Image Credit: © anastas_ | stock.adobe.com

This is the second part of a 2-article series with Martha Cline, DVM, DACVIM (Nutrition). While part 1 focused on how to use nutrition assessment to guide clinical diet selection, part 2 zeroes in on client education and practical feeding recommendations at diagnosis. 

Use nutrition assessment to guide diabetes care in dogs and cats

Editor’s note: This Q&A was drafted from an audio interview. The responses from Cline have been lightly edited for clarity and flow in a written format.

dvm360: What client-education strategies do you think about for diet adherence?

 These clients often need you to spend some time talking with them, and sometimes [it means] leveraging our support staff as well. Our vet technicians and nurses, a lot of them are capable of counseling owners as well, especially when it comes to the management of these cases. Specifically, from a nutrition perspective, it’s important to be very specific with our feeding recommendations. This means doing the calculation, telling an owner how much, how many times they should be feeding the pet, and what to expect. [Have a plan] if a pet isn’t finishing their meals or if they aren’t eating.

Sometimes these owners really need you to be very specific with them, especially when it comes to the nutrition part, because we know we’re already being specific with them on the insulin and that medical management side. But again, it can be really overwhelming. I don’t want to hand an owner a bag of food and just say, ‘follow what’s on the back of the label.’ I really want to make sure that we’re tailoring those specific feeding recommendations to the pet and to the owner, to make sure that we can get good compliance.

dvm360: How do you account for the household and real-world feeding challenges?

 It’s also really important to take into account the feeding management, because managing a diabetic dog or cat is a lot for an owner. It changes a lot of what happens daily in their household. So, we want to make sure we have a good idea of the environment and what the owner is able and capable of doing from a nutrition standpoint.

A good example would be a multi-pet or multi-cat household where we’re making specific recommendations for one cat; we really need to think about how to manage that household in a way that is actually going to be manageable from a feeding standpoint when we’re making such specific recommendations.

dvm360: What are common mistakes or missed opportunities you see in practice?

 I don’t necessarily want to call it a mistake, but maybe a missed opportunity is, again, to be very specific and tailored with your feeding recommendation. It’s going to help alleviate some of the work the owner has to do in figuring it out themselves, especially when they already feel overwhelmed. And it’s going to be more tailored specifically to that animal compared to making a generic recommendation.

So, taking the time to do the calculation and giving an owner a specific recommendation for food, how much to feed, and frequency, is really, really helpful. I do see that that doesn’t always happen, and I think that’s a missed opportunity for us in terms of managing these cases.

dvm360: Any practical tips about treats and owner expectations?

 Oh, and treat recommendations...we can’t forget that. You’re not going to be able to take treats away from everybody, but make sure that you’re accounting for them as well. Giving specific feeding recommendations and a specific medical recommendation has been shown to increase compliance in pet owners, so that’s another key thing.

dvm360: What resources or kits does Purina provide to clinics and how can they access them?

 At Purina, we provide a bag of the Purina DM for cats, or a bag of EN FiberBalance for dogs, as part of the kit when they are diagnosed with diabetes. Some of the other resources that we have...if people look at the Purina Institute website, we have calculators for helping to calculate how much to feed, and that can be really helpful.

We have maintenance energy requirement calculators that people can access, again, on Purina Institute center square, that can be really helpful in figuring out how much they need to feed these pets throughout the day. There are some other resources on there related to diabetic management as well that people can access from a clinical standpoint. So in addition to providing the food, we also have some nice resources online to help people in terms of figuring out how much [to feed] and ways to help guide the pet owner.

dvm360: How can clinics enroll or sign up?

 The website is usa.petdiabetesmonth.com. That’s where clinics can enroll. If they’re interested in participating, I would encourage them to visit that website for more information.

dvm360: If there’s one thing you want clinicians to remember about owner education, what is it?

 Take the time to give them a specific feeding recommendation, and that includes food, feeding amounts, and frequency.

Articles

Specific feeding instructions increase owner adherence and simplify diabetes management for dogs and cats.

Give clients clear feeding plans to improve diabetes outcomes

A veterinary hospital in Bend, Oregon, has turned its local veterinary charity fund into a new 501(c)(3) nonprofit aimed at expanding healthcare access and helping more pet owners in financial need. The nonprofit, called PetsForward, builds on Veterinary Referral Center of Central Oregon’s (VRCCO’s) Care Fund, which has helped countless animals in Central Oregon receive care.

