APRIL 2019 BEAT
UPCOMING WEBINARS now including large animal/equine CE training
VETGIRL BLOG unique topics in quick-read format
PODCASTS CE training on the run
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IN THIS ISSUE
QUICK RECIPES // 09 Sneak peek into our upcoming FREE cookbook for busy vets
Q1 WEBINAR HIGHLIGHTS // 02
Top 5 mistakes to avoid on social media
TECH TIPS // 10 Some unique and amazing tips and tricks we’ve learned and need to share MEMBERSHIPS // 10 PROVIDER SPOTLIGHT // 12 Check out what others are doing in our community
Novel vaccines for Lyme disease and other tick-borne pathogens Rabbit gastrointestinal disease: Teeth to cecotrophs Ocular trauma and ER procedures A leader’s response to compassion fatigue and burnout in veterinary medicine
We’re here for you! You are busy... but you still have to eat! Quick, easy recipes are on the way. Join our mailing list for a copy of our FREE PDF cookbook. Hard copy books will also be available soon!
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TOP 5 MISTAKES TO AVOID ON SOCIAL MEDIA JUSTINE LEE, DACVECC, DABT
In this 1 hour webinar, Dr. Justine Lee uses her experience and expertise to discuss the importance of social media for all veterinary professionals. She discusses the social media platforms you need to be on and recommends delegating the management of social media (i.e. stick with what you’re good at!)
1 Social media helps you build trust and allows you to connect with your pet owners in a non-rushed manner, especially in this day and age when Millennials (25-39 year olds) make up the largest generation of pet owners and Gen Z (18-24 year olds) account for >50% of the growth in the pet population. 2 If you choose one social media platform to be on, Facebook is the one. Facebook continues to remain the most popular social media platform (79% of online adults). 3 Reserve your social media name on Facebook, Instagram and/or Pinterest as soon as possible and delegate to someone who can actively manage your social media presence (i.e. hire a college intern to post on your social media pages on your behalf).
4 Know some of the cool tools available out there for you (bonus – some are free!) 5 Be sure to have a social media policy in place for clients (to allow you to post educational photos of their pets) and employees (to not allow them to post photos of client-owned pets on their personal social media pages) and if you don’t know how to make one, look online for lots of free samples for ideas. 6 Reviews are important since 92% of consumers now read online reviews and 40% of consumers form an opinion by just reading 1-3 reviews. Make sure that your website is “mobile optimized”, claim your business on Yelp, Google, White Pages, etc. and solicit your best clients for reviews. Make sure you are checking reviews regularly and respond immediately and professionally to negative comments.
7 Post good content once a day, not several times a day, and follow the 80:20 rule – 80% interesting, 20% self-promotion. Use high quality and polished photos keeping the 70% evergreen concept in mind (utilizing content that can be reused frequently). LEARN MORE
CONNECT WITH US // ON SOCIAL MEDIA
NOVEL VACCINES FOR LYME DISEASE AND OTHER TICK - BORNE PATHOGENS RICHARD MARCONI, PHD Dr. Marconi, a professor in the department of Microbiology and Immunology at the Virginia Commonwealth University Medical Center, presented a 1 hour webinar reviewing Lyme disease and discussing novel vaccines for tick-borne pathogens.
