A wooden spoon, a change in positioning, or ordinary air can help answer questions that routine radiographs leave unresolved. By Steve Mehler, DVM, DACVS When abdominal radiographs are equivocal, the next step isn’t always a more complicated test. Sometimes a different view or simple technique can reduce superimposition and make the area of interest easier to interpret. These methods won’t replace ultrasound or other advanced imaging, but they can provide useful information w

What the Latest Research Actually Shows By Steve Mehler, DVM, DACVS Revisiting the double two-thirds rule, splenic hemangiosarcoma, and the importance of evidence-based decision-making in dogs with spontaneous abdominal hemorrhage. A dog presents to an emergency veterinary hospital with weakness, pale mucous membranes, abdominal distension, and signs of circulatory shock. Focused abdominal ultrasonography identifies free abdominal fluid consistent with hemorrhage. Further exa

By Steve Mehler, DVM, DACVS How immersive technology is changing the way veterinary students learn anatomy, develop clinical skills, and prepare for real patients. Veterinary medicine has always been a hands-on profession. Students learn anatomy, practice clinical techniques, interpret diagnostic findings, and eventually develop the skills needed to make decisions for living patients. Traditionally, this education has relied on textbooks, lectures, anatomical specimens, physi

Why canine cranial cruciate ligament problems are often more than a sudden injury—and how that changes the conversation about treatment and recovery. By Steve Mehler, DVM, DACVS When a dog suddenly starts limping on a back leg, it is natural to look for the moment it happened: a jump off the couch, a hard turn at the park, or a slip on the floor. Sometimes there is a clear traumatic event. But in many dogs, the cranial cruciate ligament (CCL) has been weakening over time befo

By Steve Mehler, DVM, DACVS Gastrointestinal surgery can be among the most painful procedures performed in small animal practice. Whether we are performing an exploratory laparotomy, gastrotomy, enterotomy, or intestinal resection and anastomosis, effective perioperative analgesia is essential. Systemic opioids are frequently the foundation of pain management for these patients. However, regional anesthesia offers an opportunity to reduce nociceptive input, decrease some syst

By Steve Mehler, DVM, DACVS A dog has just undergone intestinal surgery. What should we give for pain? The answer requires more than choosing a medication from a discharge list. We need to treat pain from the abdominal incision and the affected organs, while considering hydration, perfusion, renal function, nausea and the condition of the bowel. My approach is to build a multimodal plan around effective analgesia, then adjust it as the patient recovers. Opioids often play an

By Steve Mehler, DVM, DACVS The short answer: anesthesia should be performed efficiently, but the evidence does not support a universal time limit or a predictable amount of danger added by every additional minute. Patient health, urgency, procedural complexity, physiologic stability, monitoring, and recovery care are more informative than the stopwatch alone. Why the stopwatch is an imperfect measure It seems intuitive that a longer anesthetic must be more dangerous. Anesthe

By Steve Mehler, DVM, DACVS What the Evidence Actually Shows Endotracheal tubes are routinely reused in many veterinary hospitals. A tube is removed after anesthesia, washed, soaked in a disinfectant, dried and placed back into circulation. If it looks clean and the cuff still inflates, it may appear ready for another patient. But looking clean is not the same as being microbiologically safe—and eliminating recoverable bacteria is not the same as proving that a single-use tub

By Steve Mehler, DVM, DACVS Bottom line: FMT is a biologically plausible, generally well-tolerated microbiome intervention with the strongest canine signal in parvoviral enteritis and selected chronic enteropathy cases. It is not yet a standardized treatment, a substitute for diagnosis, or a reliably effective therapy across all dysbiosis-associated disease. In cats, evidence remains early and safety deserves particular caution. Why FMT is more than “transferring good bacteri

By Steve Mehler, DVM, DACVS The future of veterinary medicine will not be defined by a single breakthrough. It will emerge when artificial intelligence, wearable sensors, continuous monitoring, precision medicine, targeted therapies, and enormous amounts of patient data begin working together. What will veterinary medicine look like in 2035? I do not think the biggest change will be a new drug, a new surgical procedure, or even artificial intelligence by itself. I think the r

