A new veterinary device that relies on nanotechnology for treating osteoarthritis (OA) in horses is expected to be available in the US in 2026. Synoglide—an intra-articular injection manufactured by biomedical company Allegro and licensed by American Regent Animal Health—is engineered to behave like biology.

“We are excited [by] the potential this device offers to equine athletes, veterinarians, and horse owners as a valuable addition to the treatment continuum for osteoarthritis in horses. Synoglide ushers in a fresh perspective on how we address arthritis, reduce discomfort, and help restore movement with intra-articular care…. We look forward to seeing the impact this product will have on the well-being of our equine partners,” Andy Ferrigno, senior director, international sales and marketing, American Regent Animal Health, said in a news release.

Equine OA is a common degenerative condition that can occur in any synovial joint. Affecting horses at any age and of any breed, it is caused by multiple factors that include repetitive trauma, historical fractures, poor coordination, and high-speed training.

Generic therapy is available for managing OA pain in horses

Lameness is the predominant clinical sign of equine OA. Reduced range of motion, joint inflammation, and heat and pain with joint manipulation are other signs. Horses with OA may also be stiff when they first begin moving and appear to be more comfortable after warming up.

"Synoglide offers a new approach to help veterinarians manage this challenging chronic condition that affects the lives of so many animals,” Paul Diolosa, CEO for American Regent, said in a news release.

Derived from natural ingredients, Synoglide is a veterinary formulation of Allegro’s Hydrocelin, a potentially disease-modifying candidate for OA treatment that is expected to be investigated in human clinical studies in 2026. It is designed to mimic the elasticity and rheopectic behavior of synovial fluid by using cross-linked microparticle bonds that strengthen under mechanical stress and provide extra support to the joint.

Results of an unblinded clinical study involving 29 horses showed that Synoglide helped restore biomechanics, leading to improved joint function. Researchers found that 89.6% of those horses experienced decreased lameness 4 weeks after treatment, and 72.4% experienced complete resolution of lameness, according to the news release.

Under the agreement with American Regent Animal Health, Allegro will manufacture Synoglide in a state-of-the-art cleanroom facility that has the capacity to produce 1 million syringes per year. Lucas Decuypere, CEO and president of Allegro, will present Synoglide’s technology at the 2025 American Association of Equine Practitioners Convention, being held December 6-10 in Denver, Colorado. Decuypere will also take questions from attendees.

Introducing Synoglide: a first-of-its-kind OA microparticle hydrogel. News release. American Regent and Allegro NV. December 3, 2025.

Allegro and American Regent sign exclusive licensing deal for Synoglide, a novel osteoarthritis treatment in animal health, valued at up to $35 million. News release. Allegro NV and American Regent. November 25, 2025. Accessed December 4, 2025. 

https://www.globenewswire.com/news-release/2025/11/25/3194042/0/en/Allegro-and-American-Regent-sign-exclusive-licensing-deal-for-SynoglideTM-a-novel-osteoarthritis-treatment-in-animal-health-valued-at-up-to-35-million.html

Young A, Katzman S. Osteoarthritis. University of California-Davis, Center for Equine Health. July 29, 2021. Accessed December 4, 2025. 

https://ceh.vetmed.ucdavis.edu/health-topics/osteoarthritis

Articles

Clinical study results show Synoglide's effectiveness in restoring biomechanics for improved joint function.

Nanotechnology treatment for equine OA may soon be available

Veterinary dental expert Heidi Lobprise, DVM, DAVDC, shares her technique for extracting an upper fourth premolar, in this interview with dvm360.

Steps for extracting an upper fourth premolar

In this video, Heidi Lobprise, DVM, DAVDC, a senior pet advocate and veterinary dental specialist at Cibolo Creek Veterinary Hospital in Boerne, Texas, describes her step-by-step method for extracting an upper fourth premolar. She provides a detailed look at each stage of the technique, from flap design to final closure.

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

 When we make a flap, I usually make a cut at the mesial aspect of the gum tissue to lift it up, kind of a triangle flap. At that point, I have good visualization of the bone. I might take out a little bit of bone so I can see the furcation area. Then I use a crosscut fissure bur to section that tooth. We have 3 roots there. I actually take out a complete V in that tooth to make sure that I can access all 3 of the roots.

