases in Mexico have risen and detections are approaching the US border, while federal agencies and veterinary groups have released guidance for clinicians on identification, laboratory submission, reporting, and therapeutic options.
Below are the most common and practical questions clinicians are asking, with concise answers with links to supporting resources and USDA/CDC guidance where appropriate.
What is New World screwworm and how does it present clinically?
New World screwworm (NWS) larvae cause primary myiasis by burrowing into and feeding on living tissue. Affected animals often present with foul-smelling, expanding wounds with visible, active maggots. Mucosal infestations of nose, mouth, or ears can also occur and are especially destructive. For clinicians, larvae are typically oriented head-down (posterior spiracles exposed) and wounds can expand quickly if not treated.1
Read more about identification and clinical signs: Screwworms: when the larvae don’t care about boundaries
Is screwworm in the US now? How close is it?
As of recent federal and dvm360 reporting, screwworm detections in Mexico have surged and cases have been detected within approximately 70 miles of the US border. The USDA reported that the parasite is actively moving northward and that border-proximate detections have increased concern. That proximity prompted US trade and surveillance actions earlier this year.
Read more about the current status and risk: New World screwworm detected less than 70 miles from the US–Mexico border and Vet Watch updates
Quick NWS facts
What it is: Cochliomyia hominivorax are obligate parasites that infest and consume living flesh of warm-blooded hosts, which causes facultative myiasis.1
Recent proximity: Confirmed cases have been reported within approximately 70 miles of the US border.3
USDA actions: USDA is working on sterile-fly production/dispersal facilities and has stepped-up surveillance; sterile-insect technique is central to eradication.10
FDA actions: EUAs issued for lotilaner (Credelio) in dogs on October 24, 2025, and cats (Credelio CAT) on November 21, 2025.5-7
When to suspect: Foul odor, expanding wound, visible larvae oriented head-down. Preserve larvae in 70% ethanol for lab ID.1,4,9
Who do I notify and how do I submit specimens if I suspect New World screwworm?
USDA guidance is to immediately notify your state animal health official and your regional Animal and Plant Health Inspection Service (APHIS) office. APHIS has a dedicated NWS response resource with standard operating procedures (SOPs), reporting flows, and a “stop-screwworm” information hub for clinicians. The CDC also provides clinical guidance for human cases. Follow APHIS SOPs for quarantine, movement restrictions, and premises disinfestation if a confirmed case occurs.4
As for submissions: According to APHIS, preserve larvae in leak-proof containers with 70% ethanol (or ≥70% isopropanol, or 5–10% formalin if necessary). Aim to submit multiple larvae in various stages. Follow your state animal health office and APHIS SOP for sample submission and chain-of-custody. If possible, photograph the lesion and preserve live larvae separately (if the lab requests live specimens).4
Read more about reporting and get specimen guidance: New World Screwworm Emergency Response
What are the current treatment options for infested animals?
Treatment is primarily mechanical removal of larvae coupled with wound debridement, topical care, and systemic support. In 2025, the FDA issued emergency use authorizations (EUAs) allowing lotilaner (Credelio) for dogs and lotilaner chewables (Credelio CAT) for cats as therapeutic options under EUA conditions; follow FDA EUA and local regulatory guidance when using these products for NWS. Also use standard wound care, antibiotics if indicated, and re-examine lesions within 24–48 hours to ensure no live larvae remain.5-7
Read more about treatment and EUAs: FDA grants EUA for lotilaner in dogs and Antiparasitic receives FDA emergency authorization to treat NWS in cats
What should I tell clients for prevention and protection of pets and livestock?
Advise owners to promptly treat and protect open wounds, practice routine wound checks, and keep companion animals on year-round effective parasiticides when risk is high. Christopher Lee, DVM, MPH, DACVPM, DACVM (Parasitology); Cert: FFC, CFV, RECOVER-ALS, has recommended isoxazoline-class products as one protective measure to kill larvae acquired by pets. For livestock, emphasize wound management, good husbandry, minimizing fly attraction, and rapid reporting of suspicious cases.8
Watch now to learn more about client education and prevention: Vet Watch: do you have normalcy bias?
What should clinics do to prepare?
According to APHIS, update your clinic’s wound-management protocols and specimen submission checklists, brief staff on identification and personal protective equipment (PPE) for handling larvae, and have contact info for your state animal health official and APHIS accessible. Consider stockpiling recommended topical/systemic wound care products and have an isolation/quarantine plan for affected patients. Also review recorded USDA/CDC webinars for staff training.4
Are there one-health or human health concerns I should be aware of?
According to the CDC, human infestations are uncommon but possible. Clinicians should counsel clients that NWS can rarely infest humans when there are exposed wounds or mucosal lesions. If there is potential human exposure, notify public health authorities and follow CDC clinical guidance. Collaboration between veterinary and public health agencies is a core part of the federal response.9
Read more about NWS and CDC guidance: Clinical Overview of New World Screwworm
References
Centers for Disease Control and Prevention. DPDx – New World Screwworm (myiasis). September 10, 2025. Accessed December 1, 2025. https://www.cdc.gov/dpdx/newworldscrewwormmyiasis/index.html
Mexico Confirms Case of New World Screwworm in Nuevo Leon. US Department of Agriculture Animal and Plant Health Inspection Service. News release. September 21, 2025. Accessed September 22, 2025.