1 Lyme disease is the most common arthropod-borne disease in North America and Europe. In the past 2 years, the number of diagnosed or probable cases per year in humans has increased by nearly 30% to approximately 437,000. 2 The causative agent of Lyme disease in N. America is Borrelia burgdorferi ; a spirochete that is transmitted to mammals by Ixodes ticks. Because Lyme disease can not be transmitted from animal to animal and since the spirochetes are not transovarially transmitted in ticks, persistence of these unique bacteria in nature requires that they cycle back and forth between ticks and mammals. When the 6 legged larval stage ticks emerge from the egg, they are infection-free and can only become infected if they feed on an infected animal. After larval ticks take a single bloodmeal they molt to the 8 legged nymphal ticks. Nymphs are the first developmental stage of the tick that can transmit Lyme disease to a mammal. After feeding, nymphs molt to sexually di ff erentiated adult ticks. Since adult male ticks do not feed, it is only the adult female tick that can transmit Lyme disease to another animal. 3 When the Lyme spirochetes are exposed to blood during tick feeding, they switch from producing OspA (Outer surface protein A) to producing OspC (Outer surface protein C). This change in their “protein coat”
animals and this requires frequent booster vaccinations. 6 The rationale behind VANGUARD crLyme was to develop a vaccine that can protect through two synergistic mechanisms: killing of spirochetes in BOTH ticks and mammals. The crLyme vaccine consists of purified recombinant OspA and a unique recombinant OspC derived protein called a “chimeritope” (chimeric epitope based protein). An inherent challenge associated with using a single OspC variant as a vaccine antigen is that OspC is a highly variable protein. To overcome OspC diversity, the immunologically important segments of several di ff erent OspC protein variants were identified and fused together to make a custom designed OspC derived protein that can stimulate the production of antibodies that can target diverse B. burgdorferi strains. 7 VANGUARDcrLyme is intended for use in dogs 8 weeks of age or older to aid in the prevention of clinical disease and sub-clinical arthritis associated with B. burgdorferi infection. Dogs should be administered two doses three weeks apart with annual revaccination recommended. VANGUARDcrLyme has a 15 month duration of immunity label: the longest of ANY USDA approved Lyme disease vaccine. LEARN MORE
is an essential step that must occur in order for the spirochetes to exit the tick and infect mammals. This important information proved central in e ff orts to develop a vaccine that can kill spirochetes in both ticks and in mammals. 4 There are two types of canine Lyme disease vaccines: bacterins and subunit vaccines. Bacterins consist of homogenized bacterial cell lysates that are inactivated (killed) and filtered. A typical Lyme disease bacterin or “bacterial soup” vaccine contains in excess of 1,000 di ff erent proteins. However, only a small subset of these proteins contribute to protective immunity. In contrast, Lyme subunit vaccines consist of one or two highly purified and well characterized proteins. Hence, subunit vaccines are well defined in terms of their composition and lack “extraneous” bacterial ingredients. Intuitively, a cleaner subunit vaccine would be less prone to trigger adverse events. 5 Until 2016, the only available Lyme subunit vaccine was Recombitek Lyme (Merial). This vaccine consists of OspA, a protein that is produced by the Lyme disease spirochetes in ticks but not in mammals. Hence, antibody to OspA can only target spirochetes inside ticks. It cannot target spirochetes that successfully pass into a mammal. Complete killing of spirochetes in ticks requires that high levels of antibody be maintained in the blood of vaccinated
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RABBIT GASTROINTESTINAL DISEASE: TEETH TO CECOTROPHS COPPER AITKEN - PALMER, DVM, MS, PHD, DACZM In this 1.5 hour webinar, Dr. Copper Aitken-Palmer focuses on gastrointestinal related disease as it is the most common presentation of a major disease in rabbits (often teeth related and GI stasis) but also discusses other common rabbit presentations.
