To initiate this year’s dvm360 Fetch Charlotte conference in North Carolina, Philip Bergman, DVM, MS, PhD, DACVIM (Oncology), global director of clinical studies at Mars Veterinary Health, delivered a keynote address on some of the top clinically relevant advances in veterinary oncology. Among the advancements discussed were a new, highly effective drug for nausea and vomiting; a vaccine for melanoma; and a pharmacogenetic test related to ‘white feet don’t treat.’

A more effective treatment for managing nausea and vomiting

As Bergman explained, vomiting is a significant problem in both human and animal oncology patients, even outside of those undergoing chemotherapy. Many patients receiving surgery, radiation, or tyrosine kinase inhibitors (TKIs) will experience nausea and subsequently vomiting.

In animal patients, more than 90% will experience vomiting with cisplatin if untreated and approximately 10% to 20% may have overt delayed vomiting. Although the approximate percentage of patients who experience vomiting is known, the percent of those who experience nausea remains unknown, according to Bergman.

“...it’s easy for clients to know what overt vomiting is, but if you ask them, ‘Did Fluffy have any nausea over the last 3 weeks?’ invariably, they'll say ‘no.’ But if you actually arm them with what nausea looks like in the dog, then all of a sudden they say, ‘Yes, oh yeah, I do remember Fluffy walked up to the food bowl, kind of licked their lips, walked away—kind of like the waterfalls we have when we're nauseous,” said Bergman during his session. “So I think we actually underestimate the amount of nausea that our patients go through, and we know that there's huge quality of life implications to that.”

Much like the human medication Emend, an NK1 receptor antagonist for treating nausea and vomiting, particularly related to chemotherapy, Cerenia—a novel, veterinary-only medication for treating vomiting and nausea in cats and dogs—is also an NK1 receptor antagonist that is highly effective. As Bergman explained, the FDA-approved drug has been found to successfully block Ipecac—a direct-acting emetogen— 

Apomorphine, an indirect-acting emetogen, giving the drug “superior broad spectrum efficacy.”

According to Bergman, recent studies have suggested that Cerenia may also help reduce diarrhea.

The vaccine for canine malignant melanoma

Canine malignant melanoma is the most common oral tumor of dogs, accounting for approximately 4% of all canine tumors.

 As Bergman explained, chemotherapy has poor efficacy against this cancer, and prior to the melanoma vaccine, treatment options were limited, with many of them being only being effective at obtaining local control.

The melanoma vaccine, however, uses a needle-free delivery system—the Bioject system—which spreads the vaccine throughout the skin. As a result, this therapy is better at inducing an immune response compared to a traditional needle-based delivery method.

 As Bergman explained, the vaccine, which received full USDA approval in 2009, shows best outcomes with stage 1 melanoma because veterinarians have the “longest runway” for inducing an immune response.

“All right, how many folks have heard of this thing called ‘white feet, don't treat?” Bergman asked his audience during his session. The phrase ‘white feet, don’t treat’ refers to the MDR1 mutation in certain dog breeds, particularly those with white feet, that can lead to dogs developing neutropenia and thrombocytopenia if they are administered ivermectin.

However, the pharmacogenetic test determines whether a dog has one or 2 alleles, helping to identify at-risk breeds, which include Australian Shepherds, Collies, Silken Windhounds, McNabs, and long-haired Whippets. According to Bergman, the mutation affects 65% of long-haired Whippets.

At the end of his section on ‘white feet, don’t treat,’ Bergman posed a question to the audience: “When should we really be testing these dogs? Should it be when they get cancer?” he asked. Bergman emphasized that these canines should be getting tested when they are puppies. Understanding whether these puppies carry the mutation can help identify which drugs may pose risks to them, ensuring safer treatment options throughout their lives.

“Thankfully, the cost for that test has come way down,” he said.

Bergman P. Top 10 advances in veterinary oncology. Presented at: Fetch Charlotte; Charlotte, North Carolina. March 14-16, 2025. 