Bautista-Alejandre A. New World screwworm detected less than 70 miles from the US-Mexico border. Dvm360. September 22, 2025. Accessed December 1, 2025. https://www.dvm360.com/view/new-world-screwworm-detected-less-than-70-miles-from-the-us-mexico-border
U.S. Department of Agriculture, APHIS. Standard Operating Procedure for Possible Detections of New World Screwworm in Animals. (PDF). Accessed December 1, 2025. https://www.aphis.usda.gov/sites/default/files/aphis-sop-detection-nws-in-animals.pdf
Bautista-Alejandre A. FDA grants emergency use authorization for lotilaner to treat New World screwworm in dogs. dvm360. October 24, 2025. Accessed December 1, 2025. https://www.dvm360.com/view/fda-grants-emergency-use-authorization-for-lotilaner-to-treat-new-world-screwworm-in-dogs
U.S. Food and Drug Administration. FDA Issues Emergency Use Authorization for New World Screwworm Drug for Dogs. October 24, 2025. Accessed December 1, 2025. https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-new-world-screwworm-drug-dogs
Bautista-Alejandre A. Antiparasitic receives FDA emergency authorization to treat New World screwworm in cats. dvm360. November 21, 2025. Accessed December 1, 2025. https://www.dvm360.com/view/antiparasitic-receives-fda-emergency-authorization-to-treat-new-world-screwworm-in-cats
Lee C. Vet Watch update: Do you have normalcy bias? dvm360. August 6, 2025. Accessed December 1, 2025. https://www.dvm360.com/view/vet-watch-update-do-you-have-normalcy-bias-
Centers for Disease Control and Prevention. New World Screwworm: Situation Summary. Updated 2025. Accessed December 1, 2025. https://www.cdc.gov/new-world-screwworm/situation-summary/index.html
Reuters. US plans sterile fly facility in Texas to combat screwworm. June 18, 2025. Accessed December 1, 2025. https://www.reuters.com/world/us/usda-plans-sterile-fly-facility-texas-combat-screwworm-2025-06-18/
https://www.dvm360.com/view/top-questions-on-new-world-screwworm-what-every-veterinarian-should-know
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DVM 360 | Advancing pain management through integrative and multimodal approaches
Author(s)Caitlin McCafferty, Editor, Adam Christman, DVM, MBA, Bonnie Wright, DVM, DACVIM
Fact checked by: Bob Alaburda, Associate Editorial Director
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.
November 25, 2025
On this episode of the Vet Blast 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:
Adam Christman, DVM, MBA: 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.
Bonnie D. Wright, DVM, DACVAA: That is silly. Thank you for being—
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: I’m curious what got you involved in that.
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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.
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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.
Bonnie D. Wright, DVM, DACVAA: 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?
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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.
Bonnie D. Wright, DVM, DACVAA: Right all the time, it’s so overused, but motion in so many ways.
Adam Christman, DVM, MBA: 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—
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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?
Bonnie D. Wright, DVM, DACVAA: 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.
Adam Christman, DVM, MBA: 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.
Bonnie D. Wright, DVM, DACVAA: Thank you.
Adam Christman, DVM, MBA: 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.
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AVMA – Cannabis in Veterinary Medicine
AAHA – Urgent care your way: Finding the right model for your team
As client expectations evolve, veterinary practices are finding innovative ways to provide urgent care that strengthens both their teams and their connection to the community.
Emily Singler, VMD
Published Nov 13, 2025
In recent years, pet owners have increasingly come to expect care for their pets that mirrors the type of medical care available to humans in both complexity and convenience. The veterinary industry responded to this need in a variety of ways, including increased specialization and segmentation, more emergency hospitals, and even the advent of veterinary urgent care centers. These practices follow the model of human urgent care centers in that they treat patients who can’t wait for a scheduled appointment but who aren’t experiencing a life-threatening emergency.
If you’re considering how your practice fits within this expanding model of care, it’s important to understand that there’s more than one way to do it. This means that depending on your capacity and desire to see urgent care cases—and the other options available to pets and their families in your area— urgent care can take several different forms. Each approach offers its own balance of client service, staff workload, and financial return. Understanding how these models differ can help you choose the one that best fits your team and your community.
The benefits of urgent care
Adam Hechko, DVM, Interim Chief Operating Officer of AAHA and owner of North Royalton Animal Hospital in North Royalton, Ohio, sees the benefits of urgent care services for patients, their families, and for veterinary teams.
Patients and families
For patients and their families, having an urgent care option can meet their needs in ways that general practice and emergency care may not always be able to do. Urgent care can allow pets with non-emergent conditions, who might otherwise have to wait an extended period of time to get an appointment, to be seen more quickly or avoid having to be worked in on top of an already-full general practice appointment schedule. In either case, this can provide relief to pets faster and provide peace of mind (or at least answers) to worried families.
Urgent care also provides another option apart from emergency care, which can also be associated with long wait times (especially for those non-emergent cases) and a higher cost of care.
General practice veterinary teams
Veterinary teams can benefit from clients having access to urgent care services in a variety of ways.
For general practice veterinary teams, having an urgent care option to which to refer families can create less disruption to the schedule on an already busy day. This can lead to less burnout and allow team members to give more time, energy, and focus to the pets and families on their schedule, which can result in better quality medicine and better patient outcomes.
Hechko said that trying to fit urgent care cases into an already packed schedule was one of the biggest challenges his team faced. “When you know that you have that pressure of that urgent care appointment in in that type of structure, you may be missing things…. because you feel the pressure to wrap up the appointment and move on,” he said.
Emergency veterinary teams
Emergency teams can benefit from the presence of an urgent care option for pets in their area because it can free them up to treat more life-threatening emergencies, stabilize and hospitalize pets, and perform surgeries without having to also handle ear infections and urinary tract infections that take them away from their other cases.
Ways to offer urgent care
Urgent care spots on GP schedule
In some general practices, urgent care visits can be accommodated within the regular appointment schedule without too much disruption to the flow of the day. This may be particularly true in times when business is slow and the demand for wellness appointments has dipped.
In addition to efforts to schedule previously recommended exams and treatments for existing clients, practices can work to bring more patients in the door by openly advertising urgent care services. This may create an opportunity to attract new clients, who may be especially grateful to have been fit in quickly when their pet needed care the most.