8 Rabbits have 6 lobes of the liver and the stalk attachment of the caudate lobe of the liver makes it prone to torsion. So if you are seeing a very sick rabbit with an elevated ALT, ALP and AST (or even azotemia) that you thought had GI stasis that isn’t getting better despite treatment, get a stat ultrasound. Mini lops may be over- represented. 9 If you have a drooling rabbit (a.k.a. rabbit slobbers), think dental disease. A proper rabbit dental exam should ideally be done under general anesthesia to visualize caudal cheek teeth. Pre-sedation with midazolam/ buprenorphine will help with blind intubation after mask induction. Essential pieces of equipment for rabbit dentals include CHEEK SPREADERS, straight dental handpiece with shielded burr, head lamp, and magnifying glass (Rose Micro Solutions head loops are nice for working with rabbits because they have longer working distance, less $$). NEVER use clippers to trim rabbit teeth as this could lead to fractures and more serious complications, a dental burr is preferred. LEARN MORE
1 Take an extensive history which will help identify potential husbandry and lifestyle issues. During the physical exam, always look at the underside of the bunny by holding the feet rocked back in your arms to visualize the face and belly. A lot of things can be missed if you don’t turn the rabbit over. Check for nasal discharge on the nose and on the front paws; signs may be subtle but if any discharge is noted, then likely the bunny has a respiratory infection. Azithromycin is the antibiotic of choice for rabbit URI’s. AVOID oral cephalosporins, β -lactams, and Clavamox in rabbits, as these can lead to fatal dysbiosis. Parenteral (injectable) β -lactams do not cross the GI tract and are safe to use. 2 Diet should consist of grass hay which has higher silica content that helps to grind teeth, NOT legume hay (e.g. alfalfa) or pellets. Pellets are NOT necessary in any rabbit diet. 3 Ingestion of cecotrophs/cecotropes are an essential part of normal digestion and is unique to rabbits. Cecotrophs/cecotropes are soft pellets covered in mucus to protect essential microbes from the low pH of the stomach (pH=2) and are packed with B vitamins, short chain fatty acids, protein, sodium, potassium and water. 4 If you’re able to get bloodwork on a rabbit ( jugular or lateral saphenous veins are preferred). AVOID the ear vein which is marginal. Phlebotomy
of the central ear vessel which is an artery, can lead to thrombosis/ sloughing of the ear! 5 These are some helpful prognostic indicators to look at: • Glucose (normal 76-148 mg/dl) – if between 360-540 mg/dl = severe disease • Sodium (normal 136-147 mEq/L) – if <129 mEq/L has 2.3 increased mortality risk • Temperature is important to get as part of a routine exam, especially on sick rabbits: • Temperature (normal=100.4 °F to 103.8 °F). Hypothermia <100.4 °F is associated with increased morbidity/mortality. 6 If a rabbit presents to you sick with no feces in the carrier and or at home, the rabbit most likely has GI stasis and needs hospitalization. If hospitalizing, always ask about the water source as a rabbit may not drink out of a bowl in hospital if accustomed to using a drinker and vice versa. 7 The mainstays of treatment for GI stasis are HYDRATION (IV maintenance is 100ml/kg/day and use an e-collar to protect the IV catheter) and ANALGESIA, since pain promotes ileus. Buprenorphine (IM – lower dose, shorter duration; SC – higher dose, longer duration), Cerenia, and/ or Lidocaine CRI (100 μ g/kg/min – profound analgesia and MAC sparing). Avoid using Meloxicam until the rabbit is rehydrated.
OCULAR TRAUMA AND ER PROCEDURES SHELBY REINSTEIN, DVM, MS, DACVO
In this 1.5 hour webinar, Dr. Shelby Reinstein reviews the approach to the most commonly seen ocular trauma in the small animal patient – blunt trauma, proptosis, eyelid lacerations and corneal lacerations.
1 BLUNT TRAUMA In addition to stabilizing a patient and assessing the neurologic status with suspected blunt trauma patients, one of the most important parts of the initial assessment should include checking for a palpebral reflex to prevent corneal ulcerations and infections and if none is present, use topical lubricant gel/ointment. The most common presentations of blunt orbital trauma include traumatic uveitis (leakage of cells and protein leading to aqueous flare, hyphema and fibrin “spider webs”), lens luxation (most commonly into the vitreous), vitreal bleeding and possibly a detached retina. Treatment involves topical therapy, systemic therapy and possibly a temporary tarsorrhaphy. Topical therapy is usually directed at treating uveitis with broad spectrum antibiotics, steroid drops (if no ulcers), atropine to prevent synechia BUT use caution with severe hyphema since blood needs to drain from the irideocorneal angle, and lubrication of the eye. Systemic therapy involves using doxycycline for the anti-inflammatory e ff ect on the eye, NSAIDs or tapering steroids (use with caution in head trauma cases) and pain control. A temporary tarsorrhaphy may be needed if blinking is inhibited with massive hemorrhage in conjunctiva or under the third eyelid.