Huston L. Ivermectin for dogs. The Spruce Pets. October 6, 2023. Accessed March 14, 2025. 

https://www.thesprucepets.com/is-ivermectin-safe-dogs-and-cats-3384698#:~:text=Ivermectin%20Sensitivity%20in%20Collies%20and%20Similar%20Breeds&text=Symptoms%20of%20neurotoxicity%20include%20lack,generally%20safe%20for%20these%20dogs

Articles

Philip Bergman, DVM, MS, PhD, DACVIM (Oncology), kicked off the 2025 Fetch Charlotte conference with his keynote address on key innovations in veterinary oncology

Advances in veterinary oncology: From a melanoma vaccine to genetic testing

Amanda Shelby talks about what an ECG can and can't tell you

Amanda Shelby interview ECG

 interview, Amanda Shelby, RVT, VTS (Anesthesia; Analgesia), explains that while an ECG is an essential tool for visualizing the heart’s electrical activity, it cannot confirm mechanical function or guarantee that the heart is effectively beating. She reminds practitioners of the importance of evaluating the entire clinical picture rather than relying solely on monitor readings.

Amanda Shelby, RVT, VTS (Anesthesia; Analgesia): 

I'm super excited to be speaking at Fetch. My name is Amanda Shelby. Apologies for my appearance—I just got back from a massage. You know, self care is important. I am a registered veterinary technician in the state of Indiana and a VTS in anesthesia and analgesia, a title I’ve held since 2010. My background in academia, especially in anesthesia and analgesia, has given me years of experience that led to this achievement and beyond.

Today, I’m focusing on topics closely related to anesthesia, sharing clinical pearls that you can incorporate into your everyday practice. I currently serve as a Senior Content Creator and CE Coordinator for VETgirl. In previous roles, I built “Think Anesthesia,” an educational platform, and I’m excited to continue that journey both virtually and in person.

For those joining me live at Fetch, you’ll experience my lecture titled “ABCs for ECGs,” which will also be available on demand. The three primary takeaways include understanding the importance—and the limitations—of ECG monitoring. The key concept is that an ECG is only the electrical reflection of the heart; it does not guarantee mechanical or actual heart beating function. I hope you become more comfortable recognizing both normal and abnormal ECGs in sedated or anesthetized patients, as well as in ER scenarios.

Let me share a personal experience: when I was just six months into being a credentialed technician and still learning my craft in anesthesia at a university, I encountered a patient arrest under anesthesia despite a normal ECG reading. I noticed a drop in carbon dioxide levels—an insight that reinforced the idea that while monitors are invaluable, they only capture part of the patient’s picture. Thankfully, with the guidance of a supervising resident, I was able to manage the situation and learn a valuable lesson that has inspired me to improve my ECG interpretation skills.

Remember, while ECGs are wonderful tools, they have limitations. I hope you never have to learn this lesson the hard way, as I did.

Videos

Amanda Shelby, RVT, VTS (Anesthesia; Analgesia), outlines how an ECG’s electrical data must be interpreted alongside clinical signs, as it does not necessarily reflect the heart’s mechanical performance

What an ECG can—and can’t—tell you

The FDA announced it was conditionally approved sirolimus delayed-release tablets (Felycin-CA1; TriviumVet). The conditionally approved medication is for management of ventricular hypertrophy in feline patients with subclinical hypertrophic cardiomyopathy (HCM), making it the first product to receive approval for use in cats with this condition for any indication.

Feline HCM is a condition that causes the muscular walls of a feline patient’s heart to thicken, which decreases the heart’s efficiency, and can create other symptoms within other parts of the body. Currently, there is no cause of HCM clearly identified, but it is prevalent in certain breeds, including British shorthair, Chartreux, Maine coon, Persian, and Sphynx cats. Mutations of several cardiac heart genes has also been identified in some cats with HCM, suggesting genetics play a role.

Feline patients with HCM may not show any signs of being ill and can live for years in this subclinical phase. Others may present with congestive heart failure, including labored or rapid breathing, open-mouthed breaking, and lethargy. The presenting symptoms occur when fluid accumulates around or in the patient’s lungs. When it comes to HCM, a serious and life-threatening consequences is the formation of blood clots in the heart. The clots could move through the blood stream, causing thromboembolism. Although rare, feline patients with HCM are also at risk of sudden death.

