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In this blog post, we have compiled the key takeaways from the session titled “Physical Therapy and Rehabilitation in Small Animals”, presented by Dr. Pınar Can, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Veterinary Physical Therapy: No Longer an Extra Service, but a Core Part of Clinical Practice Veterinary physical therapy is no longer a “luxury add-on” in clinical practice. It is steadily becoming one of the main pillars of modern veterinary care. The presentation by Dr. Pınar Can clarified both the theoretical framework and the practical applications of veterinary physiotherapy. Through real clinical cases, she provided concrete answers to the key questions clinicians often ask: why, how, and to what extent should we use physical therapy? First, the Big Picture: What Is Veterinary Physiotherapy? Dr. Can began with a very clear statement: The definition of physiotherapy in veterinary medicine is essentially the same as in human medicine — the only difference is that our patient is not human. According to the American Physical Therapy Association (APTA) Physical therapy includes examination and evaluation in order to determine diagnosis, prognosis, and the appropriate treatment protocol for patients with functional impairments. According to the World Confederation for Physical Therapy It aims to restore the highest possible level of movement and functional ability in individuals whose mobility has been affected by aging, injury, disease, or environmental factors. When we translate this definition into veterinary medicine, the goal remains the same: 👉 To restore and maximize mobility and quality of life. Why Do We Use Physical Therapy? Dr. Can summarized the main goals of veterinary physiotherapy in three key points. 1. Restoring or improving mobility If movement has been limited due to orthopedic, neurological, or cardiovascular disease, the objective is to restore the highest achievable functional level. 2. Reducing pain Pain is both: a cause of reduced movement, and a result of prolonged immobility. Physical therapy is a powerful tool for breaking this cycle. 3. Preventing injuries and improving performance In athletic animals such as sled dogs, racing greyhounds, and performance horses, the goal is not only treatment but also injury prevention and performance enhancement. The Physiotherapy Toolbox: Four Main Approaches The theoretical backbone of the session focused on four major groups of physiotherapy techniques. 1. Electrophysical Modalities These methods are generally used for pain control and preparing tissues for exercise. Examples include: Superficial thermal therapies (heat and cold applications) Therapeutic ultrasound Electrotherapy (such as TENS) Laser therapy Extracorporeal shock wave therapy (ESWT) Static or pulsed electromagnetic field therapies 2. Manual Therapy Manual therapy techniques include: Massage Soft tissue mobilization Joint mobilization These techniques help: reduce pain improve circulation increase joint range of motion. 3. Therapeutic Exercise This is one of the most important components of rehabilitation. Examples include: Passive range of motion exercises (PROM) Active or assisted-active exercises Balance and proprioception training Dr. Can emphasized an important point: 👉 Electrophysical modalities alone are not enough. Real functional recovery requires exercise. 4. Aquatic Therapy Water provides several advantages in rehabilitation: buoyancy hydrostatic pressure the muscle-relaxing effect of warm water These factors allow animals to move with less pain and greater control. Which Patients Benefit from Physiotherapy? Veterinary physiotherapy can be used in a wide range of conditions, including: Orthopedic diseases Neurological disorders (paresis, paralysis, coordination problems) Obesity Cardiovascular diseases Sports medicine and performance conditioning An Important Difference in Türkiye: Who Is Authorized? Dr. Can highlighted a critical point. Unlike human physiotherapy, where physiotherapists form a separate profession, animal physiotherapy in Türkiye is legally performed only by veterinarians. This means veterinarians must be competent in: neurological examination orthopedic evaluation cardiovascular assessment Some therapies may be contraindicated in certain patients. For example: 👉 Electrotherapy should not be used in animals with pacemakers or severe heart failure. Clinical Cases: From Theory to Practice The most educational part of the session involved real clinical cases. Each case carried an important practical message. Case 1 – Köpük Severe Hip Osteoarthritis + L7–S1 Disc Protrusion Presenting complaint 12-year-old dog reluctant to walk aggressive when touched Diagnosis Under anesthesia imaging revealed: severe bilateral hip osteoarthritis L7–S1 disc protrusion The aggression was pain-related. Five-Part Osteoarthritis Management Strategy 1. Pain control NSAIDs ± opioids ± gabapentin 2. Weight management 3. Nutritional support Omega-3 fatty acids, MSM, chondroitin, collagen, etc. 4. Physical therapy 5. Environmental modification warm and dry living environment soft bedding morning heat therapy and massage covering slippery floors limiting stairs and intense activity ramps if necessary Clinical Tip Applying TENS individually to multiple joints would take too long. Instead, electrodes were placed at: brachial plexus myotomes lumbosacral plexus myotomes This produced analgesia throughout the limb. Treatment Plan First 4 sessions heat therapy laser therapy wearable PEMF environmental modifications At home daily 30-minute TENS After pain reduction underwater treadmill (5 → 20 minutes) proprioception and balance training Outcome major improvement after 20 sessions booster sessions after 8 months about 2.5 years of good function (The dog later died due to a splenic tumor unrelated to physiotherapy.) Clinical message: Control pain → build trust → introduce exercise → maintain long-term management. Case 2 – Pati Lumbosacral Disc Protrusion + Prostatic Hyperplasia Complaint 10-year-old Pointer progressive hindlimb ataxia for 6 months dropped tail difficulty defecating Diagnosis CT revealed lumbosacral disc protrusion with cauda equina compression. Additional finding: prostatic hyperplasia Clinical reminder: 👉 In older male dogs with defecation difficulty, always examine the prostate. Treatment Strategy Since the dog was still ambulatory: Initial treatment gabapentin prednisolone (15 days) No improvement → surgery dorsal laminectomy disc fenestration Postoperative Physiotherapy First 3 days cold therapy Then heat therapy massage PROM / assisted exercises After suture removal TENS therapeutic ultrasound (must be applied dynamically) Additional support PEMF Outcome