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Andy Roark DVM MS

Reflections and Predictions

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As the year wraps up, I have been looking back at my goals and predictions from previous years. I found this piece from last year and thought it was worth sharing again. I hope you’ll enjoy it!

I’m not a New Year’s Resolution person. I have never been able to keep any resolutions past February, and when I drop them I just feel bad about myself. I also feel like the resolutions I make are often pulled out of the air based on what I feel like I “should” want, but not what really matters to me. 

When I’ve made resolutions, I’ve chosen the same generic stuff as everyone else. “I want to unplug more,” “I want to lose some weight,” “I want to read more books.” There’s nothing wrong with any of these resolutions. They just feel like they’ve been plucked off a list of resolutions everyone makes (and breaks). They aren’t personal or particularly motivating, so they go nowhere.

Anyway, if resolutions are your jam, I’m not trying to talk you out of them. Please ignore my opinion and continue to ratchet up your personal performance every January. If, however, you’re kind of done with resolutions and want something else to mark the end of the calendar year, might I recommend a nice reflection on what has already happened? How about a fun exercise of trying to predict the future?

I’ve been doing these two exercises for the last four years and really love them. The first is a reflection exercise. I’ve gotten a lot of enjoyment and clarity from thinking deeply about what has happened in the last 12 months and deciding what I want to hold on to.

Some of the questions I ask myself to reflect back are:

  • What do I want to remember forever about 2024? What were the achievements, surprises, and really great moments?
  • What relationships got stronger this year? Who am I most grateful for?
  • What relationships got weaker? Do I want to do anything about that?
  • What life lessons did I learn?
  • Where/when did I have my best experiences in 2024? 
  • Who was there? What can I do to increase the likelihood that I’ll have more experiences like these?

I’ve found that the insight I get from thinking back on what has really helped and mattered to me is deeply motivating when I look ahead into the coming year. The things that made last year great will probably be things I want to focus on going forward. The hard lessons I learned are usually things I want to remember to avoid pain and frustration in the future. The exercise, overall, is worth the time.

The second exercise is about predicting the future. At the end of each year, I create a document and make guesses about what will be true at the end of the coming year. I try to make my predictions short and clear so it will be obvious if they are correct or not. In some cases, I even jot down the percent certainty I have about a prediction (e.g. I will get back into watching TV and will be actively watching at least 2 shows at the end of 2025 – 66% certainty).

It helps me to break my life into parts and then think about each area. I make predictions about: Family, Hobbies, Fitness, Job, Personal Life/Goals.

If you want to try this, just make sections that make sense for you and start writing down what you suspect will be different one year from now. Ask yourself things like:

  • Will you be healthy? How about your parents?
  • Will you have a new best friend?
  • Will you be at a new job? Will you get that promotion?
  • Will you have a new hobby? Will you have stopped doing one of your current hobbies?
  • Will your spouse still be doing yoga daily?
  • Will you still be stopping at Starbucks 3 days a week?
  • Who will win the 2025 Superbowl or NBA Finals or World Series?
  • Where will you go on vacation? 

At the end of each year, I get to look back and see where I thought my life would be at this moment. It’s always fascinating to see how much has changed and how much or little we actually knew about the future. 

If you’ve never done these exercises before, maybe give them a try. If you’re worried about forgetting what you predicted or set out to do, I like to attach what I wrote to a calendar event I schedule for the end of the year so I’ll be sure to see it when the time comes.

I hope these little rituals might help and that you might enjoy them as much as I do. Please take care of yourself as we head to the new year, and have a fantastic 2025!

Best always,

   Andy

State of Veterinary Wellness

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Dr. Marie Holowaychuk joins Dr. Andy Roark on The Cone of Shame Veterinary Podcast to share her journey through burnout, mental health struggles, and recovery as a boarded critical care specialist turned wellness advocate. In this insightful episode, Dr. Holowaychuk discusses the realities of perfectionism, the martyr complex, and the challenges veterinary professionals face in balancing work, identity, and life outside the clinic. Marie opens up about her personal transformation, the pivotal role of boundaries, and strategies to prioritize mental health. Whether you’re navigating burnout, seeking wellness solutions, or striving for a sustainable veterinary career, this conversation is packed with actionable advice and inspiration for veterinarians, practice owners, and veterinary teams.

You can also listen to this episode on Apple Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Marie’s Website: marieholowaychuk.com

Mental Health Hub: revivingvetmed.com

Instagram: @drmarieholowaychuk

LinkedIn: Dr. Marie Holowaychuk

Dr. Know It All Card Game: https://drandyroark.com/product/dr-know-it-all-card-game/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Marie Holowaychuk brings a refreshing perspective to veterinary medicine, championing the wellbeing of veterinary teams with warmth and expertise. Based in Calgary, she’s a respected emergency and critical care specialist and a familiar name in the world of veterinary wellness.

Alongside her ER work, Marie is a prolific writer, speaker, and researcher. You might catch her hosting the Reviving Vet Med podcast or sharing insights in her monthly blog and newsletter, all geared towards supporting mental health in the veterinary community.

When she’s not at the clinic, Marie is a dedicated yoga and meditation teacher and wellness coach. She leads workshops and retreats for vet clinics, sharing practical strategies for staying balanced in a demanding field. Plus, she works behind the scenes on revivingvetmed.com, a go-to resource hub for veterinary professionals seeking support and guidance.

Beyond her professional endeavors, Marie finds joy in spending time with her daughter and beloved Standard Poodle. She stays active with strength training and HIIT, embodying the holistic approach to wellbeing she advocates for in her work.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I am here with Dr. Marie Holowaychuk. She’s amazing. You’re going to hear in a moment. She is a boarded emergency critical care specialist. She is a Yoga instructor. She is a wellness coach, life coach.

She’s just, she’s such a fascinating person. I love talking with her about mental health and wellness and the state of the profession. And this is a great conversation. She is someone who really burned out and left medicine in, almost every way, shape and form. And then came back around she was the daughter of two veterinarians and now she’s back and she practices emergency medicine.

And I get to ask her, what’s different now than it was when you burned out and oh such a good conversation. Anyway, guys, this is great just, make you think conversation about that medicine life. Dr. Marie Holowaychuk. Let’s get into it.

Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast, Dr. Marie Holowaychuk. How are you?

Dr. Marie Holowaychuk: I am very well. How are you, Andy? It’s good to see you.

Dr. Andy Roark: Good to see you! For those who don’t know you, you are a fascinating person. So you are boarded emergency critical care specialist. You were on the faculty at Ontario vet college for a number of years. You have all kinds of, you have this, a menagerie of certifications around mental health, wellness, coaching.

You have a vibrant yoga practice, which is something I have always known and remembered about you. You do these wonderful retreats in Canada that I have always wanted to attend. Like you, you just do really cool stuff. Yeah, you and I met, I’m trying to remember where it was, I remember it was at the conference when we first sat down together, and you were talking to me about your interest in mental health, and it was pre-pandemic.

It’s very pre-pandemic and you were one of the first people that I remember really talking about mental health and wellness before it really caught on and people were like, wow, this is a big issue. You were right up at the forefront of that. Why don’t you tell me a little bit if you don’t mind? Talk to me a little bit about your journey.

And, because here you are, and you’re a boarded criticalist, and you’re on the faculty, and then you decided you wanted to do something different with your life, and you started this sort of wellness focus in practice. Just tell me the story a little bit, Marie how that developed.

Dr. Marie Holowaychuk: Yeah, I was on faculty at OVC, as you said, and was loving it. I loved academia, the research, the teaching, the clinics, like the variety of it all. And I loved it so much that it was all I did. It was all consuming. At the time, nobody was really talking about mental health. Nobody taught us about self care and boundaries and work life balance and these types of things,

and so I just totally immersed myself in work. To the point where it just started to have a lot of impact on my mental and physical health. And I didn’t realize that at the time I started to have all of these health problems and feel really unhappy and disconnected. And I thought, wow, everybody around me looks like they’ve got it all together and they’re doing so well.

Like this just, Academia must just not be for me. I’m just not cut out for this because this doesn’t feel sustainable. And so I do what a lot of us do when we’re in a situation that doesn’t feel right. I just, I put in my resignation. I left and I didn’t really know fully what I was going to do, but I moved back closer to my family in the Western part of Canada.

And then I thought, I’m just gonna work as an independent contractor. I’m going to look, I’m going to speak, I’m going to do all these things. And just the same things continue to happen. The workaholism, the perfectionism, just working myself to the bone, to the point where, yeah, the burnout continued and it was a day where I was rushing around, had come back from a conference and was going to work elsewhere and I was in a bad car accident and it was like this wake up call, like physically and metaphorically, like you need to slow down.

You need to figure this out. And I used some of the money from the accident, the settlement to do my yoga teacher training and which you know about. And, from there, it just started me on this journey to wellness and taking better care of myself, my mental health, and then wanting to share that information with veterinarians in the form of retreats and so on.

Because, this was more than 10, 10 years ago now. So we weren’t really talking a lot about this back then. There was a lot of stats around, suicide and other things, but there was no solutions. And I thought we need to talk more about these solutions. And if I had some of these solutions in these steps earlier on in my career, I probably wouldn’t have and maybe I wouldn’t be where I am today and things would be very different, but here I am and that’s my short story.

Dr. Andy Roark: I think the fact that you were in a car accident, a severe car accident, and that’s what kind of gave you the opportunity to really explore wellness. The universe certainly has a sense of irony. Tell me a little bit more, because I don’t want to let you off the hook this easily. Tell me a little bit more about what your life was like as you were, as you were working in academia and you were a clinician and you say, Oh, I was doing these things and I thought everyone else had their life together.

And I go, Marie, you looked like you had your life together. you’re on the faculty. You’re brilliant. You are a brilliant clinician. You are so smart, so capable. Like every time that I have seen you, you strike me as the person who has everything. I can’t help but believe that other people saw that when they looked at you. But how were you feeling at that time? What was your life really like?