“This 501(c)(3) nonprofit organization will build on years of community support and philanthropic success to create a larger platform for impact, supporting both pets in need and advancing access to innovative veterinary care options,” wrote VRCCO in a news release announcing the launch of PetsForward.

Over the past 2 years, the VRCCO Care Fund has raised close to $200,000 through donations from individuals and the community, according to VRCCO. Those funds have helped more than 300 pets to receive rehabilitation therapy, which has helped them in their recoveries.

“When...VRCCO opened its doors in 2018, the team quickly recognized that not all pet parents could afford the quality of advanced medical services they provide,” wrote VRCCO.

 As healthcare costs rose and cases of economic euthanasia increased throughout the country, the hospital partnered with the Veterinary Care Foundation to establish the VRCCO Care Fund, designed to bridge the gap for pets in need of critical medical care.

The fund quickly grew, and VRCCO said it realized that access to care was an issue in other areas beyond emergency care, such as advanced treatments, new medications and therapies, and other resources that help pets obtain the best possible outcomes. This realization led VRCCO to create PetsForward.

According to PetsForward, its mission is to “revolutionize veterinary medicine by removing financial barriers, expanding access to advanced diagnostics and compassionate service, and advancing innovative research, ensuring every animal, regardless of financial means, receives top-quality medical care.”

Every year, between 7-10% of pet owners apply for financial assistance.

 Yet, nearly 1 in 3 pet owners know a friend or family member whose pet died because the owner could not afford necessary treatment to save their pet, a PetSmart Charities and Gallup survey found.

 Seven percent reported declining lifesaving surgeries for their pets for the same reason. Across all income levels, financial barriers were cited as a reason pet owners declined or skipped veterinary care.

“The veterinary industry must unite to ensure every pet has access to care, as the magnitude of the problem is such that no one entity can solve this on their own," Robyn Jaynes, DVM, director of veterinary affairs at PetSmart Charities, told 

 “Together, we can build a system that meets families where they are, because access to veterinary care shouldn’t be a privilege.”

Veterinary Referral Center of Central Oregon launches PetsForward. News release. November 5, 2025. Accessed November 12, 2025. https://www.newswire.com/news/veterinary-referral-center-of-central-oregon-launches-petsforward-22669971

Advanced Veterinary Healthcare Fund. PetsForward. Accessed November 12, 2025. https://www.petsforward.org/

Bautista-Alejandre A. Many pet owners cannot afford veterinary care, survey finds. 

April 17, 2025. Accessed November 12, 2025. https://www.dvm360.com/view/many-pet-owners-cannot-afford-veterinary-care-survey-finds

Every year, between 7-10% of pet owners apply for financial help.

Oregon veterinary hospital turns charity fund into a nonprofit to expand pet care access

Earlier this week, Tuskegee University, the only historically black veterinary school in the US, filed a federal lawsuit and an emergency motion attempting to block the American Veterinary Medical Association (AVMA) from proceeding with a hearing to determine whether Tuskegee University College of Veterinary Medicine (TUCVM) will be stripped of its accreditation.

A complaint and a time-sensitive motion for preliminary injunction were both filed, accusing the AVMA and its Council on Education (COE) of violating due-process requirements and failing to follow their rules during an ongoing accreditation review. According to the filings, if Tuskegee were to lose its accreditation, it would jeopardize the university's ability to operate the program, cause long-term reputational harm, and eliminate access to federal student-aid funding. 

"Tuskegee University respectfully requests that the court enjoin the AVMA from conducting an appeal hearing under procedures that deny Tuskegee a fair opportunity to present evidence and witnesses,” according to the motion.

Within the lawsuit, Tuskegee argues that the AVMA did not apply its standards consistently and conducted its review in a manner that did not follow the association's established procedures, thereby violating Tuskegee’s right to a fair process. Through its emergency motion, Tuskegee provided 4 primary violations of procedural fairness in the AVMA’s handling of the university's appeal

Blocking testimony from expert witnesses, including Willie M. Reed, DVM, PhD, DACVP, DACPV, dean of Purdue University College of Veterinary Medicine, and James W. Lloyd, DVM, PhD, former dean of the University of Florida and Michigan State University.

Refusing to release internal AVMA records related to the accreditation decision.

