[00:00:02] Intro: Welcome to All Cats Considered, a podcast from the Feline Veterinary Medical Association.
Here we interview professionals from across the veterinary world and take deep dives into the latest evidence-based research, developments, studies and guidelines that improve feline health and well-being.
We are the home for veterinary professionals seeking to enhance the care of cats through high standards of practice, continuing education and evidence based medicine. In each episode you'll hear interviews with a variety of experts in our field covering a wide range of topics and the latest developments in feline health. We'll share the key points you need to know to improve your patient's care.
Let's dive in and listen to this week's experts.
[00:00:44] Dr. St. Denis: Hello everyone. I am Dr. Kelly St. Denis, co editor for the Journal of Feline Medicine and Surgery and Journal of Feline Medicine and Surgery Open Reports.
And I'm really excited to be here today to talk about our latest Clinical Spotlight article, Clinical therapeutics in feline medicine: updates for old and new drugs. And we have three amazing authors on this Clinical Spotlight article. Isabella Sussi, Dr. Katrina Viviano, and Dr. William Whitehouse. And I'm very happy to welcome Dr. Viviano and Dr. Whitehouse here today. Welcome you guys. So nice to have you here.
[00:01:18] Dr. Whitehouse : Thank you. It's great to be here.
[00:01:20] Dr. St. Denis: I just want to start off by saying what an amazing job that you guys did with this article. And now that we're starting to see it in its full form, it is looking great and I'm sure it's going to be a really good addition to everyone's referral material in their practice. The table especially is really nice. So we're going to talk a little bit about that today. But I did want to sort of just open up by asking each of you to take a turn at telling us who you are, where you work and what your research interests are.
[00:01:49] Dr. Whitehouse: I guess I can go first. My name is William Whitehouse and I am currently an assistant professor of Small animal Internal Medicine at Purdue University where I've been here for about two years now. Sometimes I question why I did this, but in addition to being a faculty member, I am also doing a second residency. I'm in the inaugural class of residents for the American College of Veterinary Nephrology and Urology.
So my kind of clinical practice right now is really focused on nephrology, neurology, kind of with small animal patients.
So not a surprise, my research is going to be kind of within that area.
I particularly like acute kidney injury, perhaps some projects kind of looking at chronic kidney disease as well, then I also have some kind of overlapping interest with Dr. Viviano, kind of with urinary tract infections, too.
[00:02:52] Dr. St. Denis: Excellent. Thank you, Dr. Viviano?
[00:02:56] Dr. Viviano: I am Katrina Viviano. I am a small animal internist and also boarded in clinical pharmacology.
And I would say within internal medicine, I see everything, but I'm actually most comfortable or most excited about where that intersects with therapeutics and trying to make really good decisions. And sometimes I feel like I actually prescribe less drugs than more in association with that. And I think that comes out of my before I was a veterinarian, actually I was a chemist. And so I think my pharmacology interest kind of stemmed out of that. So I was able to kind of marry the two.
And I'm currently clinical professor at the University of Wisconsin–Madison at the School of Veterinary Medicine. And I would say my research always sort of intersects with therapeutics, and I would say currently most of that is more geared towards antibiotic use and optimizing that in terms of antibiotic treatment decisions or antibiotic treatment durations, especially because we don't have a lot of those in veterinary medicine. So probably the most common group of drugs our veterinarians prescribe. So, good practices are important.
[00:04:11] Dr. St. Denis: We're getting better at our stewardship with antimicrobials. But like you said, we still have so much to learn in that department. So. Yeah, well, thank you both. And I just wanted to also mention, although Isabella is not here with us today, I was excited to find out that she is in fact a fourth year veterinary student and so contributed to this manuscript as well. And I find that really amazing. And so wherever you are, Isabella, congratulations. You did a great job. Great job.
And it just really shows that we can all work on articles and other things together, even when we're in the veterinary student field. That's. That's fantastic. So congratulations to her.