Dr. Marie Holowaychuk: It’s so funny how individuals can look one way on the surface and you really have no idea what’s going on underneath. I was having so many problems with sleep, like significant insomnia. I actually went through a cognitive behavioral therapy for insomnia program while I was at OVC and it was transformative.

It really helped. I highly recommend it. It’s actually one of the only evidence based therapies to help with true insomnia. But that was taking its toll on my health, physically and mentally. I’ve always been a person who has struggled with mood and I have a mood disorder, depression, and it was, I think it was taking its hold a little bit more than I realized at the time.

Also, in addition to that, there was a lot of anxiety, like the Sunday, we talk about the Sunday scaries before I would go back on clinics on Mondays, on this Sunday night, just like again, anxiousness, can’t sleep, to the point where I was having a bit of panic episodes. And I just, I felt like I was on this hamster wheel I couldn’t get off of.

I needed to work because it was like, almost like I was using it like a coping strategy, like an unhealthy coping strategy and I was deriving a lot of self worth from that work. And yeah, you’re right. On the surface, I was publishing all these papers and I had these grad students and was busy and had a lot of successes and I felt like I had no life.

I felt disconnected from my family. I wanted to have a partner and start a family and that wasn’t happening for me because I had no time for anything. Again, physical health challenges, I was working with my physician and a naturopath and they were both can you not see what’s happening here?

you need to slow down. I don’t know what you’re talking about. This is just a part of being a busy professional and everybody must go through this stuff. And then so much so to the point where I couldn’t see it any other way, like I just thought this is the way it is and clearly I’m not cut out for this.

And it just became too overwhelming. I know that there were times where I just wasn’t able to show up as the best version of myself and that unhappiness, it just really took hold. And I just had to make a change.

Dr. Andy Roark: I was talking to this veterinarian last weekend, and she said she knew that I had worked with a lot of doctors, I’ve been doing a lot of work with a lot of medical directors, and it was funny because I thought her question was so good, but she said to me, you work with all these young leaders, have you noticed patterns?

in what they struggle with or the challenges that they face. Meaning, as individuals, do you see these recurring issues again and again? And she totally caught me off guard because it’s a hard question, but I couldn’t think of a much more valuable question than the answer to. And I love that question was asked to me.

And I want to ask that to you. Marie, you’ve been working with so many people and so many vet professionals and your knowledge is so deep. You lecture. And then I really, I keep coming back to the retreats that you do. I’m going to get you to talk about them a little bit, but just as someone who really likes to know people and to work with people, like the exposure that you have to people to really have time with them and to get to know them.

I’m always envious of that. I just, I think that’s such a wonderful thing that you’ve created. And so knowing those things, I want to put this question to you. You’ve worked with so many people and you’re so involved with wellness and mental health in the vet profession. What are the patterns that you see when you think about our profession and the challenges that people face?

Dr. Marie Holowaychuk: It’s such a great question and it’s so many different things, but I think we can identify a few commonalities and themes that weave throughout and I’m sure a lot of your listeners are going to be able to identify with these. Perfectionism is a huge thing that is pretty pervasive in our profession, I think so much so that people just think it’s normal.

Of course we want to be perfect. We don’t want to make mistakes with our patients. And what if a patient dies because I made a mistake? Like everything has to be, exactly correct all the time. And what people don’t recognize is that perfectionism, that trait of perfectionism, is highly linked with depression, anxiety, burnout, and other challenges.

Because The more we expect perfection of ourselves all the time, which let’s be honest, it’s not realistic. The more pressure we put on ourselves to have those perfect medical records and all of our clients must love us. And we must always have the answer. And it’s an unrealistic expectation.

Dr. Andy Roark: Yeah. Never ends. Yeah.

Dr. Marie Holowaychuk: It never ends. I think some additional things that we can see are things like martyr complex or martyr syndrome. Some people talk about I’m going to take one for the team. Somebody has got to do it. Client calls at the end of the day, we’ve got an emergency clinic down the road.

There are other alternatives and yet we feel it’s no, I will stay late. I will miss my daughter’s soccer game. Somebody has to do it. I don’t want them to go to ER and wait for three hours. And that’s OK. If you’re making these decisions because you genuinely want to help and you genuinely want to be that individual, then great.

What often ends up happening is this martyr complex is in combination with victim mentality, where then we stay late. We do this and then we feel like, oh, I had to do this. There was no choice, like I am at the whim of my clients and their expectations. And, it becomes just this loop that people find themselves in, which is not good either.

 so I think those are some really big things that can happen. I think there’s challenges inherently too, with people not being able to set boundaries and maybe that’s tied a little bit into that martyr complex, but, a lot of veterinarians have a difficulty, first of all, identifying themselves outside of our profession.

They identify only as a veterinarian and let’s be honest, part of that, it doesn’t help when we go to a dinner party, we tell someone we’re a vet and then we have to talk about animals and their problems for the rest of the evening. 

Dr. Andy Roark: But also I always call people out on this because I’m that way too. I will tell someone i’m a vet and then I go. Oh now I’m gonna have to talk to him but the truth is I like that their eyes light up. I like that I’m valuable and you know what I mean? Like I’m just being honest, but I do the same thing. I’ll say I’m a veterinarian then I go, “Oh man.”

Dr. Marie Holowaychuk: Oh yeah. What have I done?

Dr. Andy Roark: But I know in my heart, I told them I was a veterinarian because I wanted to impress them or I wanted them to say, oh, I wish I was a veterinarian.

Dr. Marie Holowaychuk: You’re proud of it.

Dr. Andy Roark: I am proud of it, but I still, when I’m doing it I know that I’m doing it as okay, Andy, are you going to feed your ego or are you going to or are you going to tell them? I don’t know. Tell them I work with I don’t know. I’m a manager. I don’t know. 

Dr. Marie Holowaychuk: Totally. Yeah I’m a people manager, which is true. It’s like when I tell people I’m a yoga teacher, it’s not actually a lie. It’s just not all that I do. I think yes, there is this challenge in it. And again, it varies from person to person. I’ve talked to veterinarians who work in small towns and they love going to the grocery store and seeing their clients and having conversations and being recognized.

And, they don’t mind that. work life integration where everything meshes together. And there are those individuals who resent it. They say to me, I just want to go to the grocery store and not have to talk to not run into my clients and talk to them about their pets. And they really want their life more compartmentalized and separated.

And this is where the challenges come up because when you don’t know what you need and you just start to feel resentful and frustrated. It’s hard to fix it. And I think that was for me early on, too. I didn’t know all the things that my body and my mental health needed. And so I wasn’t setting those boundaries.

I wasn’t practicing self care. I wasn’t taking care of myself. And so those boundaries, that’s a big piece. How do you want to structure your life? What are you okay with in terms of outside of your, daytime job as a veterinarian or overnights if you’re an overnight ER doctor, but whatever your work is, what are you okay with

outside of that. And again, for some veterinarians, it’s hard to shut that off. Like they, they can only see themselves in that way. And they feel like that’s a lot of pressure or that they feel like they’ve lost themselves outside of work. Like they have no identity other than vet med. And then when vet med doesn’t go well, Then it’s what else do I have?

And who am I as an individual? And everything can fall apart with that board complaint or whatever might happen. So there’s so many different things and I, have other thoughts, but I wanna hear what you think. 

Dr. Andy Roark: I think you’re spot on. I think you called out the big ones. I think perfectionism is spot on. We’re seeing more and more of the research that’s coming out now, and it talks about the mental health status. And it’s interesting when you look at sort of mental health challenges in people in the vet industry versus the general population, the actual numbers of sort of mental health challenges are not that different from the population.

However, we are more likely to have severe mental health challenges which I think is definitely noteworthy. We’re also more prone to neuroticism than other industries and other groups of people and neuroticism often manifests as perfectionism. And so I, when you were talking about perfection, I think you’re spot on.

And so it’s funny, even before you mentioned that you mentioned about yourself, that you were a perfectionist and and obviously when I see someone who’s boarded and has been very successful in all these ways, like you’re wired in a certain way that, if you frame the game in one way you’re wired to be successful.

But in another way, it just, it’s so speaks to me. And I’m sure that a lot of us have those same feelings of, I have decided that this is the game that I’m playing and I’m going to play it really hard. I’ve had that earlier in my career. I was in my thirties. I had people who would say to me like, look, Andy you’re really burning at both ends.

And I was like I’m fine. This is what it is, this is what it means to be working in the job that I’ve taken. And I don’t know. I think it’s hard. It’s hard to look at ourselves.

My, my question for you is short of a car accident. If you’re someone who feels like you’re unhappy, or you’re starting to feel these things, or you recognize that, I love the way you put this martyr complex where you’re, sacrificing yourself, but you’re not happy to do it, or you want to do it in the moment, but then you go home and you feel like a victim, you feel like you were taken advantage of. That is such a common

 mentality in our profession. If you have the self awareness to see that in yourself and you say what she’s saying I see in myself.

I know it’s going to be very different for each person, but Marie, how do you start to get out of that mindset? Like you’ve clearly been on a journey and that journey is going to be very unique to you. But you work with so many people and you see so many people I’m sure who are having these realizations of this is me. This is my life.

How do people take the first steps and starting to get some perspective and believe that they can at least change how they identify themselves?

Dr. Marie Holowaychuk: I think you’ve hit the nail on the head right there, which is, it’s that awareness, right? That is that perspective. And the way that we often get perspective is by connecting with other individuals. So that can be peers that we connect with, and we have open and honest conversations about what we’re experiencing.

Ideally, we do this in a safe space. Like I want to be careful about online engagement because sometimes that can go off the rails. And then when there’s not a mental health professional present, it can be dangerous. A safe group of individuals that’s moderated by a mental health professional.

The veterinary hope foundation is one that offers these, quote unquote support groups. for different cohorts. They can be specialists. They can be parents in vet medicine. They can be technicians or managers. They run these cohorts where they’re, where they have these discussions about these topics like perfectionism and boundaries and burnout and other things.

