Pet Vet Magazine masthead
Changes and Challenges: How the Veterinary Industry is Responding to Climate Change
Are You Dealing With an Overfilled Appointment Book? typography
Designing a State-of-the-art Dental Suite
The C.O.R.E. Dental Procedure Going Above and Beyond “a Dental” typography
February / March 2024


Pet Vet logo
February / March 24
(717) 691-3388



Copyright January 2024. PetVet Magazine is published bimonthly by Barkleigh Productions, Inc, 970 West Trindle Road, Mechanicsburg PA 17055. Postmaster: Send change of address to Pet Vet Magazine c/o Barkleigh Productions, Inc., 970 West Trindle Road, Mechanicsburg PA 17055. No part of this publication may be reproduced without written permission of the publisher. Editorial offices: 970 West Trindle Road, Mechanicsburg PA 17055. (717) 691–3388 FAX (717) 691–3381 Email:
Dr. Steven Honzelka: An Unlikely Career Dedicated to Dentistry feature image and typography
A Better Way: Promoting Wellness in the Veterinary Industry feature image and typography
PetVet’s advisory board is here to help ensure quality content to motivate & educate Veterinarians and their staff.
Picture of Courtney Campbell
Courtney A. Campbell
“My passions ultimately drove me towards becoming a veterinarian, but when I was growing up I briefly flirted with the idea of becoming a magician. As a veterinarian, the ability to save lives, keep animals healthy, and strengthen the human–animal bond makes me realize there’s nothing more magical than that.”
Picture of Jenifer Chatfield

Jenifer Chatfield
DVM, Dipl. ACZM, Dipl. ACVPM

“People should be so lucky as to get to be a veterinarian. The broad-based education empowers us to be successful in multiple fields and affords us the opportunity to choose how we spend our professional time.”
Picture of Julie Legred
Julie Legred
“I have worked in many areas of veterinary medicine and veterinary technology over the last thirty five years, and it is amazing how far our profession has grown and paved the way for the betterment of animals’ lives and happiness, as well as improving public health issues. It is an honor for me to be a part of this advisory board to offer additional education and opportunities to grow in our profession.”
Picture of Lisa Powell
Lisa Powell
“I have had the privilege of working with a variety of animals in my career and my passion has allowed me to be involved in teaching veterinary students, interns, residents and other veterinarians. I continue to enjoy going to work every day to help critically ill dogs and cats, and love the client interactions as well. I am proud to be a part of this advisory board to help teach and spread my love for this profession to others in the veterinary community.”
  • Publisher
    Barkleigh Productions, Inc.
  • President
    Todd Shelly
  • Vice President
    Gwen Shelly
  • Chief Operations Officer
    Adam Lohr
  • Executive Editor
    Rebecca Shipman
  • Art Director
    Laura Pennington
  • Sr. Graphic Designer
    Brandi Aurelio
  • Jr. Graphic Designer
    Carlee Kubistek
  • Web Master
    Luke Dumberth
  • Marketing Consultant
    Allison Smith
  • Social Media Coordinator
    Cassidy Ryman
  • Digital Media
    Evan Gummo
  • Director of Marketing & Client Relations
    James Severs
  • Accounts Manager/ Executive Assistant
    Karin Grottola
  • Administrative Assistant
    Britany Smith
Picture of Kathryn Primm
Kathryn Primm,
“Animals mean so much to the human condition. It is my privilege to make lives better every day! I cannot imagine myself in any other career.”
The best made plans and goals aren't always what you are meant to do or be.
But no matter what you do, be it in this profession or in life, make sure you are giving it your best.”

– Steven R. Honzelka,

DVM, DAVDC, Practice Owner, Veterinary Dental Specialists of Wisconsin
The C.O.R.E Dental Procedure: Going Above and Beyond A Dental

By Benita Altier LVT, VTS (Dentistry)


eterinary professionals have long been communicating with clients about dental care for pets by calling the procedure “a dental.” This adjective, used like a noun, has dominated the fabric of veterinary practices nationwide for at least as long as I have been a veterinary technician (over 35 years). No one ever told me not to call all dental care “a dental;” I just assumed that word described “it.”

Unfortunately, calling a discipline of medicine by one adjective does not even begin to define the complexity of our patients’ needs regarding oral and dental health. Using this term does considerable damage to the actual value of the procedure, which involves anesthesia, diagnostics, treatment, and preventative measures to ensure our animal patients do not suffer in silence from painful dental disease or other oral disorders.

Others have tried to make the words “a dental” go away by adopting acronyms such as C.O.H.A.T. (Comprehensive Oral Health Assessment and Treatment), O.A.T. (Oral Assessment and Treatment) and A.T.P. (Assessment, Treatment and Prevention). And, some of them did stick with veterinary professionals interested in elevating the practice of dentistry and increasing the understanding and value of the procedures we need to do. In Fraser Hale’s article “What the Heck is a C.O.H.A.T.?” he explains why we need to comprehensively evaluate the oral cavity and provide the necessary treatment once we have thoroughly assessed the oral cavity by clinical evaluation and dental radiographs.1

I have visited, on average, over 100 hospitals a year for the past 13 years or so, and I rarely come across a hospital that uses a term other than “dental” for anything to do with the mouth. The term C.O.H.A.T., despite being defined as perfect for the task, has been slow to be fully embraced by the profession.

"Dr. Paul Mitchell, DVM, DAVDC, coined C.O.R.E. to mean Comprehensive Oral and Radiographic Evaluation" pullquote in pink and blue serif and sans-serif typography

Another term that has come about is an actual word we frequently use. When added to the word “dental,” it makes sense to help us define and bring value to the foundational procedure that all animals need regarding looking for dental and oral disease and cleaning the tooth structures. That term is “core.” Core values, core curriculum, core vaccines and core wellness care are all phrases we use as a part of daily life. Dr. Paul Mitchell, DVM, DAVDC, coined C.O.R.E. to mean Comprehensive Oral and Radiographic Evaluation. When we say, “Your pet is due for their C.O.R.E. dental procedure,” we plan to take the following steps:

  1. Prepare the patient for anesthesia2 by a thorough “awake” examination of the body and vital signs and as detailed an oral examination as possible.
  1. Blood, urine, fecal testing, E.C.G., thoracic and abdominal imaging, or any other pre-anesthetic testing deemed appropriate by the doctor should be performed a few days before the planned anesthetic event.
  2. All testing results should be evaluated by the D.V.M. and reported to the client. Add on additional testing as needed to clear the patient for anesthesia.
  1. Admit the patient fasted and perform a physical examination, including standard vital signs with a blood pressure reading.
  2. Prepare an anesthetic plan and all equipment and materials to provide general anesthesia, including intubation and monitoring.
  3. Induce the patient, intubate, and provide intravenous fluid support. Ongoing monitoring of critical vital signs, including blood pressure, body temperature, heart rate, respiratory rate, and depth of anesthesia, should be provided and monitored by a trained technician or D.V.M. Active warming should be provided to ensure body temperature remains normothermic.
  4. Obtain “before” photographs of the rostral and right and left buccal sides of the dentition using gloved hands and a cheek retractor.
  5. Examine all soft tissues of the oral cavity from caudal to rostral, palate to sublingual, and all inner-lip mucosal tissues. Careful observations should be performed to look for any abnormalities or growths.
  6. Obtain full-mouth intraoral dental radiographs. Have the D.V.M. begin to interpret these images.
  7. Rinse oral and dental tissues with a 0.12% chlorhexidine solution.
  8. Perform gross removal of tartar or calculus to facilitate the comprehensive oral examination.
  1. This step is abbreviated if there are little to no calculus accumulations on the tooth surfaces.
  1. Using a dental probe-explorer instrument, a dental mirror, lighting, and magnification, fully evaluate all tooth surfaces and the periodontal structures. The dental probe should be gently advanced to a stopping point every few millimeters around every tooth. Abnormal probing measurements are noted when beyond the depth of a normal sulcus in the dog or cat.
  2. The treatment plan is updated once all pathology has been discovered or ruled out. The C.O.R.E. dental procedure is just the foundation procedure, so any treatment would be C.O.R.E. Plus (additional time) to treat dental or oral disease.
  3. All dental structures are thoroughly cleaned above and below the gingival margin using ultrasonic scaling (proper tip choice is essential) and hand scalers and curettes.
  4. All dental surfaces are then polished using a low-speed handpiece, prophy angle, and fine-grit prophy paste.
  5. Rinse all dental surfaces free of debris and prophy paste.
  6. Apply dental sealants if desired.
Another issue we commonly run into out in the world of general practice dentistry is when we say we can book multiple “dentals.” Unfortunately, when the procedure is described as a dental, it usually vastly underestimates the complexity of the procedure and the high likelihood that when done using the idea of C.O.R.E. or C.O.H.A.T., we will find painful disease that needs to be treated. How long does this all take?

Suppose full-mouth dental radiographs take someone about 10-15 minutes to obtain. In that case, we need 10 more minutes to perform an oral examination and charting procedure properly, update the treatment plan and communicate our plan to the client. The financial cost of treatment must be approved. We then professionally scale and polish all tooth surfaces except those that will be extracted that day. We concluded that cats should be 40-45 minutes for a C.O.R.E. dental procedure and dogs between 45-60 minutes.

It helps with scheduling if we know the patient has an apparent dental disease and it won’t be just the foundation procedure (C.O.R.E.). It will be C.O.R.E. Plus, which includes the additional time to treat the disease. This treatment could be extractions or periodontal therapy to save teeth that can be saved. A boarded veterinary dentist can perform other advanced dental procedures. But how long are we willing to keep a pet under anesthesia for these procedures?

Elevating the procedure's value to the client is so important, as we need to ensure that they know dental care is a part of wellness care.
Let’s say 90 to 120 minutes, maybe 180. The risk of keeping a pet under anesthesia for lengthy procedures is real; body temperature and blood pressure, as well as pain management, need to be considered.2 Also, the oral surgeon extracting teeth will become less effective and more likely to incur complications, such as fractured or displaced tooth roots, simply because of mental and physical fatigue over lengthy procedures.

Some patients have such extensive dental disease that it could be far wiser to plan the procedure in two appointments from the beginning. Clients appreciate a realistic and safe approach, especially when we know dental disease is often hidden from our view and dental imaging such as radiographs, computed tomography (CT) and clinical evaluations are impossible without anesthesia.

Given the four stages of periodontal disease, you could estimate the time a C.O.R.E. Plus procedure will take by understanding you will need to add extra time in 30-minute blocks to the original 45-60 minutes the C.O.R.E. dental procedure will take.

Elevating the procedure’s value to the client is so important, as we need to ensure that they know dental care is a part of wellness care. Starting at an early age and performing the C.O.R.E. dental procedure at least annually throughout the pet’s life will be essential.

Pet parents know how much they love their pets and how much money they can spend. Veterinary professionals need to elevate the understanding of dentistry and its importance by using terminology that shows the value is worth the financial cost to the client. We need to understand the cost to the pet if we do not communicate the value through the words we choose to use.


  1. Hale, F. (2010, April). What the Heck is a C.O.H.A.T.?
  2. A.A.H.A. Anesthesia Guidelines for Dogs and Cats. (2020). American Animal Hospital Association.
Benita Altier headshot
Benita Altier, LVT, VTS (Dentistry), began her career in veterinary technology in 1988 and has worked in small animal general medicine, ophthalmology, equine and llama neonatal care, canine reproduction and dental specialty. Benita is the current President of the Academy of Veterinary Dental Technicians, Member at Large for the Arizona Veterinary Technician Association, and former Secretary for the Washington State Association of Veterinary Technicians. She has co-authored two text books on veterinary dentistry for technicians and has published several articles on the subject in professional journals. Through her business, Pawsitive Dental Education LLC, she has provided professional dental instruction and consultation to veterinary hospitals and conferences across the U.S., Canada and China.
Changes and Challenges: How the Veterinary Industry is Responding to Climate Change typography accompanied with a illustration of Earth wearing a sad face and running a fever
By Robin Ferruggia
Photos by Dr. Colleen Duncan

n July 2023, the American Veterinary Medical Association (AVMA) endorsed the World Veterinary Association’s position statement on climate which declared climate change a global emergency. In doing so, the AVMA signaled its full support for the veterinary industry to use every skill they had, and to develop new ones, to help create a future of resilience and innovation.

The AVMA reaffirmed its commitment to the One Health planetary health framework, which emphasizes protecting animal and public health from increasing temperatures and heat stress, extreme weather events, the pollution of air quality, threats of vector-borne diseases, food safety and security, water-related health issues and safeguarding mental health.

