The Vet Vault The Vet Vault

Have you ever considered, or are considering specialising, but you are put off by the journey of becoming a specialist? Usually the path to specialising means putting almost everything else aside for 3-5 years. But what if there was a different way?

Dr Anna Dengate is a medicine specialist, and she's convinced that there could be an alternative path, and in this conversation she helps us to explore what that could look like. Anna's own career journey hasn't quite followed the the norm. After graduating from Sydney Uni in 2008 her path has meandered its way through several roles: intern, wife, resident, PhD candidate, GP vet, Member of ANZCVS, mum of 1, founding partner in a specialist hospital, Fellow of the ANZCVS, mum of 2, and resident supervisor. Most recently, Anna has been providing specialist medical and ultrasound services to GPs through her business The Vet's North. She also provides ongoing learning opportunities to wider groups of vets with teaching in ultrasound & online medical rounds, and has a new social impact project under development & is working on ways to integrate people with disabilities & traumatic backgrounds into the animal-care industry to increase diversity & inclusion.

Join in for a conversation around what more inclusive residencies could look like, how Anna made it happen for herself, the importance of getting to know yourself for creating a career pathway that fills your bucket, finding the balance between pushing yourself enough for growth without reaching breaking point, and much much more.

Topic list:

03:37 The relative rarity of female veterinary specialists with children.

04:16 Anna's journey through qualification, specialisation & having kids.

08:09 Having a newborn while studying.

11:59 Being prepared to fail.

13:38 Are institutions more supportive for part-time residencies now?

14:30 The barrier to specialising: to be a specialist or have a family?

15:05 Is specialising worth it?

16:31 More on barriers - from vet to specialist, the system is set up wrong.

18:18 Why can't we do it part-time?

20:18 The culture in specialist clinics that does not prioritise balance.

24:42 Givers, Takers & Matchers - who is the most successful?

25:56 The difference between successful vs unsuccessful Givers.

26:44 Can we change the profession & it's lack of boundaries, or is it up to us to know ourselves & our limits?

29:04 Coasting vs striving.

33:10 The benefits of making mistakes & getting to know yourself.

37:17 Negativity bias & how it affects the resilience in the vet industry.

48:37 Focussing on the positives & building resilience.

50:54 How empathy plays a role in resilience.

51:22 Empathy vs compassion - is empathy a bad thing?

53:47 Compassion fatigue vs burnout.

59:50 The connection between teaching & bureaucracy.

62:30 What's Anna excited about in the vet world?

67:49 Anna's education programs.

71:56 Anna's favourite podcasts.

73:28 How would Anna's career look different if she knew the things she knows now?

74:52 Anna's advice for new grads.



Join our Vet Vault Nerds to lift your clinical game & get your groove back with our up to date easy-to-consume clinical episodes at vvn.supercast.com. 

Visit thevetvault.com for show notes & resources for this episode.

Connect with us and other listeners through our Vet Vault Network community for episode highlights, chats, questions & support.

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Anna's Business - The Vet's North


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Who feels like Cushing's is a nice disease to diagnose and manage? Like, how often do you feel like your hyperadrenocorticism patients are really doing REALLY well? My guess is: not that often. This episode will change that.

Dr Sue Foster is a registered specialist in Feline Medicine and Senior Lecturer in Small Animal Medicine at Murdoch University in Western Australia. She’s also a medical consultant for Vetnostics and ASAP Laboratory, where a large part of her role is interpreting cortisol test results and supporting veterinarians in their clinical decision-making. In this conversation, Dr Sue challenges the belief that Cushing's is to some degree a 'lifestyle' disease that doesn't always need to be treated, we discuss the subtle ways that it can present, and of course we take a deep dive into those slippery cortisol tests, which should feel a lot less slippery after this episode. Dr Sue also presents a paradigm shift in how we think about treating these cases.



Topics:

0:00 Understanding the cortisol lab tests. 

4:40 ACTH stim vs LDDT - which is better? 

10:28 The TRUE significance of ALP in diagnosing Cushing’s.

13:30 Fasting triglycerides - your friend in Cushing’s screening? 

16:26 Deciding when to test for Cushings .

18:27 More on triglycerides and lipaemia 

23:52 Why Cushing’s cases don’t all have to have pu/pd. 

26:04 The many different faces of Cushing’s - spotting the sneaky hyperA case .

29:42 Why we should consider treating Cushing’s even if they aren’t textbook cases. 

31:41 Cushing’s and anxiety.

35:40 The dog with the high ALP but no clinical signs of Cushing’s.

39:44 Treatment trials for the ‘undiagnosable’ Cushing’s case.

45:13 Monitoring Cushing’s therapy with ACTH stim testing. 

52:30 The quick and easy ACTH stim test. 

56:20 Treating Cushing’s like a pro. 



This episode is supported by the SVS Pathology Network.