I’ll even slim down the crown of the upper 4th premolar on the backside so I have space for my elevators. Once I’ve got those 2 front roots, they’re still together, but with that V-shaped piece of tooth out, I can see where the furcation is, about midway between those 2 roots, to completely section those. After that, I get my smaller elevators, or my luxators, to start elevating out, making sure that I can get that blade of the elevator into the space between tooth and bone.

As I get further along, I go to my winged elevators, a little bit smaller for the ones in front—maybe a number 2, maybe a number 3 or 4 for the distal root, that’s a bit bigger—and put that elevator into the space between tooth and bone. Do a slight rotation and hold; that helps stretch the periodontal ligament. Then rotate the other way and it stretches a little bit more. Work on all 3 roots, or multiple teeth if I have multiple teeth, letting that ligament start to relax and loosen up.

I’ll take my extraction forceps, gently grasp the crown, and again, a little bit of rotation fatigues the ligament back and forth. Then once it’s loose enough, take it out. I will smooth off the bone and suture the flap.

Videos

Veterinary practices excel at celebrating the beginning of a pet’s life. Puppy and kitten programs are comprehensive, engaging, and designed to support families through developmental milestones with preventive medicine, nutrition advice, behavioral counseling, and client education. Yet, as our patients age, many practices lack an equally structured program for senior pets and geriatrics.

2023 American Animal Hospital Association (AAHA) Senior Care Guidelines for Dogs and Cats

, senior canines and felines represent 44% of the pet population, nearly 72 million senior pets, in the US.

 However, according to a 2025 internal study by Lap of Love and Vetsource, 44% of dogs and nearly 60% of cats have not seen their veterinarian in the 12 months preceding their euthanasia appointment.

As an end-of-life care veterinarian, this author has daily experience discussing the barriers to veterinary care in the senior and geriatric stages of our patients’ lives. Most families report that it’s too physically difficult and/or stressful to get pets into the car and veterinary office, they don’t want to feel pressure to pursue diagnostics or treatments that may be futile given their pet’s life stage, or they are afraid the only recommendation will be euthanasia.

A thoughtfully designed geriatric program can improve quality of life, strengthen the human-an- imal bond, and create a sustainable model for both families and veterinary teams. This article outlines the framework for building a program to prepare for the most commonly seen obstacles, while focusing on medical, emotional, and logistical support for aging pets and their caregivers.

Identifying the “cracks” in end-of-life care

As those statistics show, even the most compas- sionate practices often encounter patients who “fall through the cracks” in end-of-life care. These may be communication or policy gaps where families may lose confidence, pets may suffer unnecessarily, and the veterinary team may feel unprepared to provide the most meaningful guidance. These cracks can take several forms, as follows:

: Clients may not recognize subtle signs of decline, such as increased restlessness at night, changes in gait, or reduced enthusiasm for food and play. Without veterinary input, they may dismiss these as normal aging rather than recognizing them as clinical red flags that could benefit from intervention sooner rather than later.

Veterinary client-patient relationship (VCPR) expirations

: Lapsed VCPRs can delay timely care. Families often wait until a crisis arises before reestablishing contact, leaving pets without preventive or palliative support in the interim.

: Some hospital protocols may inadvertently create barriers by requiring diagnostics, procedures, or treatments as conditions of continued care. Geriatric pet owners, however, may be unwilling or unable to pursue these diagnostics or interventions, leaving them feeling excluded from care altogether. This creates tension between practice policy and client values.

: Without veterinary guidance, pet families may assume that euthanasia is the only reasonable treatment option when a new issue arises. For example, a sudden vestibular episode, progressive weakness, or incontinence is often interpreted as an immediate and irreversible sign that “it’s time,” when in fact these are common geriatric scenarios that may be managed successfully with supportive care.

: Families who have not engaged in preplanning are left scrambling when a crisis occurs, rushing to make emotionally charged decisions in the face of respiratory distress, collapse, or acute pain. These last-minute scenarios often increase suffering for the pet and distress for the family, leaving veterinary teams struggling to respond in real time.

