Tails of Truth: The Truth about Veterinary Medicine

Scratch That: A Vet Dermatologist on Why There's Real Hope for Itchy Pets

Tell Us What You Think [https://www.buzzsprout.com/2450033/fan_mail/new] If your dog or cat has ever scratched incessantly and you're left feeling helpless, this one is for you. This week Dr. Angie and JoJo sat down with veterinary dermatologist Dr. Darin Dell of Wheat Ridge Animal Hospital, the specialist Dr. Angie emails almost every week with her toughest itchy cases. Dr. Dell has a gift for taking a frustrating, confusing topic and making it genuinely enjoyable, and he answers the questions pet parents often ask. Is Cytopoint safe? Does Cytopoint cause cancer? Are Apoquel and the newer drugs like Zenrelia and Numelvi something to fear? Do those at-home allergy tests for pets work? And what finally gets to the root of allergies instead of just covering them up? Whether you have an itchy dog, a cat that's itchy, or you are a vet professional filling in the dermatology gaps vet school skipped, you will leave with real hope and a clear path forward. KEY TAKEAWAYS * Allergy is inflammation in the skin at its root. Itch is only one sign. It can also show up as hair loss, odor, a swollen foot, anal gland issues, or ear problems. * Cytopoint is a monoclonal antibody, not a drug metabolized by the liver or kidneys, and Dr. Dell does not worry about it causing cancer. The real risk is that it can mask a symptom while the underlying allergy keeps going. * Apoquel side effects are uncommon. Zenrelia is a strong option for dogs that have stopped responding to Apoquel, and the newer Numelvi is a more selective JAK inhibitor. * The FDA removed the Zenrelia vaccine warning after follow-up studies showed dogs reached adequate vaccine titers, and Dr. Dell does not change vaccine or dosing protocols because of it. * At-home hair and saliva allergy tests are not rooted in science. A dermatologist once submitted samples from stuffed animals and sterile saline and got positive allergy results. * Skin testing is the gold standard in allergy testing. Blood testing is useful in specific cases and the lab you use matters. * Immunotherapy treatment addresses the root cause and can slow the atopic march. It works best when started young. A year of testing and immunotherapy runs around two thousand dollars and is often covered if insurance was in place before symptoms began. * The most allergic dog breeds Dr. Dell sees are English Bulldogs, French Bulldogs, and Bull Terriers. Breeds he rarely sees include English Springers, smooth Collies, and Border Collies. * Cats are harder to treat because there are fewer options. Atopica is the only label-approved allergy drug for cats, Apoquel is used off label, and immunotherapy works very well, in Dr. Dell's experience even better than in dogs. * A part two is coming, covering diet, supplementation, and Dr. Dell's approach to cats. SOUNDBITES "Allergy at its root is inflammation in the skin." ~Dr. Dell "I see itchy dogs every day. All year round, I have itchy patients." ~ Dr. Angie  "The test itself is really just to get us to immunotherapy, which is where the magic happens." ~ Dr. Dell "My dog's no longer itching, therefore problem solved." ~ JoJo "No matter what we need to rescue your dog from their itchy states." ~ Dr. Angie  "If you want a constant infant, bulldog is your thing." ~ Dr. Dell  "I see those test results every day and I have to just say, I'm so sorry that this isn't helpful."   ~ Dr. Angie  "If you think about the return on investment over a lifetime, if you broke that down over the next 10 years, that's actually not that much money." ~ JoJo * Follow us on Instagram [https://www.instagram.com/boulderholisticvet/], Facebook [https://www.facebook.com/DrAngieKrause], TikTok [https://www.tiktok.com/@boulderholisticvet?is_from_webapp=1&sender_device=pc]and YouTube [https://www.youtube.com/channel/UCLB3aLrBUvteHeVfL93EdsA] * Schedule your personalized one-on-one consultation with Dr. Angie [https://boulderholisticvet.com/video-consultations-with-dr-angie/]  * Shop my favorite CBD [https://boulderholisticvet.com/product-category/cbd-for-pets/]. Please subscribe and review! xoxo Dr. Angie & JoJo

We Pressed Record on Our Weekly Check-In: Vaccine Reactions, Neurodivergent Dogs, & Puppy Fever

