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: Julien Guillaumin, Docteur Vétérinaire, Diplomate ACVECC, Diplomate ECVECC

Description:
There is limited literature in septic shock in dogs and cats, although plenty of evidence-based practices from human medicine. With a mortality rate around 15-20% in dogs, it is very important that septic shock is quickly suspected, appropriately diagnosed and treated. Both the veterinary definitions and the human Sepsis 3 definitions aligned for septic shock, which avoids confusion of having 2 sets of definitions for SIRS, sepsis and MODS. Treatment of septic shock includes rapid source identification and control, and a bundle of treatments. This bundle includes early and judicious fluid therapy, rapid administration of broad spectrum antibiotics, sometimes with higher doses or prolonged infusion, and finally rapid administration of vasopressors. Specific triggers and timing of decision-making processes regarding use of those therapies, especially antibiotics and pressors, are important. Finally, ancillary treatment such as monitoring, nutrition and specific organ dysfunction treatments are important to understand the management of this complex syndrome.

Course Objectives:

1. Understand the timing of antibiotic and vasopressor administration in septic shock
2. Recall the veterinary and human sepsis 3 definitions of septic shock
3. Apply a specific bundle of treatment to the management of septic shock in dogs and cats

Speaker Info:
Dr Guillaumin is currently an Associate Professor in Emergency and Critical Care at Colorado State University. After graduating from the Ecole Nationale Veterinaire de Nantes, France, Dr Guillaumin pursued a small animal rotating internship at the Ecole Nationale Veterinaire d’Alfort, France. After graduation, he worked in both private practice emergency settings and academia, serving as a clinical instructor in Emergency and Critical Care at the Ecole Nationale Veterinaire de Lyon (now VetAgroSup). Dr Guillaumin continued his advanced training in Emergency and Critical Care by moving to the US in 2005, working as a clinical instructor at Cornell University and then completed his ACVECC residency at the University of California, Davis in 2009.

For 10 years, Dr Guillaumin was a clinician, teacher and researcher as a clinical track Assistant, then Associate Professor at the Ohio State University. He also acted as the Blood Bank Director. In 2015, Dr Guillaumin was recognized as an invited diplomate of the European College of Veterinary Emergency and Critical Care. In 2019, Dr Guillaumin took a tenure-track position at Colorado State University. His clinical and research interests include thrombosis and thrombolysis, hemostasis, blood banking, transfusion medicine, sepsis and septic shock.

Dr Guillaumin is a former Chair of the ACVECC residency training committee and currently serves as a Chair of the Joint Committee which oversees the work of the 3 major ACVECC Committees as well as a member of the ECVECC Education Committee. Dr Guillaumin has trained over 150 interns and ECC residents and has over 200 invited lectures and scholarly publications.

By: Lisa Hacker, LMSW

Description:
As the human-animal bond strengthens over time and staffing shortages have altered every practice, veterinary professionals are faced with a growing number of clients with high emotional reactivity when their companion animal is experiencing an emergency. This course will shed some light on why this occurs and focus on techniques to help clients return to a more rational state.

Course Objectives:

1. Define & understand the term “emotionally charged”
2. Recognize the early signs of agitation in vet med clients
3. Describe the concept and importance of de-escalation
4. Acquire a collection of skills & techniques to use in practice

Speaker Info:
Lisa is an Advanced Practice Social Worker (APSW) in the State of Wisconsin, as well as a Licensed Master Social Worker (LMSW) in the State of Arizona. She earned her Master’s Degree in Social Work at the University of Wisconsin-Milwaukee in 2009. Lisa’s post-graduate experience had been in pediatric, medical social work before transitioning full-time into Veterinary Social Work in 2018. Lisa’s first program was developed at Lakeshore Veterinary Specialists in Milwaukee, WI which was featured in the June 2020 edition of the JAVMA. Currently, Lisa is the Social Work Program Manager for employee-owned, 1st Pet Veterinary Centers in the metro Phoenix area, where she also manages a training program for MSW students for multiple area universities. Lisa achieved her Grief Support Specialist Certification at the University of Wisconsin-Madison in 2021 and is a contributor to the forthcoming volume The Comprehensive Guide to Interdisciplinary Veterinary Social Work. Lisa continues her work providing relevant education for the veterinary community as well as facilitating nationwide support groups for DVM’s through the Veterinary Hope Foundation.

