By: Stacy Montgomerie, DVM, CHPV

Description: A case-based discussion of assisted natural death in ICU patients as a treatment option when euthanasia is declined. The majority of families choose direct euthanasia for their animal companions, however, there is a subset of animal caregivers that gravitate toward options other than euthanasia. How can veterinary clinicians honor animal caregiver wishes for the death of their animal companion without performing direct euthanasia while avoiding animal suffering and upholding the veterinary oath? We will explore direct euthanasia alternatives using a case-based discussion of assisted natural death in the hospital/ICU setting. The clinical management of assisted natural death, guiding the family through the process of dying, and supporting the veterinary team during and after the dying process will be addressed.

By the end of the session, attendees will be able to:

1. Discuss overview of assisted natural death as an alternative to euthanasia.
2. Discuss clinician communication and medical responsibilities.
3. Use case-based discussion as a model.

Speaker Info: Stacy Ann Montgomerie is a hospice/ER/ICU staff veterinarian at DoveLewis Emergency and Specialty Hospital in Portland, Oregon. Dr. Montgomerie joined DoveLewis in 2016 and has been an ER and ICU DVM since graduating in 2012. Dr. Montgomerie also earned her hospice/palliative care certification via the International Association for Animal Hospice and Palliative Care  (IAAHPC) in 2022. Outside of work, Dr. Montgomerie enjoys mushroom foraging, hiking, pickling/fermentation, crocheting/ knitting, travel, and skeleton preparation/articulation. She also enjoys spending time with her partner and pets.

By: Angela M Lennox, DVM, DABVP-Avian, ECM; DECZM-Small Mammal

Description: Rabbits commonly present with signs consistent with GI dysfunction; distinguishing these from actual obstruction, which may require surgical management, requires a thorough approach. This presentation helps practitioners identify this group of rabbits, and presents current thoughts on medical management of those not requiring surgery.

By the end of the session, attendees will be able to:

1. Understanding of the typical presentation of rabbits with GI dysfunction
2. Tools for helping to distinguish which are more likely to have GI obstructive disease
3. Protocols for both medical and surgical management

Speaker Info: Angela M. Lennox is a graduate of Purdue University School of Veterinary Medicine, and has practiced exclusively exotic animal medicine since 1991. She is the owner of the Avian and Exotic Animal Clinic of Indianapolis. She is a diplomate in the American Board of Veterinary Practitioner (ABVP) in both Avian and Exotic Companion Mammal Medicine, and a diplomate of the European College of Zoological Medicine, Small Mammal Medicine. Dr. Lennox is an adjunct professor at Purdue University Department of Clinical Sciences.

By: Christopher G. Byers, DVM, DACVECC, DACVIM (SAIM), CVJ

Description: In recent months, sodium-glucose co-transporter 2 inhibitors (SGLT2i) have become available for the treatment of insulin-dependent diabetes mellitus in feline patients. One of the rare potential side effects of this class of medication is euglycemic diabetic ketoacidosis (eDKA). Learners will review relevant pathophysiology of, as well as diagnostic testing and therapeutic interventions for cats suspected or confirmed to be living with eDKA.

By the end of the session, attendees will be able to:

1. To understand the mechanism of action of sodium-glucose co-transporter 2 inhibitors
2. To recognize clinical manifestations of euglycemic diabetic ketoacidosis in cats
3. To understand appropriate diagnostic tests to accurately diagnose patients living with eDKA
4. To having working knowledge of appropriate therapeutic interventions for eDKA

Speaker Info: Dr. Christopher G. Byers is a board-certified veterinary emergency & critical care and small animal internal medicine specialist, as well as a certified veterinary journalist, based in Omaha, Nebraska. He received his DDVM from Cornell University. Dr. Byers works as a teleconsultant in for VetCT, and he is the Co-Editor of the textbooks, Feline Emergency & Critical Care Medicine and Canine Emergency & Critical Care Medicine. He has also published chapters and articles in numerous textbooks and peer-reviewed medical journals.