Barring Tuskegee from introducing evidence about unequal treatment compared with other institutions.

Restricting the hearing to 2.5 hours, covering all witness testimony, exhibits, and rebuttals.

Based on the restrictions Tuskegee outlined, each violates the AVMA’s own policy, Section 2.5.4, that states each institution is guaranteed the right to present witnesses and documents pertinent to the case.

“When Purdue University faced comparable facility challenges, the AVMA COE did not demand financial documentation before approving extensions,” the complaint asserts. However, "Tuskegee’s verified commitments from its board, president, and financial institution were rejected as insufficient.”

The motion asks the court to issue an injunction before December 4, 2025, the day before the scheduled AVMA hearing, to preserve Tuskegee’s rights and maintain the status quo until the case is fully heard. The motion also warns that if things continue under the current AVMA procedures, it could damage its reputation, lead to a loss of student recruitment, and possibly result in the program's closure.

Within the filings, Tuskegee asks the federal court the following

Stop the AVMA from holding the hearing on December 5, 2025, until a fair process is guaranteed.

Compel AVMA to allow full witness testimony and document access.

Grant other relief necessary to maintain procedural integrity.

“In 2021, the [AVMA] visited our campus and identified deficiencies that Tuskegee proactively addressed, eventually demonstrating full compliance with accreditation standards. The AVMA has not returned to our campus since 2021, and accreditors refuse to recognize substantial evidence of our strong financial health, extensive clinical resources, and significant improvements in licensing exam assessments,” the school said in an issued statement.

If Tuskegee’s injunction is granted, the case would proceed to determine whether the AVMA’s accreditation process was in violation of federal due-process standards and the Higher Education Act.

For now, while Tuskegee navigates the appeals process, all of its veterinary medicine academic programming, clinical training, and support services will continue to proceed as planned. Students currently enrolled will also be able to complete their degrees, remain fully enrolled with their degree path unchanged, and become eligible for licensure, internships, and residencies.

TUCVM was the first veterinary medical professional program located on the campus of a historically Black college or university in the US. With more than 127,000 veterinarians in the US, 2% are Black; of that 2%, a total of 70% graduated from TUCVM. The college is recognized as the most diverse of all schools/colleges of veterinary medicine in the US.

Lincoln Memorial University sues American Veterinary Medical Association

In 1944, Frederick Douglass Patterson first envisioned TUCVM, and it was then established a year later. At this time, TUCVM was 1 of 10 veterinary schools in the US, and it is estimated that within the Southern part of the US, there were fewer than 5 Black veterinarians.

TUCVM had its first graduating class in 1949, comprising 5 graduates, including 1 woman. Although its first class contained exclusively Black veterinary students, TUCVM is now known as one of the most diverse and inclusive veterinary schools in the US and has served as a singular role in expanding the diversity of the profession.

 Since its first class, Tuskegee has graduated almost 3200 veterinary medical students and accepts 65 students a year.

In fall 2021, the AVMA COE's notice of accreditation actions for spring 2022 following a 2021 visit stated that Tuskegee was put on probationary accreditation with major deficiencies, including Standard 2, Finances; Standard 4, Clinical Resources; Standard 11, Outcomes Assessment; as well as minor deficiencies in Standard 3, Physical Facilities and Equipment; Standard 6, Students; and Standard 9, Curriculum.

“The integrity of the nation’s only historically Black veterinary college—and the progress it represents in diversifying the veterinary profession—hangs in the balance,” the complaint concludes.

Blevins S. Tuskegee University sues to stop American Veterinary Medical Association’s attempt to strip their accreditation. Yellowhammer News. November 11, 2025, Accessed November 12, 2025. https://yellowhammernews.com/tuskegee-university-sues-to-stop-american-veterinary-medical-associations-attempt-to-strip-their-accreditation/

Tuskegee University. Case No. 2:25-cv-00890. US District Court for the Middle District of Alabama. Accessed November 12, 2025. https://yellowhammernews.com/wp-content/uploads/2025/11/002.-Time-Sensitive-Motion-for-Preliminary-Injunction-Ruling-Requested-by-December-4-2025-1.pdf

Notice of accreditation actions by the AVMA Council on Education. American Veterinary Medical Association Council on Education. 2022. Accessed November 12, 2025. https://www.avma.org/sites/default/files/2022-04/2022-March-Accreditation-Actions.pdf

The historical legacy. Tuskegee University. Accessed November 12, 2025. https://www.tuskegee.edu/academics/colleges-schools/cvm/The-Historical-Legacy.html

The university is attempting to stop the American Veterinary Medical Association (AVMA) from stripping it of its accreditation. 

