Zachary Wright, DVM, DACVIM (Oncology), discusses the unique aspects of mast cell diseases in cats compared to dogs.

Clinical insights into feline mast cell disease

 at our 2025 Fetch National Harbor conference, Zachary Wright, DVM, DACVIM (Oncology), explained the differences between feline mast cell disease and canine mast cell disease, including the unique challenges in diagnosing and managing this disease in cats. He noted that although cutaneous mast cell tumors in cats—especially when located on the head and neck—are typically benign, more concerning forms can also impact feline patients.

Below is a full transcript, edited lightly for clarity.

: Starting with your name, can you tell us a little bit about yourself?

 My name is Dr Zach Wright. I'm a veterinary medical oncologist and the medical director at VCA Dallas [Animal Specialty Hospital] in Dallas, Texas. I also chair the Mars Veterinary Health Oncology Advisory Board.

: How does the biological behavior of feline mast cell disease typically compare with its canine counterpart?

Cats don't get enough attention, right? All of this stuff is about dogs. So, I'm happy to focus on cats. But I think the biggest take-home [message] about cats [with] mast cell diseases [is that] it's essentially a different disease process than dogs. Yes, cats absolutely will get cutaneous mast cell tumors, particularly of the head and neck, but simplistically, those are most often a benign process, not something we have to clinically worry about. The diseases that we need to worry about for cats are the visceral forms, where they arise in either the spleen or the intestines. And again, those [have] a very different clinical presentation and clinical outcome compared [with] a dog with a mast cell tumor on its elbow. 

Primary visceral disease in dogs is noted, but it's quite rare. So for cats, we can end up on a diagnosis of visceral mast cell disease with cats who generally [have adverse drug reactions] and have a variety of clinical symptoms...chronic vomiting, lethargy, decreased appetite, any collection of those things. And it's often related to the location, [as] an intestinal mast cell tumor can cause a full or partial obstruction, but also the systemic histamine toxicity associated with splenic involvement. 

So again, just a very different clinical presentation. [Although] both...are intended to be surgical diseases—and that's true even in the visceral form—I think the biggest [takeaway] is that their clinical presentation is very different. We're not looking for a skin tumor when it comes to a collection of these mast cell diseases in cats.

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Zachary Wright, DVM, DACVIM (Oncology), highlights the unique clinical presentations of mast cell disease in cats compared with dogs.

Image Credit: © Chaosamran_Studio | stock.adobe.com

Kathleen Allison-Black, DVM, is a small-animal practitioner based in Maryland who lives in Gettysburg, Pennsylvania. A graduate of the University of Tennessee College of Veterinary Medicine (UTCVM), Allison-Black has worked in relief, emergency, and shelter medicine and has practiced general practice at the same clinic for the past 5 years. Frustrated by administrative burden and incomplete records, she began using artificial intelligence (AI) tools—particularly ambient scribes—to improve documentation, client communication, and workflow. In this interview, she discusses which tools she trusts, how to evaluate an AI scribe, privacy and liability considerations, and practical steps for clinics that want to get started.

Editor’s note: This interview has been edited for clarity and length. Where content was clarified or standardized for readability, language was smoothed but the meaning preserved.

: To start, tell our readers briefly who you are and your background.

 I’m Kathleen Allison-Black, DVM. I live in Gettysburg, Pennsylvania, and practice in Maryland. I’m originally from Tennessee and graduated from UTCVM in 2002. Over the years I’ve worked relief, emergency, and shelter medicine. For the last 5 years I’ve been working in one general practice, which has been a big change from moving around. I began using AI because I was frustrated with the pace of practice and keeping records accurate and complete. I originally started using AI as a scribe.

: What workflow improvements can clinicians realistically expect from AI scribing and other AI tools? Are there cost savings or hidden costs we should consider?

 The biggest practical benefit of an ambient AI scribe is that I don’t have to rely on my memory or on staff who are on-the-job–trained and may lack clinical vocabulary. For example, a technician might not document a rectal exam as “normal,” they might just leave it blank. An AI scribe captures what I say, so if I say a rectal is normal, it’s in the chart.