Underlying all of these cracks are predictable drivers: miscommunication, fear, anxiety, inex- perience, and confusion. A structured geriatric program directly addresses these vulnerabilities by offering proactive education, preplanning, and clear guidance, empowering families and ensuring that pets experience comfort and dignity throughout their later years.

A geriatric program must extend beyond the financial and medical framework of traditional wellness plans. Whereas puppy and kitten programs focus on vaccinations, parasite preven- tion, and growth milestones, senior and geriatric care requires a broader, more holistic approach. Medical care is only one piece of the puzzle; families also need emotional support, practical training, and guidance through the uncertainties of aging.

Financial incentives are an important starting point. Bundled services, such as packages for semiannual exams, diagnostics, or comprehensive geriatric assessments, help families budget and reduce the likelihood of deferring care due to cost. Prescheduled visits also reinforce continuity, ensuring that pets are evaluated before small changes become crises. T

 provide resources that review recommended monitoring approaches and time- lines, allowing each practice to customize these bundles or discounted services as appropriate for their practice.

Equally vital is partnership and collaboration. Geriatric patients often benefit from a team approach that may include rehabilitation specialists, hospice and palliative care providers, nutritionists, and behaviorists. Strong referral networks enable the primary care veterinarian to serve as the central guide, drawing on the expertise of colleagues for complex cases.

Education empowers caregivers to understand what normal aging looks like and to recognize when something is amiss. Clear resources, hand- outs, videos, and checklists on topics such as mobility decline, chronic pain, cognitive dysfunction, and home modifications provide reassurance and direction. Targeted email newsletters, visit handouts, website, and lobby education materials all provide opportunities to introduce and reinforce this information to clients.

Hands-on training ensures that families feel capable in the day-to-day care of their aging companions. This may include instruction in
the use of harnesses, ramps, traction aids, or mobility carts; guidance on medication administration; or exercises that promote strength, balance, and cognitive enrichment. When families are confident in these skills, pets benefit from smoother daily routines and reduced stress. Teaching pets these skills before they experience pain, balance loss, and a loss of confidence in their mobility is key to accepting these aids in their later years.

At the heart of any geriatric program is supporting the human-animal bond. Structured activities—such as senior pet fitness classes, “aging gracefully” workshops, or caregiver support groups—help families feel less isolated, while encouraging ongoing connection with their pets. Celebrating milestones through birthdays, holidays, and photo sessions reinforces joy and reframes the aging process as a stage of life to be cherished rather than feared.

Finally, preplanning is essential. Conversations about end-of-life wishes, aftercare, and memorial options should occur early, when families can reflect without the pressure of a crisis. Preplanning not only reduces fear and uncertainty but also ensures that care aligns with the family’s values and the pet’s needs.

In short, a geriatric program that moves beyond wellness plans creates a road map for both medical and emotional support. It transforms the veterinary team from a service provider into a trusted partner that families can rely on for guidance, reassurance, and comfort through the final stages of their pet’s life.

Dhaliwal R, Boynton E, Carrera-Justiz S, et al. 2023 AAHA Senior Care Guidelines for Dogs and Cats. American Animal Hospital Association. December 9, 2024. Accessed November 14, 2025. 

https://www.aaha.org/resources/2023-aaha-senior-care-guidelines-for-dogs-and-cats/

Singler E. The “golden years”: encouraging veterinary visits for senior pets. American Animal Hospital Association. August 22, 2025. Accessed November 14, 2025. 

https://www.aaha.org/trends-magazine/publications/the-golden-years-encouraging-veterinary-visits-for-senior-pets/

Creating a medical and emotional support road map for patient care can take the veterinary team from “service provider” to “trusted partner.”

Strategic design of geriatric pet programs in veterinary practice: Part 1

What can primary care veterinarians do to provide care to patients with cancer? These approaches can help guide treatment.