And there is oversight by a mental health professional to number one, feel like you’re not alone. And number two, start to see maybe yourself and some other people and then once that’s mirrored back to you, it’s oh my gosh, like I can identify with that. I think there’s other professionals that can be helpful. There’s a lot of certified coaches now in the veterinary space, who have done a lot of training to be able to ask the right questions to illuminate self awareness and individuals so that they can come to these realizations. They already know it. If they don’t consciously know it, it’s there. And then of course I would not be a mental health advocate if I didn’t recommend that everybody consider some form of mental health support in the form of counseling, therapy, you name it.

There are social workers, psychologists, psychiatrists. There’s so many mental health professionals who can be of support and offer mental health support. That reflection, that perspective, they can illuminate those blind spots. They can ask the right questions. They can offer support, for me, it’s literally been a decades long journey utilizing each of these different mechanisms to get myself to where I am. And I’m by no means like a finished product. I am still a work in progress. And it just, it comes with that continual experience, reflect, better understand, and then do better from there and change. 

Dr. Andy Roark: Therapy tools are so easily accessible today, there’s things that bother me about technology in our world today and how ubiquitous, and there’s other things where I say, I’m sorry, I can’t argue with that. That’s great. That’s wonderful, it’s a wonderful advancement.

It’s just, these resources are so available. It’s just, I think that’s a wonderful thing. I want to ask you I want to ask you a personal question now about where you are because I think this is really interesting as well. So you’re back and you’re doing emergency shifts now and so you’re back, you continue to practice.

You also have a young daughter at home. I think you have a mother of a four year old. What do you know now, Marie, going into the clinic that you wish you knew? When you were in it full time and I know that’s probably a lot but imagine yourself for a moment. You’re here. You’re seeing a shift think about how your perspective is different now than it was then are there key differences in just how you approach your day that you wish you knew or you didn’t know at that at the beginning?

Dr. Marie Holowaychuk: Such a great question, and I think we could talk for an hour on this. I, my perspective has changed so much, and I know you can relate to this as a parent and not to diminish anybody who is not a parent out there, but it goes back to what I said before about our identity and just recognizing

there is more to life than vet medicine. And don’t get me wrong, I, like you Andy, I am so passionate about vet med. I live and breathe vet med and I have since I was little because both my parents are veterinarians. And at the same time, knowing that I am a mom, I am a friend, I am a daughter, I am, so many other things outside of that space.

It just helps me to keep it a little bit more in perspective. When I have a challenging client, when a patient dies, when a case doesn’t go well, when I don’t have all the answers, it’s just, It just keeps me a little bit more level and a little bit more real. And it’s hard to put it into words but that’s a huge thing.

And it has also forced me to be much stronger with my boundaries. Before it was just the work would just bleed into the night. I would be working on the couch and then I would, be working in bed and then checking my emails and it was just never ending. And part of that is academia. There’s no kind of fine limits around everything.

It’s not like we work shifts and and so on. But I’ve learned that we all need time and space in our day and in our life to shut that veterinary brain off and to be fully present with our loved ones, our pets. our neighbors, whoever it is that lights us up and enriches our lives. And the, like I said, being a mom, like I am now, it’s just, it’s forced me to do that because I have to get her from daycare and I have to take care of her at night.

She’s sadly not self sufficient at the age of four. Darn it. I wish she was a little bit more, I’m just kidding. But all that to say it’s really enforced that for me and I am so grateful for that 

Dr. Andy Roark: Oh man. That’s such a great answer your identity is different and it totally makes sense how parenthood would frame that up. And again, it’s not necessarily, it doesn’t have to be parenthood. I think, oh, that’s such a great answer because it really does change how you see yourself.

And I, think I’ve been really enjoying practice recently. I was really happy in life recently. I think that’s a big part of it is. My relationship with my kids is really good and strong, but also like I, I have these other things that I do that I put a lot of weight on and I, I, it sounds silly, I garden, I like to work in my yard.

I like to garden and things like that. I did a I did an interview with someone who works for me. Just earlier today, we recorded the 300th episode of this podcast and Kelsey was talking to me and she said, oh, thank you. She said it meant a lot to her when she started working with me and she would hear me say things like, guys, I’ve got a hard stop at four because I have to get my kids from, from school or from daycare or whatever.

And I never thought about that. That was just as it’s like sometimes that’s what it’s got to happen. You know what I mean? Like I didn’t like the bus is not running or whatever. And you just say, I have this heart, this hard stop. But before that, when you’re young, it’s. It’s easy to let work just take over everything and not push back against it. So anyway, I love that marie.

You’ve got a retreat for practice owners coming up in February. You’re lecturing all over the place. I’m sure I can’t list all the things that you’re doing but let me open the floor to you and say where can people find you because you’re so interesting you’re always doing just different things. What’s the best way for people to follow your journey and see what sort of things you’re doing and where

you’ll be?

Dr. Marie Holowaychuk: Yeah, I am most active on LinkedIn and Instagram. So those would be the top places, whatever your social media fancy is. That’s where you can find me. If you are lucky enough to not be on social media and that’s been a boundary for you, then I applaud you. And I encourage you to check out my website, mariehollowaychuck.com or revivingvetmed.com, which is a hub of resources and podcast episodes and blog posts, all. In the name of promoting mental health and wellness in our profession.

Dr. Andy Roark: Outstanding. Thanks for being here, Marie. I really appreciate you guys. Thanks for tuning in and listening. I hope you guys enjoyed it. Take care of yourselves, everybody.

Dr. Marie Holowaychuk: Okay, bye.

Dr. Andy Roark: And that’s what I got guys. I hope you enjoyed it. Hope you got something out of it Thanks to Marie for being here. Thanks to you for being here gang Take care of yourselves and if you find yourself in a place where Marie was talking about where you’re like I am wildly unhappy and I just feel like i’m always working and i’m not making space for myself I pause for a beat and and I want you to stop and take care of yourself.

And if you need to step away or you need to talk to somebody, please do that. It’s not a weakness to accept help. And that’s a lesson I learned the hard way in my life. But we don’t always have to be the ones who help every now and then, even the strongest of us need a hand. Give yourself permission just to get some support if you need it.

Just, even if it’s just getting your perspective straight, take time. I don’t want you guys to be successful today or next week. I want you to be successful for the longterm. That’s just something I always aspire to support you guys in as we go forward. So anyway, that’s enough for me. Take care of yourselves.

And I mean that. Talk to you later. Bye. 

Things I Wish I Knew About Diagnostics

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Dr. Cathy Meeks dives into this episode to discuss diagnostic innovation and what really happens at the lab. In this episode of The Cone of Shame Veterinary Podcast, host Dr. Andy Roark sits down with his longtime friend and fellow University of Florida alum, Dr. Cathy Meeks, Global VP of Medical Operations at Antech Diagnostics. Together, they explore the inner workings of veterinary diagnostics, discussing hematology cases and the advanced resources available to veterinary teams. Dr. Meeks shares insights into the diagnostic process, highlighting how practices can utilize Antech’s pathologists, AI-driven tools, and consult lines to improve efficiency and support their teams. If you’re a veterinary practice manager, technician, or veterinarian looking to understand the cutting-edge innovations shaping diagnostics, this episode is a must-listen. Dr. Roark and Dr. Meeks uncover ways to leverage technology, enhance technician development, and maximize the support available through reference labs.

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This episode is brought to you by Antech Diagnostics!

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Antech Diagnostics

Cathy Meeks on LinkedIn

Leadership Essentials Certificate

Charming the Angry Client Course

Dr. Andy Roark Swag

All Links

ABOUT OUR GUEST

Dr. Cathy Meeks received her Bachelor of Science in Animal Science, her Master’s degree in forensics and her Doctorate of Veterinary Medicine from the University of Florida in 2007.  She did a small animal internship and an internal medicine residency at BluePearl Veterinary Partners.  She received board certification in 2011 in Internal Medicine.  For the past 12 years she has practiced in the Tampa Bay area. From 2015-2020, she was the Regional Vice President of Medicine for Bluepearl Veterinary Partners overseeing the medical quality and developing medical leaders of 15 specialty hospitals. In 2021, she became Vice President of Medical Operations for Antech diagnostics and was recently promoted to Global Vice President of Medical Operations. Currently she is responsible for over 200 veterinary specialists and the day-to-day operations of the medical team.

EPISODE TRANSCRIPT

Dr. Andy Roark: This episode is made possible by Antech Diagnostics. Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host Dr. Andy Roark guys, I am here with my dear friend, Dr. Cathy Meeks. We went to vet school together and she has just gone off and had such an interesting career. 

We talk about that, has had lots of twists and turns and she’s one of those people who has ended up in just a really, really, really interesting place I do kind of an interesting episode with her today where I wanted to do like a how do you treat that based on hematology stuff and I also wanted to smash that together with an episode like I did with my other classmate, from university of florida Dr. Mary Gardner. Oh, she has a crematorium and I was like, I want to know more about what happens 

Anyway, I wanted to do that with Cathy about diagnostics. So she is with Antech diagnostics and I put those things together and we dive into a little bit of “how do you treat this hematology case” and then really what happens at the diagnostic labs and what resources are there that I don’t even know about.

How can I be more efficient? How can I be more effective? How can I be more supported? How can my technicians be more involved? We get into all that stuff. It’s a really, really great episode. Guys, I think you’re gonna get a lot out of it. I think you’re gonna enjoy it. Let’s get into it.

Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast,  Dr. Cathy Meeks. Thanks for being here.

Cathy Meeks: Thanks for having me. It’s so good to see you. 

Dr. Andy Roark: It’s good to see you as well. So, for those who don’t know you, you are a veterinary internist. You are the global vice president of medical operations at Antech. You oversee over 200 veterinary specialists there. You I know you because we went to vet school together and you graduated a year ahead of me from the University of Florida, go gators!

Cathy Meeks: Go Gators! Yeah, it’s such a small world.

Dr. Andy Roark: It’s such a small world. I am so glad that you’re here because I recently did this episode with another gator my classmate, Dr. Mary Gardner, who is there and Mary actually owns a veterinary crematorium and I had this idea with her. I was like I utilize our crematorium all the time and it’s basically a black box to me. I, I really, I don’t really know what happens.