In practices where business is not necessarily slow but leaders still feel there is a capacity to offer urgent care in house, reserving a set number of urgent care blocks on the schedule each day can be a good way to accommodate both scheduled appointments and more urgent patient needs.
How many blocks to place on the schedule will vary from one practice to the next based on how busy the practice is currently, how frequently the blocks end up being filled, and whether there are additional requests for urgent care that are currently going unmet. Practices may also need to consider the availability of other urgent care or emergency options in their surrounding area when determining how to structure their urgent care blocks.
However urgent care spots are organized, this form of delivery can not only boost hospital revenue but also provide pets and their families care in a familiar setting that allows for continuity of care.
Standalone urgent care service within a general practice
In Hechko’s practice, where they run an urgent care service alongside their general practice appointments, the presence of the urgent care service reduces burnout and provides more variety for team members.
His practice made this change because his team struggled to turn down a client in need. “Saying no was incredibly distressing to the team because we also want to be there for our patients, right? We want to help them when they’re needed.”
Hechko said most of his team members rotate between working in general practice and seeing urgent care cases. This can break up the routine and give them more variety so that not every day is organized the same way. Some team members, however, have a strong preference for one type of practice over the other, which he tries to honor as much as possible. For example, some thrive on the adrenaline rush of the urgent care cases that might need more of a workup, whereas others prefer the wellness appointments and chronic disease management typically handled by the general practice schedule. Hechko allows them to choose their own adventure.
Additionally, offering urgent care within the practice allows the team to provide their long-term patients care in a setting that is familiar with team members they already know. Hechko said, “Having that urgent care model within the practice gives those clients peace of mind knowing they they’re booking out two weeks in advance, but they know if they really need something, we’re there for them. ”
While this is a valuable offering for his existing clients, Hechko also offers this service to new clients in need of urgent care for their pets. This allows him to grow his practice.” 50% of the urgent care [cases] that come into my office are new clients,” Hechko said.
Redirect to separate urgent care
While in-house urgent care options may work well for many practices, some may be so busy handling their scheduled appointments that accommodating additional urgent care cases would be too much of a strain on the team.
Hechko has seen this play out in practice, where team members want to be able to say yes to every client, even when their schedule is already overloaded, because they don’t want any patients to go without care. “I think urgent care needs for existing clients can be really disruptive to the schedule and stressful for the doctors and the team,” he said. “They want to serve that client, they’re probably going to say yes in a lot of situations, but a lot of times then it gets them further behind and creates a lot of stress.”
In these cases, and when local urgent care or emergency options exist, referring to them can be a great way for practices to help their patients get the care they need in a timely manner without throwing the schedule off completely.
Hechko acknowledges this is a departure from how things used to be in veterinary medicine, and it may not feel comfortable for veterinary teams—or for clients—right away. But if the team can help clients feel that their recommendation is made with the pet’s best interest in mind, that can help them feel more supported even if they are being referred elsewhere.
Referral to a separate urgent care center may make the most sense in very busy practices, for practices with limited staff, those who serve a large population without much competition, and those that have been formatted to focus primarily on wellness and preventive care and lack the space, equipment, and staff to accommodate sick and injured patients.
Things to keep in mind
Whether a practice is going to see urgent care cases themselves or refer them elsewhere, it is important to define which types of cases and situations constitute urgent care for their practice. This can help everyone on the team understand how to accommodate pets who need care in a way that works with the team’s schedule and also provides care efficiently for pets who need it quickly.
Practice leaders can also create and review protocols for triage of urgent care cases with their team members so that everyone knows how to respond to clients’ requests for care.
Hechko said it’s important to acknowledge that in some cases, particularly with life-threatening conditions like a hit by car injury or a pet having trouble breathing, there is often no phone call or opportunity to discuss scheduling or referral. “Those just usually walk in,” he said. In those cases, practices should be prepared to provide initial stabilization and support where possible, even if they will ultimately need to refer the patient elsewhere for continued care.
However you choose to approach urgent care, the goal is the same: to provide access to care for your patients and clients when they need it in a way that works for your team. There’s no one-size-fits-all model, and what works best may change as your practice and community evolve. But no matter how you structure it, a responsive urgent care strategy can strengthen your practice’s connection to the pets and families you serve.
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AVMA | News – Practice improvement found in ‘doable’ changes, not sweeping reforms
Financial literacy and leveraging staff members can ease strain on veterinarians
Published on November 11, 2025
While the veterinary profession is grappling with serious challenges—such as financial stress and isolation among early-career veterinarians to the rural service gap —the situation is manageable. Crucially, addressing these issues doesn’t require sweeping, massive reforms.
The most impactful strategies to improve practice performance are, in fact, grounded in practicality: fostering connections for new veterinarians; teaching financial literacy and practice management; better leveraging veterinary technicians; and implementing efficiencies where possible.
“Employee engagement, financial stress, delegation, and client expectations are colliding in ways that make day-to-day practice unsustainable for too many teams,” said Dr. Wendy Hauser, founder of Peak Veterinary Consulting. “The fixes aren’t glamorous, but they are doable.”
She was part of a panel discussion on emerging opportunities and collaborative solutions during the 2025 AVMA Veterinary Business and Economic Forum, held October 8-9 in Denver.
Employee wellbeing
Dr. Tillery highlighted findings from the 2023 Merck Animal Health Veterinarian Wellbeing Study IV and 2023 Veterinary Team Wellbeing Study II, showing financial pressures track with burnout and mental health concerns across hospital roles.
“Sixty-eight percent of team members rated financial stress as critically important, and 60% said they were dissatisfied with their financial situation. That’s not sustainable,” he said.
One solution he suggested: Embedding business acumen in veterinary curricula.