Staging is a critical step in cancer patient management, but it does not always require referral to a specialist to be performed effectively. Most staging procedures—such as complete blood count, serum chemistry panel, cytologic evaluation of regional lymph nodes, and 3-view thoracic radiographs—are standard diagnostic tests readily available in general practice.

These tools provide essential information about the extent of disease, metastatic potential, and overall patient health, guiding both treatment decisions and client expectations. For example, aspirating a regional lymph node in a dog with a mast cell tumor or obtaining thoracic radiographs in a soft tissue sarcoma or osteosarcoma case are impactful yet straightforward steps that can be performed in-house. When these results accompany a referral, they not only streamline case management but also reduce client costs and improve continuity of care. By recognizing that cancer staging is based upon the same diagnostic principles used in primary care, veterinarians can confidently contribute to accurate diagnosis, timely treatment planning, and collaborative oncology care.

Lymphoma: Complete blood count (CBC), serum chemistry, consider 3-view thoracic radiographs with radiologist review

Mast cell tumor: CBC, serum chemistry, consider regional lymph node cytology

Soft tissue sarcoma: CBC, serum chemistry, 3-view thoracic radiographs with radiologist review

Osteosarcoma: CBC, serum chemistry, radiographs of affected limb, 3-view thoracic radiographs with radiologist review

Melanoma: Mass measurement and photo, CBC, serum chemistry, 3-view thoracic radiographs with radiologist review, regional lymph node cytology


Performing baseline staging in-house supports faster case turnover, more informed prognostication, and smoother communication with oncology referral centers. Most initial cancer staging can be efficiently and accurately performed by primary care veterinarians, expediting or even in some cases replacing oncology referral and reducing client cost.

is a new blood-based screening/diagnostic panel aimed at detecting canine lymphoma from serum or whole blood. It reports the presence or absence of lymphoma-associated circulating biomarkers and, when positive, can provide a B- vs T-cell phenotype classification in some cases.

Sensitivity: ~79% for dogs with lymphoma in IDEXX’s internal validation.

Specificity: ~99% versus healthy controls and dogs with inflammatory disease/other cancers in the same internal dataset.

Sample: single blood draw (serum or whole blood). Interference from mild–moderate hemolysis, lipemia, or icterus is reportedly minimal.

Cancer screening for apparently healthy “at-risk” dogs (IDEXX suggests integration within wellness panels for older dogs).

Cost/rollout: IDEXX promotes the test as low-cost (advertised as starting around US$15 as an add-on) and has been available in the US and Canada as of March 2025.

If lymphoma is suspected clinically (lymphadenopathy, constitutional signs, cytology suspicious): Cancer Dx can be run on the blood sample as a noninvasive adjunct, but positive results still require confirmation with cytology/biopsy/flow/PCR for antigen receptor rearrangement (PARR) as clinically indicated. A negative result does not rule out lymphoma because sensitivity is <100%.

If used for screening (as an add-on in older / at-risk dogs): discuss with owners that the test increases the chance of detecting lymphoma earlier, but is not a guarantee—explain the possibility of false negatives and what you’d do if the test is positive (confirmatory diagnostics, staging conversation).


The IDEXX Cancer Dx is a practical, low-cost blood test that helps detect canine lymphoma earlier and in some cases supplies phenotyping information useful for initial case planning. It’s a reasonable adjunct for dogs with clinical suspicion and an attractive screening add-on for older/at-risk dogs — but it is not diagnostic by itself. Use positive results to prompt confirmatory diagnostics such as cytology/biopsy/flow cytometry/PARR, and use clinical judgment for negative results because sensitivity is not 100%. Consider the current evidence base (IDEXX internal validation data only) and watch for independent peer-reviewed studies as they emerge.

Immunophenotyping (determining B-cell vs. T-cell origin) is now considered a standard part of lymphoma diagnosis because it directly influences prognosis and treatment expectations. Multiple studies confirm that dogs with T-cell lymphoma have shorter survival times and lower response rates to standard CHOP chemotherapy compared to dogs with B-cell lymphoma.

In one study, T-cell lymphoma had only a ~50% response rate to single-agent doxorubicin, versus nearly 100% for B-cell lymphoma.