As veterinarians worldwide are defining and establishing their roles in helping to combat the health impacts of climate change on animals, veterinary colleges like Colorado State University’s College of Veterinary Medicine and Biomedical Sciences in Fort Collins, Colorado are working to educate the veterinarians of the future to be stewards of planetary health.

“Climate change makes all animals sick. We are critically close to the point of no return,” says Dr. Colleen Duncan, veterinarian and professor of preventative medicine and pathology at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences.

“As public health professionals,” she continues, “veterinarians are uniquely poised to be contributors to climate change solutions, and they should be actively engaged in policy decision-making and empowered to take active roles in interdisciplinary conversations surrounding this important issue.”

“We need to change our consumptive behaviors to slow it down,” states Dr. Danielle Scott, a veterinarian who also has a master’s degree in Environmental Science and Management, is working towards her PhD in veterinary epidemiology and is doing a residency in preventative medicine at CSU’s James L. Voss Veterinary Teaching Hospital.

“Environmental health in general is my motivation,” Scott adds. “You can’t address it without addressing climate change. Climate change is the number-one threat to human and animal health. It’s the big neon sign.”

Preventive measures, such as protecting natural ecosystems, recycling and practicing environmental sustainability can not only minimize the impact of climate change on animals and humans, but promote resiliency.

Veterinary students holding bags of medical waste at Colorado's states vet school

“Healthy animals are more resilient to everything,” says Duncan. “Veterinarians and veterinary teams can do easy things like reducing their own environmental footprint in the workplace, landscaping, protect pollinators, expanding animal health care to those in need, and talking about that.

“Research shows that veterinarians are trusted messengers,” she continues. “The public is interested in hearing from them, and they can be champions of important sustainability messages. Talk to 4H and little kids about the importance of getting exercise and eating nutritious foods. Don’t pour things down a drain. It affects fish. Let water run naturally through watersheds uninterrupted. Talk about how important clean air is for everybody.”

Air pollution is a growing threat for animals, especially those who live outdoors most or all of the time. Dr. Scott is currently engaged in a research project to measure the vulnerability of animals to air pollution. She is studying the impact of air pollution on racehorses, specifically PM2.5 (particulate matter measuring 2.5 microns), which is the primary pollutant found in wildfire smoke. The fact that there is a large amount of existing, high-quality data on racehorses in general was one reason she decided to do her study on them.

“Racehorses are phenomenal athletes that live and train outdoors,” Scott says. “With their huge lung capacity, they inhale large amounts of air, which is even greater when they workout, and therefore can be at risk of experiencing higher levels of air pollution exposure. This allows them to serve as a sentinel species, which will provide opportunity to assess risk that can then be translated to other vulnerable species, as well as provide an understanding of the health risks from air pollution exposure.”

PM2.5 levels spike during smoke events, and they can get all the way into lung alveoli and cross into the bloodstream.

A group of students at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences participatED in conducting a waste audit of the anesthesia and surgery sections at CSU’s Veterinary Teaching Hospital.
A group of students at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences participatED in conducting a waste audit of the anesthesia and surgery sections at CSU’s Veterinary Teaching Hospital.
smiling globe
smiling globe

“Not many studies show the associated health impacts in animals,” she adds.

Her research, still in its preliminary stages, can be translated to other species to protect animal welfare, such as whether or not to train racehorses or race them during air pollution events, or whether other highly vulnerable animals like the average dog should be kept inside during pollution events, for example. However, the veterinary industry itself also needs to be part of the solution.

“We’re looking at how climate change affects health and how delivery of care contributes to climate change,” shares Scott. “It is a contradiction to protect animal health and use tools that are highly impactful in releasing greenhouse gas emissions that contribute to climate change. For example, anesthesia is a greenhouse gas. There are alternatives to its use, such as the use of intravenous anesthesia and flow gas techniques.”

CSU’s veterinary college is even using its hospital as a case study in changing their environmental footprint.

“We’re getting a lot of support for it,” says Scott. “Everybody truly cares about it and wants to minimize the impact but need information on how to do it. We’re working to fill that gap. How can we deliver care without harm?”

They also work in collaboration with the Veterinary Sustainability Alliance, a non-profit organization that is working with the veterinary industry to reduce emissions that drive climate change, promote preventative medicine, protect the human-animal bond, protect natural habitat and more throughout North America.

“There are many little things, but collectively they can make a big difference,” says Duncan. “Reducing energy use by unplugging computers when they are not in use, recycling materials, not using plastic to package things, use renewables, re-evaluating how companies build and create things, and how supplies are transported can all make a difference. There’s an economic advantage for vets to be knowledgeable in environmental sustainability, too.”

In addition to the other changes and challenges they are working on to help prepare the veterinary industry for climate change, Colorado State University is building a new veterinary hospital. The building, which is scheduled for completion in 2026, will be a green-built LEED (Leadership in Energy and Environmental Design)-certified building, making it the first LEED-certified veterinary education facility in the United States. It will also be WELL certified. WELL-certified buildings meet high standards for construction that enhance the mental health of those who work in them.

The college is also implementing a new curriculum, which will focus more on preparing students to meet the needs of animals now and in the future, including an expansion of preventative care, environmental sustainability and more. But there is one thing will not change…

“It’s so important to keep people and their pets together,” emphasizes Scott. “Pets foster health.

“By the time the new hospital opens, the changes being made will have been embedded into our culture; our practices. It will be how things are done,” she concludes.

Robin Ferruggia

Robin Ferruggia is an environmental journalist and science writer in Colorado. Her favorite subject to write about is our relationships with animals. She also enjoys writing about the natural world and our relationship with the non-human environment, such as our homes and communities in which we live. Robin lives in a small close-knit community in the mountains near Rocky Mountain National Park with a three-year-old Australian shepherd named ZsaZsa where she enjoys hiking, photography, graphic design, and spending time with friends.

petvet profile
Dr. Steven Honzelka: An Unlikely Career Dedicated to Dentistry title
Dr. Steven Honzelka with a dog in his lap
3 Ways to Cope with Holiday Burnout & Put the "Care" Back in Pet Healthcare
By Rebecca Shipman
Photos provided by Steven Honzelka, DVM, DAVDC
“The most exciting trend in veterinary dentistry is the increased attention and interest in dentistry over the years,” shares Board-Certified Veterinary Dentist, Dr. Steven Honzelka. “We have gone beyond just having ‘Dental Health Month’ every February to having a rapidly growing dental specialty in this country, and worldwide.