By: Ivayla D Yozova, MVM, Dr.med.vet., MBA, FHEA, Dipl.ACVECC, Dipl.ECVECC

Description: Even in the 21st century trauma remains challenging to treat in cats. The current evidence on feline trauma is mostly focused on epidemiological studies of general or specific injuries, including larger studies from the VetCOT trauma database. Mortality from trauma in cats remains high (up to 20% depending on the setting). This high mortality is associated with severity of injuries, but sadly often enough financial concerns. This talk will offer a comprehensive approach to the feline trauma patient from the ER admission through hospitalization and discharge. Focus will be placed on conservative management of common injuries and post-operative care with emphasis on pain management, IVF administration and transfusion requirements. There will be the unavoidable mention of behavioral considerations and handling of the hospitalized trauma cat. Cases will be presented throughout to maintain a clinical focus.

By the end of the session, attendees will be able to:

1. Main points of pathophysiology of feline trauma
2. Current epidemiological information
3. Dos and Don’ts on triage and initial stabilization
4. Principles of pain management
5. Principles of IVF and transfusion requirements
6. Approach to common injuries in the cat

Speaker Info: Ivayla is an ACVECC diplomate since 2017 and an ECVECC diplomate since 2019. Ivayla obtained her original veterinary degree from Trakia University, Bulgaria (2002-2007), after which she joined the National Veterinary College of Toulouse, France for a Small Animal Rotating Internship (2008-2009). Ivayla completed a 3-year ECC residency in the Veterinary Teaching Hospital, University of Bern, Switzerland (2013-2016), including a postgraduate doctoral degree on the topic hydroxyethyl starches. Prior to the residency, Ivayla worked in a private small animal after-hours ECC practice on the French Riviera. During that time, Ivayla completed an MBA (Institute of Business Administration of Nice, France, 2010-2011) and a Pain Management Certificate (Medical Faculty, University of Montpelier, France, 2011-2012). Ivayla is currently a Senior Lecturer of Veterinary ECC at Massey University (since 2017) and the director of their ECVECC residency program. Ivayla’s position splits between clinical work in the Pet Emergency Centre with patient-focused and didactic teaching of students, interns and residents and research. Ivayla is an advocate for effective learning and is a Higher Education Academy fellow. Ivayla is passionate about low stress handling and pet-centric practices, responsible for the cat-friendly clinic initiative at Massey University. Research interests include the endothelial glycocalyx (PhD project), trauma, stress response, POCUS, and other minimally invasive monitoring tools, focusing almost exclusively on felines. Ivayla is part of Massey University’s Veterinary Emergency Response Team, a swift water rescue technician and a rope rescue operator.

By: Meera Heller DVM PhD DACVIM-LA

Description: Bloat is a common emergency in small ruminants. We will briefly cover background on the ruminant forestomachs and then dive into triage and emergency treatment of the most common types of bloat

By the end of the session, attendees will be able to:

1. Review ruminant forestomach anatomy and function
2. Discuss the most common differential diagnoses
3. Describe steps for triage and emergency treatment of common types of bloat

Speaker Info: Dr. Meera Heller is a Professor of Clinical Livestock Medicine and Surgery at UC Davis. She received her DVM degree from UC Davis and completed an internship in large animal medicine and surgery at the Atlantic Veterinary College at the University of Prince Edward Island in Canada. After her internship, she returned to UC Davis for her residency in large animal internal medicine, followed by a PhD in Comparative Pathology under the mentorship of Dr. Joie Watson. Her first faculty job was at the University of Missouri in their Food Animal Medicine Service. She then returned to UC Davis in 2014 to start her current position. Her clinical interests are in medicine and surgery of ruminants and pigs, with a special focus on small ruminants. She also has an interest in acupuncture. Her research has ranged from basic research into the innate immune response to more clinical research such as pharmacokinetic/pharmacodynamic studies, diagnostic testing, transfusion medicine, and infectious/tick-borne diseases in small ruminants. She has a small herd of goats of various breeds, including some retired blood donors and her daughter’s Nubians, which she shows. When she is not working, she enjoys hiking, running, knitting, and trying to make goat cheese that her family will eat!

By: Grace VanHoy, DVM, MS, DACVIM-Large Animal

Description: Urinary obstruction due to urolithiasis is one of the most common emergencies in small ruminants and occasionally in camelids, and their unique anatomy and stone composition can make treatment challenging. This webinar will focus on triage and management of urolithiasis and urinary obstruction including ultrasound diagnosis, placement of a temporary percutaneous cystostomy tube, exteriorization and amputation of the urethral process, fluid therapy options, and management of urolithiasis in a clinic or on-farm setting.