T-cell protocols incorporating alkylating agents such as lomustine (CCNU) have shown partial responses in ~60% of cases and complete responses in 17%.

Modified multiagent protocols (eg, L-MOPP, CCNU-based CHOP variants) may offer benefit, but toxicity and practicality limit their use in general practice.

A prospective study comparing CHOP +/- the investigational agent AT-005 in T-cell lymphoma demonstrated similar response rates (~65% CR) and median progression-free survival (64–103 days), confirming that outcomes remain inferior to B-cell lymphoma.

Most informative test of all those available. Confirms B-cell vs. T-cell, but also provides additional prognostic markers that can indicate grade and expected behavior

Can be performed on tissue aspirate (ie, lymph node, organ) or fluid (ie, blood, effusions, CSF)

Requires live cells in media and overnight shipping

Available at multiple academic and reference labs

Can be performed on both cytology and biopsy samples

Only confirms B-cell vs. T-cell status, does not provide grade

Available at most academic and reference labs

Available at some academic and reference labs


Primary care veterinarians can play a crucial role by determining lymphoma immunophenotype before referral and treatment initiation, allowing the care team and pet owners to have a more informed and directed conversation about treatment options and expected prognosis.

 CHOP-based therapy remains standard, potentially good long-term prognosis.

 Expect shorter remission; consider referral or alternate protocols.

Cytologic Grading of Mast Cell Tumors (MCTs)

Traditional histologic grading remains the gold standard, but cytologic grading is validated as a noninvasive, predictive tool when tissue biopsy isn’t feasible or clinically indicated. Studies have shown that specific cytologic features—including mitotic figures, multinucleation, nuclear atypia, and karyomegaly—strongly correlate with histologic grade and outcome. 

Cytologic grading predicted histologic grade in 94% of cases.

Cytologic grading carries an 88% sensitivity and 94% specificity relative to histopathology.

) are 25–39 times more likely to result in death within 2 years.

Images courtesy of Casey J. LeBlanc, DVM, PhD, DACVP/Eastern VetPath

 Cytologically low grade MCT on the stifle of an 8 year old spayed female Labrador mix. Note the many well granulated mast cells exhibiting minimal variability in cell or nuclear size (minimal anisokarysis). 

Cytologically high grade MCTon the thigh of a 5 year old spayed female French bulldog. Note the many poorly to few well granulated mast cells of variable cell and nuclear size (mild to moderate anisokaryosis).


For general practitioners, cytologic grading provides a rapid, low-cost prognostic tool that can guide surgical planning and inform prognosis. Communicate with reference laboratory to ensure that cytologic grading can be provided for MCT submissions.

Noninvasive diagnosis of Transitional Cell Carcinoma (TCC)

The BRAF mutation test (CADET BRAF Mutation Detection Assay) represents one of the most impactful molecular diagnostics in veterinary oncology. Independent studieshave identified a single-point mutation (V595E) in the canine BRAF gene that is present in ~85% of TCC/urothelial carcinoma (UC) cases, but absent in benign or inflammatory bladder conditions.

This assay detects the mutant DNA in urine sediment, allowing:

Noninvasive diagnosis without aspirate, cystoscopy, or surgical biopsy

Early detection—often months before clinical signs

Monitoring for response to treatment and early detection of recurrence

A secondary test now detects an additional ~10% of previously negative cases. The test is offered through Antech Diagnostics (BRAF Plus; Sentinel Biomedical platform).

Consider this test for any dog with persistent hematuria, pollakiuria, or suspicion of a urinary tumor.

Submit a free-catch or catheterized urine sample for CADET BRAF testing before pursuing more invasive diagnostics such as prostatic wash for cytology, cystoscopy, or biopsy.

This test eliminates the need for needle aspiration of urinary tumors, a known risk for tumor seeding.

This test is 100% specific, so can be performed in dogs with known or suspected urinary tract infection (UTI) without concern for a false positive result.

Oncologic therapies available in primary care practice

Verdinexor is an oral anticancer medication conditionally approved by the FDA for the treatment of lymphoma in dogs. It belongs to a novel class of compounds known as Selective Inhibitors of Nuclear Export (SINE), which work by trapping tumor suppressor proteins inside the nucleus, thereby restoring normal control of cell growth and promoting cancer cell death.