By: Dr. Isaac Sabat

Description:
This presentation will provide an overview of best practices in designing selection systems based on the organizational psychology literature. Specifically, I will review research demonstrating the evidence of implicit bias inherent within typical hiring approaches. I will then discuss the business case for reducing these biases and improving diversity within organizations. Lastly, I will discuss effective recruitment and selection strategies for improving employee diversity and success.

Course Objectives:

1. Learn how to design valid selection systems
2. Learn how to evaluate bias and inequity within these systems
3. Learn evidence-based strategies for increasing diversity in organizations
4. CR

Speaker Info:
Isaac Sabat’s program of research broadly focuses on understanding and improving the working lives of stigmatized employees. He is particularly interested in examining strategies in which these employees can engage, such as disclosing or acknowledging their identities, to effectively remediate the workplace obstacles that they face. He has conducted various interrelated projects that examine how the effectiveness of expressing one’s identity is impacted by the extent to which stigmas are previously known, visible, or discovered by others over time. This is a novel area, given that disclosures have previously been conceptualized as a dichotomous, all-or-nothing phenomenon. This work has been published in Journal of Business and Psychology, Journal of Organizational Behavior, Journal of Vocational Behavior, and Harvard Business Review.

By: Gregory R. Lisciandro, DVM, DABVP, DACVECC

Description:
We will discuss the use of Global FAST point-of-care ultrasound for raising the suspicion and for the detection of traditionally difficult conditions focusing on pulmonary and cardiac conditions.  Global FAST is the combination of AFAST, TFAST and Vet BLUE as a single ultrasound examination that uniquely screens the abdomen and thorax including heart (TFAST fundamental echocardiography) and lung (Vet BLUE). By integrating findings, cardiac and lung conditions otherwise suspected or missed based on physical exam, laboratory testing, and radiography are “seen” (more evidence-based) using the Global FAST approach.

Course Objectives:

1. Understand the views of Global FAST
2. Understand AFAST and its abdominal fluid scoring system
3. Understand TFAST fundamental echocardiography
4. Understand Vet BLUE, its regional, pattern-based approach, B-line scoring system, and visual lung language for signs of consolidation
5. Understand how to integrate information by Global FAST for detecting traditionally difficult conditions

Speaker Info:
Dr. Gregory Lisciandro, DVM, Dipl. ABVP, Dipl. ACVECC, attended Cornell, completed an internship at The Animal Medical Center, New York City, and emergency and critical care residency at the Emergency Pet Center, San Antonio, Texas.  He has practiced veterinary medicine as a general practitioner, emergency veterinarian, and then as a specialist in emergency and critical care.  He developed AFAST^® and TFAST^® in 2005, and Vet BLUE^® and Global FAST^® in 2010.  Global FAST^® ultrasound is a unique ultrasound examination used to rapidly screen both the abdominal and thoracic cavities including heart and lung.  He has authored over 20 peer-reviewed Global FAST^®-related clinical studies.  He is chapter author and editor of Point-of-care Ultrasound Techniques now in its 2nd edition and has served as an ACVECC At-large Regent, member of the Scientific Committee, the Student Certification Committee, and VetCOT.  He has lectured and directed Global FAST^® ultrasound scanning workshops around the world and continues to lead in publishing clinically relevant, point-of-care ultrasound research.

By: Ginger Templeton, DVM, MS, CPC

Description: The veterinary profession is inherently stressful. Conflict and high emotions are both a cause and consequence of this workplace stress. Emotional intelligence is an important tool that can be taught and developed in order to improve conflict response, stress management, communication and leadership. Leaders who have high levels of emotional intelligent often have greater psychological safety on their teams which, in turn, are often more effective and productive.

In this course, we will explore the subdomains of emotional intelligence and how to apply these domains in stressful or conflict-laden situations. Cases will be used to illustrate the real-time application of emotional intelligence in the workplace. Participants will be encouraged to consider their own strengths and weaknesses in emotional intelligence and ways to improve their leadership through this framework.