By the end of the session, attendees will be able to:

1. Assessment of abdominal and urethral ultrasound images for diagnosis of urolithiasis and urinary obstruction in a small ruminant/camelid patient.
2. Develop a sedation/anesthesia plan for a blocked small ruminant/camelid patient.
3. Understand how to perform urethral exteriorization, urethral process amputation, and urethral catheterization in a small ruminant/camelid patient.
4. Understand how to perform a temporary tube cystostomy placement in a small ruminant/camelid patient.
5. Develop a fluid therapy and treatment plan for a small ruminant or camelid patient being managed for urolithiasis.
6. Summarize risk factors for urinary obstruction in small ruminants and camelids.

Speaker Info: Dr. Grace VanHoy is a clinical assistant professor in the Livestock Medicine and Surgery Service at the UC Davis School of Veterinary Medicine. She received her bachelor’s degree in animal science from Cal Poly, San Luis Obispo, then her DVM degree from Ohio State University. Following veterinary school, she completed an internship and residency in the Farm Animal Medicine and Surgery Service at Ohio State while completing a master’s degree with an emphasis in comparative veterinary medicine and veterinary parasitology. Following her board certification as a diplomate of the American College of Veterinary Internal Medicine-Large Animal, she was an assistant professor at Ohio State for two years until moving to her current position at UC Davis.

By: Marcia Fletcher

Description: From time to time, we are faced with anaesthetising a very old, young, sick, or emergency patient for surgery, diagnostic procedures or stabilisation. While fit and healthy patients may have significant reserves in organ function and are usually able to handle the stress of general anaesthesia and surgery, compromised patients have markedly less reserves and an impaired ability to cope with these stresses. This webinar will discuss preparation and stabilisation methods for compromised patients in the pre-operative period, as well as what to monitor perioperatively and during recovery. To put all our new knowledge and though processes together a compromised patient case example is used to finish the webinar.

By the end of the session, attendees will be able to:

1. To recognize and become familiar with the many faces of the term “”compromised””.
2. To become confident with ways to stabilize and reduce the risk associated with compromised patient anesthesia.
3. To be able to make a patient specific list of “”anticipated problems and considerations”” for each compromised patient.

Speaker Info: Marcia is a registered veterinary nurse specialist and an international speaker. Having 20 years’ experience in veterinary anaesthesia, she started her career working for the Massey University Veterinary Teaching Hospital in New Zealand and was the senior anaesthesia nurse there for over 16 years. In 2011 she became New Zealand’s first Veterinary Technician Specialist in Anaesthesia and Analgesia. She has been awarded New Zealand’s “Vet Nurse of the Year”, and several teaching awards including “Teacher of the Year”. Marcia is also a RECOVER certified instructor of both basic and advanced CPR. In 2020 Marcia left the university teaching life and created “”The Pink Stethoscope””, her platform to elevate veterinary anaesthesia within the entire veterinary community. Through The Pink Stethoscope she independently provides postgraduate veterinary anaesthesia education, training, webinars and consultations both nationally and internationally. Marcia loves all aspects of veterinary anaesthesia teaching. Her passion has always been instilling anaesthesia knowledge to the greater veterinary profession – to make a somewhat challenging subject less stressful, and ultimately to empower veterinary professionals to continue their anaesthesia learning journey. Away from work Marcia is a busy kiwi mum, enjoying her home life with her husband, daughter, son, and very special “fur-daughter” Minnie the tuxedo cat.

By: Steven Berkowitz, DVM, DACVECC

Description: Refractory Vomiting diagnosis and treatment modalities.

By the end of the session, attendees will be able to:

1. Be able to identify and diagnose causes of vomiting. Mechanism of action for multimodal care. Treatment and stabilization of said patients.

