ITCH! ITCH! and then ITCH!!!!

The multimodal approach to canine atopic dermatitis

June 3, 2021Ashley Bourgeois, DVM, DACVDdvm360, dvm360 June 2021, Volume 56,

Managing and treating dogs diagnosed with atopic dermatitis can be overwhelming for both the owner and their pet. Establishing a solid multimodal approach and having strong client communication from the entire veterinary team can help better manage this chronic disease. (Sponsored by Ceva)

Pruritus, itchy skin., can dramatically affect quality of life for both patients and their owners. Pet owners have reported that as the level of itch in their pet increases, their pet’s quality of life decreases. Different types of allergies can look the same, and patients can have more than 1 type of allergy, both of which can complicate the diagnosis. But the allergic workup is essential to provide comfort and minimize future flares.

Many issues can add to the frustration of owners of allergic dogs, including odor and visible lesions. Good client communication from the entire veterinary team can help owners work through the reality of managing a chronic disease, which often includes a multimodal approach.

Why atopic dermatitis occurs

Atopic dermatitis (AD) results from an inherited predisposition to develop hypersensitivities to environmental allergens that do not induce a problem in nonallergic individuals. Allergens can include dust mites, pollens, dander, insect particles, and molds.

The paws, under the front limbs, abdomen, and face are common areas to develop pruritus and secondary lesions. These areas also tend to have less hair and increased exposure to common allergens, making topical therapy important. Cutaneous absorption of allergens is the primary route of exposure in canine AD.

Secondary infections

Infections are a secondary issue related to allergies. It can be confusing for an owner to understand how allergies and infections are different issues but impact one another. When owners have a clear picture of this relationship, they are often more willing to commit to multimodal therapy, including frequent bathing and ear flushes.

One of the biggest missteps when working up an allergic dog is neglecting to perform cytology to identify infection. Bacterial and yeast overgrowth on the skin or in the ears can increase the level of pruritus above the dog’s allergic itch. Performing cytology during an allergic workup and on rechecks is the foundation of allergic management. Areas of crusting, erythema, debris, alopecia, and lichenification should be sampled at every exam to identify the appropriate therapy and to prevent certain therapies from appearing to be ineffective due to presence of microorganisms.

Epidermal barrier function

Maintaining the stratum corneum (top layer of the epidermis) is essential for a healthy skin barrier. The stratum corneum contains corneocytes and intercellular lipid layers that serve as a border between a dog’s body and the dry environment. An abnormal epidermal barrier allows allergens to penetrate the skin and results in a cascade of cytokines and other inflammatory mediators causing pruritus. Therefore, a multimodal approach, including topical and systemic therapies to improve the epidermal barrier, is beneficial for dogs with AD.

Why topicals are important

Topical therapy should always be considered in management of canine AD. This includes during an active pyoderma event as well as for long-term maintenance to prevent recurrence. Topicals are particularly valuable for controlling chronic, recurrent cases of Staphylococcusinfection to avoid development of methicillin resistance. Topical therapy may decrease the length of time systemic antibiotics are required or even eliminate the need for them altogether.

Certain topical therapies not only decrease bacterial populations and reduce surface recolonization, they help restore the epidermal barrier. The epidermal barrier has been shown to be abnormal in the skin of atopic dogs, even if it is nonlesional. This emphasizes the importance of utilizing restorative topical products even in well-controlled atopic patients. Used as a part of the maintenance protocol, these products can minimize the use of systemic allergy medications needed for management.

Lather up your atopic patients

Many topical formulations are available. However, bathing with high-quality shampoos is the preferred method if the dog will allow it and the client is able. Bathing removes allergens from the surface of the skin, and many ingredients include antimicrobial properties.

The most common antibacterial agent found in shampoos is chlorhexidine. It is important to use products that contain 3% to 4% chlorhexidine, such as DOUXO S3 Pyo (Ceva) if it is the sole active ingredient against Staphylococcus pseudintermedius. However, 2% chlorhexidine has been shown to have a synergistic effect with miconazole if a combination product is selected.

Bathing frequency depends on the severity of the case and the owner’s willingness or ability to bathe the pet. If you have a proactive owner, then many cases of pyoderma (even if resistant) can be managed with a bathing protocol alone. Cases of pyoderma typically benefit from frequent bathing (every 1 to 2 days) initially, followed by weekly maintenance. Contact time is another important aspect of a bathing protocol. Instruct owners to leave the shampoo on the skin for at least 10 minutes before rinsing thoroughly. If an owner is unable to bathe or additional topical therapy would be beneficial, alternate formulations such as mousses, sprays, and wipes are available.