2 PROPTOSIS It is important to di ff erentiate proptosis from exophthalmos by eyelid position; globe will be in front of the eyelids with proptosis and the globe is behind the eyelids with exophthalmos. Brachycephalic dogs only need mild trauma for proptosis to occur whereas dolichocephalic dogs and cats require significant force in order for this to occur. Besides assessing the degree of extraocular muscle involvement (more muscles avulsed = more severe proptosis), the integrity of the globe by observing shape and turgor (the weakest point of the sclera is in the
back of the globe near the optic nerve so perforation may not be obvious), for any concurrent corneal ulceration, a consensual PLR is the best prognostic indicator of vision. Perform this by shining a light in the proptosed eye and assess PLR in normal contralateral eye; if consensual PLR is seen, this signifies an intact retina and optic nerve in the proptosed eye. Treatment for proptosis typically involves replacement and temporary tarsorrhaphy unless enucleation is indicated. It is important to inform an owner that approximately 20% of proptosed eyes will regain vision, and
OCULAR TRAUMA AND ER PROCEDURES SHELBY REINSTEIN, DVM, MS, DACVO
and full-thickness lacerations will usually involve a misshapen globe, collapsed anterior chamber, iris prolapse or hyphema. The initial assessment of this injury involves MINIMAL manipulation and possibly placing an e-collar on the patient to start. NO tonometry or Schirmer tear test should be performed and these patients are often very painful and may need pain control/ sedation with topicals (proparacaine or tetracaine) or parenterals (methadone, buprenorphine or torbugesic). Small, sealed lacerations (not actively leaking) can be handled medically but anything that requires suturing or is full-thickness should warrant an emergency referral. LEARN MORE
the goal of treatment is to save the globe, not necessarily vision. Good prognostic indicators include minimal globe displacement/1 torn muscle, clear cornea or superficial (exposure) ulcer, no hyphema and intact consensual or especially a direct PLR. When prepping patients for surgery, it is important to only use dilute betadine SOLUTION since betadine SCRUB has alcohol and will scrub o ff the cornea! The main things to remember post- op in these patients is to treat with topical antibiotic drops TID-QID, AVOID topical or oral steroids due to the high risk for corneal ulceration, oral antibiotics like cephalosporine or doxycycline (anti-inflammatory benefit), and a hard plastic e-collar in addition to oral NSAIDs and pain control and atropine eye drops unless there is significant hyphema. Remember that enucleation is always an option later or may be initially indicated with compromised vascular/ nerve supply when >2 rectus muscles are avulsed, severe corneal disease with deep ulceration or pigmentation, penetrating trauma with corneal lacerations or scleral perforation (decreased turgor of the globe), pre- existing eye disease like cataracts or retinal disease (e.g. PRA), or with lack of consensual PLR indicating loss of vision in the proptosed eye. When performing an enucleation, HemaBlock (hemostatic powder) can really help to minimize bleeding and be EXTRA careful medially especially with brachycephalics because they have a large venous sinus there that
can bleed a lot if you’re not careful with pointing your instruments away from that area. A three-layer closure with an orbital rim mesh using 3-0 or 4-0 PDS to allow eyelid edges to form fibrous scar and prevents sinking in (implants not used since may cause more complications later), subcutaneous tissues with 3-0 or 4-0 PDS and skin using 3-0 or 4-0 Ethilon can provide better cosmesis without all the complications of implants, which the author no longer recommends or performs). 3 EYELID LACERATIONS The most common cause of eyelid lacerations are bite wounds and the biggest indication for surgical repair is if the eyelid margins are a ff ected. Third eyelid lacerations are less common and repair is only indicated for deep avulsions and can suture or remove that portion of the third eyelid if the gland is not involved. Utilize a 3 step closure in which the author preferentially uses 5-0 Vicryl. The most important suture placement is a figure of 8 at the eyelid margin to ensure accurate apposition. Then the subconjunctival layer is sutured only if it is a very large defect, followed by simple interrupted “French braided” for the skin. 4 CORNEAL LACERATIONS These occur most commonly due to bite wounds or cat claw injury and can be partial or full-thickness. It is important to di ff erentiate partial vs. full- thickness for treatment and prognosis
LEADER’S RESPONSE TO COMPASSION FATIGUE AND BURNOUT IN VETERINARY MEDICINE SALLY RYAN, DVM - CEO OF VETERINARY LEADERSHIP SERVICES and has over 20 years of experience as a senior leader and ER veterinarian for a multi-site emergency veterinary organization In this 1 hour webinar, Dr. Sally Ryan reviews the causes of burnout and compassion fatigue which veterinary professionals may face and how this negatively impacts employees and the organizations they work for. She helps to identify practical and e ff ective strategies, on both the personal and the leadership level, for preventing and responding to this in the veterinary workplace.
1 BURNOUT is the physical and emotional exhaustion that employees can experience when they have low job satisfaction and feel overwhelmed and powerless. It a ff ects employees in all professions and is a common problem in workers in the United States and is not just unique to the veterinary profession. It occurs over time and is cumulative. Burnout results from a mismatch between expectations and reality in 6 key areas, workload, control, reward, communication, fairness and values. There are typically 12 stages of burnout, and not everyone goes through all the stages or in this particular order: • Excessive drive or ambition • Pushing yourself to work harder • Neglecting personal care or needs • Displacement of conflict • No time for non-related work needs • Denial • Withdrawal • Behavioral changes • Depersonalization • Inner emptiness • Depression • Mental or physical exhaustion or collapse The signs and symptoms of burnout mimic those of depression with physical, behavioral and emotional manifestations.