So I often go to conferences and in various podcasts hear people say, like, this is probably one of the most exciting times for us in feline medicine. And I've been involved strictly in feline medicine for over two decades now, and it really is an exciting time. And I find that this article really highlights some of this for us. I mean, we're seeing a lot of advancements in the pharmacology field for feline with therapeutics that actually are doing some amazing things. So I wondered if one of you or both of you wanted to comment on just your general thoughts on the changes that we've seen in feline medicine in those available therapeutics in the last decade or two.
[00:05:21] Dr. Whitehouse: If you stop and kind of really think about it, it's actually kind of quite unbelievable how far treatment of diseases in cats kind of has come.
I mean, not only do we have treatment options for kind of previously untreatable diseases like FIP, we also, for instance, now have more than one option for treating diseases like with Melitostat for anemia of chronic kidney disease.
And we're learning a whole lot more about kind of other traditional therapeutics, kind of, which really, I would say, improve the quality of medicine that we are able to provide to our kind of feline patients.
So overall, I think it's really great to see all of this, and it, for me, kind of highlights the continued need to support all types of research, kind of from learning about just general kind of pathophysiology to drug discovery, to therapeutic trials kind of in Veterinary Medicine.
[00:06:28] Dr. St. Denis: Dr. Viviano, do you have anything to add to that?
[00:06:30] Dr. Viviano: Yeah, I'm going say the only thing I would add is we know cats are difficult to medicate, and some cats, you know, it's. It's one drug and that's it.
And so I think some of this newer stuff that's coming out is certainly developing more specific, not necessarily drugs for cats, but delivery of those drugs to cats in different ways that maybe is more amenable in some situations than others for some cats. And so I think that's always going to be a difficult challenge as a practitioner in terms of recommending therapies. And often we're recommending multiple therapies, and sometimes you got to pick and choose what is the most important. So having options, I think, is really good.
[00:07:14] Dr. St. Denis: Yeah, and it's been so nice to see that a lot of the drug companies are diving into this. So when there are drugs available for cats, they're actually trying to make an effort to produce something that cats will eat or consume voluntarily.
So that's been a really nice aspect of it, too.
[00:07:29] Dr. Viviano: Yeah, I'm not a big fan of owners trying to hide it in their food, even dogs, for that matter. But, like, that's. Don't do that because then that causes more problems. So having options is good.
[00:07:38] Dr. St. Denis: Yeah, it's been really good to see that. So. And for me, I mean, in addition to drugs, like for FIP, as you said, that are so amazing, and we're going to talk about that. One of the things I found very exciting in my career is the. The advancement of analgesics and cats and our ability to detect pain in cats with different things like the feline grimace scale so you do cover some of those drugs in this article. And so I found that very exciting, too, because that's something that we really needed to ramp up on.
So it's good to see. You guys have covered 12 different drugs or drug classes in this article. I'm not going to list them all off, but as I mentioned, some of them are analgesic anxiolytics. We're talking about diabetes medications and treatments for FIP and HCM.
How did you. I remember when we started this process, trying to pick which ones you were going to cover. How did you end up narrowing it down to these 12?
[00:08:32] Dr. Whitehouse: I think it was a pretty collaborative effort between kind of Dr. Viviano, kind of, and myself. I guess it was, oh, a little over a year ago now when I did a locum at the University of Wisconsin, and I forgot the case. But I think we were probably talking about one of the drugs that we covered. Maybe it was Melitostat. We had kind of previously kind of done a review article kind of about a decade ago now on kind of new therapeutics and feline medicine at that. That point in time. And so just with kind of all the influx of these new agents that are coming onto the market, kind of getting approved for cats, as well as kind of learning about kind of new uses for old drugs, we thought that it would be kind of a great time to kind of revisit this and kind of explore and summarize again, kind of what is out there for feline practitioners. We started off with, I guess, just looking at kind of what is new and then trying to think about what important papers have come about kind of for more traditional drugs. And there are probably those out there that we just weren't aware of or kind of didn't include.