Diet for epidermal barrier function

To avoid the use of more systemic medications, diets are available that can improve barrier function of atopic dogs through the use of nutrition. Diets include Royal Canin Skin Support, Hill’s Prescription Diet Derm Defense Canine, and Hill’s Prescription Diet Derm Complete. These diets are high in fatty acids and contain various vitamins that have been clinically proven to improve the epidermal barrier and decrease pruritus in dogs with AD. It is also easy for owners to implement at home if they are overwhelmed by the therapeutic plan.

Immunotherapy and antipruritics

Allergen-specific immunotherapy (ASIT) is the best long-term treatment for AD. It is formulated based on the results of intradermal or serologic allergy testing. ASIT consists of administering gradually increasing quantities of an allergen extract to a patient to improve the signs associated with subsequent exposure to the allergen. ASIT can take up to a year for full effect, and 60% to 70% of dogs have a positive response. When effective, therapy is usually life-long.

The use of systemic antipruritics is necessary in most cases of canine AD. This can range from keeping dogs comfortable while ASIT has time to become effective, managing seasonal flares, or long-term care in cases that require it. Systemic antipruritic options include oclacitinib (Apoquel; Zoetis), canine allergic dermatitis immunotherapeutic (Cytopoint, Zoetis), cyclosporine (Atopica; Elanco), or corticosteroids. It is important to weigh the benefits and risks of each therapy and to recognize that every patient has a unique response to different drugs.

How to make the best plan

Each multimodal plan is different depending on the owner and patient. With so many treatment options available for canine AD, the importance of addressing the epidermal barrier should not be overlooked. The use of topical therapy and nutritional supplementation should be considered with traditional antipruritic therapies to maximize the comfort and maintenance of dogs with AD.

References

Spitznagel MB, Solc M, Chapman KR, Updegraff J, Albers AL, Carlson MD. Caregiver burden in the veterinary dermatology client: comparison to healthy controls and relationship to quality of life. Vet Dermatol. 2019;30(1):3-e2. doi:10.1111/ vde.12696
DeBoer D. The future of immunotherapy for canine atopic dermatitis: a review. Vet Dermatol. 2017;28)(1):25-e6. doi:10.1111/ vde.12416
Cosgrove SB, Wren JA, Cleaver DM, et al. Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis. Vet Dermatol. 2013;24(5):479-e114. doi:10.1111/vde.12047
Bauer JE. Therapeutic use of fish oils
in companion animals. J Am Vet Med Assoc. 2011;239(11):1441-1451. doi:10.2460/ javma.239.11.1441
Watson AL, Fray TR, Bailey J, Baker CB, Beyer SA, Markwell PJ. Dietary constituents are able to play a bene- ficial role in canine epidermal barrier function. Exp Dermatol. 2006;15(1):74-81. doi:10.1111/j.0906-6705.2005.00385.x

Ashley Bourgeois, DVM, DACVD, practices at Animal Dermatology Clinic in Portland, Oregon. She is an owner/shareholder and on the board of directors for the practice group, which has locations in California, Kentucky, Indiana, Georgia, Australia, and New Zealand. Bourgeois is passionate about educating veterinarians about dermatology and work-life balance through her podcast, speaking engagements, and social media presence (@TheDermVet).Download Issue : dvm360 June 2021

How can dietary changes help with correcting behavioral issues?

October 14, 2021Caitlin McCafferty, Assistant Editor, Julia Burke, Assistant Editor Conferences | ACVC

During a recent interview, animal behaviorist expert Dr Christopher Pachel highlighted a few dietary changes to consider if you’re looking to correct problem behavior.

When it comes to correcting various behavioral conditions in patients, animal behavioral expert Christopher Pachel, DVM, DACVB, CABC, urged veterinary professionals to explore how dietary changes can help. During a recent dvm360interview at the Atlantic Coast Veterinary Conference (ACVC), Pachel shared multiple factors he considers when investigating dietary changes regarding behavior—starting with quality.

“I tend to look at quality first and, in my opinion, that’s just as important for dogs and cats as it is for us. If we are eating poor quality foods, that gets reflected in our overall health as well as a general feeling of well-being,” Pachel informed dvm360 staff.

