Maintaining a lean body condition is the only proven method of delaying and reducing the severity of osteoarthritis, says Kristin Kirkby Shaw, DVM, PhD, MS, DACVS-SA, DACVSMR in this interview

3 things to know about canine osteoarthritis

Multiple factors contribute to the development of osteoarthritis (OA) in dogs, with obesity being one. Excess body weight places additional strain on joints. Moreover, fat cells produce inflammatory mediators that accelerate the progression of OA, according to the Cornell University College of Veterinary Medicine.

 This makes it especially important for veterinary professionals to talk with clients about the role of exercise and weight management in preventing OA.

As Canine Fitness Month comes to a close, 

 is taking a closer look at OA in dogs. Earlier this spring, Kristin Kirkby Shaw, DVM, PhD, MS, DACVS-SA, DACVSMR, founder of Canine Arthritis Resources and Education (CARE), presented a session on canine OA during the Fetch dvm360 Conference in Charlotte, North Carolina. In this interview, Kirkby Shaw shares 3 key takeaways from that lecture.

Below is the interview transcript, which has been lightly edited for clarity:

Kristin Kirkby Shaw, DVM, PhD, MS, DACVS-SA, DACVSMR: 

Hi, I'm Dr Kristin Kirkby Shaw. I'm a small-animal surgeon and rehabilitation specialist. I did all of my training at the University of Florida, and I've practiced in Seattle, Washington, for 12 years. I have a passion specifically for osteoarthritis [OA]. I've spent my career both in the surgical suite and managing rehab patients. I'm actually excited that the next step of my career is going to be as an orthopedic surgeon at Colorado State University. [As] my passion project on the side, because I've been involved with [OA] for so long, I started the website caninearthritis.org. Check it out; it's a website full of practical, free, evidence-based tools to help you and your clients manage dogs with [OA].

There are 3 important points that I want people to take away from this lecture:

Dogs typically develop secondary arthritis, meaning they have an underlying developmental orthopedic disease or condition in their joint, which typically starts to develop in young dogs. This means we need to be screening for and identifying joint disease as early as possible so we can take a proactive approach to management. And that doesn't necessarily mean lifelong pharmaceuticals.

OA pain changes not only a dog's mobility but also their behavior, mood, and personality. So, if you have a patient that is showing problem behaviors, it's important to make sure that they're not actually in pain.

Maintaining a lean body condition is the only proven method of delaying and reducing the severity of [OA]. There [are] no other treatments that have been shown to have the dramatic impact that weight management alone can have. So, dogs with or [who are] at risk of joint disease should maintain a body condition score of 4.5 of 9.

Osteoarthritis. Cornell Richard P. Riney Canine Health Center. Accessed April 29, 2025. https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information/osteoarthritis

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Maintaining a lean body condition is the only proven method of delaying and reducing the severity of osteoarthritis, says Kristin Kirkby Shaw, DVM, PhD, MS, DACVS-SA, DACVSMR, in this interview.

Three things to know about canine osteoarthritis

A voluntary recall of a prescription sedative and analgesic for companion animals has been issued by Cronus Pharma. One lot each for 2 products containing dexmedetomidine hydrochloride injection 0.5 mg/mL (Dexased, Aspen; and Dexmedvet, Cronus Pharma) are being recalled as a precautionary measure because of the presence of visible particulate matter.

“The health and well-being of animals is the foremost priority at Cronus Pharma. We place the utmost emphasis on product quality at every step in the manufacturing and supply chain process,” the company noted in a news release.

The recalled dexmedetomidine hydrochloride injection products are used for feline and canine patients to help facilitate clinical examinations and procedures as well as minor surgical and dental procedures. Additionally, dexmedetomidine hydrochloride injection is indicated for use in dogs and cats as a preanesthetic to general anesthesia, according to the FDA.

Particulate matter was observed as crystal-like particles or “white stuff floating” during visual inspection of control samples for Dexased and Dexmedvet, according to the FDA. Identifying information for the recalled lots are as follows

Dexased: Dexmedetomidine Hydrochloride Injection 0.5mg/ml (Aspen), NDC No: 46066-088-13, Batch No: C24041AV1. Manufacturing date: November 2024. Expiration date: October 2026. Distribution dates: December 2024 to April 4, 2025.