These are the 12 that we kind of ended up with at the end of the day.
[00:09:53] Dr St. Denis: Yep. Do you think you. Now, in retrospect, are there any that you wish you had put on there or. I know we might have put some limitations on word count, but are there any missing that you guys were thinking about or have since thought about?
[00:10:04] Dr. Whitehouse: I think we included all of the ones that we had wanted to. We had thought this is a really long kind of manuscript. And so are there ones that we should probably exclude things like Gabapentin or Telmisartan, which have been out for a while, but there's been kind of a lot reported on kind of the use of both kind of over the past 10 years that I think are kind of important for people to aware of. So again, this is kind of what we ended up with at the end of the day.
[00:10:37] Dr. St. Denis: Yeah, I think it's an amazing list. I really do. Just in general, like we were discussing that there are some, some diseases that were previously not, you know, treatable. HCM and FIT probably being the most notable. Based on the, the drugs that you have in this article, like what are your thoughts on these, these types of drugs that are coming up that are really just changing the face of the way we do things. You know, I've, I've been a grad, I've graduated in 1999 and for decades a FIP diagnosis was one I didn't want to make and you know, it was like the worst thing possible and now it's like well I hope this cat has FIP because I can treat it. So I find I'm like what, what's going on in my head? It's a very, very stressful thing. But what do you guys think about all these exciting changes that we're seeing?
[00:11:22] Dr. Whitehouse: Really? I think it's just kind of as you have put it. I mean I also remember kind of early in my career like having to help so many families kind of say goodbye to their cat like after diagnosing them kind of with, with FIP. And so it's, it truly is kind of quite remarkable that not only do we have a treatment, we have one that actually kind of works kind of quite well.
So it's, it's, it's really kind of wonderful to see the complete 180 kind of in prognosis kind of for these patients like happening during our lifetime.
[00:12:00] Dr. St. Denis: And as a consultant, I have veterinarians who are reaching out about their first FIP case and so for them it's a completely different experience than what we have had over our careers. They said, this is just another treatable disease that we have. And I'm like, you have no idea what you're experiencing here. But HCM is another good. Oh, sorry, go ahead Dr. Viviano.
[00:12:19] Dr. Viviano: No, I was just going to actually say that like and it's such an evolving area of research and even the more antivirals that are out there, I mean as you know, some of it started very early on with, with people getting GS from various sources and was really exciting. And now that we actually have, you know, oral formulation that we can use to treat those cats with FIP that is pretty well tolerated in most cats and the fact that, you know, there's other antivirals that'll probably also be used. There's going to probably be multiple options, which probably is a function of, like, what you have available where you practice and knowing the drugs that are available to you so that you can kind of come up with the optimal therapy. Because it's definitely the clinical situation of not that you want to give a cat a diagnosis of FIP, but at the same because 84 days is a long time to have to be treated. But at the same time, it's one of those things that, like, you have a treatment option which is really good that we never had before. So I think it's exciting in that regard.
[00:13:29] Dr. St. Denis: Yeah, for sure. And I think for HCM is a sort of a similar thing. We're starting to see some really exciting advancements. And as someone who practices now in Northern Ontario, we don't have access to a lot of referral. We don't have echocardiogram here.
So when we diagnose heart disease in a cat, we don't always in the past have gone for any diagnostics because there wasn't a lot for us to do if they did receive a diagnosis. But now things that again, that has changed where we can say to people, look, if we can get the diagnosis, then there's probably some things we can do. And I wondered if you guys wanted to touch a little bit about the. On the new drugs that are available for HCM.
[00:14:06] Dr. Whitehouse: That I would say with regards to Rapamycin, I think is still something that is truly kind of up and coming. And we're still kind of learning about the initial studies kind of look very promising, kind of with regards to kind of what it does for progression of ventricular hypertrophy.