Approximately 25 sessions led to full functional recovery. The dog remained well for one year before developing another disc problem, and lived until 15 years of age. Clinical message: If the patient is still ambulatory in LS disc disease, consider medical management and physiotherapy before surgery. Case 3 – Mülayim (Cat) “Tilted Window Syndrome” Complaint 5-year-old male cat trapped in a tilted window non-ambulatory paraplegia Prognostic Factor 👉 Presence of deep pain perception This indicates a good prognosis. Pathophysiology The primary damage mechanism is not arterial ischemia but: 👉 interruption of venous return Even short compression can cause severe spinal cord injury. Treatment TENS PEMF manual therapy PROM Later underwater treadmill balance exercises motivation with toys and rewards Outcome Complete functional recovery after about 10 sessions over 4–5 weeks. Clinical message: Physiotherapy in cats can be challenging, but cooperative patients may recover surprisingly fast. Case 4 – Hera Post-FHNO Non-Use of Limb + Dilated Cardiomyopathy Complaint 5.5-year-old Rottweiler previous femoral head and neck ostectomy refusing to use the limb severe muscle atrophy Additional condition: 👉 Dilated cardiomyopathy Some therapies were therefore contraindicated. Imaging Findings irregular osteotomy surface bone protrusions contacting the acetabulum chronic pain Treatment Early sessions heat therapy TENS laser therapy Later underwater treadmill acupuncture After 20 sessions ESWT (3 sessions every 10 days) Purpose: 👉 convert chronic pain into an acute healing response. Outcome Weight bearing started as early as the second session. Eventually the dog returned to normal activity. Clinical message: Even poorly healed surgical cases may dramatically improve with appropriate physiotherapy. Case 5 – Helen / Gümüş (Cat) L3 Vertebral Fracture Complaint 6-month-old cat fall from height non-ambulatory paraparesis Critical Decision The fracture was: stable not compressing the spinal cord Therefore surgery was not required. Treatment supportive bandaging medical management After bandage removal TENS EMS for paraspinal strengthening laser therapy underwater treadmill Outcome Walking ability returned after 25 sessions, and the cat was completely normal within three months. Clinical message: Not every vertebral fracture requires surgery. Case 6 – Bobi Multiple Diseases, Meaningful Improvement Diagnoses included: Chiari-like malformation cervical syringomyelia severe mitral valve disease choroid plexus tumor Initial status: non-ambulatory tetraplegia deep pain perception present Contraindication Management Due to cardiac disease: full-body PEMF was avoided Instead localized PEMF low-intensity TENS dry treadmill exercise Aquatic therapy was not tolerated. Outcome Within four months: pain significantly reduced appetite improved sleep improved patient regained ability to stand and take steps Later euthanasia was performed due to tumor progression. Clinical message: Even when full recovery is impossible, physiotherapy can significantly improve quality of life. A Key Takeaway from the Q&A Session Physiotherapy in Thromboembolism In cases such as feline aortic thromboembolism: Electrophysical modalities are contraindicated, because they may increase inflammation and worsen reperfusion injury. Recommended approaches include: passive and active range-of-motion exercises therapeutic exercise manual therapy Heat therapy, TENS, and laser therapy should not be used. We will continue sharing key highlights from VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “Pulmonary Hypertension”, presented by Dr. Başar Ulaş Sayılkan, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Pulmonary Hypertension (PH): Not Just a Number — A Disease of the Pulmonary Vascular Bed When you hear “pulmonary hypertension” in the clinic, it immediately makes you pause. It’s not something we diagnose every day. But when we do, it’s never something to take lightly. As Dr. Başar Ulaş Sayılkan emphasizes: First recognize PH, then understand which type it is, and only then intervene from the right angle. Because PH is not a single disease. It is a final common pathway reached through different mechanisms. 1) What Does Pulmonary Hypertension Actually Mean? The body has two major circulatory systems: Systemic circulation (blood going to the body) Pulmonary circulation (blood going to the lungs) When the pressure balance (systole–diastole) in these systems is disrupted, organ perfusion suffers. Impaired perfusion leads to progressive tissue damage. Pulmonary hypertension occurs when: 👉 Pressure in the pulmonary arteries rises above normal levels. Under normal conditions, the pulmonary circulation is a low-pressure, low-resistance system. In PH, this system shifts from a “free-flow” state to a high-resistance state. Numerically, PH is defined as: Elevated systolic pulmonary arterial pressure Elevated diastolic pulmonary arterial pressure Mean pulmonary arterial pressure above 25 mmHg But clinically, the real issue is this: PH is not just a pressure disorder — it is a disease of the pulmonary vascular bed. 2) The Core Problem: Vascular Wall Thickening At the heart of PH lies structural change: The pulmonary vessel walls thicken. The lumen narrows. Vascular resistance increases. The right heart must now pump against a much harder system to move blood into the lungs. Initially, the body compensates. But over time: Arteries, arterioles, and venules undergo remodeling. Elasticity is lost. Vessels become stiff, almost scar-like. The feared endpoint? 👉 Right-sided heart failure. 3) Why Is PH So Insidious? Pulmonary hypertension may not become clinically evident until approximately 60% of the pulmonary vascular bed is compromised. That means a patient may appear stable for years. Even more striking: Up to 50% of dogs with moderate PH may show no obvious clinical signs. This makes PH: Late to declare itself Capable of sudden deterioration More difficult to manage once advanced 4) Which Pathways Drive Disease Progression? Pulmonary vascular tone is regulated by three major systems: 1️⃣ Endothelin Pathway Potent vasoconstrictor Increased endothelin = worsening PH 2️⃣ Nitric Oxide (NO) Pathway Vasodilator Reduced NO allows vasoconstriction to dominate 3️⃣ Prostacyclin Pathway Vasodilator Anti-thrombotic Reduced prostacyclin: Increases thrombotic tendency Worsens disease progression In short: When vasoconstrictors increase and vasodilators decrease, PH advances. 5) Cats or Dogs? In Cats Congenital abnormalities are more commonly implicated. In Dogs The most frequent cause is: 👉 Left-sided heart disease, especially degenerative mitral valve disease (DMVD). Mitral valve disease is common. However, only a subset of these patients progresses to PH. 6) Classification: You Can’t Treat Without a Map PH is not a primary diagnosis — it is a consequence. Classification guides therapy. 