For the primary care veterinarian, verdinexor offers an important at-home treatment option for canine lymphoma—particularly when referral for multiagent chemotherapy is not possible, or when a client prefers palliative care that still provides measurable clinical benefit.

In a multicenter phase II study of dogs with both B-cell and T-cell lymphoma, verdinexor achieved a clinical benefit rate of 55% (stable disease or better), with a median duration of benefit of 71 days (range 21–273 days). Notably, T-cell lymphoma cases, which are often less responsive to traditional chemotherapy, still showed a 71% clinical benefit rate.

 Commonly reported adverse effects are mild and include transient loss of appetite, lethargy, or gastrointestinal upset, which can often be managed symptomatically.

This makes verdinexor a reasonable monotherapy option for:

Dogs that cannot undergo intravenous chemotherapy.

Patients that have relapsed after CHOP-based treatment.

Owners seeking palliative oral therapy that maintains quality of life.

How SINE drugs work with other chemotherapy agents

In addition to its single-agent activity, the SINE drug class has shown synergistic and sensitizing effects when combined with other chemotherapeutics such as doxorubicin and platinum-based agents. These effects may help:

Sensitize lymphoma cells to respond better to chemotherapy.

Reverse or delay drug resistance that develops after cytotoxic treatment.

Verdinexor vs prednisone: Impact on drug resistance

Historically, prednisone has been used for palliative treatment of lymphoma, but glucocorticoids can induce multi-drug resistance (MDR) by increasing P-glycoprotein expression in lymphoma cells—reducing the efficacy of subsequent chemotherapy and worsening prognosis.

In contrast, verdinexor is not a substrate for P-glycoprotein, meaning it should not promote MDR or interfere with future chemotherapy response. In clinical studies, dogs receiving prednisone alone survived an average of 4–7 weeks, whereas verdinexor therapy offers a longer median benefit with potentially improved quality of life.

Multiple approaches to cancer treatment can be initiated by primary care veterinarians.

Understanding oncology diagnostics and therapeutics

Cynthia Otto discusses head dunking research that made her a finalist for the AKC research awards

Cynthia Otto discusses head dunking research

interview, Cynthia M. Otto, DVM, PhD, DACVECC, DACVSMR, discusses research conducted at the Penn Vet Working Dog Center in Philadelphia, Pennsylvania. Her team developed a voluntary head dunk procedure for dogs, a low-resource cooling technique that study results showed can block the typical 5-minute temperature spike post exercise in working dogs. That work has made Otto and her team finalists for the American Kennel Club’s Canine Health Discovery of the Year Award for the technique’s real-world potential to reduce heatstroke risk.

A simple, trained 30-second head dunk rapidly cools overheated dogs

Learn how to perform this technique by watching the video below:

Cynthia M. Otto, DVM, PhD, DACVECC, DACVSMR

: The start of the story goes way back. I have clinical expertise in emergency and critical care as well as sports medicine, and in the emergency [department] we would see way too many cases of heatstroke. What we know from the research and the literature is that heatstroke is one of those preventable causes of morbidity, mortality, and injury in our working dogs, but also across the board. So, we’ve been really thinking about how to address this heatstroke risk in dogs when they’re in environments where they are potentially at risk, and they have to keep doing things.

Over the years, we’ve looked at hydration and different cooling mechanisms, and it came to the point where we know that jumping in a pool of water is great...but that can’t always happen. I was working with some conservation detection dogs in Zambia...in a really hot environment. We can’t just take a break. We have to keep working. [We were trying to find] a way to cool off…we can’t carry enough water to fill a pool. The rivers are dangerous because there are crocodiles, hippopotamuses, and [other] things that would potentially put the dogs at huge risk. How do we try to cool these dogs?