Operationally, I can go into an exam room, start and stop a recording, do the exam, state my plan, check the transcription quickly, and paste it into the record. That immediacy lets my staff access the plan right away; they can read the transcript and pull the items they need without interrupting me. I can also instantly generate a client email or go-home instructions from the visit summary and send that to owners, which saves time and reduces phone follow-up.

Practically, this turned me away from having 4 hours of charting after work. I used to bring work home; I don’t anymore. That was huge for my work–life balance. It also calms my anxiety about missing details. I have ADHD, and knowing the record is complete helps me stay focused.

There are costs: subscriptions, and hardware (a phone, tablet, or a computer with a good microphone). There’s also an initial investment of time to trial systems and train them to your workflow. But the time savings and improved communications often outweigh those costs.

 You mentioned trying several scribes. How big a difference is there between products?

 Huge. Not all AI scribes are equal. I trialed 7 or 8. Some transcribed poorly or hallucinated content; others were very accurate. The one I settled on had the best mix of accuracy, low hallucination, and responsiveness from their development team. For example, I tested a scribe embedded in another software and it produced notes that lacked most of the physical-exam content. That frustrated me and reinforced that you must test tools in your real workflow. Most companies offer free trials; use them, run head-to-head comparisons, and choose the one that matches your clinical style.

 What should clinics look for when evaluating an AI tool? Any red flags?

 Prefer tools developed or vetted by DVMs. Veterinary terminology and concepts differ from human medicine.

 End-to-end encryption, clear policies on data storage, retention, deletion, and who has access.

 The tool should let you customize templates (SOAP notes, go-home instructions, lab summaries, radiology/ultrasound reports, vet-to-vet communications). It should also learn corrections. For example, if it mishears a proper name, you should be able to correct it once and have it remember.

 Good support from the vendor and fast issue resolution.

 The language model should be trained on veterinary concepts so summaries and plan outputs reflect veterinary reasoning, not just surface transcription.

 If there are no DVMs on the development or advisory team, that’s a red flag.

Also, test for hallucinations. If the scribe invents that you discussed something you did not, that’s unacceptable and a reason to switch.

 How do you balance time savings with clinical oversight? How much checking is enough to avoid errors, hallucinations, or incorrect emails to clients?

 The scribe is a tool, not a decision-maker. In my workflow everything is a cut-and-paste step: I always review the transcript or the generated note before it goes into the permanent record or before I send an email to a client. Over a year with the same scribe, it’s learned my accent and vocabulary, so small corrections are easier. Misspellings are flagged automatically by my system. If something looks off, I correct it.

For decision support tools that suggest differentials, I use those as a check, not as the origin of my plan. I might use a diagnostic plugin to surface differentials or 'do-not-miss' diagnoses and citations, then verify against the literature and my clinical judgment. I also build my own algorithms after reading primary sources, then optionally load them into a closed model to check that output against my sources.

In short: use AI to augment documentation and to organize knowledge; retain clinician judgment and verify anything that would change care.

 Do you feel AI has made you a better clinician?

 Broadly, yes. It’s made me happier and less anxious. I can communicate more clearly and quickly with owners: lab summaries, patient summaries, and next-step plans can be generated in 1–2 minutes and emailed immediately. That reduces long phone calls and the risk of miscommunication when someone else (a technician or a family member) relays information. Clients appreciate the documentation, and I think that improves compliance and trust.

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Kathleen Allison-Black, DVM, explains how veterinary clinics can use AI scribes and closed LLM tools to streamline documentation, improve client communication, protect patient data, and retain clinician oversight while reducing after-hours charting.

How to stop bringing work home by using AI scribes

“We've proven what was once considered aspirational is now achievable, and that opens doors for endangered and exotic animals worldwide," Brent Teeter, founder and owner of Infinity Exotics, said in a news release.

Pope, the Bongo calf, with surrogate Eland mother at Infinity Exotic (image courtesy of Infinity Exotics) 

Infinity Exotics located in Central Texas recently announced what they are calling one of the most significant advancements in wildlife reproductive science in decades: the birth of a Bongo antelope from a surrogate Eland antelope. The healthy male calf born was named Pope, in honor of Earl Pope, PhD, the pioneer researcher who first achieved an interspecies embryo between a Bong and Eland surrogate in 1983.