Course Objectives:

Participants will be able to:

1. Define emotional intelligence (EI), and explain the relationship between EI and effective leadership
2.  List and describe the four domains and 12 subdomains of emotional intelligence (EI)
3. Identify personal strengths and weaknesses in emotional intelligence
4. Apply emotional intelligence as a framework for handling conflict and stress

Speaker Info:
Dr. Ginger Templeton is the CEO of Vet-to-Vet Coaching, which provides leadership development and wellbeing coaching to veterinarians and their teams. She also serves as Director of Learning and Development for Mentor Vet and is on the Board of Directors of MOVES (Mobile Veterinary Specialists). Her coaching style incorporates emotional intelligence to help veterinary professionals discover innovative solutions with confidence and compassion. After earning her Doctorate in Veterinary Medicine at the University of Wisconsin-Madison, she spent fifteen years in the trenches of small animal general practice, including five as a mobile practice owner. In 2021, she completed the Veterinary Human Support Certification through the Department of Social Work at the University of Tennessee and executive coach certification through the post-graduate training program at The College of Executive Coaching. Dr. Templeton believes the key to culture change and greater wellbeing in veterinary medicine is through a combination of individual responsibility and organizational initiatives and thus finds value in working both one-on-one with leaders as well as teaching groups of veterinarians and team members.

By: Katherine Smith, DVM, DACVECC

Description: This lecture will introduce “Guidelines for the Prevention of Pain, Agitation, Delirium, Immobility, and Sleep Disruption in Adult Patients in ICU” from our human medicine counterparts and use this as a basis for our discussion on how we can improve the ICU experience for the veterinary patient.  It will focus mainly on anxiety/agitation and sleep deprivation, with a goal of understanding the science of their deleterious effects and real solutions on how to mitigate their occurrence.  This lecture is designed for all levels.

Course Objectives:

1. PADIS guidelines in human medicine – what are they and how can we use them when thinking about veterinary ICU patients
2. Anxiety and agitation – recognition, physiological side effects, and what can we do to address it
3. Sleep – physiology of sleep and sleep deprivation, how sleep disruption may affect outcomes, strategies to maximize better sleep in our patients.
4. Immobility and other forms of suffering that we can better address in our patients.

Speaker Info: Dr. Katherine Smith received her DVM from Louisiana State University (2009), a small animal rotating internship at the University of Georgia (2010), and an ECC residency at Cape Cod Veterinary Specialists (2013), receiving her board certification in emergency and critical care in 2014. She was in private practice in specialty hospitals until 2020 when she transitioned to doing only locum work, allowing her to practice across the nation spanning from Hawaii to Massachusetts. She loves teaching, infectious diseases, and feline medicine (to be honest, she loves anything to do with cats in general). Dr Smith also has a special interest in improving our patients’ ICU experience by more thoroughly addressing anxiety and sleep needs.

By: Bobbi Conner, DVM, DACVECC

Description:Fluid therapy is one of the most commonly prescribed treatments for sick veterinary patients. Its ubiquity does not, however, mean that we know all we need to know about the benefits and dangers of fluid therapy. In recent years, some new research has put a spotlight on trends in fluid therapy in medicine and as a result, some long-held recommendations have been questioned. In this discussion, we will review current recommendations for fluid therapy. Whenever possible, veterinary-specific literature will be cited and discussed; when necessary, recommendations that have been extrapolated from human medicine research and guidelines will be clearly presented. We will focus on practical application of the available research, identify and highlight the remaining gaps in our collective knowledge, and we’ll attack some of the most persistent controversies and myths involving fluid therapy. The session will be interactive and case-based.

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

1. list the benefits and risks of intravenous fluid therapy in any patient.
2. list the indications for fluid therapy and as well as the indications for discontinuation of fluid therapy.
3. choose the most appropriate fluid type for their patient’s needs.
4. describe the earliest signs of potential fluid overload in a small animal patient.
5. identify at least two resources to aid in complex fluid therapy administration cases.

Speaker Info: Dr. Conner obtained her DVM from Michigan State University in 2007, after which she completed a rotating internship at University of Illinois in 2008, followed by her residency in Emergency & Critical Care at NC State in 2011, when she became a diplomate of ACVECC. She worked at the vet school at University of Pretoria in South Africa for a short while in 2011-2012, then joined the faculty at University of Florida from 2012-2020. Since the summer of 2020, she has been developing the emergency & critical care program at the Virginia-Maryland College of Veterinary Medicine. She is passionate about teaching and learning and is currently pursuing a Master’s in Educational Psychology. Most of her current research involves identifying best practices in education and communication.

By: John Thomason, DVM, MS, DACVIM (SAIM)

Description: Transfusions are a common, integral and life-saving therapeutic option in dogs with IMHA. Also, recent therapeutic advancements are potentially providing effective options for dogs with IMHA.  Based on current research, this section will discuss the selection of appropriate blood products and other considerations for transfusions. This session will also discuss advancements in medical therapies that could aid in the treatment of IMHA.