AMA), as well as personal risk factors (gender – females predisposed, exposure or past history of traumatic situations, personality type, social support at home/work). Signs and symptoms of CF are similar to burnout with these key di ff erences (and both can coexist or CF may exist without burnout): • Anger/irritability • Emotional exhaustion • Decreased ability to feel empathy or sympathy for self and others • Changes in worldview Prevention and treatment of both burnout and compassion fatigue are very similar and both need to involve a personal approach on behalf of the a ff ected employee and an organizational approach from leaders/ employers. Leaders lead best when they are healthy and healthy organizations require healthy employees! Being proactive about recognizing, preventing and responding to burnout and compassion fatigue benefits everyone in the workplace. LEARN MORE
Why should we care? The e ff ects of burnout not only a ff ect the individual going through it with physical and mental illness, relational challenges and decreased performance and productivity, but can a ff ect others with negativity and toxicity in the workplace and ultimately leading to absenteeism or even leaving the workplace all together. 2 COMPASSION FATIGUE ( CF ) OR SECONDARY TRAUMA is the profound emotional and physical exhaustion that helping professionals and caregivers can develop over the course of their career, often referred to as the “cost of care” or an occupational hazard of the profession. It involves the gradual erosion of hope, compassion and empathy for oneself and for others and is similar to burnout but more unique and specific to caregivers. Why are veterinary professionals predisposed to CF? Their risk factors include their work ethic/personality style, personal stressors (e.g. large student loans, trying to raise a family), growing complexity of the veterinary business, highly stressed/demanding clients, strength of the human/animal bond and moral injury when doing things that don’t align with our values (e.g. euthanasias, discharging patients
Quick, easy recipes are on the way for our fellow vets, vet techs and vet community! Join our mailing list for a copy of our FREE PDF cookbook. Hard copy books will also be available for purchase. Here’s to time saving meal planning right at your fingertips!
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RECIPE SNEAK PEEK //
PEANUT BUTTER MUNCHIES ( AKA REESE’S™ ) Submitted by Dr. Emily Wilkinson San Luis Obispo, CA INGREDIENTS 1 ¼ cup graham cracker crumbs 1 cup powdered sugar 1 cup creamy peanut butter ¼ cup butter 1 cup semi-sweet chocolate chips DIRECTIONS Mix first 4 ingredients thoroughly. Roll out mixture between two sheets of waxed paper on a large cookie sheet until about ¼ inch thick. Remove top layer of waxed paper. Melt half of the chocolate chips and spread a thin layer of chocolate on the exposed peanut butter dough. Place the cookie sheet into the freezer for 10 minutes. Melt the other half of the chocolate chips. Remove the cookie sheet from freezer. Carefully flip over the peanut butter dough and remove last piece of wax paper. Spread a thin layer of chocolate on the exposed peanut butter dough. Place the cookie sheet in to the freezer for 10 minutes. Remove from freezer and cut or break into serving pieces. Store in refrigerator until ready to eat.
ADDICTIVE SWEET POTATO BURRITOS Submitted by Dr. Sarah Swenson Wineke Minneapolis, MN INGREDIENTS
3 tablespoons chili powder 4 teaspoons prepared mustard 2 teaspoons ground cumin 1 pinch cayenne pepper, or to taste 4 ounces canned diced green chilis 12 (10-inch) flour tortillas, warmed 8 ounces shredded cheddar cheese 3 green onions
3-4 sweet potatoes (enough to make 4 cups mashed) 1 tablespoon vegetable oil 1 onion, chopped 4 cloves garlic, minced
3 cups canned kidney beans, drained (2 cans) 3 cups canned black beans, drained (2 cans) 3 tablespoons soy sauce
DIRECTIONS Peel sweet potatoes and cut into 1-inch cubes. Place in saucepan with steamer basket and about 1-2 inches of water and steam for 20 minutes and mash with steam water. Set aside. In a LARGE saucepan, Dutch oven or stock pot, heat oil in pot and sauté onion and garlic until soft. Add the beans, mashing some into the onion mixture. Gradually stir in sweet potato mash; heat until warm, 2 to 3 minutes. Remove from heat and stir in the soy sauce, chili powder, mustard, cumin, and cayenne pepper and green chilis. Divide bean mixture evenly between the tortillas; top with cheese and green onion. Fold torti- llas burrito-style around the fillings and wrap in plastic. Alternatively, bake freshly made burritos in 350 °F oven until warmed through, about 12 minutes. Notes: This recipe will make about 12 (10-inch) burritos which can be wrapped in plastic wrap and frozen. Remove from plastic and microwave wrapped in a damp paper towel for 2 minutes and you have a delicious lunch at work or easy dinner.
vetgirlontherun.com VETgirl, LLC makes no claim to copyright as to any of the recipes provided herein. This publication was created based on contributions of VETgirl® and Moms with a DVM community members, and any copyrights, to the extent existing, reside with the individual contributors.