“This calf represents decades of research and determination. It validates the belief that we can use modern veterinary science not only to treat animals, but to fundamentally change their conservation outlook. What we've learned here could be applied to countless species facing similar genetic and reproductive challenges," Will Weise, DVM, the veterinarian who worked on the project at Infinity Exotics, said in the release.

According to the release, with the successful creation and implantation of viable Bongo embryos into a closely related surrogate species, a door has been opened for scientists to explore new reproductive pathways to help ensure the survival of specials that are too small or fragmented to recover naturally.

Eastern Bongos are a critically endangered species with less than 100 left in the wild because of habitat loss from illegal logging, increased hunting, and disease.

 Native to the mountainous forests of central Kenya, these animals have brown coats with a series of white vertical stripes, and both male and females have long twisted horns. Typically, female Bongos are more brightly colored that the males. In captivity, Bongos can live up to 20 years, but little is known about their life expectancy in the wild, which experts believe is less than life in captivity.

"This is a pivotal moment in safeguarding the future of the Bongo antelope and other endangered species," Brittni East, DVM, founder of Exotic Wildlife Veterinary Services, said in the release.

 "This breakthrough demonstrates that assisted reproductive technologies, once limited to agricultural or laboratory settings, can now be effectively adapted to save species at the edge of extinction."

With the success of this birth, the Infinity Exotics team and its partners plan to explore how these reproductive technology could be standardized and scale to provide support to other endangered species across the globe.

Historic Breakthrough in Veterinary Science: Birth of Endangered Bongo Antelope from Eland Surrogate Signals New Era for Wildlife Conservation. News release. Infinity Exotics. November 19, 2025. Accessed November 19, 2025. https://prnmedia.prnewswire.com/news-releases/historic-breakthrough-in-veterinary-science-birth-of-endangered-bongo-antelope-from-eland-surrogate-signals-new-era-for-wildlife-conservation-302619676.html

Bongo. Dublin Zoo. May 23, 2022. Accessed November 19, 2025. https://www.dublinzoo.ie/animal/bongo/

Innovative reproductive science at Infinity Exotics births a Bongo antelope from an Eland surrogate.

Endangered Bongo antelope born through Eland surrogate

Real resilience starts with understanding what matters most to you, explain Aaron Shaw, OTR/L, CHT, CSCS, and Jennifer Edwards, DVM, ACC, CPC, ELI-MP.

From ‘I should’ to ‘Why’?: A different approach to burnout 

“We all know that burnout in [veterinary] medicine is really kind of an epidemic,” cohost Aaron Shaw, OTR/L, CHT, CSCS, begins in this episode of 

The Resilient Vet: Mind and Body Strategies for Success

. In this installment, Shaw and Jennifer Edwards, DVM, ACC, CPC, ELI-MP, dig into why veterinary professionals continue to struggle with burnout despite the abundance of wellness information available.

They suggest that the issue is not a lack of knowledge, but cultural norms and personal barriers that make it difficult to implement meaningful change. According to Shaw and Edwards, addressing burnout starts with identifying an individual’s true “why,” recognizing what gets in the way, and shifting from gathering information to taking action in meaningful, personalized ways.

 it becomes kind of like a drill down process—[we] go a layer deeper, then a layer deeper, then a layer deeper, then a layer deeper, and then a layer deeper.... A lot of people want things like health and fitness and eating well. The “should” comes from sometimes superficial reasons. Like, “I should be skinny or I should look a certain way for society” and all of these things. But what if I don't care? [What if the person says,] “I've got my partner and she loves me just the way I am and I don't care that I'm 20 pounds overweight.” Not everybody is motivated by those “should” factors.

When we really pare it down into what they want for 

—their lives—when they think about their children, when they think about [how] they love nature, when they think about the idea of their children someday having their own children and being a grandparent, hiking a mountain, being able to walk down a beach, being able to get in and out of a fun little car easily, being able to get down on the floor with the neighbor's puppy and play with it...I might not be motivated to go to the gym because I want to be skinny and sexy in a bikini on the beach. That ship has sailed for me. I don't care, honestly. That's not motivating for me. But when I think about my daughter, like, that's my ‘why.’