Tell Us What You Think [https://www.buzzsprout.com/2450033/fan_mail/new] Some of the best Tails of Truth conversations happen before anything is planned, so this Friday Dr. Angie and JoJo just pressed record during their weekly check-in. Dr. Angie walks through a vaccine reaction she handled this week, the kind that looks fine in the room and then swells up an hour later, and the honest call she had to make about splitting vaccines. They get into whether dogs can be neurodivergent (there is real science behind it now), why a cat pulling its hair out might be a skin issue rather than stress, a bladder stone Dr. Angie had never seen in practice, and JoJo's brush with puppy fever over a foster dog that pulled at her heart strings. They also discuss what it's like to run a small business. It is warm, a little funny, and very real.  Dr. Angie and JoJo invite you into their personal and professional worlds in a way that makes veterinary medicine feel accessible.  Next week brings veterinary dermatologist Dr. Darin Dell and it's a guaranteed top 10 episode.  Be sure to subscribe so you don't miss any of the great content coming your way. KEY TAKEAWAYS * Vaccine reactions in dogs are uncommon, and reporting them matters so we can build real data on breed risk and informed consent. * A reaction can show up fast (vomiting, then facial swelling within the hour) and is treatable with anti-nausea meds, Benadryl, and steroids. * When a dog has reacted before and you do not know which vaccine caused it, splitting future vaccines is the safer path. * New research out of the UK suggests dogs can carry genetic and behavioral traits that look like human neurodivergence. It is not a diagnosis, but the science is catching up to what many pet parents already sense. * Cats who pull their hair out may be dealing with a skin problem rather than stress. Dermatology is moving up the list of suspects. * Even an experienced veterinarian feels behind, because medicine changes constantly. That honesty is what good care actually looks like. SOUNDBITES "I think it's really important so that we can give people informed consent about how often we see vaccine reactions, which it's really truly not very often." ~ Dr. Angie "I mean, I think we're just starting to name it in women. So we're not going to name it in cats and dogs for a while." ~ JoJo "I want every patient that I see to be getting like the latest and the greatest." ~ Dr. Angie "The thought on that, at least for cats right now, is that we're shifting, that it's rarely a behavioral problem, and it's more of a dermatological problem" ~ Dr. Angie "I'm amazed at how many clinics are not reporting vaccine reactions. I'm like, make sure your vet reports that." ~ JoJo "I'm gonna tell the truth about something. I started using CBD twice a day." ~ JoJo * Follow us on Instagram [https://www.instagram.com/boulderholisticvet/], Facebook [https://www.facebook.com/DrAngieKrause], TikTok [https://www.tiktok.com/@boulderholisticvet?is_from_webapp=1&sender_device=pc]and YouTube [https://www.youtube.com/channel/UCLB3aLrBUvteHeVfL93EdsA] * Schedule your personalized one-on-one consultation with Dr. Angie [https://boulderholisticvet.com/video-consultations-with-dr-angie/]  * Shop my favorite CBD [https://boulderholisticvet.com/product-category/cbd-for-pets/]. Please subscribe and review! xoxo Dr. Angie & JoJo