“We do a great job building medical knowledge,” “but we leave out financial literacy: pricing, payroll, productivity levers, and reading a (profit and loss statement),” Dr. Tillery said. “That gap shows up as stress.”
Dr. Hauser connected diminished wellbeing to a broader workforce picture. Gallup’s U.S. employee engagement survey found workforce engagement had slipped by 2% to 31% in 2024, marking a 10-year low.
“Seven out of 10 people in your building may be disengaged right now. That’s a culture and a cost problem,” she said, because it can result in lower productivity and higher turnover.
One way to promote engagement is by fostering connections among staff members, which Dr. Grice described as the most underrated retention tool for those early in their career.
“When we surveyed doctors in my Decade One program, business education mattered, but the highest-rated value was belonging—having peers who understand the same stresses and choices,” she said. “It’s a psychologically safe place to [be able to] say the quiet part out loud and compare notes on real-world practice.”
A sense of belonging can guard against feelings of isolation, something Dr. Grice says is common among equine and rural practices, which are frequently one-veterinarian operations. She suggested solo veterinarians join or form emergency cooperatives for shared coverage; hire and leverage credentialed veterinary technicians; and explore haul-in models for single-animal visits to regain efficiency.
Dr. Grice cautioned, though, that streamlining services must be done with care.
“There’s a balance between operational efficiency and the bond you build in the barn aisle,” she said.
Technicians, front and center
Not surprisingly, Foltz urged practices to immediately better incorporate their veterinary technicians’ skills.
“Your No. 1 efficiency add is a credentialed technician, paired with a plan to actually use their training,” she said. “Center credentialed technicians in rounds, skills training, and even teaching roles so new grads learn what a high-functioning team looks like.”
Throwing new hires into the deep end and hoping for the best is not a strategy, Foltz added.
“Structured onboarding, competency checks, and confidence-building reps prevent downstream errors when the caseload spikes,” she said.
Veterinary technicians can especially help when it comes to client interactions, but they need to be trained in areas such as reflective listening, open-ended questions, and de-escalation.
“We need complete histories the first time, and we need clients to feel heard,” Foltz said.
Dr. Hauser said that most client-experience failures are a consequence of poor communication about the costs of veterinary care.
“Veterinary prices have risen sharply since the pandemic, but the larger problem is that we rarely educate clients proactively about the cadence and cost of care,” she explained. “People say ‘no’ when they’re surprised, not when they’re informed.”
Dr. Hauser suggested informing clients what they can expect in terms of veterinary costs during the first year. Later, she says to talk with them about what a stable adult year looks like, when senior care begins, and what tools exist to help budget, such as wellness plans, pet insurance, or third-party credit.
Culture counts
When it comes to striking a balance between practice efficiency and practice culture, manager behavior matters more than mission statements.
“Start with shared values, trust, respect, and transparency, that’s what gives leaders credibility,” Dr. Tillery advised. “Then align incentives with the behaviors you actually want. If you reward only throughput, don’t be surprised when culture erodes.”
Dr. Hauser agreed, adding: “The single most impactful, research-supported move? Short, weekly check-ins—10 to 15 minutes per person—covering recognition, priorities, collaboration needs, and strengths. Document action items and end with explicit confidence. It sounds basic because it is. And it works.”
“Give people authority with accountability,” Dr. Grice suggested. “Define the destination and the guardrails. Then get out of the way. Engagement rises when team members can actually solve problems.”
While panelists acknowledged the pressures confronting the veterinary profession, they believe that incremental, evidence-based changes can create a financially successful practice where staff feel heard and supported.
“Culture is not a retreat exercise,” Dr. Hauser said. “It’s purpose, growth, a secure manager, ongoing conversations, and strengths, delivered weekly, not yearly.”
https://www.avma.org/news/practice-improvement-found-doable-changes-not-sweeping-reforms
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AVMA I News – Benchmarking data plus elevating efficiency equals practice productivity
Benchmarking data plus elevating efficiency equals practice productivity
AVMA Economist Frederic B. Ouedraogo provides practice data to help with benchmarking
By Malinda Larkin
October 15, 2025
U.S. veterinary practices averaged about $1.5 million in gross revenue in 2024, but adjustment for inflation shows only modest growth in this metric since 2016.
Another sobering trend: The average number of active clients per practice has been declining since 2019 by about 95 clients per year, to a total of 3,351 clients in 2024. Over the same period, the average number active clients per full-time equivalent (FTE) veterinarian has declined by 15 clients per year, to a total of 1,499 in 2024.
In 2023, there were 34,296 veterinary practices, according to the U.S. Census Bureau. On average, approximately 362 new veterinary practices have been added each year since 2010, for an annual growth rate of 1.3%.
In 2023, there were 34,296 veterinary practices, according to the U.S. Census Bureau. On average, approximately 362 new veterinary practices have been added each year since 2010, for an annual growth rate of 1.3%.
To help create stronger and profitable practices, Frederic B. Ouedraogo, PhD, senior economist and associate director in the AVMA Veterinary Economics Division, encouraged practice owners to create their own data assets to evaluate the health of their own practice and engage in benchmarking analyses.
“This allows us to gain insights into our practice performance, monitor our performance over time and against our peers, enabling us to identify our strengths and weaknesses. More importantly, it allows us to learn things that others are doing,” he said.
Dr. Ouedraogo presented data from the 2025 AVMA Veterinary Practice Owners Survey during his talk “Unlocking Practice Health: Examining the Latest Practice Health Data” at the 2025 AVMA Veterinary Business and Economic Forum, held October 8-9 in Denver.
One of the key metrics for assessing operational efficiency in veterinary practice is gross revenue per square foot, which in 2024 was $538 per square foot on average.
“This is how much revenue each practice generates per square foot and is a good indicator of practice health,” he said, adding that this figure is especially helpful for comparison because it can be done with any other kind of practice, regardless of size. “Removing bottlenecks will result in greater efficiency and increase gross revenue per square foot.”