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

1. To better understand which transfusion products are available for the treatment of IMHA, and when to use these products.
2. To better understand the advancements in medical therapies and when they should be included in the treatment of canine IMHA.
3. To better understand how to handle cases of canine IMHA that do not initially respond to standard immunosuppressive and supportive therapies.

Speaker Info: John Thomason is an associate professor of small animal internal medicine at the College of Veterinary Medicine at Mississippi State University (MSU).  He received his DVM from the Virginia-Maryland College of Veterinary Medicine and earned his M.S. in Veterinary Medicine from Mississippi State University.  He completed his residency in small animal internal medicine at Mississippi State University prior to joining the faculty. Dr. Thomason’s research interests are in the field of hematology, hemostasis, and immune mediated disorders.

By: Samuel Stewart DVM, DACVECC

Description: Increasing frequencies of multidrug-resistant infections have been noted in human and veterinary ICU patient populations, emphasizing the importance of appropriate and effective treatment protocols for these patients. Critically ill patients possess a vast array of pathophysiologic changes that can complicate antimicrobial dosing, such as increases in the volume of distribution and increased drug clearance. Dosing regimens must adhere to pharmacodynamic principles while also taking into consideration the pharmacokinetics for each patient. Previous studies have shown clinical cure superiority and better efficacy with continuous infusions of antimicrobials as they possess a higher likelihood of attaining pharmacodynamic/pharmacokinetic targets. This lecture will review the logic behind the use of antimicrobial continuous infusions in critically ill patients and how they can be utilized in clinically.

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

1. Better understand the increasing incidence of multi-drug resistant infections in clinical practice and the practices that can contribute to the incidence of these infections.
2. Learn about the pathophysiologic sequelae of critical illness that can effect the ability to adequately treat with antimicrobials.
3. Review the justification of antimicrobial continuous infusions and how this approach can improve the ability to achieve therapeutic levels of antimicrobials in critically ill patients.

Speaker Info: Dr. Sam Stewart is originally from the Hudson Valley region of upstate New York in the US. He completed his undergraduate degree in Biology at Binghamton University in New York. He then attended veterinary school at the Ross University School of Veterinary Medicine, finishing his degree in 2013. Dr. Stewart went on to complete a small animal rotating surgical and medical internship at Garden State Veterinary Specialists (Tinton Falls, NJ) in 2014 and an Emergency and Critical Care residency at the Massachusetts Veterinary Referral Hospital (Ethos Veterinary Health – Woburn, MA) in 2017. He was also accepted as a Diplomate in the American College of Veterinary Emergency and Critical Care in 2017. Following his residency, he joined Ethos Science Consultancy (a contract research and consulting organization) through which he started a Science Commercialization Fellowship. He completed the fellowship in 2022 and became the Director of Science Consultancy. Dr. Stewart also designs and conducts his own de novo clinical studies through Ethos Discovery, a non-profit incubator of scientific innovation. His areas of interest include improved means to diagnose and treat sepsis as well as novel modes of pain management in dogs and cats, such as the use of cannabidiol. He is always looking for new and exciting research opportunities to help further the knowledge and capabilities of veterinary medicine.

POSTPONED

Tonight’s VECCS x VIN Webinar will not be happening. VIN’s servers are down. The Webinar will be rescheduled ASAP, we apologize for any inconvenience this may cause you.

By: Jon Geller, DVM, DABVP emeritus

Description: This session will cover the challenges of providing effective veterinary care in low resource settings (in a field, parking lot, or under a bridge) to pets of those who are experiencing, or at risk of homelessness. Homelessness is a major unsolved problem in almost every city in America, as well as in rural settings, and those who are experiencing homelessness often their pet provides them their (only) companionship, unconditional acceptance, a sense of purpose in an otherwise purposeless life, as well as protection in a highly dysfunctional environment. Training in emergency medicine is helpful in triaging sick animals and working with limited patient-side diagnostics, with a major reliance on a good history-taking and physical exam skills. In the street setting, some chaos can be expected, especially with the challenges or working with indigent pet owners, around 30-35% of whom are dealing with their own mental health and substance abuse issues. Street Medicine is free medicine, and working without the economic constraints of estimates and high-end treatment plans can be liberating for clinicians.