“So, I am looking at quality knowing that [quality] is a subjective way to look at that,” he continued. “So the quality for me [is] that I’m really looking at the physical health of the animal and saying…‘does this really feel like it’s fitting these animals in terms of their individual needs?’”

To learn more, watch the full interview below.https://imasdk.googleapis.com/js/core/bridge3.485.1_en.html#goog_1586060297Play Video

Episode 66: It’s not what we’re detecting, it’s how we’re detecting it

October 14, 2021Kelsey Gustafson, Associate Editor

On this episode of The Vet Blast Podcast, Ashley Wood, PhD, director of research and development at Zomedica, talks with Adam Christman, DVM, MBA, about the application of bulk acoustic wave (BAW) technology to veterinary diagnostics, and how a new in-clinic biosensor testing platform is utilizing this technology to provide reference lab accuracy at the point of care. (Sponsored by Zomedica)https://embeds.audioboom.com/posts/7955546/embed/v4

Adam Christman, DVM, MBA: Hey everyone, welcome back to The Vet Blast Podcast. You know, we said this before on some of our other episodes about how amazing veterinary medicine is with technology. It is so innovative. Today I’m excited to learn more with our listeners too. We’re going to be exploring new technology in veterinary diagnostics, and with us today is Ashley Wood, PhD, from Zomedica. How are you, my friend?

Ashley Wood, PhD: I’m doing well. Thank you so much for having me. I’m excited to be here.

Adam Christman, DVM, MBA: I’m excited, listen, I am excited to learn about this too. I’ve heard about it, but I wanted to hear it straight from you too.

So, to our listeners that aren’t familiar with Ashley, a little bit about her. So, she joined Zomedica in 2019 to facilitate the development of [bulk acoustic wave technology] BAW technology. You’re [probably] like “what is that?” We’re going to chat about for use in veterinary medicine. She now leads the company’s research and development activities. Ashley’s expertise is in the areas of molecular biology, cell biology, imaging techniques, and biochemistry.

Prior to her current role, Ashley was part of the R&D group at Swift Biosciences where she was responsible for creating market viable products as the lead scientist in the advancement of next-generation sequencing assays. Her responsibilities included assay development, bioinformatics analysis, and transfer to manufacturing. Ashley has also served as a research assistant professor and completed a postdoctoral research fellowship in the cell and molecular biology department at Northwestern University’s Feinberg School of Medicine.

She has coauthored several papers that have appeared in industry prominent journals. She graduated with honors from Duke University with a degree in biochemistry and earned a PhD in molecular biology from Johns Hopkins University.

Well, congratulations for all those accolades, my friend.

Ashley Wood, PhD: Thank you.

Adam Christman, DVM, MBA: That’s fantastic. And we have to thank our friends at Zomedica for sponsoring today’s podcast. And you know what let’s get into it, I mean, you must be just as excited as we are at the veterinary space about all the latest and greatest in point of care services. Now I’ve heard about this, I heard in the pipeline a little bit about B-A-W technology. So, to our listeners, why don’t you kind of peel back the curtain a little bit and tell us a little bit about what that is?

Ashley Wood, PhD: Sure. I would love to. So, BAW, or B-A-W technology actually stands for Bulk Acoustic Wave technology. And what this is—this may sound complicated but it’s actually very simple as we get into it—basically, this is a microresonator technology. And it converts electrical energy to mechanical acoustic energy and when it does this, it creates a very stable and precise oscillation. We’ll get into a little bit more about how we use that.

What I want you to know to begin with is the reason that we, at Zomedica, kind of focused on this technology, because these resonators are widely used in wireless technologies. So, they’re in, you know, every cell phone that’s out there, they’re in Wi-Fi routers, they’re in 5g cellular towers. So, this is a very simple, robust technology that really has widespread use. But what we’ve done and what’s kind of different now is we’re working with our partners at Qorvo Biotechnologies to adapt this BAW technology and make a biosensor. So, we’re using a technology that’s really well-vetted and has been used for years in wireless technologies and now we’re bringing it to veterinary medicine as a biosensor, and that’s what’s new and innovative here. And what we’re really excited to talk a little bit more about.

Adam Christman, DVM, MBA: So, this has been around [it] sounds like? So, the BAW technology—do you love by the way to our listeners how I call it my Jersey accent BAW technology?

Ashley Wood, PhD: I do. It sounds way more exciting that way, right?