I’m just being honest. And I was like, that doesn’t feel right to me. I, I, I, and so I, I wanted to talk to her kind of about what happens behind the scenes. And so with you having this position at Antech and just being a sort of a global leader in veterinary diagnostics. I see this unique opportunity. And so I want to try to do something a little bit different with you. How do you treat that case where I give you a case?

But i’d really like for you to kind of highlight behind the scenes what happens at my reference lab. It’s sort of– help me. I guess what I’m asking you is what do you know now about your reference lab that you didn’t know? When you were in practice because you’ve been in practice a long time. You were, you were a technician before you went to vet school.

You were a GP for a long time. Like you’ve got a lot of experience here in practice Help me fill in those blanks in my knowledge while we work through this case. Is that okay?

Cathy Meeks: That sounds great. I definitely am uniquely poised as a client of Antech, a technician, and then coming to Antech and seeing the behind the scenes. I completely agree with you. It was 100 percent a black box for me as well. So this will be fun. Yeah.

Dr. Andy Roark: We put our samples out into the container that the pet owners put poop bags into accidentally again and again, no matter what signage we put around it we just put our stuff out and then it disappears and then we get magic results back. So, okay

Cathy Meeks: Yup, magic results. Yeah.

Dr. Andy Roark: I have a 12 year old female spayed domestic short hair named Misha, and she presents for anorexia.

So there’s some weight loss here. Cathy, I can’t find anything wrong on this cat with a physical examination, and the owners are, you know, they’re they, they’re cost conscious, we’ll say. So I, I just end up running sort of your basic blood work. CBC, chemistry. On the chemistry, you know, the bilirubin’s up a little bit.

It’s 0.5. The SDMA is just a little bit up. The big thing is on the CBC, this cat’s got a white cell count of over 200,000 and it’s mostly lymphocytes. It’s 182,000 lymphocytes. And for those who are listing at home normal for lymphocytes is generally less than 8,000. And this is 182,000. 

So just, crazy high white count sort of driven by lymphocytes. And so let me sort of start here and say I’ve got this cat, I’ve got this blood work, start to unpack for me a little bit about, let’s talk about sort of where the case goes and, and, and kind of how it would move through the system. And then you can sort of help me to kind of unpack what we’ve got here.

Cathy Meeks: Yeah, absolutely. So, first of all, the blood would go to the nearest lab and it would be processed in specimen processing. And then it would go to hematology and chemistry. And when we do CBCs, typically those are reviewed. If, if there’s anything abnormal such as the lymphocyte being that high, it will be initially reviewed by a techno technologist who will then say, well, pathologist needs to review this and it’ll go to the pathologist.

And in this case, you know, likely the pathologist would read it and say, if there’s, you know, presence of larger cells with this lymphocytosis and there’s immature cells in circulation that would support some type of lymphoid neoplasia. And that pathologist would then go on to say, you know, this could be leukemia.

This could be stage five lymphoma and give recommendations of what you could do. These tests to differentiate between those and kind of find out a better idea of prognosis, but the really cool part. So I always knew, you know, as, as a doctor in practice, I always knew that we had great pathologists. And what I didn’t know is the breadth of other specialists that are available to help you with these types of cases even as an internist, I would likely need to consult an oncologist on this case. And you know, you could call the consult line and get an oncologist to say, Well, now what? What’s the prognosis? Is this chemotherapy? You know, what are the prognosis without chemotherapy?

So, it really goes through these different areas throughout Antech behind the scenes to not only give you a diagnosis, but then to provide you guidance. Because that’s what you really need in these cases, it’s not really common to get a cat that comes in that’s anorexic and has a normal physical exam and you’re not expecting a lymphocyte count of 180, 000 on the CBC so, yeah, so that’s kind of how it would move through the lab in this case.

Dr. Andy Roark: So let me back up here for a second because you said a number of things and again I just I it’s been sort of a black box. Walk me through a little bit about the involvement of the pathologist with my CBC’s and chemistry, right? So let’s say if I send something normal I mean I can’t imagine that everything that you guys get is going to go by the pathologist, right?

There’s going to be certain abnormalities that are going to be flagged and we’re going to get a referral. And then is it always going to be referred to the pathologist? Is there, is there a part where in this case, for example, I know that you guys have access for me to an oncologist. How is the best way to sort of loop the oncologist in this case?

So talk to me a little bit about that, about what triggers specialist involvement as my cases are kind of moving through the reference lab.

Cathy Meeks: That’s a really good question. So when it moves through hematology in the system, we have a system called CellaVision actually, and it’s an artificial intelligence that recognizes the type of white blood cells and the technologist will review these to make sure that the artificial intelligence is getting this right.

This is a neutrophil. This is a lymphocyte. So technologists will review the cell division or the slide first, and they have certain criteria to where the technologist will actually look to make sure the lymphocyte count is real and correct and that all of that we’re seeing on the actual CBC results is correct, like the machine was right.

If that’s true, there’s also a list of parameters in which it will go automatically to one of our clinical pathologists. Lymphocytes being 180, 000 is one of those triggers where they’ll say, a pathologist needs to look at this and you can initially submit this as a CBC path review and a pathologist would look at it right away, regardless of what the CDC shows.

But we do have internal triggers to make sure that the quality of the results that you’re getting are accurate and also to provide you with a little bit of guidance. It doesn’t automatically go to an oncologist. We have a consultation line where you can call for internal medicine, for oncology, for cardiology, really whatever kind of type of consult you want.

And that’s no charge to the clients to call up and just say, I don’t really know what, like the pathologist did a great job of explaining what this is, but now I really don’t know what to do with it next. You know, does it go to an oncologist? Do I need to submit more tests, et cetera.

Dr. Andy Roark: I love this. Okay, so I’ve got a couple, a couple questions for you. Where do, again, I’m just, I’m fascinated by this. Where do the technologists come from? Like what, what, what kind of training do they have to, to move into this role? Again, I just, I, I’m always looking for opportunities for our paraprofessionals and I’m looking for interesting things in, in their career path. And I’m sort of like, so what, what does the technologist, what, what background does that require?

Cathy Meeks: It’s so interesting because I had no knowledge of this. Again, it was just the blood work just magically appeared, but the technologists come from a multitude of areas. We do have some veterinary technicians that want to work in the lab. We have people that are getting their Bachelors of Science that want to work in the lab.

The technologists are trained thoroughly in each of their sections. So we have hematology technicians and chemistry technicians. And they actually have to take a test every year. This is so crazy to me. Cause I probably wouldn’t pass. They have to take a test every year and get a hundred percent on their test or they can’t work in that area.

Dr. Andy Roark: That’s cool. really high stress. Like I would freak me out. Uh, 11 months out of the year I’d be worried about the month coming up. That’s incredible. 

Cathy Meeks: Exactly.

Dr. Andy Roark: I also have to just pause for a second and say CellaVision is top notch pun work. I I really love

Cathy Meeks: Yes.

Dr. Andy Roark: It took me a moment when I first heard it and I was like, Oh, oh, that, that is, that is good. I have to say..

Cathy Meeks: I wish I invented that, but I didn’t.

Dr. Andy Roark: as a fan of puns, I, I do, I do love it. 

Can you run me through sort of the list of specialists that you guys at Antech have? So, I mean, obviously the pathologist makes sense. The internist makes sense. Obviously, I think that’s probably where the vast majority of the calls probably go is internal medicine. That’s where most of my phone calls go,

Cathy Meeks: Yeah. 

Dr. Andy Roark: pathology, then oncology, but yeah, what is that? What does that kind of breakdown give me an idea of the breadth of specialists that, that, that we’re talking about here? Cause I, again, I’m probably missing resources that I have at my fingertips.

Cathy Meeks: Yeah, absolutely. So we have again, I also knew about the pathologist, but didn’t know about other specialties. And we have over 60 clinical pathologists and over 60 anatomic pathologists. But we also have specialists in different fields from neurology, oncology, cardiology, and internal medicine are the most popular calls that we get.

We have avian and exotic, so we have almost every specialty you can think of. Some stats for you, because this is also extremely impressive. And if you would have asked me before I went to Antech, how many, how many samples do you think Antech gets a day? I would have been like, Oh, probably a couple thousand.

They get 90,000 submissions a day. It’s crazy. And then the consult line with the oncologists and cardiologists and internal medicine, they get about a thousand phone calls a day. So they’re really like on top of it and on top of calling you back if, if they’re on the other line, but most of the time you get them right away.

So. It’s fascinating. I had no idea the breadth of specialties were in existence in a diagnostic lab.

Dr. Andy Roark: I want to, I want to switch gears a little bit here, if you’re comfortable with this. So I, I’m looking at our profession a lot and I’m looking at sort of the, the way that medicine is changing and, and that medicine is more and more of a, of a team game than it’s ever been. Now, obviously when we’re getting into diagnosing, prescribing, treating, we’re working up complex cases.

You’re going to talk to the veterinarians quite a bit. Are there technicians from private practice that are reaching out and that they engage with Antech as far as getting support there, I guess what I’m really sort of asking you is how are other practices leveraging their. They’re technicians, they’re licensed techs in order to support the diagnostic process.

Cause it’s an area I, I don’t really have any insight in and I’ve always just been the one to make the calls and things. And I, I, I, I. Not trying to delegate those cases that are challenging away, but, but it’s just this, this area of technician development is, is important to me and interesting to me. What do you see in that regard?

Cathy Meeks: Yeah. So veterinary technicians do call in quite frequently to our customer service line to ask questions about the samples. You know, if there were discordant results, they investigate those for them. And so they do have a vital role in investigating some of this blood work and adding on tests.

So they have a separate consultation or a customer service line where they can call and get all of that information and really help the veterinarians do their day to day jobs.

Dr. Andy Roark: Okay. That’s, that’s just really I just, it’s, it’s something I think a lot about again, and sort of looking at, looking at efficiency balanced with patient care, and I’m just, I’m using my technicians more and more as points of communication, really trusted points of communication to have good conversations with the pet owners, and this is an area I have not leverage my technicians very well. And so that was, that was kind of what was in my mind.

