Small Animal Sunday Schedule

Internal Medicine

Dr. Chris George, DVM, Practice Limited to Internal Medicine

Meds That Make a Difference: Pharmacologic Support for Challenging Behavior Cases

Dr. Christine Calder, DVM, Board-certified Veterinary Behaviorist

Behavioral disorders rooted in fear, anxiety, and frustration represent some of the most common and consequential threats to animal welfare and the human-animal bond. Yet psychopharmacology remains underutilized in general practice, often due to uncertainty about when and how to intervene. This session offers a practical framework for integrating medication into comprehensive behavior treatment plans, emphasizing that while drugs are rarely curative, they play a critical role in reducing arousal and emotional reactivity to create a physiological state conducive to learning and behavior modification.

Attendees will gain a working understanding of the neurochemical basis of behavioral disorders and how to choose medications. Topics include the use of SSRIs and TCAs for chronic conditions such as separation-related behaviors and generalized fear, as well as event-based protocols using trazodone, gabapentin and benzodiazepines for predictable stressors like veterinary visits, car rides and thunderstorms. The session also addresses the role of a valid VCPR, ruling out medical differentials including pain, setting realistic client expectations and managing polypharmacy risks such as serotonin syndrome.

From “Do Not Approach” to Exam-Ready: Using Pre-Visit and In-Clinic Medications to Improve Veterinary Visit Outcomes

Dr. Christine Calder, DVM, Board-certified Veterinary Behaviorist

Routine veterinary visits can be a major source of fear, anxiety and frustration for patients, and that stress creates real barriers to animal welfare, team safety and diagnostic accuracy. This session gives general practitioners practical strategies to turn "do not approach" patients into candidates for safe and more comprehensive medical evaluation through the use of pre-visit medications and in-clinic chemical restraint.

Attendees will learn to build individualized oral pre-visit protocols using evidence-based anxiolytics and sedatives. We will also cover the value of test dosing to assess individual patient responses and catch paradoxical reactions before the visit.

For patients where oral medications are not enough, we will walk through early-intervention injectable sedation protocols, making the case for chemical restraint over physical struggle to prevent patient trauma. We will review multimodal combinations that provide reversible sedation for even the most challenging cases.

Elevating the Euthanasia Experience, part 1: Helping Families

Dr. Sunday Cozzi, DVM, CPEV

Many veterinarians have received little to no education on how to guide clients and their beloved pets through the end of life process. Historically, veterinary education has discouraged doctors from sharing personal views and experiences with their clients facing tough decisions and instead focused on providing facts and options. As the field of end of life care evolves, we are improving our ability to help families determine what is important to them and empower them to choose the meaningful experience that they want for themselves and their pet. Yet, our responsibilities don’t end once we have pushed the plunger and helped our clients give their pets a dignified, loving and minimally stressful goodbye. The vast majority of veterinarians have no idea that the AVMA released a Companion Animal Aftercare Policy in 2020. The AVMA CAAP was created in response to high profile cases involving the unethical mishandling of animal remains by crematories. The AVMA CAAP outlines the duties of the veterinarian to ensure that the dignity of their patients is maintained, even after death, and ensuring that aftercare is performed ethically and responsibly.

Elevating the Euthanasia Experience, part 2: Getting the Whole Team Involved

Dr. Sunday Cozzi, DVM, CPEV

It’s no secret that euthanasia appointments are often dreaded as much by veterinary teams as by the grieving clients that schedule them. Veterinary professionals often don’t receive any formal training in best practices for handling euthanasia. Thankfully, there are a growing number of practitioners who are choosing to focus on providing an outstanding end of life experience. As public awareness of these services grows, the standard of care improves, and we do better as an industry. Yet, it is not only the veterinarians who hold the key to improving the euthanasia experience. Customer service representatives are typically the first and last team members that assist our clients, so it is imperative to ensure that they too are well-trained to support clients through these highly emotionally-charged situations. Expression of empathy and awareness of the verbiage used by the whole team can help to ensure the best experience possible by our clients. Improving communication between team members and owners is the single most important thing we can do to provide the most supportive euthanasia visit. Once that has been established, there are a number of tips and tricks that help to add the personalized touch that will help to earn glowing reviews for a practice’s end of life care. Euthanasia can truly become a practice builder once every team member has been empowered to assist families during this most sensitive time.

Injectable and Oral Options for Pre-euthanasia Sedation

Dr. Sunday Cozzi, DVM, CPEV

The idea of pre-euthanasia sedation was rarely discussed 25 years ago, but it has since become standard of care. It makes perfect sense when you compare it to the closest experience in human medicine. Euthanasia in general practice is nearly always achieved via an overdose of anesthesia (pentobarbital). Can you imagine how bizarre it would feel to go from completely conscious to fully unconscious in a matter of seconds? Your anesthesiologist would not do that to you, and we have the obligation not to do that to our patients as well. Our clients so frequently express the desire for their beloved pets to fall asleep and not wake up. While this is not necessarily common in unassisted (‘natural’) death, we as doctors have the ability, and dare I say the responsibility, to facilitate this–providing a better experience for our clients and their pets. Our patients vary widely as far as disease process and demeanor, so a ‘one size fits all’ approach to pre-euthanasia sedation may be overly limiting. It’s beneficial to have more than one injectable protocol for different situations and in the event of supply issues limiting access to certain medications. There are also certain patients and situations where it is helpful to administer sedation (ranging from mild to heavy) via oral route, so it is good to be familiar with several of these protocols. One of the most important things we can do is to promise, and then deliver a comfortable, deep sleep prior to euthanasia.