“In vet schools they are also teaching dentistry to the students in higher numbers than ever before,” he continues. “The exponential increase in board-certified veterinary dentists and dental residencies means the quality and accessibility to advanced care will continue to improve.”

At the young age of five years old, Dr. Honzelka knew he wanted to be a veterinarian. And at only 14 years old, he started working at a general practice where he discovered it truly was his calling. His dream and goal was to spend an entire career and lifetime in general practice. However, the specialty of dentistry was not part of that original goal.

“Before, during, and after vet school I did not like dentistry,” he shares. “We had some dental training in vet school, but not nearly enough. It was difficult to get excited about something you were not very knowledgeable about or skilled in.

“One day I found a small mass on the palate of my own 15-year-old dog,” Dr. Honzelka continues. “The next day I biopsied the mass and diagnosed maxillary osteosarcoma. I self-referred to Dr. Dale Kressin, a local board-certified veterinary dentist. During that visit, he opened my eyes to dentistry being more than just cleaning and extracting teeth.”

Following that initial appointment, Dr. Honzelka had a renewed energy and enthusiasm for veterinary dentistry, which guided him down a whole new path in the world of veterinary medicine.

“I started reading all I could find about dentistry in journals and VIN,” he says. “I started attending local dental CE lectures and labs, and attended the Veterinary Dental Forum. It didn’t take long for me to realize my true veterinary passion was in dentistry.”

After spending 10 years in general practice, Dr. Honzelka decided to enter a residency in veterinary dentistry and oral surgery with Dr. Kressin as his mentor. He became board certified in 2015, and in 2022, Dr. Honzelka started his own practice, Veterinary Dental Specialists of Wisconsin. However, going from general practice to becoming a board-certified veterinary dentist is not without its challenges. And the actual day-to-day of the roles varies greatly.

“I spend a few hours each work day consulting on oral and dental problems, which includes post-operative rechecks and new pet dental evaluations,” he shares. “I typically spend the rest of the day in surgery performing dental and oral surgery procedures (and writing records). This is often in the form of routine and complex dental extractions, oral biopsies, tumor removals, fracture repairs, oronasal fistula repairs, and more. We also perform a fair number of endodontic procedures (root canal therapy, vital pulp therapy, etc.), prosthodontics, restoratives, and some orthodontics.

Dr. Steven Honzelka performing surgery on an animal
It didn’t take long for me to realize my true veterinary passion was in dentistry.
– Dr. Steven Honzelka
“Most of our practice is referral based,” continues Dr. Honzelka. “The majority of our caseload consists of patients needing treatments that their primary veterinarian is not comfortable performing. This could be due to needing advanced procedures for treating fractured teeth, fractured jaws, tumors, and more. Some of our patients are referred due to being higher anesthetic risk due to age or other co-morbidities.”

While the more difficult dental cases are referred to veterinary dentists, this does not discount the role that general practice veterinarians still play in the oral health of their regular patients. But there is always room for improvement.

teeth icons
He became board certified in 2015, and in 2022, Dr. Honzelka started his own practice, Veterinary Dental Specialists of Wisconsin.
Dr. Steven Honzelka next to a Veterinary Dental Specialists of Wisconsin sign
“There are two ways to improve dental health in the general practice: education for clients and education for staff,” Dr. Honzelka states. “The biggest roadblock general practice vets and staff have in improving the oral health of their clients’ pets is due to time. As a specialist, I can spend 30 minutes or more just focusing on educating the client on oral health. For most veterinarians, you may have 15 to 30 minutes to discuss everything from nose to tail.

“Utilize staff to help educate clients by demonstrating tooth-brushing, discussing home care products, and consistently delivering a message,” he continues. “Staff education starts with the veterinarian. At least one veterinarian in the practice should seek out additional training. This not only includes lectures and wet labs, but also marketing. The technical staff can also take dental CE courses to improve what he or she can offer the clinic. The practice’s ‘dental staff’ can then assist in training the rest of the staff—other doctors, technicians, and front office staff.”

Not unlike the rest of the veterinary industry, the dental sector is also changing rapidly when it comes to advances in technology, education and products being used.

“It was not that long ago that only a handful of practices had intraoral dental radiograph capabilities,” Dr. Honzelka shares. “Today, most practices have dental radiography. The next step in dental imaging has become Cone Beam Computed Tomography (CBCT). About five years ago, the majority of dental practices did not have advanced imaging unless they were at a large multi-specialty referral practice or university. Today, a large percentage of stand-alone dental specialty practices have CBCT units.

Dr. Steven Honzelka giving a presentation
Dr. Steven Honzelka looking at an x-ray machine
There are two ways to improve dental health in the general practice: education for clients and education for staff.
– Dr. Steven Honzelka
“There have also been significant advances in bone augmentation products, increased VOHC-approved products, and more,” he continues. “Recent studies are showing promise for stem cell therapy for use in refractory feline gingivostomatitis cases.”

When not consulting on post-operative rechecks or performing extraction surgeries, Dr. Honzelka, a Wisconsin native, enjoys spending time with his wife and three children, two of which are in college and one in high school, and watching his children’s sporting events.

To conclude, he leaves us with this piece of advice: “My tortuous path to veterinary dentistry is evidence that the best-made plans and goals aren’t always what you are meant to do or be. There are a lot of opportunities within this profession that don’t require specialization. No matter what you do, be it in this profession or in life, make sure you are giving it your best.”

Designing a State-of-the-Art
animal hospital room
Veterinary Dental Suite
By Haylee Moscato
Photos provided by MD Architects
Veterinary medicine is an ever-evolving field. Specializations like dentistry continue to grow and expand as pet owners become more aware and educated on the importance of oral hygiene for their pets.

s an animal care professional, there’s a responsibility to ensure that your practice delivers the highest quality care in an environment that is functional, comfortable, clean and aesthetically welcoming. Creating this environment from scratch or within an existing space isn’t always easy, but becoming familiar with the design process can help prepare you to create a state-of-the-art space.