DexmedVet: Dexmedetomidine hydrochloride Injection 0.5mg/ml (Cronus Pharma LLC), NDC No: 69043-038-10, Batch No: C24041AV2. Manufacturing date: November 2024. Expiration date: October 2026. Distribution dates: March 2025 to April 4, 2025.

Pet owners who have received recalled lots of the affected dexmedetomidine hydrochloride injection products should be advised to stop using them. Administration of an injectable product that contains particulate matter may result in serious adverse events. Potential complications include inflammation, granuloma, fibrosis, and blockage of blood vessels in the heart, lungs, or brain, which can cause stroke or life-threatening blood clot events, including death. The overall risk depends on factors such as the route of injection, the composition of the particulate matter, and patient comorbidities.

Possible signs and symptoms of an adverse event include pain, weakness, swelling, paralysis, fever, labored or fast breathing, vomiting, decreased activity level, vocalization, or loss of consciousness, according to the FDA. If these or any other concerning signs are observed in an animal that may have been administered this recalled product, a veterinarian should be contacted as soon as possible. Adverse reactions or quality problems experienced with the use of this product may also be reported to the FDA at 1-888-FDA-VETS or online at 

Cronus Pharma—a division of Cronus Pharma Specialties in Hyderabad, India—is working with distribution partners to help ensure that unused product is no longer being distributed or with customers. Cronus Pharma is also notifying its distributors and customers directly and is arranging for the return of the recalled product.

Pet owners in possession of the affected products with recalled lots should refer to the recall notification with instructions for returns or contact their point of purchase for details. Pet owners with technical questions regarding the recall should call 1-844-227-6687 and send an email to pv@cronuspharmausa.com.

Cronus Pharma LLC initiating voluntary recall for (Dexased-Aspen and Dexmedvet\-Cronus Pharma LLC) of dexmedetomidine hydrochloride Injection 0.5 mg/mL for veterinary use due to presence of particulate matter. News release. April 23, 2025. Accessed April 29, 2025. 

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/cronus-pharma-llc-initiating-voluntary-recall-dexasedtm-aspen-and-dexmedvettm-cronus-pharma-llc

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Visible particulate matter was observed in 2 products containing dexmedetomidine hydrochloride injection 0.5 mg/mL for dogs and cats.

Prescription sedative and analgesic is voluntarily recalled

The American Veterinary Medical Association (AVMA) has created guidelines for veterinary internships specifically in large animal hospitals and those in a primarily ambulatory setting. The new policy is an adaptation of the AVMA’s Veterinary Internship Guidelines, which were created more than a decade ago.

According to the AVMA, committee members of the Veterinary Specialty Organizations Committee (VSOC) agreed that the original document did not adequately address issues specific to interning at large animal practices, especially for internships in predominantly ambulatory settings, prompting the development of the Veterinary Large Animal Hospital Internship Guidelines. Following a review of the internship guidelines, VSOC members devised new guidelines and recommended minor edits to the existing internship policy.

The draft and recommendations were subsequently approved by the AVMA Board of Directors as a policy specific for small animal internships and both large animal hospital and large animal ambulatory internships. Together with the Veterinary Small Animal Internship Guidelines and the Large Animal Ambulatory Internship Guidelines, the new Veterinary Large Animal Hospital Internship Guidelines help establish reasonable expectations for internship providers and participants, said the AVMA.

According to the 3 internship guidelines, veterinary internship programs should be a 1-year educational experience that focuses on clinical training that covers a variety of clinical disciplines. The guidelines also maintain that the main purpose of internships is educational, and not a source of labor for the benefit of the institution offering the internship.

“The internship should help to prepare veterinarians for high-quality service in practice or advanced specialty training,” wrote the AVMA in its guidelines.

“The internship should emphasize mentorship, direct supervision, and didactic experiences.... The key to providing or completing a successful internship experience is establishing a clear, mutual understanding of what is being provided and what is expected in return.”

Examples of training include teaching rounds, seminars, and journal clubs, according to the AVMA.

 The guidelines also recommend detailed orientation programs, regular performance reviews that use several assessors, and assigning interns a mentor who is an experienced veterinarian.