Feline HCM Is extremely common in cats, affecting 1 in 1 of all pet cats, and for cats over 9-years-old, the prevalence is 1 in 3, making it the leading cause of mortality in adult cats.

Sirolimus, the active ingredient in Felycin-CA1, at a higher dose is used as an immunosuppressant in human patients receiving organ transplants. Felycin-CA1 is given to cats at a target dose of 0.3 mg/kg orally once a week and is not expected to be an immunosuppressive in patients.

In order for an animal drug to be eligible for conditional approval, it must address a serious or life-threatening disease or address an unmet need in animal or human health. The drug would also need to demonstrate effectiveness, requiring a complex or particularly difficult study or studies. Felycin-CA1 met this requirement because subclinical HCM progresses to clinical HCM, impacting daily functioning in cats and could be fatal. Felycin-CA1 also addresses an unmet animal need because there were no other drugs approved for use in feline patients with ventricular hypertrophy due to subclinical HCM. 

“Felycin-CA1 is the first and only medication shown to reduce the ventricular hypertrophy that is the principal feature of subclinical HCM. It provides a valuable treatment option for veterinarians and pet owners and will transform the way feline HCM is managed’ said Stuart Fitzgerald, Chief Scientific Officer at TriviumVet, in an organizational release.

For Felycin-CA1, demonstrating effectiveness required a complex or particularly difficult study or studies because the detection of subclinical HCM requires advanced diagnostic tests, which makes it difficult to enroll enough eligible cats.

Felycin-CA1 is only available by prescription from a licensed veterinarian, and cats should be screened for pre-existing live disease before starting the medication. This medication should also not be used in feline patients with diabetes mellitus or a pre-existing liver condition.

Felycin-CA is available in 0.4 mg, 1.2 mg, and 2.4 mg tablet sizes.

FDA Conditionally Approves Drug for Management of Ventricular Hypertrophy in Cats. News release. US Food and Drug Administration. March 14, 2025. Accessed March 14, 2025. https://www.fda.gov/animal-veterinary/cvm-updates/fda-conditionally-approves-drug-management-ventricular-hypertrophy-cats?utm_medium=email&utm_source=govdelivery

Cornell University. Hypertrophic Cardiomyopathy. Cornell University College of Veterinary Medicine. Accessed March 14, 2025. https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/hypertrophic-cardiomyopathy

Kaplan JL, Rivas VN, Walker AL, et al. Delayed-release rapamycin halts progression of left ventricular hypertrophy in subclinical feline hypertrophic cardiomyopathy: results of the RAPACAT trial. 

. 2023;261(11):1628-1637. Published 2023 Jul 26. doi:10.2460/javma.23.04.0187

TriviumVet Secures FDA Conditional Approval for Feline Cardiology Disease. News release. TriviumVet. March 14, 2025. Accessed March 14, 2025. https://www.triviumvet.com/blog/triviumvet-secures-fda-conditional-approval-for-feline-cardiology-disease

Felycin-CA1 manages ventricular hypertrophy in feline patients with subclinical hypertrophic cardiomyopathy 

FDA conditionally approves first drug for feline subclinical hypertrophic cardiomyopathy 

Erica Brandt, CVT, VTS (ECC), discusses what Fetch dvm360 Conference attendees can take away from her CE session on "Surviving Triage."

Confronting triage challenges

The ability to accurately and rapidly assessing an patient in an emergency situation makes the difference between a good veterinary technician and an excellent one, according to Erica Brandt, CVT, VTS (ECC), hospital director at WestVet in Meridian, Idaho. 

, her educational session being presented Saturday, March 15, at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina. The session highlights the importance of recognizing a true emergency and immediate interventions.

The following is a transcript of the video:

, what I really want technicians to take away is [that] we've gone through a really rough time with communicating with clients, through the pandemic and those types of things. And I just want to reiterate we are all going through the same types of concerns, and troubleshooting that [what] we're trying to do to reestablish our relationship with clients and get back into those rooms. And then, it's not easy. It's not easy to look at a patient and decide, is this patient truly having an emergency, and what next steps do we need to take? So, I want a big collaborative room, a safe space to say this is a very difficult thing that we do, and here are some tips that I use to make it a little bit easier.