Tuskegee University sues the American Veterinary Medical Association 

Tarantino, DVM, MBA, discusses signs of pain in senior canines.

Signs of chronic pain in geriatric dogs

 at the 2025 New York Vet Show in New York City, Monica Tarantino, DVM, MBA, cofounder of the Senior Dog Veterinary Society in Alexandra, Virginia, discusses signs of chronic pain in geriatric dogs. She notes that signs of chronic pain can be subtle and often mistaken for old age, but any behavioral changes in older pets should be brought to a veterinarian's attention.

In addition to cofounding the Senior Dog Veterinary Society, Tarantino is also the coauthor of 2 books for early career veterinarians—

. She is also an active animal rescuer with 4 adopted dogs, 2 rescue cats, and the occasional foster.

The following is a transcript of the video, which has been lightly edited for clarity and cohesion.

I'm Dr Monica Tarantino. I am a veterinarian and the cofounder of the Senior Dog Veterinary Society, and we're on a mission to advance the care of elderly canines in [veterinary medicine].

What are some subtle behavioral and physical signs of chronic pain in geriatric dogs?

I think chronic pain can vary quite a bit depending on the source and where it's coming from. We have a lot of the classic signs such as limping, an intermittent limp, having difficulty getting up from sitting to standing, maybe some reluctance to go for a walk, or some sort of evidence that maybe something in their musculoskeletal system is bothering them. Oftentimes, the signs of chronic pain are going to be very subtle, [and it might] look like a change that a lot of people might say is just due to old age, but every single behavioral change that you're seeing in the older dog or an older pet, you want to actually bring to the attention of your veterinarian.

Videos

Signs of pain may be subtle and be mistaken for old age, explains Monica Tarantino, DVM, MBA, in an interview at the 2025 New York Vet Show.

Chronic inflammatory enteropathies (CIE) in dogs are defined as persistent gastrointestinal (GI) signs lasting more than 3 weeks after other systemic and extra-GI causes have been ruled out.

 As a small-animal internist practicing in a major metropolitan referral center, one of the most frequent presentations I encounter is the young dog—typically under 5 years of age—with chronic GI signs. These dogs have often already undergone baseline diagnostics with their primary veterinarian, including normal blood work and fecal screening, before being referred for advanced evaluation.

While many of these patients are referred for abdominal ultrasound or endoscopy, it is worth emphasizing that most young dogs with CIE do not require these advanced diagnostics initially. In my experience, ultrasound findings in these cases rarely change the initial treatment plan, which nearly always begins with a diet trial. For most young dogs with chronic GI signs, the disease is ultimately food-responsive enteropathy (FRE).

Dietary management: The first and most crucial step

The cornerstone of management for CIE in young dogs is dietary therapy. The goal is to minimize antigenic stimulation of the intestinal mucosa. Several studies have shown that hydrolyzed or novel-protein diets can induce clinical remission in approximately 60–88% of dogs with CIE and normal serum albumin.

 In one randomized controlled trial evaluating hydrolyzed fish-protein diets, 83% of dogs with non-protein-losing enteropathy (non-PLE) responded to their first diet, and all remaining non-responders achieved remission after switching to a second hydrolyzed diet.

When initiating a diet trial, client education is essential. Owners must understand that strict adherence is non-negotiable: the prescribed diet must be the only source of nutrition. No other animal-protein treats, supplements, chews, or table scraps should be allowed. Approved hydrolyzed protein treats or small amounts of specific non-animal foods, such as certain vegetables or fruits, are acceptable but should remain limited.

A meaningful dietary trial typically lasts about 4 weeks. However, in my experience, some dogs require up to 8 weeks to show full improvement. If a dog fails to respond to one hydrolyzed or novel-protein diet, it is not appropriate to give up and proceed immediately to advanced diagnostics. Instead, trialing a second hydrolyzed or novel-protein diet is warranted. Because our current understanding of the canine intestinal microbiome and its dietary interactions is still evolving, no single diet is universally effective for all dogs. The long-term evaluation of 60 dogs with CIE demonstrated that many patients initially classified as immunomodulator-responsive enteropathy (IRE) were later reclassified as FRE after additional dietary trials.