QML/TML Vetnostics (QLD & Tas): 1300 838 765 vetnostics@qml.com.au

Vetnostics (NSW & ACT): 02 9006 7468 enquiries@vetnostics.com.au

ASAP Laboratory (VIC): 1300 838 522 admin@asaplab.com.au

Vetpath (WA): 08 9317 0777 admin@vetpath.com.au



Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up to date easy-to-consume clinical episodes at vvn.supercast.com, visit thevetvault.com for the show notes and resources for this episode, and connect with us through our online Vet Vault Network. for episode highlights, discussions, questions and support.

Join us at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, live podcasting and snow... lots of snow!


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Our guest for this episode - Dr Olivia Oginska, has made it her mission to help us have better relationships, both in and outside of work.

Olivia Oginska is a veterinarian, speaker, positive psychology coach, a certified workplace conflict mediator and an emotional intelligence specialist. Liv has been immersed in the global veterinary community since 2010 when she did multiple externships in the UK, North America and Australia. It was through Liv's veterinary career in the UK, including a surgery residency, that she also gained experience and credentials in positive psychology, emotional intelligence and conflict mediation. This cemented her passion for human wellbeing and interpersonal dynamics and for the last 3 years, Liv has devoted her veterinary career to supporting both individuals, teams and especially leaders in becoming more human-savvy through her consulting and coaching service.

This conversation with Liv is all about navigating work relationships and our relationships with ourselves - we explore what a healthy work relationship looks like. We explore the connection between burnout and the reliance on work to provide not only our professional and financial needs, but also our relationship needs, and we discuss a new way of thinking about balance, what self awareness and emotional intelligence looks like in practice, and much much more.



Topic List:

6:54 Relationships and connections at work - taking care of them.

10:11 Private life and professionalism.

11:00 On the floor relationships and friendships - do people want to be friends with colleagues anymore?

14:36 The connection between burnout and the reliance on work to provide money, growth, community etc.

17:43 The truth about work-life-balance.

23:19 Setting expectations with your partner or friends.

27:59 How to navigate conflict with colleagues.

35:31 Open conversations and leaning into 'conflict'.

38:47 Importance of self-awareness during conflict and how to view things from a different perspective.

48:00 Why do we feel the need to be right and prove ourselves?

49:35 Why we should change our minds and listen to other opinions?

54:49 How Olivia started her career and why she ended up in emotional intelligence coaching.

60:03 Hitting rock bottom and triggering a change in life.

60:09 What does a good team dynamic look like in terms of emotional closeness?

60:10 The importance of aligning values and boundaries.

60:19 Working through imposter syndrome.



Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up to date easy-to-consume clinical episodes at vvn.supercast.com, visit thevetvault.com for the show notes and resources for this episode, and connect with us through our online Vet Vault Network. for episode highlights, discussions, questions and support.

Join us in at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, live podcasting and snow... lots of snow!

Dr Liv's Consulting Business - Vet Gone Real


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Many of us struggle with attaching a dollars-and-cents value to this ‘fixing animals’ thing that we do for a living. We tell ourselves stories about how our work is a labor of love, about ethics and about the noble nature of our profession, and we underestimate the value of our skills and knowledge. But stories can become limiting beliefs that hold us back from realizing our full potential as veterinary professionals and as thriving humans, which all-too-often ends up with this story that Dr Olivia James hears over and over in her coaching work: "I’m overworked, I’m poor, and I’m lonely."

Dr Olivia James is an equine dentistry specialist, former practice owner, founder and director of the educational platforms The Veterinary Dental Company and The Equine Practice Company and mentor and teacher though the business masterminds and coaching groups she hosts for equine practice owners, and in this episode she helps change our stories and beliefs around valuing our services. Olivia also provides practical strategies for reviewing what you charge in your business. Ultimately, this is a conversation about avoiding 'overworked, poor, and lonely.'

Topic list:



2:50 What has Olivia been up to since our last conversation.

7:20 Happy/ Thrive /Flourish: What are we actually aiming for?

9:20 Loneliness in practice.

14:40 How Olivia learnt how to charge.

19:50 Life changes that can happen when your business works better.

26:10 Why it sometimes makes more sense to invest money in the stock market than in buying a practice.

29:10 The mental blocks that make it hard for us to charge appropriately .

30:40 When clients accuse us of 'just being in it for the money.

34:30 Getting the team on board with price changes in your business.

36:50 The three ways of setting your charges.

42:10 The things we commonly fail to account for in working out cost of service.

44:30 The ethics of what we charge.

47:40 How to decide which prices to adjust.

50:30 Tying business to what matter most.

56:00 Olivia's book choices.

59:00 Olivia's answer to the one question.



Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up to date easy-to-consume clinical episodes at vvn.supercast.com.

Visit thevetvault.com for the show notes and resources for this episode.

Join us in at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, live podcasting and snow... lots of snow!








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This episode from our clinical series is brought to you by Elanco, makers of the broadest range of parasiticides including Advocate, Milbemax, Seresto and Credelio Plus.