Erica Brandt, CVT, VTS (ECC), discusses her educational session being presented at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina.

As veterinary medicine advances, the demand for compassionate, holistic care for pets at every stage of life grows. For general practitioners, urgent care, and emergency veterinarians, becoming a Certified Hospice and Palliative Care Veterinarian (CHPV) offers numerous benefits, enhancing both career satisfaction and quality of patient care. Here’s why CHPV certification is a smart move for veterinarians in these fields.

Clients increasingly seek specialized care options, especially for aging or terminally ill pets. They want to ensure their pets have comfort and dignity in their final stages of life, along with support in making difficult decisions. When veterinarians have the CHPV certification, it allows them to provide the compassionate end-of-life care clients are seeking, turning potentially challenging conversations into reassuring, educational moments.

CHPV certification empowers veterinarians to broaden their services to include hospice and palliative care, meeting the growing demand from pet families prioritizing their pets’ quality of life. Integrating these services into practices not only provides a unique offering but also strengthens client relationships as well as opens new revenue opportunities.

Additionally, it’s crucial to meet the expectations of your clients. You can enhance client loyalty and retention by delivering comprehensive care, including compassionate end-of-life services. Various studies show a 14-25% client attrition rate following pet loss- often due to owners feeling dissatisfied with the support they received during their pet's end-of-life care. Offering dignified and respectful end-of-life care addresses the evolving needs of all your clientele, ensuring your practice remains their trusted choice.

 These insights highlight the need for veterinary practices to provide adequate training to their staff in handling pet loss to maintain client trust and satisfaction.

Build skills in compassionate communication

A CHPV-trained veterinarian learns how to navigate sensitive discussions around pet illness, end-of-life decisions, and euthanasia. This skill is particularly valuable in general practice, where routine visits often turn to difficult conversations as pets age, and in emergency care, where emotional support is essential. CHPV certification provides tools and techniques for effectively communicating with pet owners, helping veterinarians support clients through emotionally charged situations.

One of the primary focuses of hospice and palliative care is to maximize comfort, even in the absence of a cure. Veterinarians trained in hospice and palliative care can offer pain management, anxiety relief, and supportive therapies that improve quality of life. CHPV certification empowers veterinarians with the knowledge to assess and treat complex cases, improving patient outcomes and satisfaction.

Dealing with end-of-life care can be emotionally challenging, but CHPV certification helps veterinarians approach it with confidence, empathy, and skill. Many veterinarians find that by offering hospice and palliative services, they experience greater career satisfaction and a renewed sense of purpose.

 Supporting pets and families during the end-of-life journey can be one of the most fulfilling aspects of veterinary practice.

While many veterinarians pursue hospice and palliative care for its profound emotional rewards, it’s also important to recognize its potential to generate additional revenue streams. With growing demand for options that prioritize pets’ comfort and quality of life, clients are increasingly willing to invest in services that align with their values. By incorporating hospice and palliative care, veterinarians can offer a vital service that supports both their patients and their practice’s sustainability.

These services also help bridge a critical gap in emergency cases, where families are often presented with only a few options: high-cost interventions, limited middle-ground treatments, or euthanasia. Providing hospice and palliative care offers families another path that prioritizes their pet's comfort and dignity when other treatments are not viable. This alternative helps alleviate the distress and negativity that can arise when choices feel limited, empowering families to make decisions with greater compassion and clarity.

For veterinarians in all types of practices, CHPV certification represents a chance to enhance their approach to care, expand services, and experience greater fulfillment in their careers. The skills and perspectives gained from CHPV training foster empathy, professionalism, and a commitment to the well-being of every pet, making it a valuable addition for any veterinarian looking to provide comprehensive, compassionate care.

Fernandez-Mehler, P, Gloor, P, Sager, E, Lewis, FI, & Glaus, TM. Veterinarians' role for pet owners facing pet loss. 