Prebiotics, probiotics, and fiber: Targeting the microbiome

For dogs that improve clinically but continue to have loose stools or large-bowel signs, adjunctive therapy with prebiotics, probiotics, and fiber can be highly beneficial. Soluble fibers serve as fermentable substrates for colonocytes, generating short-chain fatty acids that enhance colonic health. A study evaluating a diet rich in mixed fiber sources showed significant improvement in stool quality and frequency in dogs with large-bowel diarrhea.

Similarly, probiotics have an important role. One randomized, controlled trial demonstrated that dogs with idiopathic inflammatory bowel disease experienced improved mucosal microbiota balance when given a multi-strain probiotic.

 has been shown to promote microbiota diversity and mucosal homeostasis in dogs with CIE.

In my experience, adding a high-quality probiotic and soluble fiber to a hydrolyzed diet frequently resolves residual stool-quality issues and helps stabilize chronic large-bowel diarrhea. A diet combining hydrolyzed protein and pre-/probiotics can often maintain long-term remission without escalation of therapy. A main goal should be to avoid chronically medicating young dogs unless necessary.

The role of GI panels and cobalamin/folate testing

Even when routine laboratory results are normal, assessing for functional GI changes is crucial. A gastrointestinal panel (measuring serum cobalamin, folate, trypsin-like immunoreactivity (TLI), and pancreatic lipase immunoreactivity (PLI) can help identify malabsorption or concurrent pancreatic disease.

Hypocobalaminemia has been shown to negatively affect prognosis in dogs with CIE.

 Fortunately, both oral and parenteral supplementation effectively correct deficiencies and improve clinical outcomes.

 Hypocobalaminemia, hypofolatemia, or hyperfolatemia support gastrointestinal inflammation and CIE is likely. I typically follow the dosing guidelines provided by the Texas A&M Gastrointestinal Laboratory. Testing should be performed on a fasted sample to avoid post-prandial variability and to allow concurrent evaluation for exocrine pancreatic insufficiency and pancreatitis.

Additionally, a baseline cortisol test is often worthwhile to screen for atypical hypoadrenocorticism, even when electrolytes are normal, particularly in dogs with chronic GI signs and unremarkable standard diagnostics.

Rule out extra-GI causes with standard baseline testing.

Start with a strict hydrolyzed (or novel-protein diet trial) and enforce compliance.

Trial at least two diets before concluding a patient is non-responsive.

Add prebiotics and probiotics for dogs with residual stool issues.

Run a GI panel to check cobalamin and folate status; supplement as indicated.

Reserve advanced diagnostics for true non-responders, older patients, or those with PLE indicators.

Remember, in most young dogs, ultrasound rarely changes the initial therapeutic plan. A diet trial should always come first.

If a dog has failed to respond to multiple diet trials (ideally 2 or more hydrolyzed/novel-protein diets), pre-/probiotic supplementation, and cobalamin support, referral for advanced diagnostics is appropriate. Abdominal ultrasound is particularly indicated when there are abnormalities such as hypoalbuminemia or hypocholesterolemia, which may suggest protein-losing enteropathy (PLE).

It is also important to remember that dogs over 5 years with new-onset GI signs are more likely to have neoplasia or severe inflammatory disease. In such cases, early imaging is appropriate to assess for focal disease, such as masses. If ultrasound imaging is normal, then treating for FRE would be the appropriate next step. However, for many young dogs, ultrasound findings rarely alter the initial management plan. Dietary therapy remains the foundation of treatment.

When dietary and adjunctive measures fail, abdominal ultrasound and, subsequently, endoscopic biopsies become necessary to reach a definitive diagnosis. Histopathology often reveals lymphoplasmacytic enteritis—the hallmark lesion of inflammatory bowel disease. Only at this stage should immunomodulatory therapy be considered. Empirical immunosuppressive treatment is discouraged unless anesthesia or cost constraints preclude endoscopy.

Hodel S, Brugger D, Kook PH. Long-term evaluation of the initial response to therapy in 60 dogs with chronic inflammatory enteropathy. 

. 2024;38(5):2444-2453. doi:10.1111/jvim.17161

Mandigers PJ, Biourge V, van den Ingh TS, Ankringa N, German AJ. A randomized, open-label, positively-controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy. 