Programming & Needs Assessment
When approaching the design of a new space or renovating an existing one, the first step is to thoroughly ask yourself questions to uncover the needs of the practice and a prospective dental suite. For example, what size is your current animal hospital or practice? What specific dental services do you want to offer? How many dental procedures do you intend to perform daily? If you have an existing veterinary practice, where can you incorporate the dental suite? What species will you primarily treat and how will this impact the design? What specialized equipment and technology will you need for dental procedures? How many exam tables will you need?
These thoughts may also lead to more specific questions like, how many x-ray arms will the suite need? What type of training will the staff need to use the equipment confidently and safely?

Many of these answers may be dictated by the available space or funds for this project. Nonetheless, walking through a basic programming and needs assessment is a vital first step.

Safety Measures
The safety and comfort of the animals in your care and of your staff are equally important. Your chosen designer and architect should greatly value your input; intimately listening to your needs, aspirations and pressures that come with developing a veterinary dental space. However, when collaborating to accommodate your vision, there are specific safety design considerations that should always be accounted for.
animal hospital room
The wellbeing of both your team and patients remains the foremost important goal. The functionality and efficient workflow of the space will help to support this, and a successfully designed space will take each of these aspects into consideration.
A few examples include the x-ray equipment in the room—proper shielding protection is required for the patient and staff. Non-slip flooring, secure animal-restraint systems for a hands-free approach, proper ventilation to minimize airborne particles, and following proper protocols for anesthesia handling are nonnegotiable design considerations that an animal care architect and designer should come to the table prepared to discuss with you and your team.
Specialized Equipment
The equipment and tools used in veterinary dentistry are unique to this specialization. The design needs to work in tandem with the dental table(s), dental delivery service cart, medical gas outlets, anesthesia, x-ray equipment, radiography, lasers and lights, and ultrasonic scalers and polishers, just to name a few of the more common components. Incorporating these into the dental suite is more than just anticipating their presence; determining their placement while considering safety, workflow efficiency, visibility, storage and power sources will all play a role in the overall design.
An experienced animal care architect will also bring an unmatched expertise that’s filled with creative solutions to your design challenges. The wellbeing of both your team and patients remains the foremost important goal. The functionality and efficient workflow of the space will help to support this, and a successfully designed space will take each of these aspects into consideration.
front outside view of animal hospital during dusk
Renovating or expanding your space to accommodate a dental suite won’t just affect that wing or section of the building, but the animal hospital as a whole.
When developing the layout of the space, there are a few items to keep in mind. The location of the dental area, if open to other areas of the hospital, should avoid being adjacent to surgery suites. By doing this, it limits the exposure to aerosols. If your dental suite is within its own room, this is less of a concern. Within the dental suite, the dental cart should have space to sit out of the way. Perhaps equipment that isn’t used as often, like the x-ray machine, can be placed where it’s able to be utilized by two individuals at different times between two different services if you have multiple tables. Or, when floor or counter space is limited, wall-mounting a piece of equipment can free up countertop real estate for other frequently used tools.

Consider the auxiliary aspects of lights, power, plumbing and medical gas. The locations of these are often dictated by the larger pieces of equipment. Medical gas needs to be in a location where it is easily accessible, yet not in the way of your team while working. Power needs to be where it best serves the equipment. Overhead lighting and medical exam lights should be oriented to avoid creating any shadows or dark spots while a patient is on the table. It can’t be overstated enough that every inch of space counts!

Flexibility for Growth
One last piece of the puzzle before adding a dental suite or any additional service space is to plan ahead with the future in mind. If your practice is starting small—planning for one exam table or the capacity of your current existing clientele—don’t skip over the notion that your dental services will likely grow over time, just as your practice does. The flexibility to adapt as demands do and as technology advances is an opportunity to capitalize on, but only if you have the space to do so.

A dental suite may be a small section of your veterinary practice, but designing for one requires keen attention to detail and an abundance of thought. Renovating or expanding your space to accommodate a dental suite won’t just affect that wing or section of the building, but the animal hospital as a whole. You’re constructing an operational veterinary hospital to deliver the highest quality care possible and a space to foster a positive professional environment for your team. By understanding the process that comes with creating an innovative dental suite, you’ll set your hospital up for successful years to come.

Haylee Moscato headshot
Haylee Moscato is an Interior Designer with MD Architects (MDA), a full-service, relationship-based architecture firm with studio locations in Boston, Indianapolis, and Seattle that specializes in animal care design. MDA is dedicated to providing superior planning, design, specifications, and construction guidance. Their seasoned leaders and talented designers assist clients in every step of the process, from conceptual designs to the final inspection in construction administration. With experience designing hundreds of animal care facilities around the world, MDA has worked alongside leading veterinarians that have provided them with the knowledge to design equally beautiful, functional, humane, and advanced spaces.
Oral Health and the Veterinary Team: Working Together for Pet Wellness typgraphy
Minimalist vector image of vet holding dental chart
Oral Health
and the Veterinary Team
Working Together for Wellness

By Kara M. Burns, MS, MEd, LVT, VTS (Nutrition)


very individual working in a veterinary hospital is part of the veterinary team, and all members of the team are passionate about their specific role and how that role benefits the pet. Ensuring the health of the pet involves a team approach by working together to care for the pet and identify and alleviate potential health issues.

Oral health is a place where the entire veterinary team can make a significant positive impact on pet health. The oral cavity is constantly inundated by bacteria and provides the perfect environment for microbial growth. Dental disease causes pain and discomfort, and the associated disease processes may lead to systemic issues.1 Veterinary care team members know that animals require dental care to maintain oral and overall health; however, dental health is seldom top-of-mind for pet owners.

Additionally, many animals hide pain and obviously cannot tell the caregiver where it hurts. Oral malodor, changes in eating behavior and drooling are often accepted as “normal behavior” in pets by their owners. Therefore, standard procedures guiding the efficient operation of every veterinary team should always incorporate protocols for evaluating oral health whenever possible due to the importance of dental health to the overall wellbeing of the pet.

A tool is now available that is extremely beneficial in identifying infection in the oral cavity. A thiol test is a tool that can be used on awake animals in the exam room. Simply slide the thiol test strip along the upper gumline of every canine or feline pet patient during the exam—ideally, at every wellness exam and whenever there is the opportunity to assess the oral health of the dog or cat. If the strip changes color to any shade of yellow, infection is present, and this color-changed strip will command the attention of the pet owner as well as the veterinarian. If there is no color change, the patient’s medical record can be updated with the result, and the pet owner should be encouraged to maintain the great work done to keep their pet’s mouth healthy and to continue to follow up with the veterinarian.