Adam Christman, DVM, MBA: So, tell me a little bit about how it works in the veterinary space?

Ashley Wood, PhD: Sure. So, what we’re actually talking about is a resonator. This resonator is made of a piezoelectric material, and it actually resonates or vibrates at a very specific frequency. What’s really cool about the BAW technology is that it’s vibrating or resonating at a very high frequency, and that’s important because that’s how we get to the really high sensitivity of the sensor that we’re using. But, what’s also interesting is, we’re using a kind of traditional chemistry, so we’re creating immunoassays—and for those of you who aren’t really familiar with what an immunoassay is—basically this is just using an antibody to detect an analyte of interest. So, the most traditional kind of immunoassay is called a sandwich assay, you basically have one antibody that recognizes your analyte of interest. Then that first antibody is called the capture antibody, it’s usually immobilized on some sort of solid surface or bead, and then it captures your analyte of interest.

So, this is whatever molecule you want to measure in a sample. It could be for us, you know, TSH, or thyroxin, or something like that. Then you have a second antibody that can come on and it sandwiches that analyze that’s why it’s called a sandwich assay. We get that second antibody that comes on and recognizes the same analyte. So, this is how most immunoassays work. And we’re doing that same chemistry. But what we’re doing is we have a different way of detecting that chemistry. So, most devices that are out there are going to use something like optical detection or they’re looking at radioactivity. But what we’re doing is using this BAW sensor to measure when an analyte is present in the sample. We have a resonator that’s our technology, our BAW biosensor is a resonator, and we take that capture antibody, and we immobilize it on the surface of the resonator. So, we actually attach that first antibody to the sensor, and then when an analyte binds and when a second antibody binds—you can imagine if you have something that’s vibrating at a specific frequency when you get weight or mass on top of that sensor, it’s going to slow down. I mean, that’s just logical, right? If you put something heavy on something that’s vibrating, it’s going to start vibrating at a slower frequency and that’s what we’re actually measuring—the rate of vibration.

As you get more and more analytes on the surface of the sensor, it’s going to slow down, and we measure that shift in resonance frequency, and then we just convert it to an analyte concentration. So, it’s a really simple process, it’s just all we’re doing is measuring vibration, rates of vibration, and then how they change when a sample is applied to the sensor.

Adam Christman, DVM, MBA: Give me an example then in vet med; how would that look like to us? And, you know, it sounds like it’s really specific and sensitive too.

Ashley Wood, PhD: Yeah. So, we’ve developed a device called TRUFORMA, and we have 3 assays that are currently available, and we’re developing more, but 1 of those assays is for TSH, so to look for thyroid diseases in both dogs and cats. And for that TSH assay, what I’m talking about, is a traditional sandwich assay. So, we put a TSH antibody, and we attach it to the surface of the sensor, then the sample flows over so we have microfluidics that allows that sample to flow over the sensor.

Any TSH molecules that are in that sample are going to be captured by that TSH antibody. We then release another second antibody, the detection antibody, and that flows over the surface of the sensor. And that second antibody is then going to recognize that TSH molecule as well. So, if a sample has a lot of TSH in it, it’s going to slow down that resonance frequency more than a sample that has less TSH in it. And we have a standard curve that just allows us to convert that shift in resonance frequency to the concentration of TSH molecules in the sample.

Adam Christman, DVM, MBA: That’s incredible and so fascinating. It really is. So, it really is about those vibrations that you’re talking about. Right?

Ashley Wood, PhD: Yep. And what makes it so kind of special here is that, again, it’s about the sensitivity and the robustness of the sensor. So, this is what hasn’t existed kind of in previous devices that might be available. So, because that sensor can resonate at such a high frequency that allows us to capture really low concentrations of molecules and a sample, and that’s something that people haven’t been able to do in this kind of device previously. Also, because the sensor is so robust, small, and cost-efficient, we can put it into a really small, pretty little package, that can be a device that can go just in the clinic. It doesn’t have to be in a reference lab. It’s not some huge piece of equipment. It’s just a very small, concise device that can go just on the benchtop in a clinic.

Adam Christman, DVM, MBA: I was going to actually say that I saw it online and I was like, “Oh my gosh,” I thought when I was reading this I said, “This has got to be a huge piece of equipment.” But coming into the veterinary space, I can tell you that space is a commodity and [when] I saw this I said, “Oh my gosh, this is literally like a countertop space,” like it’s almost even smaller than some of the centrifuges that I see out there.