Cathy Meeks: I think that one, one thing that was also surprising to me when I came to Antech is right when I was coming to Antech is when they were creating the KeyScreen PCR, which is a PCR that tests for fecal parasites. The discussions that I was in in those meetings were how can we contribute to the changing of the industry because it’s so different now than when you and I were finishing vet school and it’s so busy now and the cost of services are so high that the conversations weren’t only, okay, we need a PCR test for feces because, you know, we’ve been doing fecal floats for a hundred years, but it was also, how can we do it to where it’s not expensive for pet owners and that, the turnaround time is quick.

So people can utilize their technicians doing other things instead of doing 100 fecals a day. And so we have seen a little bit of a shift in that of submitting PCR for checking for fecal parasites to really lessen the burden of, you know, the work that the technicians are doing.

Dr. Andy Roark: There’s such a drive for innovation in diagnostics, even when you’re talking about sort of cell division and AI, I mean, I, I am using my AI usage has skyrocketed in the last decade. It’s just it’s just, we’re just figuring out more and more and more things. And so I’m, I’m looking at diagnostics and things, and I’m looking at the potential for things like AI.

And then I’m hearing you talk about advanced techniques using PCR and things like that. Cathy, what does innovation in the diagnostic space kind of look like in your mind in the coming years? And then the other part is sort of the black box issue is how do I, how do I know if the diagnostic lab I’m using is leaning into technology or, or, or, or, continuing to innovate or not. Is there a way to sort of tell other flags I should be looking for?

Cathy Meeks: Yeah. So, artificial intelligence is a big one that a lot of diagnostic companies are talking about and using. One example of AI technology that we’re using now is RapidRead, which is essentially an artificial intelligence way of looking at radiographs and giving results within 10 minutes.

And the reason that that was invented along with other inventions is because we’re looking at the industry. We know that veterinarians need help. We know that they need quicker results. And so really, that’s the main focus when we think about innovation. We’re doing the same thing behind the scenes with artificial intelligence to help our pathologists kind of speed up looking at things.

So for example We have one that’s behind the scenes that no one would ever see that when the technician scans a slide in the lab, if it’s blurry, then the artificial intelligence will tell the technician, this doesn’t go to a pathologist, it’s blurry, we need to rescan it. And you have no idea how much time that actually saves pathologists.

Just little things that really have contributed to helping speed up you know, and be more efficient for all of our vets because, you know, there was a study recently that showed we’re going to be down to, you know, over 20,000 veterinarians by 2030. And the number of pets isn’t decreasing. The pet care need isn’t decreasing.

So what can we do to help contribute to the industry and make things more efficient and make quality of life better?

Dr. Andy Roark: Yeah. I, you know, it’s so funny. The most powerful innovations are really those ones that just streamline processes. You know what I mean? It’s when you have 90,000 samples a day coming in, yeah. Having something’s like, yeah, we’re kicking this one back. 

Cathy Meeks: Yeah, exactly.

Dr. Andy Roark: I can see that being a huge deal. So what is, again, so going back to reference labs in general, what are the signs that I should be looking for to understand that I’m dealing with a reference lab that is keeping up with innovation? Are there, how do I, how do I kind of know that? Because again, I think a lot of us, we, we take kind of what we’re given and we’ve got a lab that we’ve been working with and we don’t, we don’t generally know what else is out there.

So help me to get my head around, how do I know I’m working with a company that’s pushing innovation forward?

Cathy Meeks: I think there’s three, you know, great ways of looking at that. One would be through the website. Those are constantly being updated with things that are being worked on and coming out in the future. The other is at conferences. So we have a huge presence at VMX and WVC and ACVIM, those types of conferences.

Stopping by the booth. Usually we have veterinarians at the booth and saying, Hey, like what’s new, what’s coming. And then the third way would be to really just talk to your Antech rep. Every, every hospital has an Antech rep to say, what are you doing for innovation? What’s coming down the pipeline?

If they need to get them in touch with a specialist, the specialists are always on top of that so they can talk to them as well. But those are kind of the three ways I would say of staying on top of what type of innovation is coming and what is at the top of mind when we’re innovating products. You know, each diagnostic company probably has three things top of mind of When we’re innovating, let’s make sure we make sure the turnaround time is good, make sure it’s affordable and make sure it’s helping contribute to the industry.

So that’s kind of the best way to go about that. One of the things I would recommend, though, is getting with your Antech rep and just asking for a tour of the lab.

Dr. Andy Roark: You can do that? Be like, “Hey, let me, let me come in check it out.”

Cathy Meeks: Yeah, if you have a lab that’s close to you, you know, like Orlando or New York or Fountain Valley, California, like it is, it is mind blowing walking through Yeah. Anytime you let me know, I’ll take you through, but it’s. It’s really impressive.

Dr. Andy Roark: I had no idea. I think I’ll be, I think that to be fascinating. All right. So one of the things that gives me great joy in this podcast is that sometimes I’ll put out episodes and I’ll talk to people and then I will have somebody come up to me later on and say, “I was really inspired by the episode.

I wanted to learn more. I saw an interest that I had and wanted to maybe lean into personal development for myself. I, we’ve had people, you know, obviously say, I just devoured all of your dental podcasts. And then I decided I was going to go and do a residency.” And there’s things like that for people who are going “I just, I would like to engage with diagnostics, with pathology at a deeper level and I don’t really know what that means.” What kind of resources do you like? So someone who’s just like this, this is a fascinating conversation. Where can, where can they kind of go? Where can they learn more?

Cathy Meeks: So LinkedIn is a great area to go to learn more that, that on our LinkedIn page, we’re constantly updating to show new labs, new innovation. So that’s one, one great place, but I can’t emphasize enough to talk to your Antech rep because it is either having a tour of the lab, or if you say, you know what, my, I lead a team of 20 veterinarians and 100 technicians.

I’m just making that up, but we all want to learn more. Like we’re always as specialists wanting and willing to get on a call to go over what we currently offer and what we’re thinking about innovating and that sort of thing. So just getting with your Antech rep and they’ll know who to put you in contact with based on your requests. So, but we all love talking about it. So.

Dr. Andy Roark: fantastic. Well, good. Well, Cathy, thank you so much for being here. You’re amazing. I really appreciate your time.

Cathy Meeks: Oh, thank you.

Dr. Andy Roark: Guys, thanks for tuning in and listening to everybody. Take care of yourselves. I’ll talk to you guys later on.

Cathy Meeks: Thank you.

And that’s what I got for you guys. Thanks for being here. Thanks to Dr. Cathy Meeks for being here. Thanks to Antech Diagnostics for making this episode possible. Guys, take care of yourselves, everybody. Be well. I appreciate your time. I’m glad to spend some time with you. Bye.

Are you standing in the pantry?

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I love to eat. It’s probably my favorite thing to do. Deep down, I believe there are few situations that can’t be improved by a snack. Celebrating? Mourning? Nervous? Bored? Let’s get a menu! For me, food is a social and emotional swiss army knife.

Obviously, this has some drawbacks that I have to manage. I’ve learned that I can’t eat mindlessly or even “listen to my body” (because my body is similar to that of a pug’s and believes it could die of starvation at any moment). I have to be intentional about how often I snack.

Not snacking, it turns out, is HARD. Especially during the holidays when there is food everywhere. To make matters worse, I have a food-driven autopilot mode that gets me into trouble.

Have you ever been lost in your thoughts and found yourself standing in front of the open refrigerator? I have. Much more frequently though, I find myself standing in the pantry. I will be talking on the phone and feeling nervous, or looking for my keys and stressing, or watching commercials on TV and battling boredom and then, all of the sudden… I’m standing in the pantry looking at the granola bar shelf.

Our minds are amazing things. They care about us, but they are pretty simple machines. Our brains notice how we are feeling, and respond in simple ways that have previously been positively received. They recognize a stimulus and immediately react in whatever way has brought us relief in the past. For this reason, I imagine my brain regularly saying things like:

  • “Oh, you’re bored? You won’t feel bored with ice cream!”
  • “Hey buddy, I hate to see you sad. We should have some chocolate.”
  • “Congratulations!!! This is a huge accomplishment! TREAT YO SELF!”

And before I know it… I’m standing in the pantry (except for the ice cream).

Recently, it’s come to my attention that the pantry is not the only place that my mind takes me. In fact, my brain keeps a running list of “pantries” that it can walk me into whenever I have an unmet need (or simply find myself unengaged in any way). I bet your brain has a list like this as well.

Think about it. What are the ideas or imaginary scenarios that your brain automatically turns on when it notices you are stressed or bored? Do you find yourself thinking about the nastiest client encounter you ever had, the time you felt betrayed by a friend, or some future scenario that may or may not happen?

If you find yourself unintentionally returning to a stressful or painful idea again and again, your mind is walking you into the pantry. You might imagine your mind saying something like:

  • “Oh, are you bored? You won’t be when you think about the medical board complaint that client made against you 6 years ago.”
  • “It looks like you’re anxious because you had too much coffee? Let’s imagine the most horrible version of what might happen if the vet clinic where you work decides to be open on Sundays!”
  • “Hey, I know you want to spend your time doing whatever is most important. Well, nothing seems to get your attention more than thinking about the kid who might be bullying your child at school.”

My point here is not to tell you that you shouldn’t work through issues or make hard choices. It’s that you and I should recognize when our minds are walking us into the pantry over and over again. We should notice when our brains are “helping us” by triggering thought or behavior patterns that we find interesting (but that are not good for us).

When we catch our mind slipping into these engaging but destructive patterns, we need to recognize that we are in the pantry and get out of there!

About the photo: A recent photo I took of a frigid morning at Bradley Airport in Connecticut. A much better view than the pantry or freezer!