You're Not to Blame: A Veterinary Oncologist Gets Honest About Cancer in Pets

Tell Us What You Think [https://www.buzzsprout.com/2450033/fan_mail/new] Your pet just got a cancer diagnosis. Your first instinct is to wonder what you did wrong. Dr. Brooke Fowler, veterinary oncologist at Veterinary Cancer Services in Boulder, CO, is here for that conversation. The honest answer is: we don't fully know what causes cancer in pets. Genetics, aging, and biology are doing most of the work and the guilt most pet parents carry is rarely warranted. In this episode, Dr. Brooke joins Dr. Angie and JoJo for one of the most honest, grounded conversations we've had on this show. We talk about why dogs and cats get cancer, what you can actually control, and how to make treatment decisions without losing yourself in the process. We get into mast cell tumors, hemangiosarcoma, the real cost of chemo, newer treatment options, quality of life, financial limitations, and the question every pet parent dreads: would I actually do this for my own pet? Dr. Brooke also shares where integrative and conventional oncology work well together and when turkey tail mushroom and Yunnan Baiyao actually have the studies to back them up. Note: This episode leans heavily toward dogs and specific dog cancers. We love our cat people and we're bringing Dr. Brooke back for a dedicated feline oncology episode. Stay tuned. To reach Dr. Brooke Fowler: vetcancerservices.com | 720-414-0116 Key Takeaways 1. Cancer in pets is multifactorial. Genetics, breed, and aging play a far larger role than food, vaccines, or environment though the honest answer is we don't fully know. 2. Immunosenescence — the immune system's declining ability to catch and correct DNA errors as a pet ages — is a primary driver of cancer in older animals. 3. Mast cell tumors are the most common skin tumor in dogs. 4. Stelfonta injection resolves approximately 83% of mast cell tumors with a single injection, though it creates a significant wound during healing. 5. Hemangiosarcoma remains one of the common cancers we treat, but splenectomy often restores quality of life and dogs frequently feel better post-surgery than they did in the weeks before. 6. Chemo does not have to mean misery. Starting at the lower end of dosing ranges and adjusting is Dr. Fowler's approach. 7. Metronomic chemotherapy is low-dose oral chemo combined with anti-inflammatories and is an accessible middle-ground option many people don't know exists. 8. Turkey tail mushroom and Yunnan Baiyao have studies showing inhibition of hemangiosarcoma cell lines. This is where East and West medicine work well together. 9. Your quality of life is part of your pet's care equation. Acknowledging that is not selfish. It's honest.  Soundbites: "I'm saying this because a lot of people love to blame themselves. What did I not feed him? We live by power lines. And the truth is it's none of that." — Dr. Brooke "We're all gonna die. And I think it's okay to give our dogs and cats permission to die too. Which is a controversial thing to say." — Dr. Angie  "So often we are buying time for ourselves more than the animal." — JoJo "You get all of the joy from your pet in their life. You get that joy and then you pay for it in the end, right? Because we lose them before we want to." — Dr. Brooke "After doing integrative medicine and being hired by people that feed raw or home cook or do all the things I can't say that I see cancer rates in that population be any less." — Dr. Angie  "Your dog has no concept of what the future is or what the past is. Today's the day. That's all there is. And that is what we fundamentally love about them.  — Dr. Brooke "The difference between one kibble and the next is just not as much as you might think. It's really so small." — Dr. Angie * Follow us on Instagram [https://www.instagram.com/boulderholisticvet/], Facebook [https://www.facebook.com/DrAngieKrause], TikTok [https://www.tiktok.com/@boulderholisticvet?is_from_webapp=1&sender_device=pc]and YouTube [https://www.youtube.com/channel/UCLB3aLrBUvteHeVfL93EdsA] * Schedule your personalized one-on-one consultation with Dr. Angie [https://boulderholisticvet.com/video-consultations-with-dr-angie/]  * Shop my favorite CBD [https://boulderholisticvet.com/product-category/cbd-for-pets/]. Please subscribe and review! xoxo Dr. Angie & JoJo

Thick Skin Required: Burned Out, Rude People, and Still Showing Up

Tell Us What You Think [https://www.buzzsprout.com/2450033/fan_mail/new] This week's episode is an honest, unfiltered vent session from two people who had a rough week in veterinary medicine and decided to record it. Dr. Angie and JoJo — both sick, both on their second or third round of antibiotics — talk about the client who announced to the lobby that Dr. Angie was a terrible veterinarian, the YouTube commenter who said they need empathy training, the one-star review left on a Shopify product that hadn't been opened yet, and the person who called JoJo cold-hearted after JoJo spent over an hour trying to make their cat's care work financially. This episode is for anyone who's ever wondered what it's actually like to be on the receiving end of that. Veterinarians are people. Veterinary nurses are people. And this week was a heavy one. This episode is a raw and vulnerable look at what's happening with your veterinary team. KEY TAKEAWAYS 1. One negative interaction can undo an entire day of positive ones.  2. One-star reviews on small businesses have big impacts. They affect search ranking and long-term viability.  3. Veterinary dark humor is a coping mechanism, not a character flaw. 4. Financial pressure on clients is intensifying right now and that pressure is landing on vet teams. 5. Reaching out before leaving a bad review costs nothing and gives the practice a chance to make it right. 6. Two people run this entire operation. Every review and every comment lands directly on them. 7. Empathy and professional boundaries are not opposites and holding both doesn't make someone greedy. 8. Most veterinarians are not in it for the money. SOUNDBITES "I definitely went to my office and cried." — Dr. Angie  "I have severe empathy problems, like in terms of too much of it." — JoJo  "I have personally had to euthanize animals because they started growing resistant bacteria that we couldn't fix." — Dr. Angie  "We care about your animal and we care about you. Facts. Full stop." — JoJo  "No we only hire incompetent veterinarians here. Like what?" — JoJo  "I saw one client that was so unkind to me and I probably saw 16 that were extremely kind. And the one we're talking about today was the one that was unkind." — Dr. Angie  * Follow us on Instagram [https://www.instagram.com/boulderholisticvet/], Facebook [https://www.facebook.com/DrAngieKrause], TikTok [https://www.tiktok.com/@boulderholisticvet?is_from_webapp=1&sender_device=pc]and YouTube [https://www.youtube.com/channel/UCLB3aLrBUvteHeVfL93EdsA] * Schedule your personalized one-on-one consultation with Dr. Angie [https://boulderholisticvet.com/video-consultations-with-dr-angie/]  * Shop my favorite CBD [https://boulderholisticvet.com/product-category/cbd-for-pets/]. Please subscribe and review! xoxo Dr. Angie & JoJo