Rate of technology utilization in veterinary practice
Optimizing practice resources, including space and workforce, and removing inefficiencies in systems and processes, such as adopting new technologies, can help veterinary practices boost productivity and revenue, says Frederic B. Ouedraogo, PhD, senior economist and associate director in the AVMA Veterinary Economics Division.
Other productivity metrics from the survey are as follows:
Gross revenue per exam room: This is total revenue divided by the number of exam rooms in the practice. In 2024, U.S. veterinary practices generated $444,668, on average, per exam room per year. Inflation-adjusted (real) revenue per exam room has been trending down since 2020.
Gross revenue per FTE veterinarian: In 2024, the average veterinary practice generated $554,982 per veterinarian, down in inflation-adjusted terms from nearly $600,000 in 2019. Revenue per veterinarian per hour averaged $288 in 2024. “According to our data, veterinarians spend about 30 minutes per patient and complete about 15 scheduled appointments per day, on average, under normal circumstances,” Dr. Ouedraogo said.
Patients per veterinarian per day: The average veterinary practice saw 15 patients per day in 2024, compared with 16.6 in 2021, which he noted may have been unusually high during the pandemic. “If demand for veterinary services slows down, no matter how efficient you are, you will see fewer patients. So it can be a market-related issue, but let’s make sure that our systems and processes are as efficient as they can be, and again, ways to increase efficiency include but are not limited to optimizing your space, empowering your staff through training, and adopting cutting-edge technology that could boost productivity,” he said.
Veterinary practice space utilization: The average veterinary practice measured 3,845 square feet and had 3.5 exam rooms in 2024. The number of FTE veterinarians per exam room was 0.92. “It should be 0.5 or so, allowing one veterinarian to go from one room to another without waiting for the exam room to be ready for next patient,” Dr. Ouedraogo said.
Veterinary practice staffing numbers: The average veterinary practice reported 2.76 FTE veterinarians, which has varied between 2.5 and 2.8 since 2019. In addition, practices averaged 3.7 nonmedical staff members plus 5.74 veterinary technicians and veterinary assistants. But these numbers depend on the species, he noted. Companion animal predominant and exclusive practices averaged a little more than 2.6 FTE veterinarians, 6.35 FTE veterinary technicians and veterinary assistants, and around 4.1 nonmedical staff. Food animal and equine practices had between 3.34 and 2.56 FTE veterinarians, 1.55 and 2.6 veterinary technicians and veterinary assistants, and 1.25 and 1.45 nonmedical staff. Overall, the medical staff-to-veterinarian ratio was 2.21:1 in 2024.
Dr. Ouedraogo encouraged attendees to use the statistics derived from that survey as benchmarks to identify areas for improvement and drive better performance.
He added, “Keep in mind that your PIMS system may have capabilities to generate [these metrics] for you. Take the time to understand your management software, understand what it can do.”
Results Frederic B. Ouedraogo, PhD, presented at the forum will be published in the 2026 AVMA Report on the Economic State of the Veterinary Profession. The 2025 AVMA Report on the Economic State of the Veterinary Profession is available for AVMA members to download for free, and for a fee of $375 for non-members. This annual report examines the major trends through the lens of veterinary education, veterinary employment, and veterinary services.
For more practical advice from the “Unlocking Practice Health: Examining the Latest Practice Health Data” session at the 2025 AVMA Veterinary Business and Economic Forum, take a look at the 3-2-1 Insight-to-Action Guide created on the topic.
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National Veterinary Technician Week
October 12-18, 2025
National Veterinary Technician Week is an annual recognition of the work and contributions of Veterinary Technicians. CVMA recognizes the importance of the role of professional Veterinary Technicians and the importance of their contributions. Using the training and skillset of Veterinary Technicians benefits animals, clients, and veterinarians. The time of veterinarians becomes available to work on matters that require the veterinarians’ medical background and education.
Thank you to the professional Veterinary Technicians for their role in animal welfare.
Adapted from Indeed Career Guide
Written by Oluwatobi Agbetunsin, DMV
March 3, 2025
Veterinary Technicians and Veterinary Assistants
What is a Vet Tech
A veterinary technician is an animal care specialist who assists veterinarians in caring for animals and improving their overall health.
Veterinary technicians undergo training to complete the following responsibilities:
- Recording and organizing patient’s medical history
- Conducting X-rays and diagnostic tests
- Analyzing various animal behaviors and health conditions
- Creating reports of animal behaviors and conditions
- Speaking with pet owners to address questions regarding diagnosis, medication or general pet care
- Assisting veterinarians in animal illness research
- Getting animals prepared for surgery or other procedures
- Cleaning, maintaining and preparing medical equipment
Primary responsibilities for veterinary technicians
Veterinary technicians are qualified to assist veterinarians with complex procedures and surgeries. Other small, procedure-related tasks veterinary technicians complete include:
- Performing emergency services on animals, including first aid
- Administering simple treatments and vaccines
- Inserting catheters
- Drawing blood
- Managing and administering anesthesia under veterinary supervision
Veterinary technician requirements
Before becoming a veterinary technician, one often completes the following requirements:
Education
Veterinary technicians typically complete 60 hours of veterinary technician courses along with a designated amount of practicum hours, depending on the program. To complete the required hours, one can enroll in a junior college or a veterinary technician school that is accredited by the AVMA Committee on Veterinary Technician Education and Activities I t’s important that your veterinary technician school has accreditation from the American Veterinary Medical Association (AVMA) Committee on Veterinary Technician Education and Activities (CVTEA). During these courses, the student ordinarily receive both hands-on experience and lectures on the following subjects:
- Animal behavior
- Animal diseases
- Basic clinical practices
- Veterinary hospital management
- Animal pharmacology
Certifications
After completing the education requirements, one can earn the state veterinary certification and license by completing the Veterinary Technician National Exam (VTNE). This exam is approximately three hours long with 170 multiple-choice questions. The testing center sends your scores straight to the state veterinary board two to three weeks after you take the exam. Common test subject areas may include:
- Animal care
- Dentistry
- Pharmacy and pharmacology
- Anesthesia
- Surgical nursing and assistance
- Emergency medicine
- Pain management practices
- Diagnostic testing and imaging
- Laboratory procedures
Training
All vet techs undergo specialized training to ensure that they have the proper experience for handling situations in a clinical or hospital environment. Most students receive this training while pursuing their degree or certificate. Many veterinary technician programs require students to complete a designated amount of hours of hands-on training before graduation.