Ashley Wood, PhD: It’s tiny. We say it’s like the size of a shoebox and I think it weighs about 7 pounds. I measured them a couple of times. But yeah, I mean, it’s really small, it’s really light, and you can move it around. Like if you needed to, you could move it from one place to another if things in the clinic are changing.

Adam Christman, DVM, MBA: Yes. So, is this being done on the human side at all, then?

Ashley Wood, PhD: Yeah, so our partners, I think I mentioned Qorvo Biotechnologies, so that’s who we’re working with to develop this technology, and they are also developing assays on a very similar device for human medicine. So, they actually have 1 assay, it’s a SARS-CoV-2 Antigen Test that actually just recently received emergency use approval from the FDA. That was really exciting. We’re really happy to see that because this is really showing how BAW technology is advancing in medicine across the board. But we were able to bring this to veterinary medicine first because we don’t have the same regulatory constraints that we have in human medicine. So just the timeline can be faster. But it’s been a really cool process to see, especially [with the], lessons learned from both sides. Veterinary medicine helps human medicine and human medicine helps veterinary medicine, and then everybody, you know, advances.

Adam Christman, DVM, MBA: Yeah, yeah, everybody advances too. You know, I’m thinking of the accuracy of something like this that you’re using with the B-A-W technology, BAW technology. So, how can you be sure that BAW technology produces accurate results?

Ashley Wood, PhD: It’s all about our development process. So, at Zomedica and at Qorvo Biotechnologies, we really have made an effort to make sure that we’re taking all the proper steps to create really good, accurate, high-performing assays, and this starts from the very beginning. So, a lot of assays, I mean, this is just something that we all know happens in veterinary medicine, a lot of times, there’s a human assay or human test that’s created and optimized, and then it just gets validated for use in animals. But it really wasn’t developed for use in animals. Well, Zomedica is taking a different approach.

From the very beginning, we are optimizing and developing our assays to work on the samples where we intend them to be used. Right now, we’ve been using dog and cat serum samples and plasma samples. And from the very beginning, whenever we do our testing, we’re doing that testing on those kinds of samples, because we think it’s important for our patients, you know, our animals, that we make sure these assays are optimized for use on them. Because there are differences, you know, between humans and animals, there are some differences that come about. So, if you have an assay that was, you know, made for use in humans, and then you’re just using it in a cat, for example, you might not have the optimal performance, and one example of that is actually the TSH assay we were talking about earlier.

The TSH assay that’s available right now, this one’s a little bit different, was optimized for use in dogs. So, when you send out a TSH sample to the reference lab, you’re actually getting—even if it’s a feline sample—it’s being tested on a canine test. Well, the problem with that is it works, and it’s been validated, you know, you can measure TSH levels, but in dogs, you’re really looking at high levels of TSH because you’re looking for hypothyroidism and dogs where TSH levels become high. Well, in cats, cats tend to be hyperthyroid, so you’re looking for very low TSH levels. Well, the canine TSH test doesn’t measure low enough to really differentiate a normal healthy cat, it may just have a slightly low TSH from a hyperthyroid cat. So, that test doesn’t have the sensitivity that you need to make the actual diagnosis. So, we’ve made sure when we were developing our TSH assay, we optimized the assay for use in canines, but also, we optimized an assay for felines, so our feline TSH assay can measure a lot lower than the canine TSH assay, and that’s because that’s where it matters, clinically. So that’s part of what we’re doing that’s different and that makes sure not only are the results accurate, but they’re also clinically useful.

But then just you’re asking about accuracy. The other thing that we do is verification. We do validation on all of our assays—we’re comparing the results from our tests to reference lab results, and we make sure that we’re testing along the way we make sure all of our assays are functioning the way that we know that they should, and we’re really comparing to what we consider a gold standard test to make sure we’re giving the veterinarians an accurate result.

Adam Christman, DVM, MBA: Right, right, and, you know, I was also thinking, as a general practitioner, if I have the TRUFORMA benchtop, do I have to run an accuracy test or, you know, quality control tests every day, or how does that work from a practical standpoint?