1️⃣ Pulmonary Arterial Hypertension (PAH) Idiopathic Secondary to left-to-right shunts (PDA, VSD) 2️⃣ PH Secondary to Left Heart Disease Most common in dogs DMVD is the key player 3️⃣ PH Secondary to Respiratory Disease Chronic hypoxia Pulmonary fibrosis Chronic bronchitis Pneumonia 4️⃣ PH Secondary to Pulmonary Thromboembolism (PTE) Hypercoagulability Endothelial injury Blood flow stasis 5️⃣ Parasitic Causes Heartworm disease (Dirofilaria) 6️⃣ Multifactorial For example, DMVD plus chronic lung disease Key clinical message: It’s not enough to say “this patient has PH.” You must determine which group. 7) Precapillary vs Postcapillary PH A practical clinical shortcut: Precapillary PH Problem originates in the pulmonary vasculature. (Heartworm, PTE, lung disease) Postcapillary PH Problem originates in the left heart. Elevated left atrial pressure increases pulmonary pressure. (DMVD is the classic example) This distinction directly impacts treatment decisions. 8) Clinical Signs: The Language of the Right Heart Signs are not specific, but patterns emerge: Exercise intolerance Dyspnea or tachypnea Lethargy Inappetence Syncope (fainting episodes due to reduced cerebral perfusion) Cough (more common in dogs) Cyanosis Jugular distension Ascites Hepatomegaly Tricuspid regurgitation murmur But again: 👉 Mild to moderate PH may be clinically silent. 9) The Diagnostic “Gold Trio” in Practice 1️⃣ Radiography Right heart enlargement Pulmonary artery dilation Parenchymal lung changes Pleural effusion or ascites 2️⃣ Laboratory Testing CBC and biochemistry Blood gas analysis Coagulation profile NT-proBNP, troponin (supportive) Annual heartworm testing 3️⃣ Echocardiography (Most Powerful Tool) Key parameters: Tricuspid regurgitation jet velocity (Vmax) 3.4 m/s = strong suspicion Pressure estimation: 4 × V² 50 mmHg = concerning 80 mmHg = critical D-sign Septal flattening due to right pressure overload Main pulmonary artery to aorta ratio 1.2 suggests dilation RPAD index < 36% supports PH Pulmonary artery flow notching Characteristic in advanced PH 10) Treatment: Not Just “Start Sildenafil” Yes, sildenafil is often the first drug that comes to mind. But Dr. Sayılkan stresses: Never start sildenafil blindly without distinguishing precapillary from postcapillary PH. In Precapillary PH Sildenafil is often appropriate and beneficial. In Postcapillary PH (e.g., DMVD) Sildenafil may reduce cardiac output and worsen the patient. In these cases, priority should be: Pimobendan Management of left heart disease Reduction of venous congestion Additionally: Oxygen for hypoxic patients Anticoagulation for PTE Guideline-based heartworm treatment when indicated In short: We do not treat “PH” in isolation. We treat the pathway that led to PH. Conclusion: Clarity Wins in PH Management Pulmonary hypertension may sound like a single diagnosis, but it is the result of multiple potential mechanisms. A structured approach is key: 1. Is PH present? 2. Which group does it belong to? 3. Precapillary or postcapillary? 4. What is the underlying cause? 5. How should treatment be tailored to this specific patient? When you think clearly and systematically, pulmonary hypertension becomes less intimidating — and more manageable. We will continue sharing key takeaways from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “Lower Urinary Tract Diseases in Cats and Dogs”, presented by Dr. Erman Koral, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Lower Urinary Tract Diseases: Accurate Diagnosis, Proper Interpretation, and Targeted Treatment Lower urinary tract diseases are extremely common in clinical practice—so common that they can appear in one out of every five patients—yet they also represent a world where conditions easily overlap and get confused. In Transcript 11, Dr. Erman Koral presents a clear, practical roadmap that makes real-life work easier: look closely at the urine, collect it correctly, interpret the pH–sediment–ultrasound trio accurately, and then place the disease into the correct category. 1) Why Are Lower Urinary Tract Diseases Such a “Clinical Headache”? Cystitis, crystal/stone problems, feline idiopathic cystitis (FIC) / FLUTD, and urinary incontinence in geriatric patients all originate in the same anatomical region and often arrive with very similar clinical signs. That is why: they are seen very frequently, they are easily confused with one another, and they are often overlooked. The lifetime prevalence rates shared by the speaker are striking: 14–20%. In practical terms, this means one out of every five patients visiting a clinic. 2) “Urine Is Gold”—But Only If You Collect It Correctly Urine provides extremely valuable information. However, if the sample is collected incorrectly, we may misinterpret contamination as disease. Two main collection methods: Spontaneous urination / sample obtained by compression high risk of contamination from the urethra or vagina seeing bacteria does not automatically mean infection Cystocentesis (preferably ultrasound-guided) minimal contamination the only correct method for culture and susceptibility testing A clear statement from the speaker: If you plan to send a culture, the sample must be collected via cystocentesis. A crucial additional detail: bacteria in urine left at room temperature begin to die within one hour sediment begins to settle within 30 minutes If you are not evaluating the sample immediately, send it to the lab right away. 3) The First Thing to Check on a Dipstick: pH Normal canine and feline urine should be mildly acidic: pH 5.5–6.5 (maximum around 7). If pH is elevated (7.5–9): The first suspicion should be urinary tract infection, because many causative agents are urease-positive gram-negative bacteria (E. coli, Klebsiella, Proteus, Pseudomonas, etc.) → they shift urine toward alkaline pH. If pH is decreased (4.5–5.5): Possible causes include: diabetes mellitus renal failure (loss of concentrating ability) very high-protein diets fever, prolonged fasting, intense exercise In short: pH is the first directional signpost. 