So, for each person, I would start to really consider what's important to you in your life. For example, if there is a grandchild or a niece or a nephew or a puppy or a beach, that can be your motivation...

Transcript has been lightly edited for clarity and cohesion.

From ‘I should’ to ‘Why?': A different approach to burnout 

The Veterinary Oral Health Council (VOHC) has granted the VOHC Seal of Acceptance to Tartar Shield Pro Care Natural Pet Toothpaste for tartar control in dogs.

 According to VOHC, regular use of products that have the VOHC Seal of Acceptance will lower the severity of periodontal disease in pets.

According to the American Veterinary Dental College, from whom VOHC is an affiliated entity, the seal is awarded to products that meet the criteria for effectiveness in controlling plaque and/or calculus in dogs and cats.

Currently, 9 veterinary dentists and dental scientists sit on the VOHC Council, along with a nonvoting director.

According to Tartar Shield Pet Products, the developer of Tartar Shield Pro Care, clinical studies following VOHC protocols found that topical application of the toothpaste was associated with reductions in tartar, plaque, and halitosis in dogs.

 The reduction was observed without use of any brushing device.

Tartar Shield Pro Care is an enzymatic toothpaste and is the only chemically-active pet toothpaste that has received the VOHC Seal of Acceptance, according to Tartar Shield Pet Products.

 The toothpaste’s base consists of coconut oil and contains natural and nature-derived ingredients,

 including miswak, malic acid, zinc citrate, and kaolin clay. In its product site, Tartar Shield Pet Products states that the toothpaste is human grade.

“Our unique blend of organic antimicrobials targets the root causes of plaque and tartar, resulting in fresher breath and healthier gums,” states Tartar Shield Pet Products on its product website.

According to the company, the malic acid in the toothpaste is a type of carboxylic acid that is naturally found in a variety of common fruits. Meanwhile, the zinc citrate in the toothpaste is used for its antimicrobial and anti-inflammatory properties, while the coconut oil helps protect dogs’ teeth and gums from microbes and plaque.

“Tartar Shield has demonstrated a strong commitment to scientific rigor and to supporting the VOHC’s mission to provide assurance of clinical efficacy for pet oral care,” Ellen Lowery, DVM, PhD, director of the VOHC, said in a news release.

Other canine toothpastes that have received the VOHC Seal of Acceptance include Petsmile Professional Pet Toothpaste by Supersmile and HealthyMouth Toothpaste/Brush Kit Combination by HealthySmile. The Petsmile Professional Pet Toothpaste received the seal in 2011 for its plaque-controlling properties, and the HealthyMouth Toothpaste/Brush Kit Combination, was recognized shortly after in 2015, also for plaque reduction.

Tartar Shield Natural Pet Toothpaste granted VOHC Seal of Acceptance. News release. Tartar Shield Pet Products. November 17, 2025. Accessed November 19, 2025. https://www.businesswire.com/news/home/20251117759410/en/Tartar-Shield-Natural-Pet-Toothpaste-Granted-VOHC-Seal-of-Acceptance

Veterinary Oral Health Council. Veterinary Oral Health Council. Accessed November 19, 2025. https://vohc.org/

Veterinary Oral Health Council. American Veterinary Dental College. Accessed November 19, 2025. https://avdc.org/veterinary-oral-health-council/

Tartar Shield PRO CARE Toothpaste for Dogs & Cats. Tartar Shield Pet Products. Accessed November 19, 2025. https://www.tartarshield.com/products/pro-care-natural-pet-toothpaste

VOHC accepted products. Veterinary Oral Health Council. Accessed November 19, 2025. https://vohc.org/accepted-products/

The seal is awarded to products that meet the criteria for effectiveness in controlling plaque and/or calculus in dogs and cats.