And I obviously am not a cardiologist, so I've not treated a lot of cats kind of with HCM. But I do know a lot of cardiologists who are kind of really excited to see kind of what the results of the HALT kind of HCM study kind of reveal. Because kind of, as you have alluded to, kind of there really is kind of a lack of evidence for kind of benefit of other therapeutics kind of for that disease. Kind of similarly, like, I haven't treated a lot of HCM, but I have treated a lot of kind of chronic kidney disease kind of in cats. And kind of. We all know that there's a lot of negative prognostic indicators regarding disease progression for them.
But of all the things that we do, there really is only a small handful of things with substantial evidence that show kind of improved outcomes. And so it would be, in my opinion, kind of really great to have another agent kind of in our arsenal, so to speak, kind of to help them.
[00:15:25] Dr. St. Denis: Yeah, absolutely. Dr. Viviano, thoughts on that one?
[00:15:29] Dr. Viviano: I mean, I think, as you kind of alluded to, though, because probably its use is most optimal in association with like, subclinical hcm. Yeah, certainly. Probably reaching out to get that diagnosis earlier, to intervene, is probably going to kind of change, I think, how we approach some of these cats. Yes, I think it's something that's going to evolve with time.
[00:15:54] Dr. St. Denis: Yeah. And I think it's going to be even just understanding when a cat has heart disease is. It's such a challenge with murmurs and. No murmurs and tapes, no changes.
And the percentage of disease that we, you know, cats are walking into my office every day, and I don't know they could have HCM.
So that even in of itself is trying to get those cats identified as a potential issue so that we can again send them for diagnostics is something I'm looking forward to learning more about as we see research unfold.
So, Dr. Whitehouse, since you are sort of focusing on kidney, did you want to talk about the agent that we. That you guys have covered in here that helps with feline chronic kidney disease?
[00:16:36] Dr. Whitehouse: Traditionally, Darbepoetin kind of has been used as an erythrocyte stimulant stimulating agent kind of to treat anemia associated with CKD, kind of in cats. And it does seem to be effective. It does have kind of some side effects kind of as well. But I would say kind of one of the biggest limiting factors, especially for the cases that kind of I've personally seen, is the cost kind of associated kind of with that kind of medication can be cost prohibitive for kind of quite a lot of diets.
So it's kind of great to have kind of another option, an oral option that comes in a liquid, which we know for the majority of cats, usually it's a little bit easier to administer kind of than tablet or pill form. But it's also shown to be kind of very, very beneficial kind of for treating their anemia, kind of, which we again know is a negative prognostic indicator and is something that does contribute to kind of a decreased kind of quality-of-life kind of with them as well, too.
So there's no kind of head-to-head right now showing kind of which one kind of is better. But I do think that kind of having Lorienzine out there now, which is Melitostat, kind of does offer an alternative option kind of for these patients, and one that is comparably kind of less expensive as well.
[00:18:07] Dr. St. Denis: Good. Yeah. And I, as a Canadian, I have to say we don't have it here yet. So there's a lot of medications that we don't get before you guys or even at the same time. So I'm looking forward to having access to that because we are still using Darbo in rare cases, still using Epo, but really not that very often. So it is exciting to see. And it's on a conditional approval, is that correct? So we're so impressed. See final FDA data. Is that how that works?
[00:18:32] Dr. Whitehouse: Correct. And so essentially kind of in the US that means that there has been kind of enough evidence to have it out there kind of on the market, but kind of during this conditional timeframe, collecting more data in order to generate kind of more substantial evidence, kind of on kind of how it contributes to kind of a better outcome kind of for cats, along with getting more information on its side effect kind of profile as well. I'd say kind of the one side effect that seems to be kind of most common, which is reported in the initial studies, is vomiting. That could be a potential challenge for some cats to get that medication.