. 2010;24(6):1350-1357. doi:10.1111/j.1939-1676.2010.0632.x

Simpson KW, Miller ML, Loftus JP, Rishniw M, Frederick CE, Wakshlag JJ. Randomized controlled trial of hydrolyzed fish diets in dogs with chronic enteropathy. 

. 2023;37(6):2334-2343. doi:10.1111/jvim.16844

Lappin MR, Zug A, Hovenga C, Gagne J, Cross E. Efficacy of feeding a diet containing a high concentration of mixed fiber sources for management of acute large bowel diarrhea in dogs in shelters. 

. 2022;36(2):488-492. doi:10.1111/jvim.16360

White R, Atherly T, Guard B, et al. Randomized, controlled trial evaluating the effect of multi-strain probiotic on the mucosal microbiota in canine idiopathic inflammatory bowel disease. 

. 2017;8(5):451-466. doi:10.1080/19490976.2017.1334754

Tamura Y. Chronic Enteropathy and Vitamins in Dogs. 

. 2025;15(5):649. Published 2025 Feb 23. doi:10.3390/ani15050649

Chang CH, Lidbury JA, Suchodolski JS, Steiner JM. Effect of oral or injectable supplementation with cobalamin in dogs with hypocobalaminemia caused by chronic enteropathy or exocrine pancreatic insufficiency. 

. 2022;36(5):1607-1621. doi:10.1111/jvim.16528

Explore effective strategies and management techniques to enhance gastrointestinal health and treatment outcomes for canines with CIE.

How to manage chronic inflammatory enteropathies for young canines, in general practice 

On this week's regularly scheduled episode of 

, host Adam Christman, DVM, MBA, welcomed Brian Hare, MA, PhD, to the show to talk about Hare's work with puppies. Hare and Christman chat about the Duke Puppy Kindergarten, socialization, and why it is so important to these young pets. They also discuss more about Hare and his research in general, including a program on Netflix. 

Below is a partial transcript, edited lightly for clarity: 

 from Disney? Everyone has a gift, a door to open. And I say this to puppy owners, [that] there [are] multiple doors and gifts that they have. It may not be the same gift that the next puppy has. Some are just incredibly well at socialization. Maybe some are great at crate training—whatever [it] is—and that's OK. Sometimes we're comparing apples to oranges...with different dog breeds. Would you say?

 Well...each dog is an individual, and part of what you know creates individuality that we fall in love with, because they all have these idiosyncratic things. If they were all the same, you wouldn't have these remarkable relationships. They're not the same. They're individuals. They're beings. 

Part of what creates that [is] these different cognitive abilities, and we've been able to measure when they come online and when they first develop some of the abilities. For instance, when a puppy is born, they don't have very much self-control, so it's not really until 14 weeks that most puppies develop self-control. But different puppies develop self-control at different times, and that shapes who they end up becoming as an adult. So we have all sorts of leads on some of the things that end up creating the individuals we fall in love with.

What about those dogs we see on social media that...have that ability to communicate with different buttons? [They're] like, "Mommy, out the door," or "[I] have to pee," or "Shut up." What are your thoughts when you see some of these dogs that use those kinds of communication tools...? Is there something to be said about that?

 One of...our big discoveries is that dogs are geniuses for their comprehension of our gestures. So relative to other species—whether it's other chimpanzees or bonobos or wolves—dogs really are special.... In fact, one of the things we further studied in the puppy kindergarten [is] that at an early age, puppies are amazing [at] understanding our gestures.

But what makes the buttons potentially remarkable—and I'll come back to why I say potentially—is that it's about production. It's about producing requests. It's about actually producing communication, not just understanding.... Very few animals have demonstrated to have flexible abilities to communicate, so the buttons have caught everybody's attention because dogs using these buttons seem to be communicating to us in a way that really resonates as a human being. 

Now, whether the science is actually going to bear out that dogs...as they begin to learn language, are they creating words? Are they creating grammatical structures that a young infant begins to make as they begin to show linguistic abilities? The jury's out on that. But should people use the buttons if they want? Absolutely. Are they fun? Are they adorable? If your dog enjoys it, go for it. It's awesome.

Podcasts

Learn more about puppy behavior on this episode of The Vet Blast Podcast presented by dvm360. 