VOHC grants Seal of Acceptance to canine toothpaste for tartar control

Hypoadrenocorticism, also known as Addison’s Disease, is an uncommon condition, with an estimated prevalence between 0.06% and 0.28%. Known as “the great pretender,” its vague, nonspecific clinical signs often mimic other illnesses, as do diagnostic findings. Early recognition, diagnosis, and treatment can prevent significant mortality secondary to hyperkalemia, hyponatremia, dehydration, and hypovolemic shock.

The adrenal gland comprises an inner medulla and an outer cortex. Three layers make up the cortex, and each is responsible for hormone production. The outermost layer, the zona glomerulosa, is responsible for mineralocorticoid (aldosterone) production, while glucocorticoids and androgens are produced by the zona fasiculata (middle layer) and reticularis (innermost layer).

Primary hypoadrenocorticism is most common and is most often caused by autoimmune destruction of the medullary layers. Thus, destruction of the zona glomerulosa results in mineralocorticoid deficiency, while cortisol (glucocorticoid) deficiency occurs secondary to destruction of the zona fasiculata and reticularis.

Secondary hypoadrenocorticism is rare. It is caused by lack of secretion of adrenocorticotropic hormone (ACTH) from the pituitary gland or lack of secretion of corticotropin-releasing hormone (CRH) from the hypothalamus. This, in turn, results in atrophy of the zona fasiculata and reticularis, and therefore lack of cortisol production; mineralocorticoid production from the zona glomerulosa is not affected. Secondary hypoadrenocorticism most commonly occurs secondary to neoplasia or intracranial trauma.

Most dogs with primary hypoadrenocorticism are deficient in both glucocorticoids and mineralocorticoids; however, glucocorticoid deficiency can occur without mineralocorticoid deficiency. The latter population lacks electrolyte abnormalities; this is referred to as ‘atypical.’

These dogs can progress to develop mineralocorticoid deficiency, so sodium and potassium should still be monitored in these patients.

Hypoadrenocorticism is thought to have a genetic basis in dogs, but mode of inheritance has not been established. Breeds with a known genetic predisposition include the Nova Scotia duck tolling retriever, standard poodle, bearded collie, and Portuguese water dog.

 Other commonly affected breeds include great dane, West Highland white terrier, Saint Bernard, Wheaten terrier, leonberger, and rottweiler.

 Young to middle-aged female dogs are predisposed.

Hypoadrenocorticism has also been reported in cats, but is rare.

Hypoadrenocorticism can present as an acute crisis or with waxing and waning clinical signs. The most common presentation is with a history of vague symptoms, such as lethargy, inappetence, weight loss, and/or waxing and waning gastrointestinal signs that have not fully responded to traditional supportive therapies. There may be a history of illness developing in association with a stressful event.

The array of clinical signs includes, but is not limited to, vomiting, diarrhea, inappetence, weight loss, lethargy, weakness, collapse, polyuria, polydipsia, shaking, abdominal pain, melena or hematochezia, and hematemesis. Patients in crisis can present with signs of hypovolemic shock, including bradycardia, tachycardia, collapse, hypothermia, weak pulses, and poor capillary refill time. Otherwise, physical examination findings are nonspecific and can include thin body habitus and dehydration.

Diagnostic testing should begin with a minimum database, including complete blood count (CBC) and chemistry panel (including electrolytes). Pertinent CBC findings may include anemia (most often non-regenerative), lymphocytosis (or lack of the lymphopenia expected secondary to a normal stress response), eosinophilia, and neutrophilia. The most common biochemical abnormalities are hyperkalemia, hyponatremia, and hypochloremia. Other common findings include hypercalcemia, azotemia, hyperphosphatemia, hypoglycemia, hypocholesterolemia, and hypoalbuminemia. 

 Abdominal ultrasound often reveals adrenal glands that are much smaller than normal or cannot be identified.

 In patients with severe hyperkalemia, an EKG can reveal bradycardia, lack of P waves, wide QRS complexes, and tall T waves.

Because of the variety of vague presenting symptoms, veterinarians should be testing a large number of dogs for hypoadrenocorticism compared to the small number that are definitively diagnosed with the disease.