Ashley Wood, PhD: Yeah. This is a really good question. That’s one of the things about this technology that makes it kind of unique. So as opposed to some of the other detection methods that might be using optical detection, where you really have to constantly be running calibrators and making sure the instrument is performing the same on a daily basis, our instrument really does not show any sort of drift over time, and we’ve shown this and so we don’t require that kind of constant calibration on a daily or weekly or monthly basis. The other thing that we do is all of our reagents come in a disposable cartridge. So, that cartridge contains our calibration curve and is actually factory calibrated. So, you don’t have to worry about any differences from one lot to the next, which is a lot of time what you’re doing when you run those kinds of calibrators. All of that is done for you by the manufacturer. So, all you have to do with your sample into the cartridge, put it in the instrument, and let it go. Yeah. So, we don’t require that kind of QC over a period of time and that’s just because it’s a different kind of sensor, different kind of technology.

Adam Christman, DVM, MBA: You know, I want to share some interesting statistics, get a load of this. So hypothyroidism in dogs, one of the most common endocrine diseases with a prevalence rate estimated at .2% to 1.89%. That’s pretty significant, and hyperthyroidism in cats is a significant cause of morbidity in older cats having an estimated prevalence of 4.5%.

Then this other statistic I always find interesting too, [this is courtesy of Qorvo.com], is Cushing’s disease in dogs, another common endocrine disorder in dogs with an estimated incidence of one to two cases per 1000 dogs per year. The reason why I mentioned that to you is that I do think that we really need to start using more point of care services, you know? Because, you know, pet parents want answers yesterday or sometimes it’s a matter of “Do I need to ship or refer this animal out when I have pending lab results?”

So, you know, to that point, how will the BAW technology enhance, you know, in-house diagnostic capabilities?

Ashley Wood, PhD: Yeah, and I think those statistics are exactly why we targeted these markets. You know, we think this is really a place where there’s a gap right now, where veterinarians cannot do what they need to do. So we’re trying to put control back in the hands of those veterinarians, so we don’t want them to have to wait to get those results by sending a sample out to the lab or you know, the lab doesn’t run samples over the weekend or on certain days.[If Veterinarians] have a patient that comes in on Saturday—we want them to be able to get their results on Saturday if that’s what they need. By doing this, I mean, the issue has constantly been that you just can’t get the same quality result in-house as you can when you send it out to the reference lab, and that’s what we’re trying to fix. That’s why when we sat down and thought about, okay, what’s missing? Why can we not provide the right result or the correct, or that most accurate or highest performance assay at the point of care? What we decided was that the problem is really the detector, it’s not the chemistry, it’s not the immunoassay, it’s the detection method. That’s why Zomedica went out and found a different detection method that we realized is actually superior to what can currently be done. And we brought this to veterinary medicine and said, “Okay, we’re going to create a device that really gives veterinarians what they need at the point of care, and allows them to diagnose and provide, you know, better results to pet owners and for the patient also.”

Adam Christman, DVM, MBA: Yeah. So, what’s generally speaking, the turnaround time from when I insert it into the machine and then get those results?

Ashley Wood, PhD: So right now, our assays are 20 minutes or less and we’re really going to stick around that time point because I think that’s something that allows the right amount of time that they need the results while the animals in the clinic. They can get it if they want to wait, maybe run it a little bit later and just get it the same day they can. But, I think that’s the timing that we’ve established.

Adam Christman, DVM, MBA: Excellent, you know, listen, like I said, with curbside and whoever knows what the future holds in veterinary medicine. You know, it’s so helpful to have these tools and diagnostics at point of care services because me—as a dog dad myself—I want to make sure I know the answers and these are life-changing decisions that we might have to make too, so it’s really important. So, I can’t thank you enough for all the hard work that you’re doing.

So, to our listeners that are tuning in, where can they find more information about all this, Ashley?

Ashley Wood, PhD: [Listeners] can go to our website, which is www.zomedica.com, and they should be able to find all the information they need on the assays that we have available at the moment and the instrument itself, and they can reach out we have contact information there if they want to reach out and they have additional questions, we would always be happy to talk to them.

Adam Christman, DVM, MBA: Excellent. Ashley Wood and our friends at Zomedica, thank you so much for joining us today.

Ashley Wood, PhD: Thank you so much for having me. This has been a lot of fun. We love your podcast. So thanks for everything you’re doing.

Adam Christman, DVM, MBA: Thank you. This is why it’s called The Vet Blast Podcast! And to our listeners thank you so much for tuning in. Thank you for all your hard work please stay safe out there and continue to stay pawesome. Take care everyone.

Transcribed by https://otter.ai