[00:19:13] Dr. St. Denis: Right. For sure. Okay. I just also wanted to talk. I know we have so many drugs to talk about and not enough time, but I wanted to just look at analgesics in general. But Fruvet MAB was one of the things that I wanted to talk to you guys about today because it's been around for a little while and everyone's very generally very happy with its outcome and how it helps quality of life for these patients with degenerative joint disease.
It's just as with everything, we start to see cautionary tales, whether online, rightly or wrongly. And I wanted to talk to you guys about what your feelings about the drug are. I mean, the safety profile. For me as a, as a veterinarian working with only cats and a lot of really older cats, I'm really pleased with how it's working, but we do see some concerns. So what are those potential concerns? Do you think they're founded at all? Would you be more research? And then as veterinarians, if I'm starting a cat on Fruvet MAB, is there something that I should be doing, like pretreatment blood work, like I would do with any other drug that I might be using? What kind of clinical advice can you give us?
[00:20:17] Dr. Viviano: It's one of those drugs that comes out and really addresses a need in terms of I think a lot more cats have osteoarthritis than we probably clinically appreciate. And this giving us an alternative option to NSAIDs makes it exciting because most of the cats that not all of them, but a large majority of them are going to be older cats and they have comorbidities. And I think that's where the challenge comes in is when they look at a drug and getting working on approval, they're looking not only at safety and toxicity, but they're also looking at a specific clinical population, right. That otherwise are healthy cats that just have osteoarthritis and then it gets put out into the public in terms of use once it's approved. And then there's probably a lot of diversity in the patient population that gets treated. And so I think what you're alluding to is a lot of the discussion that's come up with Librela in dogs. And so that's one of the things that like are the post approval reporting information that's out there, which I think is super important for any drug because, you know, now we're using broader population of dogs or cats and then we may see things that didn't show up initially on the approval study. So I think they're all warranted and important to report and investigate. The challenging thing is we're actually using a monoclonal antibody against nerve growth factor. And we have to also remember that the target is thought to be that nerve growth factor is increased in joints of patients with osteoarthritis. And that's our target is the inflammatory piece or the inflammatory role that's sort of negative associated with osteoarthritis. But nerve growth factor also has other roles in terms of neuroprotection. It's neurotrophic. And so can we potentially see adverse effects that we didn't actually predict? And that's always possible with a new drug. So I think it's, it's an exciting area and offers another way to try to treat osteoarthritis in cats. I don't know of a lot of anything specific coming out of cats in its use. And it seems like anecdotally the cats that I've known that have had it, it's actually helped quite a bit. And so I think it's just like any other drug or even a drug that's known is having your clinical criteria of what is effective and what isn't and then also close monitoring especially when you're starting to use it in an individual patient, knowing that a lot of our cats with osteoarthritis are going to have comorbidities probably on other therapies. And so is there also the risk that we may see more adverse effects than we anticipate? And that's always possible. So I would say know your patient population and know what you're a cat that's starting Fruvet MAB is consider what are their baseline in terms of not only kidney function, but like their level of pain, their level of activity. So you can make objectives assessments as is it working and always balancing that risk benefit ratio for any drug. So I think it's exciting in that, you know, it's another way and maybe it's going to end up being an adjuvant therapy or sole therapy in some cats. It's yet to be determined. As we use it more and more.
[00:23:40] Dr. St. Denis: Osteoarthritis is somewhat of a progressive disease and presumably using that drug is not necessarily going to stop the process. So, you know, over time we sometimes see people posting on VIN, for example, saying, oh, it's not working anymore. Is that more of. In my mind that's the disease is progressing and we need adjunct multimodal analgesia and we need to add other drugs for pain. Is that what your perception that you guys would think is happening there or is there something else going on with the drug?