At-Home Dental Care They’ll Actually Do

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Struggling to get pet owners on board with dental care for their pets? In this episode of The Cone of Shame Veterinary Podcast, host Dr. Andy Roark tackles this common challenge with the help of board-certified veterinary dentist and oral surgeon Dr. Amy Thomson, aka “Toothy Thompson.” Together, they discuss practical strategies to inspire pet owners to adopt home dental care routines that actually get done. From realistic toothbrushing techniques to advice on leveraging treats and routines, Dr. Thomson shares actionable tips and communication strategies tailored for veterinary teams to use in exam rooms. Whether you’re a veterinarian or practice manager, this episode delivers the tools you need to improve client compliance, enhance pet oral health, and ultimately support longer, healthier lives for pets. Don’t miss this motivating and insightful conversation!

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

At Home Dental Care Handout

American Veterinary Dental College: https://avdc.org/

Amy Thomson IG: https://www.instagram.com/toothy.thomson/

Amy Thomson website: https://toothythomson.ca

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Dr. Amy Thomson is a specialist in small animal dentistry & oral surgery. She began her career in small animal general practice and while challenging at times she was fortunate to gain a great deal of dentistry CE. The more she learned the more her passion for dentistry grew as well as a desire to become a specialist. While Dr. Amy enjoys all aspects of clinical practice as Board Certified Veterinary DentistTM, she also very much enjoys providing continuing education for all veterinary professionals in small animal general practice. There is a huge demand for veterinary dentistry and oral care, and she wants to support general practice teams to provide the best care to their patients. 

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome, everybody, to the Cone of Shame veterinary
podcast. I am your host, Dr. Andrew Roark. I am here with board
certified dentist and oral surgeon Dr. Amy Thompson, or Toothy
Thompson, as she’s known online on her socials. I am talking to her
about home dental care that actually gets done. I’m on this kick right now
about really thinking deeply about how to advise pet owners to increase
the lifespan and quality of life of their pets.
Like, if I could make a program that would give you the highest chance
possible of having your dog or cat live to age 25. What program would
that be? And obviously, it’s going to have a nutrition component. It’s
going to have sort of an orthopedic wellness fitness component. It’s
going to have a dental health component.
And so that’s what I talked to Amy about is how do I communicate this to
pet owners? What would you put into a program like this? And again, the
emphasis here is not on what’s ideal. What can we actually get pet
owners to do and she has strong thoughts and so that’s what we talked
about today It is a good episode.
It’s really it’s motivating. It makes me want to jump back in there and
work with my dog And I think i’m probably going to do that. I think i’m I
may even film it and see how it goes So anyway, that’s kind of where my
head’s at. This is a great fun episode It’ll inspire you get you talking
about dentistry again.
Let’s get into this episode
Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We
want to help you in your veterinary career. Welcome to the Cone of
Shame with Dr. Andy Roark.
Dr. Andy Roark: Welcome to the podcast. Dr. Amy Thompson. Thanks
for being here.
Dr. Amy Thomson: Hi. Thanks so much for having me
Dr. Andy Roark: back.
I love having you back. You are such a joy to talk to. You just have this
infectious energy. It’s, it’s why you are growing such a nice little

presence on social media. Your passion and enthusiasm for dentistry
just comes through.
You’re one of those people who has the ability to I want to say infect, but
yeah, infect other people with your enthusiasm. Like I feel. excited and
sort of inspired about, about dentistry and what’s possible after I talked
to you. And I just, I really think it’s a gift that you have. And so I like to
keep that medicine fun and upbeat and I like to get sort of reenergized.
And I think that one of the gifts that you have is that you are able to sort
of instill this energy into other people. And so anyway, I appreciate that
you make time to come and talk with us.
Dr. Amy Thomson: Oh my gosh, you’re so sweet. Thank you so much.
That means so much. I just, I love teeth. I’m excited about it, and I’m
excited to see our colleagues get excited about it.
Dr. Andy Roark: I told you this when we first started chatting before,
before I hit record on the podcast here, but I’ll say it again, the thing I
think I, one of the things I really admire about you, I think is so great
about you and your story is that you were a general practitioner with not
a particularly great level of interest in dentistry and then there as a
doctor, this wasn’t picked up in vet school, you sort of started to fall in
love with this piece of that medicine and you were able to go back into a
residency and really make this your life.
And there’s so many vets and technicians that I talked to or see who at
some point come to feel kind of stuck in basic general practice. And I
just I love to see people like you and try to hold up people like you who
did general practice, liked it just fine, but then decided to, Make it into
something different you found something that you loved and decided to
do more of that And you were really able to kind of bend the profession
to your will and kind of make for yourself what you wanted to have And
so I just think that’s an important part of your background as we start to
talk about this because the other thing I always like to talk about with
you really is communication to pet owners and the fact that When you’re
a specialist, you see a certain type of pet owner, and maybe that’s not
what you see as a general practitioner, but, but you have that
experience talking to GP clients. And so I really think that you’re a
uniquely wonderful resource here. So anyway that’s kind of what, why I
sort of reached out to you. I’ve got this, I’ve got this wild idea, Amy, and
I’m really getting into this idea of longevity in pets.

I really am starting to think about. What could I do if I was a pet owner to
increase the likelihood of my dog living to be 20? Or 25, or 30. And I
think about this because, I’m just being transparent, I’m not getting
younger myself, and my parents are getting older and things like that.
And so I’ve been doing some reading on human longevity and things
that that are helpful in, in helping people have not just quality of life, but
quantity of life.
And I see so many parallels in pets. And as I’m thinking about this and I
say, I would like to advise pet owners as their veterinarian, I would like to
be able to guide them or at least support them in the idea. Let’s make
your dog live 20 years. And so dental health has got to be a part of that.
Like we know that weight control and dental health are probably and
behavior are probably the three big things that really impact longevity for
pets.
I think that’s probably the things that are most in our control. And so
what I wanted to talk with you about today is what’s really feasible for pet
owners as far as home dental care? Because I, you know, I’m in the
exam room and I’m talking to them and they’re, and it always comes up.
It always comes up when you say your pet needs to get their teeth
cleaned and they go, Oh, well, what could I do at home? And that’s a
whole different thing. But it’s a whole different thing. But what if I
empower them to What can we do better at home? What can we talk to
them about as far as home health care that they could start at an at a
young age to really try to increase their pets quality of life and quantity of
life.
And so let me sort of pause here for a second and sort of hand this over
to you and say, Amy, when we talk about home dental care. How
optimistic are you here? And, and, and what is sort of your approach to
this? Because I know that, you know, the absolute best practices, but
also I’m sort of reaching out to you because of the pragmatism that you
have about what will they actually do?
And so I don’t want to give them a presentation that they just politely
smile through going. I’m not going to do any of this. So help me sort of
get started with, with that approach.

Dr. Amy Thomson: Yeah, for sure. And I’m so eager to talk about this.
And I think it’s funny, and I enjoy it. I was very honest when you reached
out, like, let’s talk about dental home care that owners will
Dr. Andy Roark: We’ll actually do.
Dr. Amy Thomson: the subtext to that is, not toothbrushing. And I think
I wrote back like, totally pleased to, but we will talk about
Dr. Andy Roark: But we’re going to talk about toothbrush today.
Dr. Amy Thomson: We’re going to talk about toothbrushing. And I think,
It can go back to that conversation of, all over here, we need, you know,
we’ve got gingivitis, I’m concerned, we need to do a cleaning, and, you
know, we start talking about that and the expense of that, and that’s
something we need to do, but what can we do to preserve that health or
maintain that health as long as possible?
And I mean, sometimes just, being frank and honest with owners of,
listen, tooth brushing, there’s nothing better. If there was anything better,
we’d be doing it for our health. I just broach that and just say, I know you
are thinking this isn’t gonna happen, or a lot of owners are like, yeah, I
tried, he hates it, it doesn’t go well.
I’m like, great, I’m so glad you tried. May I ask what didn’t work? And I
would say 99 times out of a hundred, the owners will say, Oh, they’re
chewing on the toothbrush and they’re like spitting it out of their mouth.
And I’m like, okay, tip number one, you’re going to like, so my tip number
one is that don’t brush your pet’s teeth.
Like you brush your own teeth. And I think that that’s something really
important to acknowledge. We’re all brushing our teeth every day. We’re
doing a pretty good job at it. So naturally, if we’re just being told Okay,
brush your dog’s teeth, we’re going to do it the same way we do our
own. Which makes sense.
I will say, listen, brushing every surface of your pet’s teeth, The reality of
that happening daily is about 0. 1 percent chance because they don’t
want anything in their mouth. They’re like, this is weird. We don’t want it
in there. Their tongue is being hit the roof of their mouth. It’s not really
that pleasant.

We do it because we know that we need to, but they don’t know the
benefit of it. So I actually say, I would love you to brush all the surface of
the teeth. And that is what I would call like super advanced gold
standard brushing. But let’s just talk about being consistent, like with
anything in life, learning a language, training for a marathon.
It’s more about consistency than what you’re actually doing. And so I say
I’m right handed. So take your left hand, make an L and just wrap it
around their little muzzle. Just soft, like no firm, or not white, not linear,
just enough to encourage them to keep their teeth clenched. And then I
take my toothbrush, or I’ll start with a finger, and then I just stick it in their
cheek pouch, so they can keep their mouth closed, and I just rub the
outside surfaces of their teeth.
And we’ll do that in the exam room. I’ll get in there with a finger. I won’t
use a toothbrush. And I’ll just say like four to five swipes back and forth.
And most dogs and cats for that matter, that are just like, hell no, they
will tolerate pretty okay. And then the owners have this moment of like,
Oh, well that wasn’t terrible.
And I’m like, you know, this is the goal. The goal is to get the brushing
back and forth. But if you can just start touching a tooth, and then giving
them a treat, which is tip number two. Cats don’t get cavities. Less than
5 percent of dogs get cavities. I’ve treated two dogs with cavities in the
last year.
Very rare. So unlike you and I, where we’re going to eat and then brush,
you can actually brush and then feed them. And I don’t know about you,
Andy, but I’m very food motivated. So,
Dr. Andy Roark: Yeah,
Dr. Amy Thomson: if I’m going to get my meal or a tasty snack
afterwards, after repetitions, you know, like four or five, 20 repetitions,
our pets are smart.
They know where the treat bowl is. They know when treat time comes.
As long as we keep it positive, keep it short, keep it positive. They tend
to be like is it really that bad? I get the treat afterwards. So I really like to
talk to owners about those being my two main tips is focus on the
outside, make it positive.