A thiol test powerfully enables a whole-team approach to oral health, especially because the test can be administered by a veterinary technician or veterinary nurse and then interpreted by the veterinarian. This test provides a fast, objective assessment of the pet’s periodontal health that has been proven to enhance pet owner adherence to treatment recommendations.2

Whenever the test changes color, this is where the whole veterinary team can shine by explaining to the pet owner how attending to oral health needs now (such as a periodontal infection that needs immediate treatment) can prevent problems down the road for the pet. Veterinary technicians and veterinary nurses can take time to explain this thoroughly, both before and after the veterinarian makes a treatment recommendation. The rest of the veterinary team can use encouraging positive reinforcement to be consistent in emphasizing the importance of oral health and facilitating every aspect of follow-up, including scheduling the next appointment.

This dental health example shows the importance of veterinary teams working together effectively for the benefit of their patients. Companion animals’ oral health needs are a critically important aspect of their health care and essential to maintaining every animal’s wellbeing.

All members of the veterinary team are passionate about the needs of the pet, so working together to address oral health issues is an opportunity for the team to do what they are uniquely positioned to do: Help the pet owner understand and address their beloved family member’s needs so they can live a healthy and joyful life.

  1. Burns, KM. The Importance of Dental Homecare in the Management of Periodontal Disease. The NAVTA Journal. December 2019/January 2020. Pp. 9-16.
  2. Goldstein G, Chapman A, Herzog L, et al. Routine use of a thiol-detection test in every wellness examination increased practice dental revenues and enhanced client compliance with dental recommendations in veterinary general practice clinics. J Vet Sci Technol. 2016;7(2):312.
    Kara Burns with 2 dogs
    Kara Burns MS, MEd, LVT, VTS (Nutrition), VTS-H (Internal Medicine, Dentistry) is Editor in Chief of Today’s Veterinary Nurse. Kara is founder and president of the Academy of Veterinary Nutrition Technicians and is past president of NAVTA, the National Association of Veterinary Technicians in America. She has authored numerous articles and textbook chapters and is an internationally invited speaker, presenting on topics including leadership and technician utilization. Kara currently serves as clinical advisor and key opinion leader for PDX BIOTECH, makers of the OraStripdx thiol test (
    Are You Dealing with an Overfilled Appointment Book graphic of book with appointment papers sticking out

    By Louise Dunn


    uring the pandemic, it seemed as if everyone was suffering from the stress of too many appointment requests and not enough hours in the day to see all the patients. Fast forward to today, and your practice is still likely suffering from this same problem. Looking back, is it possible that appointment scheduling snafus were an issue before the pandemic, and the pandemic just exacerbated an existing problem that continues up to today?

    Unfortunately, how you scheduled appointments may have already been on the verge of breaking years ago. An overbooked appointment schedule may be one symptom. To fix this, you need to look deeper into the root cause of your scheduling snags and what you can do about them.

    A sweet spot is a particular point where something will be most effective or beneficial. For the appointment schedule, it is where there is the correct number of appointment openings to provide access to care and allow for the delivery of exceptional medical service without overwhelming the team. That sweet spot is also where there are enough openings, but not too many openings that the business suffers a financial crisis. So, where is your scheduling sweet spot?

    To find out, you first need to dig a little. More specifically, you need to find out where your practice’s capabilities match client needs in a way your competition can’t.1 And this starts with identifying three key elements: your competition, your clients’ needs, and your capabilities. Achieving the sweet spot for optimal scheduling requires a strategic process that looks at all three elements.

    venn diagram showing the sweet spot that balances vet's capabilities with client's needs
    venn diagram showing the sweet spot that balances vet's capabilities with client's needs
    Recall that the sweet spot is where your practice's capabilities match your clients' needs in a way your competition can't.
    Know Your Competition
    Yes, you have probably looked at your competitors’ websites and even made those phone calls to gather pricing information. However, did you drill down on how their clients request or schedule appointments? Did you find out what the wait time is for an open slot? Knowing your competition is vital to keeping abreast of what is happening in your market, so look at veterinary practices and retail (box store) clinics. Also, look at human medical and dental offices as well. Even though they offer a different service, they try to satisfy similar client needs.

    Listen to what your clients are saying. Did they switch to your practice because their last veterinarian never had any openings? Do they talk about how easy it is to schedule with their dentist but scheduling an appointment for their pet takes twice as long and feels as if they have to jump through hoops to do it? In the big picture of competition, your competitor is anyone your client compares you to, so look beyond veterinary and monitor trends in other industries.

    Know Your Clients
    Learn what your clients think about your service and what they want. To do this, just ask them! They will tell you what they expect. There are several ways to do this: conduct a survey, including an email or text a link to a survey; ask a quick question at checkout; or include a message with the survey link on the invoice.

    Asking, “How easy was it to schedule your pet’s appointment?” sounds simple enough, but let’s get a little more specific. You must explore the entire client journey—from requesting an appointment to checking out—because all those touchpoints factor into setting up your appointment schedule. You may want to select a specific group of clients, making sure it is diverse (e.g., age of clients and pets, services requested, time and doctor preferences, scheduling methods preferred, etc.).

    Consider asking your clients for suggestions on technology use, automated processes or other customer service innovations they feel would be beneficial. Using technology can not only improve the client experience, but it can also improve how the practice allocates time and schedules the team.

    Know Your Capabilities
    Assess the strengths and weaknesses of your standard operating process (SOPs), from requesting an appointment to in-hospital experience to post-visit contact. Do you experience snags at registration or discharge? Is the length of time allotted to different appointment types correct? Is the wait to get an appointment causing clients to look elsewhere? Is the wait time from the lobby to the exam room causing clients to leave? Is the need for treatment or tests causing the team to run behind on appointments, backing everything up until closing? Where are your office inefficiencies? Are the phone lines always tied up? What is your office capacity?

    Identify what capabilities you need to develop to overcome scheduling snags, best serve your clients’ needs and efficiently schedule the team.

    Taking Action
    If you are constantly having trouble with office hours, your SOPs for scheduling appointments need to be changed; you can’t keep doing the same thing and expect a better outcome. Doing the same thing is still giving you overbookings, upset clients, burned-out team members and causing you to run behind schedule. So what are your options?