Speaker Info: Dr. Berkowitz attended St. Georges University and did his clinical year of training at University of Illinois. Dr. Berkowitz joined the Critical Care Team at NorthStar VETS in 2017. Prior to that, he completed a three-year residency in Emergency and Critical Care at Oradell Animal Hospital in Paramus, NJ. His residency was completed at one of the first level one veterinary trauma centers in the United States. Dr. Berkowitz can be seen on seasons 5 and 6 of “Animal Precinct” on Animal Planet, which was filmed at the Bergh Memorial Animal Hospital of the ASPCA wherein he did his rotating internship. Dr. Berkowitz’s professional interests include management of metabolic and endocrine emergencies, as well as septic patients. He is published as the primary author in the Journal of Veterinary Emergency and Critical Care with his article “Resolution of spontaneous hemoabdomen secondary to peliosis hepatis following surgery and azithromycin treatment in a Bartonella species infected dog. “ Dr. Berkowitz proudly serves on the Board of Trustees for “Mickey’s Kids,” which helps provide service dogs in New Jersey for children in need. He is also on the Board of Diversity and Inclusion with the College of Veterinary Emergency and Critical Care, on the New Jersey Veterinary Medical Association’s Educational Committee, as well as serving as a critical care reviewer for Vet Companion, which is an online service for veterinary professionals. He is also currently involved in the reviewing process for the newest version of the RECOVER Guidelines for advancing knowledge in CPR in the veterinary field. In addition to being the staff Criticalist at NorthStar VETS, he also serves as the Director of the Ann Smith Memorial Blood Bank, and holds a certificate of completion in Tactical Emergency and Casualty Care through NAEMT (National Association of Emergency Medical Technicians,) which qualifies him as a first responder to mass casualty events involving both human and veterinary patients. He is currently an instructor for this organization as well.

By: Andrew Linklater, DVM, DACVECC

Description: Damage Control is a set of techniques which have developed over a few decades to help minimize mortality associated with hemorrhage, the leading cause of death in patients suffering trauma, accounting for 75% of mortality in human patients. Hemorrhage leads to the common triad of physiological changes which exacerbate patient stability and contribute to both morbidity and mortality: acidosis, hypothermia and hypotension. This lecture will review many aspects of Damage Control including medical (Damage Control Resuscitation, DCR) and surgical (Damage Control Surgery, DCS) techniques to help avoid ongoing blood loss and death in patients suffering from significant hemorrhage from trauma. DCR involves all attempts to avoid the lethal triad, including permissive hypotension, early administration of blood products, reduced crystalloid infusion, immediate hemorrhage control and correction hypothermia, acidosis and coagulopathy which all occur with hemorrhage and shock. Each of these will be reviewed in detail. The techniques to successfully perform DCS will also be reviewed. These involve a rapid, but short lived anesthetic and surgical event to arrest hemorrhage and minimize contamination, followed by a period of resuscitative efforts (medical management) to return the patient to a normal physiological state, and a second surgical procedure for definitive care is pushed at a later time. Alternative (conservative) methods for managing traumatic hemoabdomen patients will also be discussed.

By the end of the session, attendees will be able to:

1. Know how to rapidly assess a patient for life-threatening hemorrhage
2. Learn the concepts of damage control resuscitation for the hemorrhaging patient
3. Learn the concepts of damage control surgery
4. Know of alternative non-surgical techniques for patients with cavitary hemorrhage

Speaker Info: Dr. Linklater grew up in Canada and graduated from the Western College of Veterinary Medicine in Saskatoon, Saskatchewan. He completed a rotating internship in Los Angeles before moving on to residency at the Animal Emergency Center in Milwaukee. He became board certified by the American College of Veterinary Emergency and Critical Care in 2009. He worked at and was part owner of Lakeshore Veterinary Specialists in Wisconsin prior to acquisition by BluePearl. During his 20 year tenure in Wisconsin, he has served as Medical Director, Emergency Service head, Director of a certified Veterinary Trauma Center and Director of an Internship and Residency Program, where he has mentored more than 100 individuals. He has authored more than 50 peer-reviewed journal and textbook chapter publications, been the senior editor of two veterinary emergency textbooks, and has hundreds of lecture and lab instruction at a multitude of national and international conferences. In his hospitals, he instituted IPASS rounding, lead the Patient Safety Initiative, developed and instituted COVID, ER Service Pause, Antibiotic Stewardship, Critical anesthesia, Blood Banking, and Sustainability guidelines. He was a top-awarded veterinarian of the Veterinary Involvement Program at his previous hospital for three years. Recently, he has embarked on a new chapter, moving with his family to Colorado, and is excited to be the lead criticalist at Veterinary Specialists of the Rockies. Dr. Linklater’s professional interests include trauma, surgical emergencies, coagulpathies, respiratory intervention, and transfusion medicine; he is also a certified RECOVER instructor. On a personal note, he has run several marathons and half marathons, enjoys curling, outdoor activities such as hiking, and camping, traveling, and spending quality time with his wife and their pets. He is excited to participate in all the outdoor adventure that Colorado has to offer.