I mean, some pets, very few, are not food motivated, but I’ve had, like, a
cat owner use the cat loves being brushed. Okay? Just touch a little
tooth, brush, brush, brush, touch a little, and work up to that.
Dr. Andy Roark: I like it. That’s awesome. It’s funny. It matches up what
I was just thinking today because I was, I was out walking Skipper and
he is, he’s super treat motivated. It’s just really funny. It took me an
embarrassingly long time to figure out how treat motivated he was and
that he’s a wonderfully compliant dog.
As long as I have treats in my pocket and you know, and It doesn’t have
to be anything extreme for, you know, for him, like the little crunchy low
calorie milk bones. He goes nuts for
Dr. Amy Thomson: Mm hmm.
Dr. Andy Roark: This is not a big lift, but boy, I fought a lot of battles. I
didn’t need to if I had just gone heavier on the treats at the very
beginning.
Dr. Amy Thomson: Yeah. Yeah, and it’s you know, we’ll show them in
the exam room Like this is ultimately what I want to get to but like you’re
not gonna start, you know You’re not gonna just put on the shoes and
run the half marathon, right? you’re gonna start by like walking around
the block and then maybe Jogging for one minute walking like so we’re
gonna have to build but the biggest key is consistency So like keeping it
relatively positive if that means just touching a tooth and they get a
cookie Great because we’re building on that.
This isn’t so bad. This is a positive And yeah, I mean I think I’ve heard
before it takes 21 days to build a habit. So like we need to, we need to
commit some repetitions here put some reps in, but it’s amazing, you
know, like my technician’s cat will come and wait to have his teeth
brushed when it gets to be, cause they know it’s dinnertime and like, this
is a routine.
We do the tooth brushing and then we get our bowl of food. And I’ve had
pets in the past that we did it at bedtime. And so anytime after 8 PM, you
go in the bathroom, the dog’s following you. And they’re like, okay, I’m
ready. You know, we can really use that, Pavlovian dogs, really, that
classical conditioning to our advantage.

Dr. Andy Roark: this a lot. I can honestly see this working into my
routine.
One of the things you said that I really loved is just the way you can turn
a phrase. When you say, you know, if there was something better than
brushing teeth, then we would do it ourselves. And I was like, oh, that’s a
really good phrase.
Amy, how do you give the value proposition before we’re talking about
dental disease or periodontal disease. You know what I mean? So what
I’m saying is I saw, okay, just as an example, let’s say that I saw a 16
week old puppy slash kitten yesterday, and they came in, everybody’s
happy they’re playful, they have, they still have their puppy and kitten
teeth How do I start talking at that point so that the pet owners hear me,
right?
It’s much easier to wait until they have periodontal disease and say, ah,
yeah we don’t want to have to clean these teeth as super often. Let’s get
them clean and then you can start doing this so that we can hold this off.
And there’s sort of, they’ve experienced some pain.
They’ve kind of seen what intervention looks like. And so I feel like
you’ve, At least I feel like I have more leverage to have that conversation
but that’s not ideal. Really, I would love to get them started when there’s
not a fleck of tartar on any of the teeth. And, you know what I mean?
And not wait until we’ve had this sort of like car crash and then we’re
like, Oh, well, let’s not do that again. So how do you, do you have any
good ways or phrases to sort of try to sell them on the value of making
this commitment? When there’s no periodontal disease, there’s no sign
of disease at all.
Dr. Amy Thomson: Yeah, no, that’s great. And obviously, maybe not
obviously, but you know, this, the earlier we’re teaching our pets, the
better, because, as babies, they don’t really know quote unquote yet
what is totally normal. So that whole, you can’t teach an old dog new
trick. I don’t agree with. We can teach them anything, but certainly
starting younger is better.
Prevention or maintenance is definitely better than treatment. I mean, it’s
been many, many years, but I, but back in the day when I was in general
practice and it’s hard to fit everything in a puppy visit, but I would just

say, you know, everything’s looking good. And I would at least make
sure there was a conversation like, okay, we’ve got, baby teeth.
We’re starting normally around 16 weeks. We’re starting to see some
adult teeth come in. And so at least have the conversation of like, I was
told many, many years ago, talk through your physical exam. Cause if
you’re just doing your physical exam, owners aren’t realizing how much
we’re picking, like we’re looking the mouth, we’re checking the gums,
we’re checking the teeth, the occlusion, things like that.
And so I’d talk through it like, really happy occlusions, normal, like We
don’t need to address anything with the teeth now, which is wonderful.
Certainly, you know, just mentioning, you know, I really am about
preventative care, really want to keep fluffy as healthy as we can moving
forward.
And so the num, the number one and number two disease that we’re
going to deal with is going to be periodontal disease and obesity. So let’s
really talk about that. So like with cats, meal feeding, even dogs meal
feeding, so then we can better assess what they’re eating, how much
they’re eating, if they need to go on a diet.
It’s something we can do if you end up having more than one pet in the
house, we can manage that. So we’ll talk about meal feeding and then
the other thing I would say is now is the time to get them used to tooth
brushing. Because it’s going to take a while. for you both to get proficient
at it, for them to accept it, for you to remember every day.
And so like the baby teeth are just like our trainers, right? Like they are
going to exfoliate most of them. Some of them will be persistent. We’ll
address those at spay and neuter, but most of them are going to fall out.
So if it takes us a couple of months to get it figured out, then once the
adult teeth come in and now we’re primed and ready.
And I will always say, tooth brushing is not going to remove the need for
regular professional cleaning like we brush our teeth multiple times a
day We still go to the dentist But shifting away from like avoiding
professional care and shifting that to keeping it them healthy longer, less
extractions, which means less surgical time, which means less
anesthesia time, less overall costs, less risk not needing to heal.

Like I would absolutely like my heaven is All pets get their teeth brushed,
they get professional cleanings once a year, and we’re not dealing with
extractions. So then the day after they have their teeth cleaned, we’re
back to brushing instead of taking a break and allowing that plaque and
calculus to build up.
And so, and then with my really tiny dogs, I’ll say, you know, like,
unfortunately I’d love to see a shift. I hope in my career I’ll see a shift, but
because home care hasn’t been a huge part of veterinary medicine
when it comes to dental home care cause there’s just so many things to
deal with.
And tooth brushing, everyone’s like, ah, they hate it. They don’t like it.
We’ll buy this treat or whatever. But like 90 percent of toy breed dogs will
have periodontitis by the time they’re one year old which is crazy. And a
lot of owners are like, my pet’s only five. How is this possible?
And I’m like. They’re only five. I mean, they’re doing well. They’re beyond
the, the curve because at a year, sometimes I’ll see puppies come in at
ten months. To have persistent deciduous teeth taken out and they’ve
already got gingivitis. They’ve got enough calculus that they’ve got
gingivitis.
So Sometimes just sharing those facts of it’s not gonna remove the need
For professional care, but it’s gonna decrease the severity of disease
which is gonna then decrease You know the overall anesthesia time the
number of visits the cost is a big one I think is you know, we have to be
transparent That is a big part about professional dental care because it
does require anesthesia to be done appropriately.
I think just trying to focus on, okay, we’re the healthiest. We’re all the
healthiest, generally speaking, when we’re younger. And then while age
isn’t a disease, as we age we’re more likely to develop disease and
periodontitis, periodontal diseases. Unfortunately, number one. But it is
something we can fight with a toothbrush, and it is something if caught
soon enough, we can actually reverse, which I think we’ve talked about.
I really nerd out about that because, you know, once you’ve got a
disease, we’re managing it. But if we’re seeing these patients when
we’ve got gingivitis, but no ligament loss, no bone loss, I Thorough and
thorough, deep cleaning actually will reverse that inflammation and reset

to zero to no disease, which really lights me on fire because that’s, I
think that’s so cool.
Like, normally, once we’ve got a disease, we’re just managing it. So if we
can really work together, I say, like, what I’m gonna do is only one day.
364 is on you, and so I just really want to be a team and keep this mouth
as healthy as possible because, like you said at the intro, like, our oral
health is really the gateway to our entire body and that’s a lot of bacteria,
like a ton of bacteria that sits in that plaque and calculus.
And then once we get inflammation in the gums, we can get that in the
bloodstream, and so, you know, a healthy mouth is a healthy pet.
Dr. Andy Roark: Yeah. Oh, definitely. What do you like? Do you like a,
do you like a toothbrush? Do you like gauze pads? Do you like the finger
brush? Are you neutral? If I’m starting with a dog or a cat from the very
beginning, am I trying to get them to a soft bristle toothbrush? Or are you
okay with the finger, gauze pads, things like that for the long term?
Dr. Amy Thomson: Yeah. I’m a big fan of a toothbrush. It needs to be
soft bristle. Basically all like dog cat toothbrushes are going to generally
be soft bristle. I actually still have, maybe it’s weird. I still have a little
raisins nose, pediatric toothbrush. So pediatric toothbrushes are great
for really small dogs and cats because we want to disrupt that biofilm.
So my worry is if we’re using something that’s not a little bit abrasive, like
we don’t want it super abrasive, but we need something to break up that
film. And then so my worry is sometimes if you can get those really fine, I
think they sell them as like cat toothbrushes. But I use them for small
dogs as well, but like it’s smaller, like I have small hands, but it’s
narrower than my pinky.
And so you can really, and it’s got a long handle, so you can really get
back. So I personally prefer getting to a toothbrush. Now that may start
with like a finger and then a wipe and that kind of thing. But honestly, like
any sort of mechanical debridement of that biofilm is going to be ideal.
But my goal is to get to a toothbrush.
Dr. Andy Roark: that makes sense. Are you worried if you start to
introduce alternatives to toothbrushes, or supplemental tools, right?
When we start talking about shoes and things, are you seeing this as a