    Recall that the sweet spot is where your practice’s capabilities match your clients’ needs in a way your competition can’t. You looked at what competitors were doing, asked key clients about their needs and assessed your capabilities. Your next move depends on your findings, but here are some things your colleagues are doing to improve access to care and relieve appointment headaches:

    • Holding huddles to review the schedule and map out a plan of action
    • Reserving slots for same-day appointments
    • Reserving times for walk-in appointments
    • Forward booking appointments
    • Setting up a 24/7 veterinary nurse advice line
    • Conducting virtual exams
    • Establishing Technician/Nurse appointments
    • Using a transcriptionist in the exam room (e.g., a vet assistant or using a virtual transcriber)
    • Creating an Admit Nurse position
    • Creating a Floater DVM position to handle walk-ins, emergencies, work-ups, and care for hospitalized patients
    • Repositioning what team members are responsible for so as to work at the top of their license more effectively (e.g., not having a veterinarian draw blood when a technician or assistant can do it)
    • Conducting client education classes instead of using up exam room time (especially for puppy and kitten topics)
    • Creating a Physician Assistant position utilizing veterinarians who graduated out of the country and have yet to be licensed in the U.S.
    • Contracting with a semi-retired veterinarian to conduct virtual consults
    • Streamlining paperwork by completing it electronically in advance of the appointment
    • Changing exam room procedures to mitigate inefficiencies (e.g., the use of scribes or Fear Free techniques).

    Some of these options address available time slots to mitigate overbooking, others expand access to care via other means of seeing a medical professional, some seek to reduce time spent in an exam room, and others utilize different positions to handle the workload. There is no one-and-done solution found on this list, but it demonstrates that your colleagues are thinking beyond only an overflowing appointment schedule.

    Your action plan depends on your pain points because your practice is unique, as are the mix of patients you see, procedures you perform and treatment plans you recommend. Your choice also depends on where you want to develop your capabilities for future client and business needs. Don’t take the stance that “this too shall pass;” that your scheduling problem resulted from the COVID pandemic, and you will soon be back to your old ways.

    Efficiency and Productivity
    Efficiency and Productivity
    An overfilled appointment book could be just one symptom of a more significant issue—one of efficiency and productivity.

    The following are efficiency indicators to track each quarter:

    • Team and DVM hours per transaction (should be 1.33-2.33 for best efficiency)
    • Revenue / FTE DVM
    • Invoices / FTE DVM
    • Support-team wages as a percentage of revenue.

    Start with the numbers from the past year and set goals for the next quarter. Implement a few changes to how appointments are scheduled and how the team is scheduled to see if it changes the numbers.

    In addition to efficiency indicators, conduct a time study to track how much time is needed for your services. After all, there have been advances in technology and changes to your standard procedures over the years—did you ever evaluate how these changes affect time slots for different services? Then, look outside the box (the exam room box, that is) for ways to change how you deliver your services to patients.

    For example, can the practice have a virtual team performing virtual visits which then opens up exam rooms for other visits? Can a tech/nurse conduct client education via a Zoom call (such as new puppy/kitten issue or dealing with an ongoing long-term condition), thus relieving the strain on the appointment book from unavailable exam rooms? It behooves you to consider future business performance by looking at what weaknesses were exposed, what responses you made (or didn’t make), and where the future of patient care and client experience is going.

    What constitutes the best appointment schedule is evolving…as is what clients value and expect in their veterinary experience. The veterinarian continues to lead patient care, but now shares the responsibility with other team members. The client sees those other team members as extensions of their pet’s veterinarian and is comfortable working with a team of veterinary healthcare providers.

    Reimagining how your practice sees patients and communicates with clients goes beyond time slots on a computer screen. It is about improving access to care and staying connected with clients. It involves taking into consideration the wellbeing of the team in addition to the patients. The goal is to achieve schedule efficiency (both staffing and patient scheduling) without sacrificing accessibility or quality of care. Take time to determine your scheduling sweet spot and improve how you provide care to your patients.

    1. Collins, D., Rukstad, M. (2008, April). “Can You Say What Your Strategy Is?” Harvard Business Review, page 89.
    Louise Dunn headshot
    Louise Dunn is a renowned award-winning speaker, writer and consultant. She brings over 40 years of in-the-trenches experience and her business education to veterinary management. Louise is founder and CEO of Snowgoose Veterinary Management Consulting. SVMC works with veterinarians who want to develop a strategic plan that consistently produces results. Most recently Louise received many awards including the WVC Educator of the Year numerous times and VetPartner’s The Life Time achievement Award in January 2016.
    A Better Way: Promoting Wellness in the Veterinary Industry

    By Marisa Brunetti, VMD


    urnout. It’s a word we’re hearing more and more in the world of veterinary medicine. And unfortunately for too many of us, it’s a reality.

    In a study published in the American Veterinary Medical Association Journal, 86.7% of U.S. veterinarians had ProQOL burnout scores in the moderate or high range. Taken together, the long hours, complex cases, emotional demands and traumatic situations—not to mention the challenges of managing client and interoffice dynamics—can be overwhelming. Add stress and physical exhaustion to the mix and it’s a petri dish for personal crisis.

    Worst of all, burnout and compassion fatigue can feel like an assault on our very selves. We go into this profession to help others, and when we hit our own emotional and psychological limits, it can bring up feelings of shame and guilt. We’re healers. So why can’t we heal ourselves? Of course these negative feelings only compound our existing fears and sorrows.

    These days, we all hear way too much about creating our own “work-life balance.” While we are ultimately responsible for ourselves, the conditions that have led so many of us to this place in the veterinary industry are not in our control. It’s not just about our self-care or taking time to do yoga, although those things help. What we need is something much bigger—a cultural shift in our workplaces that centers our wellbeing.