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

1. To provide an overview of pets and homelessness in the US
2. To explore and discuss the complex issues related to pet ownership and access to care for those that are homeless
3. To discuss in detail effective means of providing effective care, both preventive and urgent, in low resource settings

Speaker Info: Dr. Jon Geller is a graduate of Colorado State University College of Veterinary Medicine. After graduating, he practiced as an emergency clinician in Colorado for 20 years and started up 4 emergency clinics. He became Board Certified as Veterinary Practitioner in Canine and Feline Medicine in 2010. In 2015 he founded The Street Dog Coalition, a non-profit charity, which provides free medical care, and other related services, to pets of owners at risk of, or experiencing homelessness in over 50 US cities.

Recently, The Street Dog Coalition went international, setting up a vet clinic in a tent at the Romania-Ukraine border, where teams of veterinarians have been providing free veterinary care to pets of Ukraine refugees. Currently, The Street Dog Coalition is working with Worldwide Vets to send in the first mobile veterinary clinic into Ukraine.

Dr. Geller was named Veterinarian of the Year by the Colorado Veterinary Medical Association for 2019. In the spirit of unbridled learning, he is currently enrolled as an MPH candidate at the University of Minnesota. He recently received the ASPCA Henry Bergh Award for 2022 and just started a new position as an Instructor at The Colorado School of Public Health teaching a class called “Homelessness in America.”

By: Rose Nolen-Walston DVM, DACVIM

Description: Diagnosis is considered the pinnacle of cognitive skill in medicine, being both essential for successful outcome and yet extraordinarily difficult to master. In human medicine, a recent report found that almost everyone who goes to the doctor will experience a misdiagnosis in their lifetime, a key factor in ~50% of litigation against doctors. In this session we’ll talk about the two ways we come to a diagnosis: “thinking fast” (known as system-1 reasoning) is the rapid, intuitive and non-analytical approach to identify common diseases, and used in the majority of cases by experienced clinicians, whereas “thinking slow”, or system-2 reasoning, uses an analytical, hypothesis-driven, problem-based approach to diagnosis and is essential for patients with complex or multisystemic disease. Given the realities of veterinary practice, system-1 reasoning is an essential skill but it comes with a much higher risk of subconscious cognitive biases that make misdiagnosis more likely. We will go over some of the most common examples of cognitive biases, discuss how they apply to veterinary medicine, and identify some simple strategies that can be incorporated in a matter of seconds into every day, high-paced practice. Then we’ll review the fundamentals of the problem-based approach to diagnosis and hone some skills that will improve your ability to pursue a diagnosis in cases where pattern recognition is insufficient.

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

1. How does your brain work when you make a diagnosis? Discriminate between system-1 (“”think fast!””) and system-2 (think slow!””) reasoning and identify the benefits and pitfalls of each approach in the context of veterinary diagnosis.
2. Thinking about thinking: use metacognition to understand why our brains can lead us down the wrong path, and being able to recognize when we are at risk of cognitive errors.
3. Why do misdiagnoses happen? Analyze the cognitive biases that result in misdiagnosis and create usable strategies to avoid them. What are the common ways our brains lead us astray? How you can tell when it’s happening, and what are some simple tricks you can use to avoid them.

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: M. Ryan Smith, DVM, DACVECC

Description: This hour of rounds will focus on bringing to light some of the nuances of canine anaphylaxis. A broad review of pertinent pathophysiology will take place to provide better understanding of the nature of the presenting clinical picture. The focus of the discussion will be on treatment approaches with a review of the evidence, where possible. Anaphylaxis-associated hemoperitoneum and hemostatic derangements will be included and related to alterations in treatment approach.

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

1. Provide information with which to understand the clinical presentation of canine anaphylaxis.
2. Provide an overview of current treatment considerations with which to base a clinical approach to canine patients with anaphylaxis
3. Provide an understanding of when deviation from standard anaphylaxis treatment approaches may be necessary and how to do so

Speaker Info: Dr. Smith is the clinical service chief of small animal emergency & critical care at the Louisiana State University Veterinary Teaching Hospital. He graduated with a D.V.M. from LSU in 2009. After completion of a rotating internship in Orlando, FL in 2010, he practiced emergency medicine for two years. Dr. Smith then pursued residency training in Emergency and Critical Care in St. Louis, MO, completing the program in 2015. Over the following couple of years, he practiced as a specialist in a private specialty hospital prior to assuming his current role with his alma mater. Dr. Smith joined the LSU faculty in 2017 and has since published articles and proceedings on various aspects of canine anaphylaxis and point-of care viscoelastic coagulation testing.