4) Protein, Glucose, Ketones: The “Three Siblings” Protein (+) Can originate from three sources: renal: glomerulonephritis, renal failure pre-renal: hypertension, fever, intense exercise post-renal: cystitis, bleeding, urine retention Because blood and leukocytes also count as protein, false protein elevation is common in hematuria. Glucose (+) It is tempting to say “glucose always means diabetes,” but this is incomplete: diabetes is the most common cause leptospirosis (rarely) stress-induced glucosuria in cats is important If you see glucose in a cat’s urine, never ignore stress as a possibility. Acute pancreatitis may also increase glucose. Ketones (+) This is often the “next step after glucose.” diabetic ketoacidosis is the primary concern prolonged fasting low-carbohydrate diets pregnancy If ketones are present, the case is no longer mild. 5) Knowing How to Read Sediment Is a Clinical Turbo Boost A simple but effective protocol: centrifuge urine at 5000 rpm for 5 minutes place sediment on a slide and examine microscopically Findings: RBCs: bleeding, stones, infection, trauma, neoplasia WBCs: suggests infection, but not proof alone bacteria: meaningful only if seen in cystocentesis samples epithelial cells: transitional: bladder/ureter inflammation, stones, infection squamous: distal urethral or vaginal contamination (increases with catheterization) renal epithelial: kidney-origin damage (AKI, tubular necrosis, etc. casts: if you see them, recognizing them is enough; the exact type often does not significantly change clinical decisions 6) Clinical Signs: Translate the Owner’s Words Correctly Dysuria: difficult urination Stranguria: painful urination (crying/meowing) Pollakiuria: frequent but small urinations Hematuria: blood in urine Periuria: urinating outside the litter box (very typical in cats) Nocturia: nighttime urination Pyuria: pus/inflammatory cells in urine A key distinction: in diabetes, frequent urination = large volume in lower urinary tract disease, frequent urination = small volume repeatedly 7) Bacterial Cystitis: Common in Dogs, Less Common in Cats Risk profile: more common in female dogs recurrent cases are more likely with diabetes, Cushing’s disease, or thyroid disorders Key clinical tip: If urolithiasis is present, bacteria are often present as well. Stopping antibiotics too early while dissolving stones means giving underlying bacteria a chance to recur. Diagnostic support: sediment: WBCs + bacteria + RBCs ultrasound: thickened and irregular bladder wall clots/sediment (“snow globe” or “rice grain” appearance) Treatment logic: Target gram-negative bacteria first: fluoroquinolones (enrofloxacin, marbofloxacin, ciprofloxacin) Alternatives: amoxicillin–clavulanate trimethoprim–sulfonamide first-generation cephalosporins (cefadroxil, cefpodoxime) nitrofurantoin (concentrates in the bladder; an effective urinary antiseptic) Important: Do not combine fluoroquinolones with nitrofurantoin due to antagonism. If recurrence occurs: fewer than 3 episodes/year → sporadic 3 or more episodes/year → recurrent/chronic → culture and susceptibility testing are mandatory. 8) Feline Idiopathic Cystitis / FLUTD: More Stress Than Bacteria Feline idiopathic cystitis is: sterile (no bacteria) stress-related highly recurrent (~58%) Typical clinical package: pollakiuria + periuria + hematuria + stranguria/dysuria Most important task: identify the stressor. This is not “exam stress,” but micro-change stress: changes in feeding time, brand, bowl type changes in bowl location changes in litter box location or litter brand increased household traffic/noise a family member leaving or arriving renovations, new furniture, new electronics multi-cat households → resource competition → number of litter boxes and food stations should be at least the number of cats + 1 Diagnostic clue: In FLUTD: urine is usually bacteria-free bladder wall thickening may be absent urine can appear completely clear Treatment foundation: Environmental modification (MEMO): quiet, safe resting areas feeding through puzzles/hunting-style enrichment scratching posts (horizontal and vertical) elevated observation spots water fountains / running water pheromone diffusers If needed, medical support: analgesics anxiolytics/antidepressants (amitriptyline, fluoxetine, clomipramine) phenoxybenzamine if urethral spasm is present 9) Stones and Crystals: Match the Shape With pH Struvite alkaline urine (pH 7.5–9) “coffin lid” crystals dissolves with urine acidification diets if resistant: acetohydroxamic acid Calcium Oxalate acidic urine (pH 5–6) “envelope” or square-shaped crystals does not dissolve → prevention is key potassium citrate is very effective thiazides (hydrochlorothiazide) rarely used Cystine hexagonal low-protein diet + potassium citrate Urate / Ammonium Biurate yellow, “sea urchin-like” appearance associated with liver disease allopurinol + low-purine diet Breed notes: Dalmatian / English Bulldog → urate and ammonium biurate may be considered “normal tendencies” Newfoundland / Terrier breeds / English Bulldog / Mastiff breeds → cystine more common 10) Prostate Problems: Present as Constipation, Detected Through Urinary Signs When the prostate enlarges: compresses the colon → thin ribbon-like stool compresses the urethra → dysuria stiffness in hindlimb movement chronic cases may show preputial discharge (toothpaste-like) On ultrasound: normally homogeneous and bright gray-black areas raise suspicion of prostatitis, cysts, or abscesses Treatment: Antibiotics that penetrate the prostate barrier (clindamycin, trimethoprim–sulfonamide, chloramphenicol, third-generation cephalosporins) For symptomatic benign prostatic hyperplasia: finasteride 11) Urinary Incontinence: Storage or Emptying Problem? Storage disorder: leaking occurs while sleeping or lying down common in early-spayed females urethral sphincter mechanism incompetence (USMI) / lower motor neuron bladder Emptying disorder: the patient urinates but cannot fully empty repeated attempts at short intervals Quick treatment guide: USMI → phenylpropanolamine, estrogen emptying disorder → bethanechol, diazepam (sometimes acepromazine or cisapride) if there is a lower motor neuron hernia → surgery is necessary 12) Obstruction Is an Emergency: “Acute Kidney Injury Is Coming” When obstruction occurs: the bladder fills back pressure travels to the kidneys risk of acute kidney injury and hyperkalemia rises Practical tips: If the catheter does not pass, attempt high-pressure flushing (20–50 ml syringe) using saline and appropriate solutions. If unsuccessful, proceed with sedation and smooth muscle relaxation. In hyperkalemia, glucose + insulin can rapidly reduce potassium levels. Do not force aggressively before relieving pressure by emptying the bladder. Final Message: Success in Lower Urinary Disease = Correct Classification The essence of this session was clear: collect urine correctly interpret the pH–dipstick–sediment trio accurately complete the picture with ultrasound determine whether it is cystitis, FLUTD, stones, prostate disease, or incontinence select treatment accordingly Lower urinary tract disease is not something solved by “just giving an antibiotic.” If you correctly name what you are treating, half of the clinical work is already done. We will continue sharing key takeaways from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “Dilated