The policy also offers guidance for employment arrangements, stating that interns should be offered clear contracts that detail duties, schedules, and benefits. Benefits and salary should be representative of the intern’s level of training and their responsibilities.

Noncompete clauses should not be part of the employment agreement, according to the AVMA policy.

 Additionally, internship programs should underscore work-life balance that aligns with the Accreditation Council of Graduate Medical Education standards for residency programs.

The policy also highlighted the role of interns assisting with surgeries. “Internships should provide the opportunity to be the primary surgeon on a broad range of elective and entry-level procedures to ensure appropriate progress is made after appropriate supervised surgeries,” read the guidelines.

Moreover, interns must not be the only veterinarians at satellite sites.

 The guidelines also call for adequate caseload, as well as access to faculty, facilities, and essential diagnostic and surgical tools.

“Internship providers should collect and utilize appropriate outcome measures to monitor program quality, identify areas for improvement, and assist candidates in the selection process,” states the policy document.

Large animal internship guidelines emphasize mentorship, supervision, outcomes. News release. American Veterinary Medical Association. April 28, 2025. Accessed April 29, 2025. https://www.avma.org/news/large-animal-internship-guidelines-emphasize-mentorship-supervision-outcomes?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

Veterinary large animal hospital internship guidelines. American Veterinary Medical Association. Accessed April 29, 2025. https://www.avma.org/resources-tools/avma-policies/veterinary-large-animal-hospital-internship-guidelines

Internships should help prepare veterinarians for high-quality service in practice or advanced specialty training, according to the new guidelines.

AVMA releases veterinary large animal hospital internship policy

Steven Ringold, DVM, DACVR, discusses his Fetch dvm360 Conference lecture on pulmonary patterns in thoracic radiology, in an interview

Understanding pulmonary patterns in thoracic radiology

Steven Ringold, DVM, DACVR, a veterinary radiologist with VetRad, discusses the significance of pulmonary patterns in thoracic radiology, in a 

interview at the 2025 Fetch dvm360 Conference in Charlotte, North Carolina. Ringold presented a continuing education (CE) lecture on the topic during the conference, and discusses in the interview the key takeaway. The lecture can now be virtually accessed for CE credit at 

The following is a transcript of the video:

: Pulmonary patterns abound in thoracic radiology, and there's a number of different pulmonary patterns, and many of them exist at the same time. And I think that it's really important for people to be able to recognize these individual patterns and break down the causes of these patterns, and by learning the fundamentals that will enable them to better pinpoint the pathology that's occurring in their particular patient. I would like attendees to bring [away] with them an understanding of the different pulmonary patterns and how that understanding could allow them to better help their patients.

 delivers expert-led veterinary continuing education on your schedule. With 

, you can access top-tier sessions anytime, anywhere—whether at home, in the clinic, or on the go. Ready to earn CE credits? Watch this session and more on 

Steven Ringold, DVM, DACVR, discusses his Fetch On-Demand lecture and what attendees can learn from it.

Feeding the Equine Immune System: The Good and Bad Gut and Immune Health Connection

Sponsor: Standard Process Veterinary Formulas 

Nutrition plays a huge role in the overall health of the horse. We will focus on 2 key systems— digestion and immune health—and discuss how compromise can contribute to multiple common conditions we see daily in our equine patients. We will also discuss the good and bad relationship between gut and immune health. Kelly Neale, DVM, will cover key ingredients to consider for nutritionally supporting the gut and immune system.

Frustrating Otitis Cases Got You Shaking Your Head?

This course covers the essential points of diagnosis and treatment of otitis. Both acute and chronic cases of otitis will be discussed. Particular emphasis will be placed on the PSPP classification system (primary causes, secondary causes, predisposing causes, and perpetuating factors).

Your Analysis Requires Urinalysis—What AI Has to Offer

Speaker: Dennis J. Chew, DVM, DACVIM (SAIM) 

Review information about current diagnostic practices and attitudes toward urinalysis in veterinary hospitals and discuss key components of a complete urinalysis. Learn how to maximize results obtained from your urine sediment and leverage new artificial intelligence technologies with the Vetscan Imagyst by Zoetis to improve your diagnostic and treatment capabilities.

