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.
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
Leadership Essentials Certificate
Charming the Angry Client Course
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.