Cardiomyopathy”, presented by Dr. Onur İskefli, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Dilated Cardiomyopathy in Dogs: It Starts Quietly, Then One Day It Knocks With Syncope Some diseases appear to happen “suddenly” in the clinic, but in reality they have been building for years. Dilated cardiomyopathy (DCM) in dogs is exactly that kind of process. It is typically associated with medium-to-large breeds as a “genetic fate,” but we now know the issue is not purely genetic. Diet, medications, endocrine diseases—many different pathways can open the door to the same clinical picture. In the 7th session of New Horizons in Veterinary Clinical Sciences, Dr. Onur İskefli explained DCM in a practical, field-oriented way. Two key messages stood out: “The most critical thing in DCM is early detection. Once clinical signs appear, you are already in a completely different phase.” “If you see syncope in a patient, you cannot move forward without an ECG.” 1) What Is DCM? A Disease of “Loss of Contractile Power” Dilated cardiomyopathy is a disease of the heart muscle. The basic problem is: The heart chambers enlarge (especially the left ventricle and left atrium). The walls become thinner. Contraction (systolic function) decreases significantly. In other words, the heart becomes larger but not stronger; it becomes weaker as it dilates. 2) The Cause Is Not One: Genetics + Nutrition + Secondary Factors The speaker challenged the classic “purely genetic disease” assumption. Genetics still play a major role: Breeds such as Dobermans and Boxers have clear predispositions. Several genetic variants have been identified. However, other important contributors exist in real-life practice: Nutritional causes Taurine deficiency is one of the most critical factors. Well known in cats since the 1990s, which is why taurine is routinely added to cat foods. In dogs, the risk also increases with certain diets. Carnitine deficiency (especially in Spaniel-type breeds) may trigger DCM. Drug-related and toxic causes Cardiotoxic chemotherapy agents such as doxorubicin can directly cause DCM. These patients must be monitored cardiologically before and after treatment. Secondary / endocrine-related pathways Conditions such as hyperadrenocorticism and pheochromocytoma can create chronic catecholamine overload, gradually damaging the myocardium and leading to DCM. In summary: “Sometimes DCM is fate, sometimes it is an incorrect diet, and sometimes it is the final stage of another disease.” 3) Phases: The Gap Between the Occult Stage and the Clinical Stage Clinical management of DCM is impossible without understanding its phases. The speaker explained this clearly by comparing it to the ACVIM mitral valve staging system: Occult phase (asymptomatic) The breed is at risk but shows no clinical signs. Or arrhythmias are present on ECG/Holter without systolic dysfunction. At this stage: monitoring is the priority, not medication. annual echocardiography and, ideally, Holter screening are recommended. Overt phase (symptomatic) Clinical signs are now present: heart failure, arrhythmias, syncope, etc. At this stage, treatment becomes more aggressive and quality of life becomes the main goal. 4) Clinical Signs: How Does DCM Reveal Itself? DCM typically presents in two ways: Signs of left-sided heart failure cough exercise intolerance tachypnea If both left and right sides are affected ascites (abdominal fluid accumulation), in addition to the above signs Arrhythmias (the most critical alarm signal) ventricular premature complexes (VPCs) atrial fibrillation ventricular tachycardia → may progress to fibrillation The speaker emphasized an important clinical reflex: “If you see syncope, do an ECG first.” Many fainting episodes have a potentially fatal arrhythmia in the background. 5) The Cough Issue: “Heart Patients Cough” Is Not Always True This was one of the most educational parts of the talk. The main mechanism of cardiac cough: the left atrium enlarges it compresses the left main bronchus coughing begins However, pulmonary edema does not always cause cough, because: cough receptors are concentrated in the upper airways there are very few in the alveoli If edema is mainly alveolar, the patient may have severe dyspnea without coughing. Cough becomes more likely once fluid reaches the bronchi, sometimes accompanied by pink frothy discharge. Clinical takeaway: Do not rule out heart disease because there is no cough, and do not assume edema simply because cough is present. 6) Diagnosis: Suspect With Radiographs, Confirm With Echocardiography Physical examination is the foundation The speaker strongly emphasized full-body clinical examination before advanced testing: inspection palpation auscultation respiratory rate, pulse quality, temperature Without this, further testing becomes “imaging without knowing what you are looking for.” ECG Common findings: sinus tachycardia atrial fibrillation ventricular premature complexes In syncope cases, ECG is a life-saving first step. Radiography Generalized cardiomegaly can be seen, but this alone does not confirm DCM because: pericardial effusion may create a similar appearance. Echocardiography (the diagnostic key) Echocardiographic criteria supporting DCM include: normalized LVIDd > 1.7 sphericity index > 1.65 fractional shortening (FS) < 25% ejection fraction (EF) < 45% LA/Ao ≥ 1.6 EPSS > 7.7 With echo images, the speaker clearly demonstrated: the ventricle is enlarged, walls are thin, and contraction is weak—like “an incomplete closure performed by hand.” 7) Nutritional DCM: The Grain-Free Diet Paradox A growing issue in real-world practice: a small-breed dog (for example, a Yorkshire Terrier) developing DCM after 10 years on a grain-free diet. The mechanism: grain-free diets often rely heavily on plant-based proteins (lentils, peas). The methionine–taurine synthesis cycle may not be adequately supported. Over time, nutritional DCM may develop. Key warning: “Even if the breed is not predisposed, diet history can still lead to DCM.” 8) Treatment: Management Based on Phase Occult phase do not start medication in asymptomatic at-risk patients regular monitoring + avoid intense exercise omega-3 may be recommended (evidence is limited but benefits are possible) Arrhythmia present without systolic dysfunction Holter monitoring is ideal; if not available, serial ECGs antiarrhythmic therapy if needed taurine/carnitine supplementation + dietary correction Systolic dysfunction begins (preclinical stage similar to B2) pimobendan becomes essential based on the PROTECT study, it is emphasized to delay clinical signs Clinical heart failure (Stage C) Four core drugs form the backbone: loop diuretic (furosemide) ACE inhibitor pimobendan spironolactone Arrhythmia-specific therapy: atrial fibrillation: diltiazem / digoxin VPCs: sotalol / mexiletine / amiodarone when necessary Monitoring becomes essential: electrolytes (K, Na, Mg) renal function Refractory advanced stage (Stage D) torsemide (approximately 10 times stronger than furosemide) hospital-based dobutamine / IV inotropes close monitoring 9) Home Monitoring: Sleeping Respiratory Rate Saves Lives The most valuable homework for owners: sleeping respiratory rate. over 30 breaths per minute = early edema alarm If owners detect this early, the patient can often be stabilized as an outpatient before severe edema develops. If not detected, the patient may arrive in emergency with 50–60 breaths per minute, requiring hospitalization. 