Speaker: Craig Webb, DVM, PhD, DACVIM (SAIM) 

Sponsor: Nutramax Laboratories Veterinary Sciences 

This presentation will briefly compare and contrast canine and feline liver physiology, setting the stage for the discussion of how clinicians can best recognize hepatopathies in both species.'

Feline Fine: The Value of Wellness Testing and Parasite Prevention in Cats

Speaker: Michelle Evason, BSc, DVM, DACVIM (SAIM), MRCVS 

In this podcast, Michelle Evason, BSc, DVM, DACVIM (SAIM), MRCVS, will discuss topics related to the spectrum of care and feline care and provide practical tips for communicating with pet owners about these topics.

The Role of JAK Inhibitors in Treating Pruritus Associated With Allergic and Atopic Dermatitis in Canines

This podcast will cover the causes of allergic and atopic dermatitis and outline various treatment options available on the market. We will also discuss various treatment solutions based on an individual dog’s presentation of symptoms.

Fetch On-Demand brings the value of Fetch conferences to your fingertips with recorded CE sessions led by industry leaders. Attendees can extend their CE opportunities and earn additional credits, while non-attendees can experience Fetch’s renowned faculty and education. Earn CE credits anytime, anywhere, with the flexibility busy veterinary professionals need.

Check out these continuing education opportunities now available

Flex Forecast: March/April 2025

Liver biopsy and analysis of samples are important steps in diagnosing hepatic disease. Fine-needle aspirates of the liver tend to have poor diagnostic accuracy, as low as 30% when compared with histopathology in one study, leading to the recommendation for surgical biopsies.

 Depending on the underlying disease process, these patients may be systemically ill, with prolonged clotting times, ascites, or significant cirrhosis of the liver, which can make surgical biopsies more challenging and at a higher risk for complications. The most significant risk to consider, given the function of the liver, is bleeding. As a result, checking a patient’s clotting times prior to obtaining biopsies is generally recommended.

When obtaining liver biopsies for a patient, it is important to do so in a manner that maximizes the likelihood of a diagnosis while minimizing risk to the patient. In 2019, the American College of Veterinary Internal Medicine published a consensus statement on the diagnosis and treatment of chronic hepatitis in dogs that outlines recommendations for the procurement of samples and submission processes.

Samples must be large enough that 12 to 15 portal triads are obtained. Additionally, sampling different liver lobes is recommended, as there may be variation between different lobes. Finally, samples should also be submitted for aerobic and anaerobic culture and copper quantification. Twenty to 40 mg of liver is required to submit a sample for copper quantification. Ultimately, this has resulted in the recommendation for a minimum of 3 surgical biopsy specimens from at least 2 liver lobes for histopathology: 1 for anaerobic/aerobic culture and 1 for copper quantification.

One of the least invasive options for liver biopsy is using a biopsy instrument, such as a Tru-Cut biopsy device. This core biopsy needle enables sampling larger lesions than a fine-needle aspirate. These samples can be obtained with ultrasound guidance. Studies have found these samples to be 48% to 83% consistent with surgical liver biopsies.

 There is a larger possibility of hemorrhage with this technique compared with fine-needle aspirates, although the likelihood of major life-threatening hemorrhage is low. Although this is certainly the least invasive option that exists for liver biopsy, diagnostic accuracy may be limited by sample size. If relying on needle biopsy for sampling, more than 4 specimens are recommended to ensure the requisite number of portal triads is obtained.

 These samples often also need additional care when handling because of their small size. It is easy to crush or otherwise induce artifacts into these samples.

There are multiple techniques for performing liver biopsies via a celiotomy. Ultimately, the choice of technique is at the discretion of the primary surgeon.

One of the easiest techniques is obtaining a biopsy of the periphery of a chosen liver lobe via the guillotine technique. For this technique, a portion of the liver lobe periphery that is more pointed or comes to a taper is selected, and a loop of absorbable suture, such as polydioxanone, is placed around it. The loop is tightened, and the liver lobe is ligated and then transected distal to the suture. This sample can then be submitted for histopathological analysis or, if of an appropriate size, can be divided into different portions for culture and copper quantification. Even if the sample is of an appropriate size to be divided into multiple portions, it is important to remember the previously stated recommendations regarding sampling multiple liver lobes due to potential variation between them.