    Strategies to Support Work-Life Balance for Associates:
    • Take Your Time. Take your PTO when you need it. It’s owed to you—don’t squander a minute of it. Dedicate time each day or week to activities that recharge and rejuvenate you. This can include self-care like exercise, hobbies, mindfulness practices, spending time with loved ones, or engaging in activities that bring you joy and relaxation. The work will never be done, but you need to step away and nourish yourself.
    • Establish Boundaries. Define specific working hours and avoid bringing work-related tasks or stress into your personal time. Communicate these boundaries to colleagues, clients and employers. Assertively protect personal time and say no to additional work or commitments.
    • Put Yourself First. Ask for support from your employer to help mitigate burnout. If your employer is unwilling to assist you or acknowledge these issues, then consider finding another employer who will take your wellbeing seriously.
    • Seek Professional Support. Don’t hesitate to seek professional support if you’re experiencing stress, burnout or mental health challenges. Reach out to therapists or counselors who specialize in working with veterinary professionals. They can provide guidance and coping strategies tailored to your unique needs. You can also make use of resources offered by veterinary associations or organizations that focus on improving wellbeing in the industry.
    Dedicate time each day or week to activities that recharge and rejuvenate you. This can include self-care like exercise, hobbies, mindfulness practices, spending time with loved ones, or engaging in activities that bring you joy and relaxation.
    Strategies to Support Work-Life Balance for Employers:
    • Address Burnout and Compassion Fatigue. All employers in this industry should be willing to acknowledge the realities of veterinary life and the high-stakes mental health risks that are in play. Foster a culture of support and understanding by providing opportunities for debriefing and counseling, as well as ongoing open dialogue among employees. Schedule regular staff meetings to discuss challenging cases and ways you can better support your team. Also make sure your team takes all of their PTO each year. Did you know research shows preventing doctor burnout will save your clinic an average of $17,000-$25,000 a year?
    • Foster a Supportive Work Environment. Lead by example for your employees by demonstrating your own strategies for wellness. Give employees access to mental health resources. Create workplace policies and procedures that promote open dialogue, feedback gathering, peer support and mentoring across multiple channels, including online and in person. Allow your staff to say no and be sure to honor their boundaries. Set the example by keeping appointments on schedule so the clinic can close on time and your team can get home as scheduled.
    • Utilize Relief Staffing Agencies. Whether you’re a large hospital or a small private practice, relief staffing agencies are a valuable resource to have. Hiring relief vets gives clinics the ability to provide their own staff with the time off they deserve without disrupting the flow of patients or revenue. Relief doctors can cover your employees’ parental leaves, leaves of absence, time off for continuing education and other situations. They’re a great solution when you’re understaffed or just want to lighten the load to prevent your staff from burning out.
    Woman with dark brown hair in a white overcoat and a pink stethoscope around her neck
    Marisa Brunetti, VMD and Chief Veterinary Officer at IndeVets, is a native Pennsylvanian. After graduating from Syracuse University, she moved back to Philadelphia for veterinary school at Penn. In 2010 she went into private small animal practice and spent a year as a regional medical director for a veterinary company in Texas before moving back to PA in 2018, when she joined IndeVets. In her role, she supports her doctors’ practice of medicine, nurtures client relations, and does her part to improve the quality of life of veterinarians everywhere.

    The mission of this non-profit organization is to enhance Indigenous representation, foster connections, and cultivate leadership for Indigenous professionals in veterinary medicine, as well as support Indigenous veterinary students.

    Instead of a traditional dinner date at a nice restaurant, stay in and surprise each other with a delivery or takeout option you think your partner would enjoy. And don’t forget the desserts!

    Hosted on JUNIPER, a groundbreaking, women-owned online community that provides a platform for Generation Z and Millennial dog parents, users can upload a photo of their dog and choose a superlative such as “Fastest Zoomies” or “Goofiest Smile.”

    Get 10 RACE-approved CE hours in veterinary dentistry taught by six board-certified veterinary dentists AND have a vacation at a wonderful destination at the same time.

    With the rise in popularity of chickens being kept as pets, more owners are now seeking out veterinary care for their flock. If your practice doesn’t treat the feathered variety, those that do can be found on

    Hosted on JUNIPER, a groundbreaking, women-owned online community that provides a platform for Generation Z and Millennial dog parents, users can upload a photo of their dog and choose a superlative such as “Fastest Zoomies” or “Goofiest Smile.”

    With the rise in popularity of chickens being kept as pets, more owners are now seeking out veterinary care for their flock. If your practice doesn’t treat the feathered variety, those that do can be found on

    Get 10 RACE-approved CE hours in veterinary dentistry taught by six board-certified veterinary dentists AND have a vacation at a wonderful destination at the same time.

    In this heartwarming memoir about one woman’s veterinary career and the unique role pets play in our lives, Dr. Karen Fine shares touching, joyful, heartbreaking, and life-affirming tales that make up her career as a vet.

    Similar to tennis but lower impact and more easily accessible, this fun-first activity is gaining in popularity! And, it can benefit your health by improving cardiovascular and pulmonary function, as well as balance and agility.

    Taking place February 22nd-24th in Columbus, OH, the MVC offers consistently low registration fees for more than 300 hours of CE, plus networking and social opportunities for every member of the veterinary team.

    In this heartwarming memoir about one woman’s veterinary career and the unique role pets play in our lives, Dr. Karen Fine shares touching, joyful, heartbreaking, and life-affirming tales that make up her career as a vet.

    Taking place February 22nd-24th in Columbus, OH, the MVC offers consistently low registration fees for more than 300 hours of CE, plus networking and social opportunities for every member of the veterinary team.

    Similar to tennis but lower impact and more easily accessible, this fun-first activity is gaining in popularity! And, it can benefit your health by improving cardiovascular and pulmonary function, as well as balance and agility.

    Gain a better understanding of how to diagnose and treat kidney disease in cats and dogs with the help of IRIS (International Renal Interest Society).

    The Merck Vet Manual App digitally enhances all of the information in The Merck Veterinary Manual, providing guidelines through thousands of topics, photos, illustrations, and videos of disorders and diseases, as well as clinical calculators, numerous reference guides, and hundreds of useful tables.

    Helping Pet Pros Take the typography
    Best Care of Your Best Friend typography
    left: cover of Groomer to Groomer Vol. 30 Ed. 12; right: cover of Pet Boarding and Daycare Magazine Vol. 7 Ed. 3
    Groomer to Groomer logo
    Pet Boarding and Daycare Magazine logo

    2 leading trade magazines for the pet professional in your life with all the content to assist them in keeping your pet healthy, happy and beautiful.

    Free subscriptions available
    online or in print at
    Facebook icon

    Twitter icon


    Pet Vet Magazine masthead

    Thanks for reading our February/March 2024 issue!