Gut to Butt: The Anal Gland Episode

Tell Us What You Think [https://www.buzzsprout.com/2450033/fan_mail/new] Nobody puts "anal glands" on their list of things to learn about when they get a pet. Then your dog scoots across the carpet,licks incessently during the night, or your cat leaves a mystery smell on the couch cushion, and suddenly it's the only thing on your mind. In this episode, Dr. Angie and JoJo get into all of it: what anal glands actually are, why chronic anal gland problems are often a sign of food or environmental allergies most pet parents never connect, whether those fiber supplements flooding your social feed are worth it, and when a scooting situation turns into a needed vet appointment. Straightforward, a little gross, and genuinely useful.  KEY TAKEAWAYS  1. Anal glands are scent-marking sacs positioned at the 4 and 8 o'clock positions just inside the anus. They're meant to express naturally with each bowel movement. 2. Scooting, excessive rear-end licking, and a persistent foul or fishy odor are the three main signs of a problem. 3. Chronic anal gland problems are frequently a sign of food or environmental allergies. If your pet needs regular expression, the allergy is the thing worth investigating, not just the glands themselves. 4. Groomers routinely expressing anal glands at every visit is not standard of care. If there is no problem, it is unnecessary and can cause irritation over time. 5. Fiber supplements marketed for anal glands work by bulking stool to support natural expression during defecation. They will not clear an existing impaction on their own. Expression first, then support. 6. You can express anal glands at home with gloves, water-based lubricant, and a willing assistant. Your veterinarian or veterinary nurse will show you how. 7. An abscessed anal gland requires veterinary treatment. Antibiotics often need to be instilled directly into the sac. 8. Anal gland removal surgery carries a risk of permanent fecal incontinence. In nearly 20 years of practice, Dr. Angie has not had a single patient require it. SOUNDBITES "I wouldn't ever touch them if I didn't need to. If there isn't a problem, why get in there and muck around?"  — Dr. Angie  "The marketing is butt to gut, but the product is actually gut to butt." — JoJo "If your dog is scooting a lot, has a lot of problems with their anal glands, they probably have a food allergy, or maybe an environmental allergy, but more commonly a food allergy."  — Dr. Angie  "If anybody has experience with them and you've smelled anal glands, you've never forgotten that." — JoJo "Even when you give systemic antibiotics, sometimes it's hard to actually make the antibiotic get into that anal sac. And so we like to instill the antibiotics right into the anal sac."  — Dr. Angie  * Follow us on Instagram [https://www.instagram.com/boulderholisticvet/], Facebook [https://www.facebook.com/DrAngieKrause], TikTok [https://www.tiktok.com/@boulderholisticvet?is_from_webapp=1&sender_device=pc]and YouTube [https://www.youtube.com/channel/UCLB3aLrBUvteHeVfL93EdsA] * Schedule your personalized one-on-one consultation with Dr. Angie [https://boulderholisticvet.com/video-consultations-with-dr-angie/]  * Shop my favorite CBD [https://boulderholisticvet.com/product-category/cbd-for-pets/]. Please subscribe and review! xoxo Dr. Angie & JoJo