10) Anxiety Management in Acute Cases: The Butorphanol Note In acute pulmonary edema, the animal feels like it is suffocating and panics. A practical point highlighted by the speaker: Butorphanol is a good anxiolytic. It has minimal cardiac effects and makes treatment much easier to manage. Closing: The Most Important Thing in DCM Is Catching It Before Symptoms Appear This session left three clear clinical messages: 1. DCM is not caused by a single factor. Diet history is extremely valuable for diagnosis. 2. A patient diagnosed in the occult phase will have a completely different life compared to one diagnosed in the symptomatic phase. 3. Syncope + arrhythmia risk = never skip ECG. Heart disease can progress silently for years… But one day, that silence turns into a patient that suddenly collapses in the clinic. In that moment, your strongest tool is knowledge and clinical reflex. “The heart may become enlarged, but if you are late, the game becomes much bigger.” We will continue sharing key highlights from VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “The World Within Us: Gut Health and Nutrition”, presented by Prof. Dr. Pınar Saçaklı, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Why Is Gut Health So Important? How the Microbiome Is Changing the Veterinary Perspective In veterinary medicine, there are topics we learn in lectures, touch in clinical practice, and only fully appreciate once we face their real impact in the field. Gut health is one of the most important of these. Because the issue is not simply “diarrhea happened, change the diet.” The gut is a major control center that quietly influences dozens of systems—from immunity and behavior to skin and coat health, and even aging. Prof. Dr. Pınar Saçaklı’s talk, “The World Within Us: Gut Health and Nutrition,” reminded us of this truth. The main message was clear: “The gut is a dynamic ecosystem inside the body. The clinician who understands this changes the entire game.” A 2,500-Year-Old Statement Still Holds True: “Disease Begins in the Gut” Hippocrates’ statement from 460 BC—“All disease begins in the gut”—is now being confirmed again through modern scientific evidence. Thanks to new molecular techniques, we can now see more clearly that: The gut is not only an organ of digestion and absorption. It is also: the first defense line against incoming pathogens, the largest immune organ in the body, containing approximately 70% of immune cells, the home of the vast ecosystem we call the microbiome. When gut health is disrupted, the result is not just “diarrhea”—a systemic domino effect begins. Gut Health Stands on Three Pillars The speaker described intestinal integrity as a balance supported by three key components: 1. Histomorphology (the structure of the intestinal wall) 2. Microbiota / microbiome (the microbial ecosystem) 3. Immune system cells If one pillar weakens, the others are affected as well. A healthy gut means all three pillars remain strong at the same time. Histomorphology: A Tissue That Renews Quickly and Damages Quickly The renewal cycle of intestinal epithelium is remarkably fast: villi are shed and regenerated every 3–5 days. This speed has two meanings: the gut can repair itself very quickly, but if energy and nutritional support are insufficient, it can deteriorate just as quickly. The mucous layer secreted by goblet cells forms the first barrier. The tight junction proteins beneath it form the second barrier. If these proteins weaken and spaces open between cells, pathogens can “leak” through the wall, and the process becomes infection. This is why the intestinal barrier is far more clinically important than we often assume. Microbiota vs. Microbiome: The Difference Matters The talk clarified an important distinction: Microbiota: the community of microorganisms living in the gut (who is there and how many). Microbiome: the genes of that community + its interactions with each other and the environment + its functions. So the microbiome is not only about bacterial counts—it includes biological outcomes such as: metabolite production, immune regulation, digestive support, behavioral effects. Where Does the Microbiome Come From? It Starts at Birth and Is Shaped by Nutrition The gut microbiome begins colonizing at birth. In natural birth: maternal flora is transferred to the newborn—almost like a natural vaccination. In cesarean birth: environmental and skin flora dominate, and antibiotic/antiseptic exposure becomes more influential. Factors that shape the microbiome afterward include: environment antibiotic and medication use stress age breed/species and most importantly: nutrition Nutrition is the fastest and most powerful tool for microbiome modulation. What the Microbiome Produces: The Balance of “Good Metabolites vs. Bad Metabolites” Gut bacteria ferment nutrients and produce short-chain fatty acids (SCFAs): acetate propionate butyrate Butyrate is especially important: it is a primary energy source for intestinal cells and strengthens tight junctions. But the story does not end there: Some bacteria also produce harmful metabolites from protein fermentation, such as ammonia. So the gut has a constant “good production vs. bad production” balance. In dysbiosis, the issue is not simply a single pathogen—it is the disruption of this production balance. Dysbiosis Is Not Infection (And Antibiotics Are Often the Wrong Answer) This was one of the most important clinical messages of the talk: Dysbiosis is not the overgrowth of one pathogen—it is the disruption of the ecosystem’s balance. Therefore: Antibiotics are often not the solution in dysbiosis—they can actually worsen the problem, because antibiotics “kill the good microbes while killing the bad ones.” Typical dysbiosis signs include: chronic or acute diarrhea vomiting gas and foul odor loss of appetite behavioral changes and anxiety joint pain and skin problems Gut imbalance can affect the body from end to end. Probiotics, Prebiotics, Synbiotics: Which One, and When? Probiotics Live beneficial