good thing to introduce in the conversation? Or are you worried that you
are giving them alternatives to the toothbrush?
For example, if I say to you, Hey Hey, pet owner, I’ve got this thing that I
want you to do. And you go, well, I’m not going to do it. And I say here’s
a thing that’s significantly easier. Did I just let them completely off the
hook for the first thing? And, and I don’t know, do you have that thought?
Are you okay? You know they’re going to bring it up. They’re going to
say, Well, what else? Or, what do you think about these rinses? Or, I do
antlers. Do you like antlers? They’re going to say those things. You know
they’re going to say them, you know? I heard, I got antlers yesterday.
Yesterday, I got
Dr. Amy Thomson: My gosh. It kills me, it kills me the antlers. Yeah, so
I think, I think that unfortunately and again as it, like, all I do is teeth,
right? So, like, I have 30 minute consults to talk about treatment and I
sneak home care in, but we also do a lot more home care discussion. I
have complimentary recheck visits.
One, because I want to make sure they’re healing well. I want to hear
how they’re doing and then really delve into home care. Like, once I’ve
done this treatment, okay, but like, what are we doing? So I would say I
definitely have more time than general practitioners. However, I do think
that it’s well, I’m not going to brush.
And it’s just sort of like, okay. but we haven’t taught them how to do it.
Like we haven’t given them the steps. And so they’ve tried most owners
and some will say like, I just, I’m too busy or it’s just not going to work.
And I’m like, okay. But most have tried because they hear what you’re
saying and like, we’re going to try.
And then they do it, quote unquote, the wrong way. And then it doesn’t
work. And then they stop. So I do think, letting them off the hook. I
mean, sometimes it’s letting you off the hook. You have like eight other
things to talk about, but I do think if we can as a team really be focused
on what is the best and sometimes you know, like I said, there’s nothing
better than toothbrushing.
The other thing about toothbrushing is there’s no added calories. Obesity
is a big problem. We don’t have to worry about allergic dogs or cats or
things like that. And the cost is Very minimal, right? Some of these

chews can really get up in cost. So not only is it the gold standard for
health wise, but there’s a lot of positives to that.
So I think mentioning that and then also, I’m game to talk about other
things because We’re not perfect. Have I missed days of toothbrushing?
Yes, and like adding other things on can be really helpful You know if
you’re traveling and whoever’s pet sitting can’t, there’s lots of reasons So
I would say that I like to base my home care around daily toothbrushing,
but I’m all for other things However, we have to be very careful about
what we expect out of those.
So a rinse is not going to mechanically debride the plaque. It’s just isn’t
right. It’s not mechanical. So the rinse may decrease. minerals calcifying
onto the plaque to make calculus, but it’s not getting rid of the plaque. So
if you have plaque, you’ll always have calculus. If you’re getting rid of
plaque, you can’t get calculus.
and then like with chews, okay, those are, those are mechanical, but
those are only helpful for teeth used to chew. So their canine teeth, they
don’t chew with. So like, we’re not getting a benefit from the chew on
those teeth. So I think being very, and acknowledging and I will kind of
spell that out of, what are the pros and cons?
Because I see a lot of stuff being like as good as toothbrushing. And
then you read in the font, it’s like as good as brushing twice a week,
which is because calculus develops within 24 hours. So if you’re doing it
every three days, you’ve got two days worth of calculus that you can’t
brush off.
So you’re behind the eight ball. So unfortunately, Pet care is a huge
market. It’s a huge market, right? It’s overwhelming, even for me going
into the pet store and seeing all the things that are like good for their
teeth. And then you see something like antlers, which is like actually
terrible.
It’s going to cause teeth to break just based on physics and anatomy
alone. So it’s hard for pet owners. So I do think, when and if we can find
the space and the time and our appointments, whether it’s us directly or
other veterinary professionals on our team, to at least acknowledge,
because they’re gonna go find those things and be like, yeah, they said
toothbrushing, but I can’t do it.

And this says as good as toothbrushing. So like I’m gonna just swap that
out. So I do think just acknowledging that like, I’m all for rinses and diets
and chews and things like that. They’re just they’re not going to get to
the same point as tooth brushing. So I think if we can supplement use
those things to supplement i’m all for it.
Dr. Andy Roark: Potentially stupid question. When you see, when you
see, when you see dogs that they have dental calculus builds up and
gingivitis on their canines but then you don’t see a lot of calculus or
gingivitis on their premolars, I just kind of assume that that was a weird
thing or a part of their mouth anatomy, something like that.
Are those dogs potentially that are doing some like dental chews or
things like that? And maybe that’s why they’re not getting it this buildup
on premolars, but we’re seeing up on their canines. I guess I hadn’t, I’ve
seen a lot of those dogs where I go, I don’t really see it on the premolars,
but definitely on the canines.
is that an idea that might bear weight? Or is it like, no, Andy, probably,
probably not. That’s probably just, just thumb luck.
Dr. Amy Thomson: No, absolutely. I think that’s the case like I i’ve had
many cases where you know, we look at the front of the mouth and the
incisors and canines are not looking so hot and then I pull back and i’m
like Looking pretty good back here. Looking pretty good because
generally our calculus pattern in our canines and feline patients is the
most is going to be on the maxillary fourth premolar because our salivary
Ducts empty there and so they’re getting the most saliva the most
minerals in those saliva So like all the teeth are pretty evenly going to
get plaque build up and I will tell owners, you know, it’s like when you
wake up and you have that like weird, slimy, fuzzy sweater feeling.
Like we all get that. Like we get it, our pets get it. And then if we don’t
brush that off, it’s actually the minerals in our own saliva that mineralize.
And so we should see naturally more calculus on these maxillary fourth
premolars because they’re the first one to be bathed. And so when I
really dive into it and I’m talking more to owners, it’s the, I do see, and
sometimes it’s not super obvious, but like I had a case last week where I
was like, Things look real good back here, like really good in a small
breed dog, which always I’m like Did you get an anesthesia free
cleaning?

Is there something like that? That’s one of the first things when I don’t
see a lot of calculus in these little guys, but no, this little guy was on a
dental diet, got dental chews, but tooth brushing, they were really
struggling with. And then we worked through like how we can get on top
of that.
And so for now, because we do have some gingivitis, I say like, let’s not
get get in there hardcore in case we cause a little bit irritation and then
it’s painful and then we, Lose traction. So what they’re doing between
our appointment and coming in for a cohat is they’re just going to focus
on like touching teeth lifting lips, just getting more comfortable with the
mouth being handled.
But yeah, I’ve definitely seen that in some, in some patients that are
really doing the dental diets and the chews. And then we’re seeing more
periodontitis up front where those chews aren’t helping because those
teeth aren’t used to chew.
Dr. Andy Roark: that makes sense. It always stands out to me. I see
him fairly regularly. I mean, not not nearly as often as, you know, just
Funk everywhere, but I do see him sometimes where I I, you know, you
start you do that first look and you see the incisors and the canines and
you go, Ooh. And you look in the back and you go, Oh, well, that’s much
better than I thought it would be.
So anyway Amy, you are amazing. Thank you for being here. Where do
you like to send people if they’re looking for resources? I know that you
are actually making a lot of educational resources always for vet
professionals, but also for pet owners. Tell me about that. Tell me where
people can find it.
Dr. Amy Thomson: everything for me started a few years ago on
Instagram, and so I like to do kind of short, fun, try and be entertaining
but if you’re looking for something more got some more grit to it the meat
and potatoes of things, as they say I just relaunched my website, which
I’m really excited about.
It’s a work in progress, but we have both a pet parent side and a
veterinary professional side, and so we’re working on keeping them Like
short and sweet, but like one page handouts of things like
malocclusions, fractured teeth anesthesia free cleanings. That’s been a

big one. The reason we need anesthesia to appropriately clean and and
manage your pet’s oral health.
What is a cohat? So just trying to like support all of you and I’ve asked
Many times on social media what you all are looking for because I know
it’s a lot in that exam room And so you’re touching on these points and
then you know You don’t get the same amount of time to talk to them as
I do So just really trying to to have something like tangible that you can
either kind of print off and give to an owner or you can where you can
send them to that PDF document to get a little bit more information.
We’ve got some pictures in there. I’m very visual learner. So some
pictures in there to just sort of help round out or, supplement the
information that you’re giving your pet parents.
Dr. Andy Roark: Cool. Thank you so much. Thanks for being here,
Amy. Guys, thank you for tuning in and listening. Take care of
yourselves, everybody. We’ll talk to you later.
And that’s it. That’s what I got for you. Thanks for being here. Thanks to
Amy for being here. Gang, if you like this episode, send it to a friend.
Share it with your staff. Let’s get more people. Talking about dentistry in
the exam room. I think it’s just an important thing to do. Again, it’s about
increasing the quality and the quantity of the pets lives that we serve.
I think this is an important part of it. Gang, take care of yourselves. Be
well. I’ll talk to you later on.

Good decisions are underappreciated

by

It’s not hard to appreciate a bad decision. 

“I should not have given that client my cell phone number” 
“I should not have used the cheapest electrician I could possibly find” 
“I should not have eaten that shrimp appetizer”

Bad decisions stand out because of the obvious and painful consequences they bring. Good decisions, by contrast, are often invisible and unappreciated.

No one thanks you for spaying their dog when they don’t get a pyometra. None of us will ever celebrate the pain and drama you avoided by having a hard conversation other people would have shied away from. Pet owners will never know how much shorter their pets’ lives would have been or how many more health problems their pets would have had if you hadn’t pushed them to be vigilant about weight control. 

Be careful about evaluating yourself based only on the things that have gone wrong or on mistakes you have made. Remember that good decisions almost always lead to silence instead of celebration. This is why the true mark of experience is a quiet life. 

About the photo: If you don’t have deviled eggs at Thanksgiving, did you really have Thanksgiving? Not eating all three platters of deviled eggs was my good decision that seemed underappreciated last weekend…