 Several studies have documented that measurement of basal (resting) serum or plasma cortisol is a reliable screening test for dogs with a clinical history consistent with hypoadrenocorticism, with a 100% sensitivity for a cutoff of ≤2 µg/dL. This diagnosis is less likely if the cortisol is >2 µg/dL

Because a basal cortisol of ≤2 µg/dL has a low specificity and a low positive predictive value, an ACTH stimulation test must be performed in these patients to obtain a definitive diagnosis.

 Although cosyntropin doses of 5 µg/kg IV are most commonly employed, one study showed that doses of 1 µg/kg IV may be sufficient.

Treatment of hypoadrenocorticism can be divided into management of the acute crisis and chronic management. Treatment of a hypoadrenocortical crisis is focused on restoration of tissue perfusion and correction of hypovolemia with IV fluid therapy, correction of electrolyte abnormalities, correction of hypoglycemia (if applicable), restoration of acid-base balance, and providing glucocorticoid support.

 ECG should be monitored, and immediate treatment initiated for hyperkalemia if it is severe enough to cause ECG changes.

Intravenous regular insulin and dextrose should be utilized to shift potassium into cells along with glucose; blood glucose should be monitored for 6 hours concurrent with weaning of dextrose supplementation.

 Calcium gluconate 10% is cardioprotective and can be administered to antagonize the cardiac effects of hyperkalemia.

 A rapidly acting corticosteroid such as dexamethasone sodium phosphate should be administered to provide glucocorticoid support. A reasonable starting dose is 0.1-0.2mg/kg IV every 24 hours until an oral glucocorticoid, usually prednisone or prednisolone, can be tolerated. Mineralocorticoid supplementation should be delayed until the patient has recovered, and electrolytes are normal or nearly normal, and the patient’s perfusion has been restored.

Chronic therapy for typical hypoadrenocorticism entails both mineralocorticoid and glucocorticoid supplementation; only glucocorticoid supplementation is required for an atypical Addisonian. Prednisone/prednisolone is used most with a starting dose of 0.2-0.25 mg/kg/day.

 Once a diagnosis of hypoadrenocorticism has been established, the ACTH stimulation test is no longer useful; dose adjustments are made based on subjective information provided by the owner, making good client communication imperative for management.

The glucocorticoid dose can be tapered to the minimum amount necessary, usually 0.1-0.2 mg/kg/day, to prevent symptoms of hypoadrenocorticism while avoiding side effects of corticosteroids.

 For some large breed dogs, a dose of slightly less than 0.1 mg/kg/day may be required to accomplish these goals. During periods of stress, increased doses of glucocorticoids should be recommended; the author typically doubles the prednisone/prednisolone dose during the event and for 2-3 days before and after.

Either desoxycorticosterone pivalate (DOCP) or fludrocortisone acetate can be used for mineralocorticoid supplementation. The starting dose of fludrocortisone is 0.02 mg/kg/day orally, divided into 2 doses.

 Electrolytes should be monitored weekly until stable within normal range, and the dose can be adjusted by 0.05-0.1 mg/kg/day as needed.

 Fludrocortisone has glucocorticoid properties, therefore only about 50% of dogs treated with this medication will also require prednisone, though both should be started as initial management.

 The prednisone dose can then be tapered to the minimum dose necessary to prevent symptoms while controlling side effects.

DOCP is a long-acting mineralocorticoid supplement with no glucocorticoid activity. Traditionally, the starting dose has been 2.2 mg/kg subcutaneously or intramuscularly every 25-30 days (most commonly), but more recent studies have demonstrated that low-dose DOCP (1.1-1.5 mg/kg every 28-30 days) is safe and effective for most dogs.

After initiation of treatment with DOCP, electrolyte levels should ideally be rechecked at weeks 2, 3, and 4 to determine the duration of action, dose, and dosing interval.

 For both therapies, once an appropriate dose (and dosing interval for DOCP) has been established, electrolytes should be checked every 3-6 months indefinitely. 

Prognosis for hypoadrenocorticism is excellent with prompt treatment of the initial crisis and early diagnosis.

 Addisonian patients can have a normal quality of life and life expectancy, and most die of unrelated causes.

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Discover the complexities of Addison's disease in dogs, including diagnosis, treatment options, and management strategies for hypoadrenocorticism.