[00:24:09] Dr. Viviano: I mean, I think that's a hard question to answer definitively because I don't think that we know. And if you read about it in people, certainly when it's combined with NSAID, there is that concern in people that these monoclonal antibodies against nerve growth factor can be associated with more rapidly progressive osteoarthritis. I don't think that that's been well documented in our animals. To say that's why animals are necessarily failing versus, like you said, is it more of a progressive disease that's going to happen no matter what we're managing their pain with? And I think that's impossible to answer from the data that we have right now, but it's one of those things.
Again, looking at your patient population and trying to assess efficacy and adverse effects and then trying to decide what is the best approach for pain control in any individual cat, because I think some of them respond very differently or show pain very differently.
[00:25:05] Dr. St. Denis: And then like continuing to monitor them. So like, this isn't a. You come in every month and we don't ask you again how things are going because things can change.
[00:25:15] Dr. Viviano: Yeah. Or have it on autopilot - every month we're getting an injection. Like we need to kind of always be reassessing that.
[00:25:22] Dr. St. Denis: Yep, yep. Dr. Whitehouse, did you have anything that you wanted to add to that?
[00:25:27] Dr. Whitehouse: No. I mean, I would basically kind of echo all of that. I think that the biggest thing is what you had. Kind of both just said kind of with regards to a lot of the drugs that we kind of covered in this article are treating chronic diseases. And so they require kind of chronic follow up and there can be complications. And so it's going to be our job to figure out what is causing that complication. Like, is it the drug? Is something else going on and how best to treat the patient kind of from there?
[00:25:58] Dr. Viviano: Yeah, yeah.
[00:25:59] Dr. St. Denis: So always an ongoing process. Right. And then on the topic of analgesia, I know I asked a lot of questions in my prep for this about, but I wondered if the two of you want to talk to us a little bit about Gabapentin versus Pregabalin, because we're seeing a lot of shift. You know, we used to use Gabapentin thinking it was really good for pain. Now, it's not necessarily that we have a lot of evidence for that, but it's great for an anxiolytic.
And my own experience of Pregabalin has been pretty good. But what are your thoughts on head-to-head, what the role of those two drugs are going to be for us moving forward?
[00:26:33] Dr. Whitehouse: Yeah, I mean, I think that there's a lot of consideration when choosing kind of what to prescribe, especially kind of between the two. There's obviously a lot of similarities kind of with their kind of mechanism of action and what they can be kind of used for. But I think that some things that clinicians should consider would be what type of pain are they treating kind of is it musculoskeletal or soft tissue pain kind of versus neuropathic or chronic maladaptive kind of sort of a pain?
What is the evidence out there and kind of what is each individual, individual cat's kind of response kind of to it. Currently there's very kind of limited evidence and kind of what is out there isn't very strong kind of for the use of Gabapentin, mostly because that's what's been reported. And Pregabalin's relatively new.
But on its use as a sole agent, kind of for musculoskeletal or kind of soft tissue pain, however, it can potentially be beneficial kind of used as part of multimodal approach.
I think that both could potentially be used as sole agents kind of for maladaptive chronic pain processes.
The evidence that's out there is really limited to like case reports at this point in time. But it does seem like in some individual cats can benefit from kind of either of those kind of drugs kind of by itself. So we're really lacking kind of in veterinary data, which is oftentimes kind of the theme for kind of a lot of different topics in our profession.
Going back to your question on thinking about kind of head to head kind of which one would I choose?
I think for analgesia the jury is kind of still out there, but there's actually a recent kind of meta-analysis in kind of people looking at both of them for kind of neuropathic pain. And it does seem like Pregabalin is superior kind of with regards to getting control of analgesia faster, being more effective and kind of having fewer side effects kind of than Gabapentin. So that might be true for our patients as well.
[00:28:57] Dr. St. Denis: Right? Yeah. And again, it might be for the patient to patient. You might see differences too. Dr. Viviana, what are your thoughts on that?
[00:29:04] Dr. Viviano: Yeah, I agree with all of that. I think it's hard.