By: Stacy Meola, DVM, MS, DACVECC and Kelly Knudson, MD, FACS

Description: This session will be presented by a critical care veterinarian and a human general and trauma surgeon. We will discuss how to diagnose a pneumoperitoneum on radiographs and CT. The lecture will work through an algorithm to determine if surgery or medical management is appropriate and what the common medical management would be in humans and animals. When appropriate we will compare the differences between the causes and treatments in humans and companion animals.

By the end of the session, attendees will be able to:

1. Participants will have a great understanding of the causes of pneumoperitoneum
2. Participants will learn how to determine which cases should go to surgery and which cases medical management can be considered.
3. Participants will learn some of the trick for diagnosing a pneumoperitoneum on different imaging modalities

Speaker Info: Dr. Stacy Meola attended the University of Utah and received her Bachelor’s degree in Biology and Chemistry, and her Master’s degree in Medical Laboratory Science. While in Utah, she spent six years conducting research on artificial hearts and other biomedical devices. Dr. Meola earned her Doctor of Veterinary Medicine degree at Colorado State University in 2006 and accepted the internship at Wheat Ridge Animal Hospital. After completing this program in June 2007, Dr. Meola was selected to stay on for a surgical internship. She completed her residency in Emergency and Critical Care at Wheat Ridge Animal Hospital and became board-certified in Emergency and Critical Care in 2012. She accepted the position of Associate Medical Director for Wheat Ridge Animal Hospital in 2016. Presentation Title: Management of Pneumoperitoneum This session will be presented by a critical care veterinarian and a human general and trauma surgeon. We will discuss how to diagnose a pneumoperitoneum on radiographs and CT. The lecture will work through an algorithm to determine if surgery or medical management is appropriate and what the common medical management would be in humans and animals. When appropriate we will compare the differences between the causes and treatments in humans and companion animals.

Dr. Knudson received her medical degree from University of Colorado School of Medicine where she was active in AOA, the medical honor society. She is board certified in general surgery. She completed a five-year surgical residency at University of Colorado and joined Exempla Healthcare in 2008. Dr. Knudson has served as Chair of the Performance Excellence Quality Committee, Surgery Department Chair and finally as Chief of Staff for the Medical Staff at Good Samaritan Medical Center 2018-2020. She has also served as Medical Director for Specialty Care and General Surgery for SCL Health now Intermountain Healthcare.

By: Elke Rudloff, DVM, DACVECC & Elizabeth Rozanski, DVM, DACVIM, DACVECC

Description: Ever wonder about what it is about Yorkies? We have too! Dr. Rozanski and Dr. Rudloff are going to talk about when cuterebra, collapsing tracheas, PSS and carotid arteries make the Yorkie go bad. This interactive case discussion will identify and discuss some unique factors that we see with this terror breed.

By the end of the session, attendees will be able to:

1. Highlight unique features the Yorkie breed may have
2. Review pathophysiology and the Yorkie breed
3. Discuss case management of certain emergent situations in the Yorkie

Speaker Info: Dr. Rudloff worked as a specialist in emergency and critical are for over 30 years and is now exploring the end-of-life care space for BluePearl Pet Hospice. Dr. Rozanski is a specialist in emergency and critical care on faculty member at Tufts University.

By: Beth Davidow, DVM, DACVECC

Description: We know that overuse of antibiotics can lead to resistance. We also know that not using the right antibiotics fast enough can increase mortality in septic patients. How do we then problem solve when to go fast and when to go slow? How do we choose antibiotics with different types of cases? This presentation will give concrete ideas on initial patient assessment, evidence based choices for different disease, and diagnostics that can help with antibiotic choice.

By the end of the session, attendees will be able to:

1. Understand which patient presentations indicate that antibiotics should be given as rapidly as possible.
2. Become familiar with the ISCAID antibiotic guidelines for urinary, respiratory, and skin diseases.
3. Describe the evidence for and against using antibiotics in patients with diarrhea.

Speaker Info: Dr. Davidow is one of the co-founders of Timberline Veterinary Emergency and Specialty in Seattle, WA. She has previously been on faculty at Washington State University, is past president of ACVECC, and has been one of the Emergency medicine consultants for VIN since 2002. When she has time, she writes the blog, The Veterinary Idealist.