Skills
Below are some skills that can help one succeed in the role of a veterinary technician:
- Collaboration and teamwork skills
- Physical health and ability to lift animals throughout the day
- Passion for helping animals and healing their diseases
- Patience and calming abilities when handling unstable or nervous pets
- Experience with medical software and veterinary safety procedures
- Ability to remain calm during high-stress or emergency situations
- Knowledge of basic veterinary medical terminology
- Strong time management, multitasking and organizational skills
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AVMA – October 10, 2025
Integrative veterinary medicine: an emerging trend in veterinary practice
Mushtaq A. Memon, BVSc, PhD, DACT
Huisheng Xie, DVM, PhD
Abstract
The American Veterinary Medical Association’s (AVMA) House of Delegates recently adopted a revised policy on Complementary, Alternative, and Integrative Veterinary Medicine (IVM), reflecting a growing clinical and academic interest in complementary therapies. IVM is defined as “a comprehensive approach to animal health care that combines conventional veterinary practices with complementary and alternative therapies, such as acupuncture and chiropractic care.” While the utilization of IVM is increasing, a critical knowledge gap remains regarding its evidence-based integration into mainstream veterinary practice. This article provides an overview of the purpose, scope, and potential clinical contribution of commonly used modalities, including acupuncture, physical rehabilitation, manual and massage therapies, herbal medicine, and integrative nutrition. Each modality is briefly examined in terms of proposed mechanisms, therapeutic indications, and current research support. The goal is to clarify the role of IVM within veterinary clinical decision-making and promote a balanced, science-informed framework for its application. Acupuncture, a core IVM modality, uses fine needles to stimulate the body’s natural healing mechanisms. Physical rehabilitation targets neurological and musculoskeletal conditions, providing multidimensional care. Manual therapies apply hands-on techniques to soft tissues, joints, and nerves to promote relaxation, pain relief, and mobility. Integrative nutrition emphasizes personalized dietary plans that support overall health. Botanical medicine leverages the therapeutic properties of plants and their derivatives as part of a holistic treatment strategy. The takeaway emphasizes the importance of interdisciplinary collaboration, ensuring safety, and ethical practice in offering integrative veterinary care.
The AVMA House of Delegates recently passed a resolution adopting a revised policy on complementary, alternative, and integrative veterinary medicine (IVM). Integrative veterinary medicine is defined as “a comprehensive approach to animal healthcare that combines conventional veterinary practices with complementary and alternative therapies, such as acupuncture (ACP) and chiropractic care.”1
Integrative veterinary medicine reflects the growing interest in complementary therapies in both human and veterinary medicine. An analysis of national survey data reported that the proportion of US adults who have at least 1 complementary health approach (eg, ACP, chiropractic, massage, yoga, meditation) increased from 19.2% in 2002 to 36.7% in 2022.2 Similarly, a bibliometric study of veterinary literature documented a marked rise over the past 2 decades in publications referencing nonconventional therapies, particularly traditional Chinese veterinary medicine (TCVM), herbal medicine, plant products, essential oils, and other natural products.3
Integrative veterinary medicine encompasses a wide range of modalities, including ACP, physical rehabilitation, manual and massage therapies, herbal medicine, and integrative nutrition. The overarching goal is to combine the strengths of conventional and complementary approaches to enhance the quality and effectiveness of veterinary care.
This integrated framework reflects a broader societal shift toward complementary and integrative health practices, observed in both human and veterinary medicine. In 2007, approximately 38% of US adults reported using complementary therapies.4 Many of these adults may also seek complementary therapies for their pets. Even if such treatments are not a core part of a veterinarian’s practice, it is still important to have a basic understanding of the options, their uses, and when they can be effective.5 The American Animal Hospital Association’s member survey conducted from 1996 through 1999 documented an increase in the proportion of practices reporting the use of alternative therapies, rising from 6% in 1996 to 22% in 1998 and reaching 31% in 1999, indicating a marked upward trend in the provision of complementary and alternative veterinary medicine or IVM services.6
The term IVM has increasingly replaced earlier labels, such as “alternative” or “holistic” medicine, signaling a more collaborative and scientifically grounded approach. This shift is mirrored in institutional developments, such as the renaming of the NIH National Center for Complementary and Alternative Medicine to the National Center for Complementary and Integrative Health, a change that underscores a commitment to integrating complementary practices into mainstream healthcare.7
Integrative veterinary medicine encompasses a wide range of modalities, including ACP, physical rehabilitation, manual and massage therapies, herbal medicine, and integrative nutrition. As a reflection of a growing paradigm shift, IVM offers veterinarians a multifaceted, evidence-informed approach to treatment that merges traditional Western practices with complementary therapies. This evolution in veterinary medicine aligns with contemporary healthcare values and anticipates a future in which integrated care becomes the standard rather than the exception.