By Steve Mehler, DVM, DACVS One day your puppy is sprinting through the backyard. The next, they're limping. You don't remember a fall. They didn't yelp while playing. Yet suddenly they don't want to put weight on one leg. For many puppies, especially large and giant breeds, this isn't simply a sprain—it's often the first sign of juvenile orthopedic disease (JOD). Juvenile orthopedic disease refers to a group of developmental conditions that affect growing bones, cartilage, g

By Steve Mehler, DVM, DACVS For decades, veterinarians have repeated a remarkably specific set of numbers when discussing when to spay a female dog: Spay her before her first heat, and her risk of developing mammary tumors is only 0.5% of the risk in an intact female. Wait until after one heat, and that relative risk increases to 8%. Wait until after two heats, and it rises to 26%. These statistics have appeared in veterinary textbooks, lectures, client education materials, a

By Steve Mehler, DVM, DACVS The short answer: glucosamine is generally well tolerated, but the best available veterinary evidence does not show a reliable, clinically meaningful benefit for most dogs with osteoarthritis. It should not displace treatments with stronger evidence. Few supplements have become as closely associated with canine arthritis as glucosamine. It appears in tablets, chews, powders, prescription diets, and combination products. Owners often begin it at the

By Steve Mehler, DVM, DACVS For decades, few topics in veterinary medicine have generated more concern—and more misinformation—than vaccine-associated sarcomas (VAS) in cats. Pet owners worry about causing cancer by vaccinating their cats. Veterinarians worry about balancing disease prevention with a rare but devastating complication. A new systematic review and meta-analysis published in the Journal of Small Animal Practice provides one of the most comprehensive evaluations

By Steve Mehler, DVM, DACVS For more than two decades, stem cells have been one of the most exciting frontiers in veterinary regenerative medicine. The idea seemed straightforward: inject stem cells into damaged tissue, allow them to become new cartilage, tendon, or other specialized cells, and watch healing occur. But science has a way of challenging our assumptions. Today, many researchers believe that stem cells may not be the primary treatment at all. Instead, much of the

By Steve Mehler, DVM, DACVS For decades, pain management in surgery was largely reactive. A patient woke up from anesthesia, showed signs of pain, and then received pain medication. Today, veterinary medicine has embraced a very different philosophy—one supported by decades of research in both human and veterinary anesthesia: The best pain management begins before the first incision is ever made. It may sound counterintuitive, but one of the primary goals of modern surgery is

By Steve Mehler, DVM, DACVS For many pet owners—and even some veterinary professionals—that statement comes as a surprise. After all, medications like morphine, oxycodone, hydrocodone, codeine, and tramadol are among the best-known pain relievers in human medicine. If they're powerful in people, shouldn't they be equally effective in dogs? Not necessarily. One of the most important lessons in veterinary pharmacology is that species matter. Dogs are not simply smaller humans.

By Steve Mehler, DVM, DACVS Gabapentin has become one of the most frequently prescribed medications in veterinary medicine. Every day, veterinarians dispense it to help dogs with chronic pain, nerve injuries, seizures, and anxiety associated with stressful events such as veterinary visits or fireworks. For many practices, it has become a cornerstone of multimodal pain management. Yet despite its widespread use, gabapentin is also one of the most misunderstood medications in v

By Steve Mehler, DVM, DACVS For generations, veterinarians have been taught a relatively simple approach to canine hip dysplasia. If a dog wasn’t painful, we watched. We monitored body condition, recommended appropriate exercise, managed weight carefully, and introduced medications or surgery only if clinical signs eventually developed. It was a logical strategy. After all, why perform orthopedic surgery on a dog that appears perfectly happy? Today, however, advances in biome

By Steve Mehler, DVM, DACVS If your dog has ever been prescribed Pepcid® (famotidine) for stomach ulcers, acid reflux, or a mast cell tumor, you may assume that it works the same way every day it’s given. Surprisingly, that’s not always true. One of the more fascinating—and often overlooked—concepts in pharmacology is something called tachyphylaxis. While the name sounds complicated, the idea is actually straightforward: some medications become less effective surprisingly qui