Another appropriate technique, particularly if a lesion is not on the periphery, is the use of a biopsy punch. This may be used anywhere in the liver, although caution should be used toward the center and hilus of the liver lobe to be biopsied. When using a biopsy punch, care should be taken to penetrate no more than half the depth of the lobe. Some hemorrhage is to be expected, and a gelatin sponge may be placed into the defect that is created. Hemorrhage is reported to be greatest with this technique but rarely requires intervention.

Finally, it is also acceptable to use vessel sealing devices to seal and transect a portion of the liver. However, a large enough sample must be acquired, as the use of these devices will result in some thermal spread and artifact throughout the edge of the sample.

Laparoscopic liver biopsy is a safe technique that results in highly diagnostic samples. The magnification and illumination associated with laparoscopic surgery may also aid in targeted biopsy of lesions, and the use of laparoscopy can result in reduced pain and a faster recovery.

 This is typically performed with two 5-mm single instrument ports or 1 multi-instrument port to facilitate a 5-mm camera and 5-mm cup biopsy forceps. Multiple techniques exist, such as forcefully pulling once the cup biopsy has been closed over a liver lobe, rotating the forceps 360° in one direction after closing until the sample twists off, or even pulling the forceps through the laparoscopic cannula while simultaneously advancing the cannula to use it as a dissection device.

Image courtesy of Rachel Williams, DVM, DACVS-SA

All these techniques have been proven to be safe and effective, but the twisting technique is reported to have the fewest artifacts.

 Some bleeding can be expected with laparoscopic liver biopsies (

), but it should be relatively mild and self-limiting. Careful assessment of all biopsy sites for active hemorrhage should be performed prior to closure. If persistent hemorrhage is noted, this may be addressed with electrocautery, a vessel sealing device, or other hemostatic agents, or conversion to an open approach may be necessary.

Postoperatively, patients should be monitored for pain and hemorrhage. Vital signs may be early indicators of bleeding and should be recorded. Many surgeons recommend checking the packed cell volume/total solids and blood pressure 2 to 4 hours after surgery to monitor for a significant decrease in those values. If that is the case, hemorrhage is a possibility, and a point-of-care ultrasound is prudent to look for evidence and sample if indicated.

Most patients who undergo liver biopsies can be discharged the same day. They should be discharged with analgesics as appropriate for the procedure performed. There is generally no need to discharge patients on antibiotics or steroids, and prescribing these medications should be delayed until the results of the biopsy samples are available.

, is a clinical assistant professor of small animal surgery at the University of Florida College of Veterinary Medicine in Gainesville. Her professional interests include urogenital surgery, minimally invasive surgery, and wounds and reconstruction. Outside the operating room, she enjoys being outdoors with her dogs, as well as gardening and traveling.

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Vasanjee SC, Bubenik LJ, Hosgood G, Bauer R. Evaluation of hemorrhage, sample size, and collateral damage for five hepatic biopsy methods in dogs. 

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Cole TL, Center SA, Flood SN, et al. Diagnostic comparison of needle and wedge biopsy specimens of the liver in dogs and cats. 

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Webster CRL, Center SA, Cullen JM, et al. ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs. 

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Culp WT, Mayhew PD, Brown DC. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. 

. 2009;38(7):811-817. doi:10.1111/j.1532-950X.2009.00572.x

Gauthier O, Holopherne-Doran D, Gendarme T, et al. Assessment of postoperative pain in cats after ovariectomy by laparoscopy, median celiotomy, or flank laparotomy. 

. 2015;44(suppl 1):23-30. doi:10.1111/j.1532-950X.2014.12150.x

Walsh PJ, Remedios AM, Ferguson JF, Walker DD, Cantwell S, Duke T. Thoracoscopic versus open partial pericardiectomy in dogs: comparison of postoperative pain and morbidity. 

. 1999;28(6):472-479. doi:10.1111/j.1532-950x.1999.00472.x

Buote NJ, Loftus JP, Miller AD. Laparoscopic twist technique has the best overall artifact profile when comparing three laparoscopic hepatic cup biopsy techniques for dogs. 

.2022;83(12):ajvr.22.08.0127. doi:10.2460/ajvr.22.08.0127

Sample analysis is critical for diagnosing hepatic disease