Acupuncture
A recent study8 evaluated the efficacy of acupuncture and electroacupuncture, integrated within a physiotherapy protocol, for postoperative rehabilitation in dogs with acute intervertebral disc extrusion. The multimodal approach was designed to enhance the recovery of ambulation. Analysis of 41 canine patients demonstrated that incorporating acupuncture into the rehabilitation protocol significantly increased the likelihood of regaining ambulatory function. Another study9 compared the therapeutic outcomes of decompressive surgery (DSX), electroacupuncture (EAP), and a combined approach (DSX + EAP) in dogs with thoracolumbar intervertebral disc disease (IVDD) and severe neurological deficits persisting for more than 48 hours. Findings indicated that EAP alone was more effective than DSX in promoting ambulation and improving neurological function in dogs with prolonged, severe deficits secondary to thoracolumbar IVDD.
According to this system, Qi circulates through defined pathways called meridians, and disease is understood as a disruption or blockage in this flow. Diagnostic evaluation within TCVM relies heavily on observational methods, such as tongue appearance, pulse quality, and other subtle physical cues.10,11
Acupuncture is one of the most commonly utilized modalities within IVM and is supported by the most extensive body of efficacy literature among complementary therapies. The term ACP originates from 2 Latin words: acus, meaning needle, and pungere, meaning to pierce or prick. Acupuncture involves the insertion of sterile, fine needles to stimulate the body’s natural healing mechanisms, aiming to diagnose, treat, and prevent disease. The core objective of ACP is to achieve therapeutic benefits with minimal trauma.12
Acupuncture is thought to relieve pain and reduce inflammation through multiple biological pathways. Needle stimulation triggers the release of natural pain-relieving chemicals, such as endorphins and enkephalins, from immune cells, which act on nerve endings and the sympathetic nervous system to block pain signals. Electro-ACP can also activate the hypothalamic-pituitary-adrenal axis and influence the autonomic nervous system, leading to broader anti-inflammatory effects. Research further suggests it may mobilize mesenchymal stem cells via hypothalamic activation, supporting tissue repair and regeneration.13
The use of fine, sterile needles is referred to as dry-needle ACP. Other common techniques include aqua-ACP, which involves injecting small amounts of fluid (eg, vitamin B12 or saline) into ACP points for prolonged stimulation—particularly useful in patients who cannot tolerate retained needles—and electro-ACP, which involves the application of electrical stimulation to inserted needles. Electro-ACP is employed to enhance neuromodulation and stimulate the release of neurochemicals by varying electrical frequencies.14
Acupuncture is commonly utilized for pain management. A recent clinical trial tested ACP in 32 dogs with osteoarthritis. Dogs received either ACP or placebo treatment once a week for 4 weeks. Measures of mobility and activity did not show a clear difference between the 2 groups. However, dog owners reported noticeable improvement in their pets’ comfort and ability to do daily activities after ACP.15 While ACP is practiced globally—in China, Korea, Japan, Europe, and the Americas—its application varies, much like the regional differences observed in Western medical practice, despite shared foundational principles.
Physical Rehabilitation
Animal physical rehabilitation stands out as a rapidly expanding domain within veterinary medicine. It is gaining prominence in treating small animals and equine and is increasingly recognized as a crucial facet of veterinary care, especially for animals with physical limitations stemming from surgeries or illnesses.16 This trend is accentuated by advancements in the life expectancy of companion animals and the rise in chronic conditions often linked to movement disorders.17 The American Association of Rehabilitation Veterinarians defines animal physical rehabilitation as the “diagnosis and management of patients with painful or functionally limiting conditions, particularly those with injury or illness related to the neurological and musculoskeletal systems.”18 Similar observations were made in a retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital, with 39% involving a combination of therapeutic modalities. Among 274 patients receiving multiple modalities, neurologic and orthopedic diseases were the prominent concerns: 50.7% and 49.6%, respectively. Older neutered or spayed dogs, particularly Dachshunds, were more frequently treated, with common modalities including ACP, laser therapy, electro-ACP, and hydrotherapy (> 50% of patients).19
The overarching objective of rehabilitation is to alleviate pain, reduce edema, facilitate tissue healing, restore gait and mobility, rebuild strength, prevent further injury, and enhance overall quality of life.20 A foundational understanding of the anatomy of animals, such as canines, felines, and equines, is imperative for formulating safe and effective rehabilitation plans. The ideal rehabilitation strategy involves a comprehensive patient assessment to identify musculoskeletal or neurological impairments, discern TCVM patterns, address pain, and employ a combination of rehabilitation therapies (ACP, manual therapy [MT], and therapeutic exercises), along with herbal and pharmaceutical supplements. Additionally, commonly utilized therapeutic modalities encompass cryotherapy, thermotherapy, photobiomodulation, and electrical stimulation.
Therapeutic exercises, whether on land or in water, serve as the linchpin of veterinary rehabilitation, irrespective of the specific problem or diagnosis. Regular reassessment intervals are vital for monitoring the patient’s progress. For a more in-depth exploration of various facets of veterinary rehabilitation, readers are directed to the comprehensive information provided by Koh and Huntingford.21
Manual Therapies
Manual therapy is a comprehensive term encompassing veterinary manipulative therapy, massage, touch, osteopathy, and related techniques.22 Manual therapy involves a skilled, specific hands-on approach utilized by clinicians and therapists to address soft tissues, joints, and nerves of diverse etiologies. The primary objectives of MT are to induce relaxation, enhance circulation, alleviate muscle tension, diminish pain, increase the flexibility of soft tissues, and restore joint mobility.23 The precise therapeutic mechanism behind MT is not fully elucidated, likely involving a combination of physiological, biomechanical, physical, and psychological effects.24
Physiologically, MT may reduce pain through the pain gate theory and stimulate descending inhibitory tracts, leading to pain inhibition and tissue relaxation.25 Biomechanically, MT can alter tissue extensibility and fluid dynamics by mechanically pressuring and mobilizing soft tissues and joint capsules, thereby facilitating tissue repair and remodeling and improving tissue function.26
While MT plays a vital role in the rehabilitation of many patients, there is a scarcity of studies validating its clinical benefits in animals. Two studies27,28 suggest that MT, in combination with ACP, may be effective and safe for improving pain relief, physical function, and quality of life in dogs with degenerative diseases, chronic pain, or musculoskeletal pain.