microorganisms. Effects: reduce pH competitively inhibit pathogens produce antimicrobial peptides strengthen intestinal integrity Prebiotics Fibers that the host cannot digest; they reach the colon and feed probiotics. Effects: increase beneficial microbes increase SCFA production Synbiotics A combination of probiotics + prebiotics given together. A key point: Prebiotics mainly act in the large intestine, so the type of diarrhea must be distinguished first. Small Intestinal vs. Large Intestinal Diarrhea The speaker placed this distinction clearly into clinical practice: Small intestinal diarrhea: increased stool volume greasy or very bulky stool may be present weight loss is more prominent blood may be digested (dark/tarry stool) Large intestinal diarrhea: normal or reduced stool volume very frequent defecation prominent mucus fresh red blood may be present Dysbiosis mainly occurs in the large intestine. Therefore, fiber-based prebiotic support is far more meaningful in large intestinal diarrhea cases. Where Is the Future Going? The Era of “Personalized Nutrition” The goal of microbiome research is now becoming clear: identifying each individual’s core microbiome creating individualized diet and supplement strategies accordingly In other words, the one-size-fits-all prescription era is fading. The era of microbiome-based personalized nutrition is coming. In parallel, we will likely see growing visibility in: new probiotic and prebiotic species behavior–microbiome research microbiome-based strategies for aging and longevity Closing: The Clinician Who Understands the Gut Ecosystem Can Manage the Clinic This talk reminded us once again: Gut health is not a “side topic.” Nutrition, clinical medicine, behavior, immunity, aging—everything connects here. A fitting sentence for the new era of veterinary medicine might be: “If you cannot manage the gut ecosystem, you cannot manage disease.” And perhaps the best summary remains the speaker’s own message: “The world within us is very intelligent and very dynamic. We must become clinicians who are equally intelligent and equally dynamic.” We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “Thoracic, Cardiac, and Vascular Surgery in Cats and Dogs”, presented by Prof. Dr. Hakan Salcı, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. Thoracic, Cardiac, and Vascular Surgery in Cats and Dogs: The Vital Journey of Breathing and Circulation This time, on the clinical sciences stage of VetSummit, we took a closer look at a highly critical field that directly affects the lives of our furry companions: thoracic (chest), cardiac, and vascular surgery in cats and dogs. Prof. Dr. Hakan Salcı from Bursa Uludağ University Faculty of Veterinary Medicine explained both the essential anatomy and the emergency conditions commonly encountered in daily practice, supported by real case examples throughout the session. As Kito, we summarized the key insights from this valuable session in a way that pet parents can easily understand—because sometimes what looks like “shortness of breath” or “getting tired quickly” can be a warning sign of something far more serious. What Is the Thorax, and Why Is It So Important? The thorax, or chest cavity, is essentially home to two vital organ systems: The respiratory system: the lungs The circulatory system: the heart and major blood vessels Because problems in this region directly affect breathing and blood circulation, thoracic surgery is considered one of the most delicate areas in veterinary medicine. One point especially emphasized by Prof. Salcı was this: Before performing thoracic surgery, anatomy and physiology must be understood extremely well—because the surgical approach from the right or left side changes which organs can be accessed and which techniques should be used. The Most Common Reasons for Thoracic Surgery: Traumatic and Non-Traumatic Causes Conditions requiring thoracic surgery can be broadly grouped into two categories: 1) Traumatic Causes (Sudden-Onset Emergencies) The most common include: traffic accidents falls from height fights and bite wounds blunt trauma (impact or crushing injuries) These cases may cause emergencies such as rib fractures, pulmonary contusions, or air leakage into the chest cavity. 2) Non-Traumatic Causes (Congenital or Acquired Conditions) Examples include: congenital cardiac abnormalities lung tumors esophageal foreign bodies pleural or pericardial fluid accumulation Some of these conditions may progress silently, which makes routine veterinary check-ups especially important. A Major Emergency in Pets: Pneumothorax (Air Accumulation in the Chest Cavity) One of the most detailed topics in the session was pneumothorax. Simply put: Pneumothorax refers to air entering the chest cavity, causing partial or complete collapse of the lung. It may occur due to trauma, but can also develop spontaneously because of lung lesions or tumors. What warning signs at home should be treated as an emergency? open-mouth breathing obvious respiratory distress very rapid breathing weakness and a collapsed posture pale or bluish mucous membranes sudden rapid deterioration As Prof. Salcı emphasized: Pneumothorax is an emergency, and the first goal is to stabilize breathing and circulation. If necessary, air is removed using a chest tube, and negative pressure is restored. Chylothorax: Can “Milky White” Lymph Fluid Collect in the Chest? Yes—it can. Chylothorax is the accumulation of lymphatic (chylous) fluid in the thoracic cavity. It may present with: respiratory distress exercise intolerance (fatigue easily) reduced appetite weight loss Diagnosis is supported by the milky-white appearance of pleural fluid and its triglyceride levels. Treatment may be medical or surgical (such as thoracic duct ligation), depending on the case. A Congenital Condition: PDA (Patent Ductus Arteriosus) Another important topic was PDA, which is the persistence of a vascular connection that should close after birth. In young animals with PDA, signs may include: getting tired quickly heavy breathing stunted growth pulmonary edema Diagnosis is confirmed through advanced imaging (echocardiography and, in some cases, CT/MRI), and most cases are treated surgically by closing the abnormal connection. After successful intervention, cardiac workload decreases and quality of life improves significantly. The Hidden Hero of Surgical Success: Proper Monitoring and Support In thoracic and cardiac surgeries, the process does not end with the operation. As Prof. Salcı explained, even the smallest detail matters: full monitoring during anesthesia blood gas analysis, oxygen saturation tracking, ECG monitoring appropriate management of drainage duration postoperative pain control and calm recovery conditions supporting