We wanted to look at field-relevant cooling, things that you could take with you to do in a place where you might not have the resources. We had previously done a couple of studies. We know that dogs get really hot within 10 minutes of just running back and forth about 25 yards between 2 people to catch a ball or a toy, and they get really hot. It might surprise a lot of veterinarians. It certainly surprised me. The first time we looked at the temperatures of these dogs after they’d either been working in an actual search-and-rescue training or even this little exercise, their temperatures got up to about 105 to 106 °F, which is considered heatstroke, but these dogs weren’t experiencing heatstroke. They were still able to function fine.

To try to reframe that and figure that if they might be closer to risk of heatstroke, how do we prevent that? How do we prevent that from progressing? In this particular study, we tested field-ready approaches. One of them was using those cold chemical ice packs you might carry while hiking; you snap them, and they get cold. We put those under the collars on the dogs. We didn’t shave the dogs or anything. We just relied on what would naturally happen.

A second approach was to take a towel and wet it with cold water—this was 72 °F water, basically room temperature—but when you’re in 90 °F, 72 °F is cold. We wet those towels and tried one under their armpits because we discussed wetting dogs on their bottom half where there’s less fur; that might be a better place to cool them. We tried one wrapped around their neck because we also know that cooling blood going to the head can be effective. Then we tried a technique we’d been using at the Working Dog Center for quite a while to help dogs flush out their eyes and noses: having them voluntarily dunk their head into a little pool or bucket of water to get a treat or a toy. We call that the head dunk. It’s a voluntary head dunk because we train the dogs to do it, and they think it’s a fun game.

We didn’t have much confidence it would work, but it turned out that by dunking their head into this cold water—again, the water was 72 °F, not freezing, just room temperature—the usual pattern after you stop exercising is that your temperature continues to rise for about 5 minutes. That blocked that rise in temperature, and it really dropped their temperatures. Part of our cooling mechanism in dogs is panting, but panting requires evaporation of saliva and fluids in the respiratory tract. When it’s too hot and too humid, you can’t evaporate well. There’s a lot of blood flow to the head that allows for some cooling by heat exchange through breathing: You breathe out hot air, and heat moves from the oral cavity and the head to the environment. When we cool the head, they might drink a little bit during this, but not much. We actually measured how many times they lapped the water. It cooled their mouth, the roof of their mouth, their head, and their face.

We didn’t have them dunk far enough to get their ears wet because we didn’t want to fill their ears with water. Thermal cameras showed their ears as bright red—a lot of heat is being lost through the ears—but mostly we were looking at what was happening in their face and mouth, and the impact was quite remarkable. It can be done in a limited environment; it doesn’t require a huge amount of water, and it doesn’t take much training. Often, we’ve had a couple of puppies in demonstrations like this—a puppy who had never done this before, literally within 5 minutes, it was dunking its head. Some dogs take a little longer; they’re less excited about it, but it’s a really great technique not only for cooling but also for flushing eyes and noses.

We’re big advocates of low-stress handling and cooperative care, so anything that helps with cooperative veterinary care is fantastic. Cooling is really important in the field; flushing eyes and noses can be important in the field and in the veterinary clinic environment. We published a video in JAAHA/JAFFMA (video tutorials), open access, freely available, and it goes step by step on how to train this and when it’s appropriate to use it and when not to use it. Certainly, if a dog is already in heatstroke, that’s too late. We want to do this before they reach that point. We want dogs that are mentally appropriate and showing signs of heat stress, which, again, is worth reminding everybody that there are physical signs of heat stress regardless of what [the dog's] temperature is. Their eyes narrow, their tongues gets long, sometimes there’s more ropey saliva; they pant excessively, the commissures of the mouth are retracted, their ears may be retracted, they may be less motivated to return on a retrieve, or they might be seeking shade. All of those signs tell us the dog is feeling the effects, and we need to stop the activity and actively cool them. We also looked at what happens if we just stop the activity and let them rest in the shade. It doesn’t do much, and it takes a long time for them to come back down. So we want to actively intervene and actively cool them.

Otto breaks down the physiology and field data behind the head dunk technique and why active cooling is preferable to passive rest in hot conditions.