A survey of equine practitioners revealed a generally positive view of MT therapies, with over half referring owners to veterinary chiropractic (manipulative therapy) or massage.29 The reason for equine practitioners’ patient referrals is not entirely clear but may be linked to an understanding of the importance of soft tissue pathology or due to the restrictions on certain drug therapies in performance horses.30 Studies in horses suggest increased tolerance to pressure and improved vertebral flexibility following spinal manipulative therapy.31 Massage of equine hind limb muscles has been shown to increase active and passive protraction.32
Massage therapy
Massage therapy, defined by Hippocrates as “the art of rubbing,” boasts an extensive history dating back to 2,500 BC, making it one of the earliest documented treatment modalities.33 Initially described in China, ancient Greeks and Indians also practiced massage, but it was the Roman Empire that notably embraced massage therapy for sports and war injuries.34,35 For detailed massage techniques and descriptions, readers are referred to Maler.33
Tui-na
Tui-na (pronounced twee-nah) is a Chinese MT used for preventing and treating disease. Tui-na practitioners use various manipulations applied to ACP points (acupoints) and Meridians as well as special limb-stretching movements to prevent and treat diseases.36 Traditional Chinese veterinary medicine practitioners, from the novice to the senior clinician, can use this unique modality to help more animals.
Tui-na is generally very safe to practice on animals, and they also tend to enjoy the administration of Tui-na techniques. It is especially well suited for fractious or anxious patients or those with an aversion to needles. Tui-na can be effectively used alone for soft tissue injury, pain management, and anxiety. It can also enhance the effects of ACP and herbal medicine for a variety of chronic illnesses.37 Many Tui-na techniques can be applied as a tool for TCVM pattern diagnosis, which is central to TCVM practice. In addition, it is a tool that can be taught to caregivers to enhance the human-animal bond.37
Integrative Nutrition
The timeless maxim “Let food be thy medicine and medicine be thy food” often underscores the pivotal role of nutrition in maintaining optimal health. In the realm of veterinary medicine, contemporary clinical assessment guidelines underscore the significance of nutritional evaluation, with conventional veterinary nutrition forming a cornerstone of the veterinary curriculum.38
Embracing an integrative approach to veterinary nutrition empowers practitioners to craft tailored, all-encompassing nutrition plans for each patient. This involves drawing from both established and emerging insights into nutrition and supplements, strategically employed for both nutritional support and therapeutic purposes.39
Nutritional assessment and intervention are seamlessly integrated with other IVM modalities, such as physical rehabilitation and sports medicine. Dietary modification can improve performance, preserve lean body mass, reduce inflammation, and improve recovery from injury.40 Notably, the pet owners seeking physical rehabilitation for their pets commonly grapple with the issue of being overweight or obese. Therefore, a comprehensive exploration of the physiological implications and contemporary guidelines for managing obesity is pertinent.41–43 The role of diet in various diseases, especially in cancer, has been reported.44
Beyond the realm of nutrition’s direct impact on the musculoskeletal system, its interplay with other bodily systems is worth examining. For instance, TCVM emphasizes the incorporation of food therapy as an energetic approach to diets applied by IVM practitioners in their dietary recommendations. Explaining all the details of TCVM’s food therapy is beyond the scope of this article; readers are encouraged to explore the comprehensive insights provided by Fowler and Xie.45
Botanical and Herbal Medicine
Herbal medicine, also known as botanical medicine, involves the utilization of plants or plant derivatives with medicinal or therapeutic effects on the body. This encompasses the use of entire plants or specific parts, such as flowers, berries, leaves, stems, and roots, which may contain various active constituents producing therapeutic effects.46 The application of herbal supplements is on the rise among veterinarians and pet owners, with a notable prevalence in veterinary oncology.47,48 Traditional medical systems, including Chinese, Western, Ayurvedic, and indigenous North American practices, incorporate natural products into treatments. Plant-derived products offer potential avenues for drug discovery, exemplified by the reported effects of medical mushrooms on cancer.49 A Chinese herbal researcher was awarded a Nobel Prize in medicine for the discovery of Artemisia derivatives, now utilized in treating resistant malarial infections in humans.50,51 Silymarin, a derivative of milk thistle, is commonly prescribed by veterinarians for hepatic diseases.50,51 Numerous publications detail hundreds of herbs and herbal combinations for animal use, drawing from case reports, clinical experience, expert opinions, or data from other species.52
Conclusions
In conclusion, IVM represents a progressive approach that blends conventional Western veterinary practices with complementary therapies, driven by the growing interest of humans and animal owners. The term “integrative” reflects a preference over “alternative” or “holistic,” aligning with the broader shift observed in medical practices.
The diverse spectrum of IVM includes ACP, physical rehabilitation, manual therapies, integrative nutrition, and herbal medicine. Acupuncture, rooted in ancient Chinese practices, employs fine needles to stimulate the body’s healing abilities. Physical rehabilitation is crucial for animals with mobility issues, emphasizing a comprehensive approach to veterinary care. Manual therapies involve hands-on techniques to address soft tissues and joints, contributing to pain reduction and improved mobility. Integrative nutrition recognizes the role of tailored diets in promoting overall health. Herbal medicine offers therapeutic benefits in veterinary treatments.
In essence, IVM strives to provide comprehensive, evidence-based care that integrates the best of conventional and complementary approaches for the well-being of animal patients. The evolving landscape of IVM necessitates ongoing education to ensure that veterinarians are adept at navigating this integrative paradigm.