By: Rose Nolen-Walston DVM, DACVIM

Description: It’s incredibly hard being a veterinarian, and practicing clinical medicine is one of the highest pressure, high stakes environments out there. Even the most competent, confident veterinarian has days where it feels like nothing is coming together for them. But it turns out that there are functional limitations to how much the brain can do: we’ll discuss cognitive load theory and the myth of multi-tasking, and why feel like our brains fail us sometimes. Then we’ll cover extrinsic and intrinsic cognitive load and go over evidence-based strategies to allow your brain to work at full capacity. Even with that, though, everyone has days where imposter syndrome sneaks up on us (and some of us wish we had even the occasional day where it didn’t!). We’ll delve into why imposter syndrome occurs and how to address it, with a quick tour of the Dunning-Kruger effect. And finally, we’ll discuss the second victim effect, which is the emotional trauma that healthcare providers experience when they make a medical error, and how these factors lead to burnout and compassion fatigue. These problems are endemic, and we’ll finish with how to recognize them, why they occur, and most importantly, how we can find strategies to protect ourselves from them.

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

1. Why it feels like our brains can’t keep up: how cognitive load theory affects your ability to process high-volume information in a high-stress environment, and how to leverage the theory to become a more efficient, effective clinician and teacher.
2. Why it feels like our brains can’t keep up: using “deliberate practice theory” as a roadmap to improving expertise, even after years in practice.
3. Why it feels like we’re not smart enough: examining the interplay of the Dunning-Kruger effect (a cognitive bias in which people wrongly overestimate their knowledge or ability in a specific area) and imposter syndrome (an internal experience of believing that you are not as competent as others perceive you are) is so prevalent in our field, and how we can grow past it.
4. Why do we feel burned out: how burned out are you, is there a way to measure it? We’ll describe the consequences of burn-out, and what works and what doesn’t, to mitigate burnout and compassion fatigue in clinical medicine.
5. Why we feel burned out: who is the “second victim” of medical error? It’s the practitioner who made the mistake. What responsibilities do we have to care for the second victims, and what does that look like?

Speaker Info: Rose Nolen-Walston grew up on a farm in England with plans to become a professional dressage rider but a complete lack of talent for the sport led her to veterinary medicine, where she eventually graduated from UGA in 2001 with her DVM. She went on to do an internship and residency in large animal internal medicine at Tufts before joining the faculty at the University of Pennsylvania’s School of Veterinary Medicine in 2006. In 2014 Dr Nolen-Walston won University of Pennsylvania’s Lindback Award for Distinguished Teaching and is past president of the Veterinary Comparative Respiratory Society. She is currently pursuing a non-traditional residency in clinical pathology at Tufts while continuing her Penn faculty appointment and is loving every second of learning more about the small animal side of medicine too!

By: Christine Culler, DVM, MS, DACVECC

Description: Blood product shortages are increasingly common and many hospitals may not regularly keep blood products on hand. Having an established contingency plan for patients requiring blood products is important. It is stressful to find alternative solutions in a crisis and the delay can compromise patient outcomes. We will review various blood products and their uses, including dosages, rates, proper administration, and how to navigate transfusion reactions. We will discuss a variety of alternatives to reach for when your blood refrigerator is empty, including the pros and cons of each. This will include xenotransfusion for cats when type-specific products aren’t available, how to appropriately collect and store blood from a donor animal, stabilizing the anemic patient while waiting for a transfusion, and suggestions on navigating blood product purchasing in urgent situations. A goal for this course is to leave more confident in transfusion medicine and to have an organized plan for handling blood shortages.

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

1. To understand potential indications and risks of xenotransfusion in cats.
2. To be familiar with a protocol for in-house blood collection
3. To know the content of various blood products and alternatives when the ideal product is not available

Speaker Info: Christine Culler, DVM, MS, DACVECC is a traveling emergency doctor with Veterinary Emergency Group. She completed her DVM, Master of Science, and residency in Emergency and Critical Care at The Ohio State University. She then completed a fellowship in extracorporeal therapy at North Carolina State University. She was a medical director at BluePearl North Carolina and joined VEG in 2023. The challenge of end of life and quality of life decision-making in her critical patients fueled her interest in palliative care and improving communication in serious illness. She also enjoys managing trauma, sepsis, acute kidney injury, and intoxications and appreciates working in hospitals that encourage teachers and learners to be humble and curious.

By: Daniel J. Fletcher, PhD, DVM, DACVECC

Description: Delivery of quality healthcare requires highly skilled teams that can remain effective in the complex, unpredictable environment that is the modern veterinary practice. Drawing on the evidence based TeamSTEPPS system developed for human health care, this session will describe the VetTEAMS framework, a series of team competencies and simple communication tools that can be integrated into your practice to reduce medical errors, and improve team performance, and enhance staff satisfaction. Delivery of high-quality veterinary care requires extraordinary team work. Learn how you can help your team reach the next level of efficiency, quality, and safety.

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

1. Explain the principles of good leadership of a veterinary healthcare team.
2. Describe the 4 fundamental characteristics of good communication in a veterinary healthcare setting.
3. Demonstrate techniques and tools for achieving situation awareness through situation monitoring skills.
4. Describe the principles of mutual support and the behaviors that can maximize a team’s ability to ask for and offer help to allocate resources where they are needed.

Speaker Info: Dr. Fletcher has been faculty at Cornell since 2006. After receiving a BS in Electrical Engineering from Drexel University and a PhD in Bioengineering from the University of California, he obtained his DVM from the University of California at Davis. He then completed an internship and emergency and critical care residency at Penn. He is co-chair of the RECOVER Initiative, which published the first evidence-based veterinary CPR guidelines, and is past-president of the American College of Veterinary Emergency and Critical Care.

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.