Compassion Understood. (n.d.). The impact of pet loss on veterinary Compassion Understood. Vets. Compassion Understood. Accessed March 14, 2025. https://www.compassionunderstood.com/vets

Cooney K, Lewis J. Consider end-of-life care as a career. Veterinary Practice News. Published January 26, 2023. Accessed March 14, 2025. https://www.veterinarypracticenews.com/myvpnplus/consider-end-of-life-care-as-a-career

The Certified Hospice and Palliative Care Veterinarian certification enables veterinarians to be not only healers but also compassionate guides through the final chapters of a patient’s life.

How pursuing a CHPV certification can benefit veterinary teams

Editors note: Quotes have been lightly edited for brevity and clarity.

At Fetch Charlotte 2025, Joya Griffin, DVM, DACVD, kicked off her dermatology series of lectures with 

Treating the itch that won't quit: Diagnostic approach to the pruritic pet. 

One aspect she keyed in on was the fundamental importance of a meticulous history and basic diagnostics in the evaluation of pruritic pets.

“For me, it really is just getting back to basics,” Griffin said, “I'm trying to figure out how do I get the case from looking like a disaster to looking good again and feeling good?” She explained to attendees that focusing on these foundational principles is 1 of the most important pieces of the puzzle for effectively managing complex dermatologic cases.

“All of pruritus is not created equally”, Griffin said. “The history of pruritus sometimes can confuse us. Sometimes that confusion comes from a pet parent, because they can actually know when the disease how it started, but they don't know how it started.”

With the mindset of getting back to the basics, Griffin said that when assessing a dermatologic condition, these are the questions she’s asking and the information she is looking for:

 Determining the age of onset, whether symptoms are intermittent or continuous, and how they have evolved over time.

 Ascertaining if signs were initially seasonal and if pruritus preceded lesions or vice versa.

 Inquiring about the pet's travel history, indoor/outdoor status, and the health status of other pets or human family members.

 A thorough review of past and current medications, including their efficacy, dosage, duration, and consistency of administration.

Asking whether the pet’s bowel movements were solid or diarrhea, and whether there was any vomiting.

: Assessing the type of flea control being used and the consistency and correctness of its administration—especially in atopic dogs, which may exhibit heightened sensitivity to flea bites.

Griffin stressed the importance of cytology, stating, "I do have cytology on the majority of my dermatologic cases because looks can be deceiving." She reminded attendees that you can't truly know if a lesion is bacterial, yeast, or sterile without it. She advocates for its use not only as a diagnostic tool, but also as a means of monitoring response to treatment and to guide decisions on whether to pursue culture and susceptibility testing.

For those who find cytology intimidating, Griffin suggests utilizing available tools such as AI analyzers and online image libraries to improve confidence in sample interpretation. She also shared a tip for improving client compliance. "I like to show pictures when I'm talking about cytology, because it really is just pattern recognition." She added, "If I have a skeptical client, I can bring them back, show them, and say, 'This is what I'm looking for. This is why,' and I can help them understand the importance of the cytology and the importance of the recheck exam."

Griffin also reminded attendees that skin scrapes are essential for detecting superficial and deep ectoparasites. She also shared a tip for improving client compliance, “Another reason to have a camera on your scope is you can bring the pet parents back, and they can show them the mites, and then they will believe that you're not just trying to sell them.”

Griffin said that these in-house diagnostics are not only quick and cost-effective but also integral in prioritizing treatments and determining the necessity of further diagnostics.

Griffin explained that a back-to-basics approach helps prevent overlooking simple diagnoses. A thorough history and basic diagnostics provide a solid foundation for subsequent diagnostic and therapeutic decisions, ultimately leading to more effective management of pruritic pets.

Griffin J. Treating the itch that won't quit: Diagnostic approach to the pruritic pet. Presented at: Fetch Charlotte 2025; Charlotte, North Carolina. March 14-16, 2025.

Joya Griffin, DVM, DACVD, reminds Fetch Charlotte 2025 attendees to maintain a strong foundation when it comes to diagnosing itchy pets