"The question about the biochemistry is really interesting, because what your question now is, is 'what is it, and where is it?' And the problem that we have is that the liver enzymes aren't gonna tell us, because it's really hard to separate hepatic from post-hepatic on bloods. ALP is very insensitive in the cat and will go up with both hepatic and post-hepatic. ALT will go up with hepatic and post-hepatic. Bilirubin will be up. So what?!"



We recorded this case-based interactive session about how to work up the jaundiced cat with one of the world's leading Small Animal Medicine specialists and teachers, ⁠Prof Jill Maddison⁠ at session our live event in 2022.

Prof Jill Jill Maddison, BVSc, DipVetClinStud, PhD, SFHEA, MRCVS, is a professor of general practice, the director of professional development, and the BVetMed and CertAVP course director at Royal Veterinary College. She is also a coordinator for London Vet Show and is a consultant at a local veterinary practice and at Beaumont Sainsbury Animal Hospital in London. Dr Maddison is the senior editor of the second edition of Small Animal Clinical Pharmacology and the senior editor of Clinical Reasoning in Small Animal Practice. She has lectured worldwide on clinical problem-solving, small animal internal medicine, and clinical pharmacology. 

In this session she helps us reason through a case of jaundice in a cat to create a deeper understanding, rather than a simple list of facts. She also shifts some long-standing beliefs around diagnostic testing in liver disease in both dogs and cats.



Topic list:

5:07 Where to begin your workup.

6:05 Defining the problem and localising the problem: Pre-hepatic, hepatic or post-hepatic?

9:17 How much does dehydration actually affect PCV?

10:43 Bilirubin - how useful is it?

"It’s the most over-interpreted test I reckon. I have so many vets tell me, “Oh, the bilirubin is 16, it has to have a problem with its liver…” No, it probably just has inflammatory disease."

13:14 Dd’s for hepatic disease in cats.

14:20 Dd’s for post-hepatic causes of jaundice.

16:04 Biochem in jaundice: ALP, ALT, GGT.

"The problem that we have is that the liver enzymes aren't going to tell us."

19:51 Why bile acids are useless in the diagnosis of liver disease.

"The bile acids don't tell you anything more than you already know. There is no relationship between the level of bile acids and the prognosis or reversibility of the lesion."

24:25 Can't I just trial-treat?

26:16 Ultrasound.

28:27 Signalment: how useful is it?

29:36 Cholesterol and liver disease.

30:52 Pancreatic lipase and pancreatitis in cats.

"What we found was that we had 24% false negatives. So we had a quarter of our cats who had what seemed to be pancreatitis that did not have an increased Pli."

36:54 Hepatic lipidosis.



For more world-class specialists in an easy-to-consume format join our community of Vet Vault Nerds at vvn.supercast.com.

Visit thevetvault.com for the show notes for this episode.

Join us in at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, more live podcasting and snow... lots of snow!








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Dr Andrew Ciccolini is a Medical Director at the National Mill Dog Rescue, a non-profit that rescues and rehomes discarded breeding dogs, and also the Director of Non-Profit Initiatives at Galaxy Vets. His background includes serving in the U.S. Army, where he worked his way up from Associate Veterinarian to VP of Operations. In addition to his veterinary degree, he also has a Master’s degree in Organizational Leadership.

In this conversation Andrew takes us on a wild ride through his career with detours into what it’s like to be a military vet, working with high-performance dogs, why choosing not-for-profit work works for him, why it might work for you, and how incorporating some of it in your business might work for your team. We draw on Andrew’s military experience and his leadership Master's to talk about leadership styles, finding the right ways to motivate a vet team beyond money (but also including money!), and Andrew tells us about his current work for the Galaxy Vets Foundation to support pet owners in Ukraine. 

Time markers: 

1. Bad decisions, good stories. 6:00

2. Life as an army vet in the US. 9:00

3. Working with high-performance dogs 12:15

4. What Andrew learnt in his time as a military vet. 14:46

5. Leadership lessons from the military. 16:00

6. Can you change your leadership style?  23:19

7. Motivating veterinary teams: beyond the $$$'s.  26:41

8. National Mill Dog Rescue. 31:40

9. Dealing with 'divided' teams. 33:30

10. Not-for-profit work. 35:54

11. Galaxy Vets Foundation and its work in Ukraine. 39:58

12. What we've learnt about Telemedicine from their work in Ukraine. 41:07

13. Rediscovering your passion through charity work. 43:24

14. Being okay with being okay. 49:10

15. The pass-along question. (Chihuahuas!)  53:00

16. Andrew's podcast choices.  56:20

17. The one question. 56:56

Join the mailing list to hear about new opportunities at Galaxy Vets here, or volunteer to provide telehealth services to the pets and pet owners of Ukraine here.

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Go to thevetvault.com for show notes and to check out our guests’ favourite books, podcasts and everything else we talk about in the show.

We love to hear from you. If you have a question for us or you’d like to give us some feedback please get in touch via email at info@thevetvault.com, or catch up with us on Instagram.

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