Cynthia M. Otto reports research showing the benefits of a trained head dunk to prevent heatstroke in dogs

Veterinary professionals at Chulalongkorn University’s Faculty of Veterinary Sciences in Bangkok successfully performed a pacemaker implantation on Pepsi, an 8-year-old domestic shorthair cat, making it the first in Thailand’s history.

Pepsi, an 8-year-old domestic shorthair cat, became the first feline patient in Thailand to have pacemaker surgery (Image courtesy of Chulalongkorn University Small Animal Hospital (Bangkok Animal Hospital))

Pepsi experienced frequent fainting spells, up to 4 times a day, caused by severe cardiac arrhythmia. She was initially brought into the Chulalongkorn Small Animal Hospital with lethargy, weakness, and sudden collapse accompanied by muscle stiffness and occasional vocalizations.

 During primary testing, it was noted that she possibly had a neurological or cardiac issue, but medication did not improve her condition. After being examined further, she was diagnosed with a severe cardiac arrhythmia.

Pepsi’s condition stemmed from a blockage of electrical signals between the heart’s chambers, which prevented blood from reaching the brain. In feline patients, these arrhythmias are rare and often occur in older animals. Pepsi’s team was able to confirm through 24-hour Holter monitoring, which is a more accurate tool than standard ECG testing.

“Normally, a cat’s heart beats about 140 to 220 times per minute, regulated by natural electrical impulses,” Anusak Kijtawornrat, DVM, PhD, explained.

 “When the signal is blocked, the heart stops contracting effectively, causing syncope. Such cases are uncommon—around 10% of feline cardiac cases—but are more prevalent in older cats.”

For feline patients, implanting a pacemaker can be challenging because cats have smaller veins and thinner heart muscles, unlike canine patients in whom the pacemaker lead can be inserted through the neck. Due to these challenges, the standard technique is too risky and could potentially puncture the patient’s heart.

Images courtesy of Chulalongkorn University Small Animal Hospital (Bangkok Animal Hospital)

The surgical team needed to open the cat's chest cavity between the ribs to access the heart directly. Then, they attached the pacing lead to the heart’s surface and connected that to a small generator implanted under the abdominal muscles.

 The procedure in its entirety took 1 hour and involved a multidisciplinary team working in close coordination.

“This method is more complex but safer for small animals,” Anusak said.

 “It was an improved technique from our previous feline case just 2 weeks earlier. Switching from a diaphragmatic approach to a thoracic one made the implantation easier and more accurate.”

Pepsi’s pacemaker device is the same model that is used in humans. It was customized with appropriately sized leads, and for Pepsi, the pacemaker had been donated and sterilized for reuse. Following the procedure, Pepsi made a quick recovery. She no longer faints, interacts energetically with her owner and the other cats at the home, and eats normally. She visits the hospital every 3 months for follow-ups, but overall lives a normal life.

Feline patients who undergo this surgery can live a normal life, albeit with some minor restrictions. Owners whose pets have had this procedure must inform their veterinarians before MRI scans. A minor lead dislodgement occurs in approximately 1% to 2% of patients, but it can be corrected surgically.

A major veterinary medicine advancement for Thailand

Although this procedure has been practiced outside of Thailand for years, it is rare in Thailand due to the specialized training requirements, diagnostic challenges, and equipment costs.

“This success showcases Thailand’s readiness to perform advanced procedures at an international level,” Anusak concluded. “Chulalongkorn’s veterinary faculty now has the expertise, technology, and multidisciplinary collaboration to match global standards.”

Anusak urged clients to seek immediate veterinary care for their pet if they show signs of weakness or fainting.

Chula veterinarians perform Thailand's first pacemaker implant in a cat. News release. Chulalongkorn University. November 23, 2025. Accessed December 3, 2025. 

https://prnmedia.prnewswire.com/news-releases/chula-veterinarians-perform-thailands-first-pacemaker-implant-in-a-cat-302624230.html

Panlee S. Chula veterinarians achieve national first with pacemaker Implant in a cat. Chulalongkorn University. November 14, 2025. Accessed December 3, 2025. https://www.chula.ac.th/en/highlight/271336/

This groundbreaking achievement was made possible by veterinarians from Chulalongkorn University’s Faculty of Veterinary Science.