TECH TIPS // WITH VETGIRL COO, DR. GARRET PACHTINGER, DACVECC
After months of hard work and dedication, we are proud to announce the upcoming launch of our new website which coincides with our expanding role as a global leader and the #1 online CE resource for busy veterinary professionals!
The website boasts a clean design and intuitive and consistent site-wide navigation system with improved menu functionality, directing you to the CE you want! It is also fully responsive with mobile devices, making it easy to navigate on a wide range of web browsers and portable devices.
We are dedicated to making it easier for YOU, our colleagues, to learn on-the-run with VETgirl each and every day. We’re really proud of the new website and can’t wait to show you more! We promise to keep you updated on the launch. STAY TUNED!
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PROVIDER SPOTLIGHT //
DR JUSTINE LEE , DACVECC, DABT CEO AND CO - FOUNDER OF VETGIRL
Justine A. Lee, DVM, DACVECC, DABT is a board-certified veterinary specialist in both emergency critical care (DACVECC) and toxicologist (DABT). She is the CEO and co-founder of VETgirl, the #1 online veterinary continuing education platform. She also works as a criticalist at Animal Emergency & Referral Center of Minnesota, and is a consultant for ELEVATE DVM, ASPCA Animal Poison Control Center, and several other veterinary companies. Previously, she was the Associate Director of Veterinary Services for an Animal Poison Control Center in Minneapolis (2009-2013) and on faculty at the University of Minnesota Veterinary Medical Center (2003-2008). Dr. Lee graduated from Virginia Tech with a BS in Animal Sciences, and then obtained her veterinary degree at Cornell University (where she was a C student, but hey...). She pursued her internship at Angell Memorial Animal Hospital, which is a ffi liated with the MSPCA. In addition, she has also completed an emergency fellowship and residency at the University of Pennsylvania.
Currently, she is 1 of approximately 500 board-certified veterinary specialists world wide in emergency and critical care, and is a Diplomate of the American College of Veterinary Emergency and Critical Care (DACVECC). Dr. Lee is also a Diplomate of the American Board of Toxicology (DABT). Dr. Lee has been published in numerous veterinary journals, including the Journal of American Veterinary Medical Association, the Journal of Veterinary Emergency Critical Care, the Journal of Veterinary Internal Medicine, and the Journal of the American Animal Hospital Association. Dr. Lee is one of the editors and primary authors of Blackwell’s Five-Minute Veterinary Consult Clinical Companion: Small Animal Toxicology textbook. She is also one of the editors for the Veterinary Clinics of North America: Emergency Medicine textbook (Elsevier, 2013). Dr. Lee is the author of two humorous pet reference books entitled It’s a Dog’s Life...but It’s Your Carpet and It’s a Cat’s World . . . You Just Live in It. She has also published several veterinary book chapters, and has been aired on radio and television to promote preventative medicine, animal health, and the overall well-being of pets. Dr. Lee was recently the co-host veterinary analyst on Nat Geo Wild’s Animal ER LIVE, and is the former contributor/blogger to Prevention magazine, PetMD: The Daily Vet, Pet Health Network, and Voyce. Dr. Lee has been featured on NBC Weekend Today, The Rachael Ray Show, WCCO, Minnesota Public Radio, and various other TV and radio engagements. Dr. Lee lectures throughout the world on emergency, critical care, and toxicology and was recently honored with the North American Veterinary Conference Small Animal Speaker of the Year (in 2011, 2015, 2016) and the Association des Médecines Vétérinaires du Québec (2012). When Dr. Lee isn’t working in the ER or o ff somewhere lecturing, she is chasing her 2-legged toddler around, exercising (e.g., ultimate Frisbee, ice hockey, HIT, running); hiking, traveling, gardening, reading, or having the rare date with her husband. Dr. Lee’s four-legged kids include: A rescued cat named “Lola” A rescued pit bull mix named “Milo”
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