I think that evidence out there for either of those drugs is really associated with being an anxiolytic and dealing with stress and fear in cats, which it does a great job for. And I think either is probably appropriate in that situation. In terms of pain control, though, I think it's more difficult to define that. And I think using it probably as a multimodal approach to pain is probably more reasonable because you are using different, utilizing different mechanisms of action and certainly controlling anxiety and stress can be an important piece of that in cats. And then also I do feel like Gabapentin is maybe a little more sedating in cats than Pregabalin. So sometimes if you're, I'm thinking more chronic pain and a chronic medication, I don't want the cat to just be sedate all the time. Right. I want the cat to have a normal quality of life as much as possible. And so maybe Pregabalin has a, a role there in the sense that maybe it's less sedating as it addresses analgesia. And at least in people, at least, nerve pain seems to be the main thing that Gabapentin is really good with. So that, you know, picking why is my cat painful? And getting a good assessment. You as a veterinarian but also from the owner's perspective because they know their cats way better than we ever will is what is painful. And then again going back to having some criteria to say are they better or worse on this medication. And I think some cats are probably going to respond better to it than others for pain control too. So it's, it's kind of individualize it and, and try to feel what, what works in the population that you see or what works in an individual cat, I think is, is really where we're going to be.
[00:30:55] Dr. St. Denis: Yeah, that's cool. And you know, you mentioned fear anxiety and knowing we describe feeling emotions, pain is part of that emotional scale of fear anxiety. And I think we know in humans that pain makes your fear anxiety worse and fear makes your pain worse. So I'm sure that probably applies to our feline patients as well. So just even having an anxiolytic, it's probably going to be difficult to tease out the analgesic effects where we have patients that have fear anxiety as well, because they're. It's tough. Right. But it's very exciting. And I tend to keep all, all kinds of modes of Gabapentin capsules, liquid tablets and then same for Pregabalin in the, in the practice now just to make sure that we have options for every individual patient because they don't all respond the same depending upon. I need it for. And even with anxiolytics, I find there's a lot of variation. So nice.
It's been such a pleasure chatting with you guys and I could probably chat with you for another half an hour because I had so many questions to ask. But for our listeners, I would urge you to go and read this, this Clinical Spotlight article, Clinical Therapeutics and Feline Medicine Updates for Old and New Drugs. Because you're going to find all the answers to your questions here.
There's great coverage of each of these 12 different drugs, drug classes, and also some tables with information, information on dosages and indications and contraindications which are really helpful. And I really like this because this is going to be something that I'm going to keep in our practice for all of the doctors to refer to if they need information about these drugs. So thank you again to both of you for joining us today and again for writing this article.
[00:32:31] Dr. Whitehouse: Thank you for having us. I had a great time.
[00:32:33] Dr. St Denis: Thanks.
[00:32:34] Dr. Viviano: Yeah, thanks.
[00:32:35] Dr. St Denis: It was fun.
[00:32:36] Dr. Viviano: Part of the design of the publication was to have it something that you can refer to and actually use in practice. So hopefully you find the table and stuff helpful.
[00:32:44] Dr. St Denis: Yeah, they're. Thank you.
[00:32:45] Dr. Viviano: Because it's sometimes hard to go back and find.
[00:32:48] Dr. St Denis: Wait, I read it here, but where exactly? Right. I always keep a binder of these types of articles because they're great for referring to in a hurry. So yeah. Thanks again.
[00:32:59] Conclusion: Thank you for listening to this episode of All Cats Considered. We hope you enjoyed this interview. For more information on the topics discussed in this episode, please head over to CatVets.com podcast and explore the links in the show notes. Don't forget to subscribe to this podcast on your platform of choice so you won't miss any episodes as we release them. Have thoughts or ideas about the interview you heard today? Share them with us by leaving a comment on our Facebook page or shoot us an email
[email protected]. Thank you again for joining us today.