overall physical resilience as part of healing Where Does Nutrition Fit Into This Process? For pets dealing with thoracic or cardiovascular problems, highly digestible, balanced, clean-ingredient nutrition is extremely valuable. Because: the body needs high-quality protein for tissue repair, the immune system is under stress and needs support, appetite may decrease, so smaller portions with stronger nutritional density are often more appropriate. At Kito, we value supporting pets through these sensitive periods with fresh, natural-ingredient products developed alongside veterinary professionals. Every pet’s needs are different, so nutrition plans should always be designed together with your veterinarian. In Summary… This session reminded us once again: Breathing and circulation sit at the very center of life for our furry companions. In chest, heart, and vascular conditions, early recognition and timely veterinary support can save lives. If you notice breathing changes, sudden weakness, or unusually rapid fatigue in your pet, do not assume it will “go away.” Consult a veterinarian as soon as possible. We are all here together to support our pets in living long, healthy, and joyful lives. We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “Looking to the Future in Veterinary Practice: Potential, Opportunities, and Making a Difference”, presented by Prof. Dr. Duygu Dalğın, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. The New Game in Veterinary Medicine: Where Are Clinics Going, and What Should We Be Looking At? While studying in veterinary school, many of us imagine a similar “future picture”: opening a clinic right after graduation, establishing stability within a few years, and building a comfortable life around vaccines, parasite prevention, and routine examinations. Ten to fifteen years ago, this picture was largely realistic. Today, the scene has changed—and not only locally. Globally, the veterinary sector is moving in a completely different direction. Prof. Dr. Duygu Dalğın’s talk explains exactly this turning point. Her message is very clear: “If we keep playing the old game, we lose. If we build the new game, we win.” 1) Let’s Face Reality: There Are Too Many of Us The number of veterinary schools and graduates has reached a level where competition is no longer “normal.” To illustrate this, the speaker gave a striking comparison: In the United States, with a population of 360 million, there are 28 veterinary schools and around 2,650 graduates per year. In countries such as Germany, the Netherlands, and Canada, the number of schools is far lower. In Türkiye, there are 32 veterinary schools and nearly 3,000 graduates annually. This is not meant to discourage—it is meant to help build strategy. Because when supply exceeds demand, doing “what everyone else is doing” decreases the chance of survival. In short: Opening a clinic is no longer an “automatic post-graduation step.” It is a high-risk business decision that requires a serious plan. 2) The Netherlands Example: If Resources Are Limited, Is the Game Over? No. One of the most impactful examples was the Netherlands: a very small country, with salty soil and limited agricultural land—yet one of the world’s biggest exporters. How? Through added value and re-export. They import raw products produced elsewhere, transform them through technology and processing, and then export them again at a much higher value. The message is clear: “Resources may be limited and conditions may be difficult, but leadership is possible with the right strategy.” Veterinary medicine works the same way: instead of clinging to the old model, we must move toward high-value new fields. 3) Pet Ownership Has Changed, and Clinic Income Is Shrinking For many years, the main motivation for owners to visit veterinarians was vaccines and parasite control. The speaker argues that this is no longer sustainable. Key findings from studies: Vaccine skepticism is increasing among cat owners, especially after the pandemic. Veterinary visits occur more for routine procedures than for illness-driven consultations. Visits for behavioral problems or psychiatric support are extremely rare. What does this mean? “If a clinic survives mainly through vaccines and parasite treatments, that clinic model is already dead.” It is harsh, but true. Without new revenue models and new service types, many clinics will either close or shrink dramatically. 4) The Biggest Wave: Geriatrics and Longevity If you observe the patient population in clinics, you will see that cats and dogs are getting older. A significant portion of patients is now geriatric. The speaker stated clearly: In cats, the proportion of patients older than 11 years is nearly half. Dogs show similarly high ratios. After age 6, the frequency of clinic visits increases dramatically. In other words, modern companion-animal practice cannot exist without strong geriatric knowledge. But an even bigger trend is rising: longevity and wellness. The “long life and well-being” industry, already massive in human medicine, is rapidly entering the pet world. In the United States, for example: DNA methylation / cellular age tests are being sold for pets. Owners collect a swab sample at home and send it to a lab. The result measures not chronological age, but biological/cellular age. Veterinarians then prescribe supplements and lifestyle protocols. The test is repeated in 6 months, with the goal of “pushing the age backward.” This represents a new treatment paradigm in veterinary medicine. And the most striking news shared: Longevity vaccines designed to reduce IGF hormone levels in dogs have received FDA approval and are expected to enter the market in 2026. The speaker described this almost like an alarm: The world is shifting into a new medical paradigm, and many of us are not even aware of it. 5) Integrative / Holistic Medicine: Why Is the Profit Going Elsewhere? Today, there is a broad “holistic medicine” market—from acupuncture and phytotherapy to behavioral counseling and rehabilitation. But in many places, veterinarians are not the ones earning from this space. People outside the profession are taking the market, because veterinarians remain in their comfort zones. The speaker gave a blunt example: “There are ‘animal telepaths’ who are fully booked and earning huge money—not because I approve, but because we never entered the space, so the profit flows there.” Integrative medicine includes many areas: acupuncture rehabilitation / physiotherapy laser therapy phytotherapy and supplementation regenerative medicine (stem cells, PRP, exosomes) hyperbaric oxygen therapy clinical nutrition behavioral medicine / psychiatry The key idea is simple: If you do the same work as the clinic down the street with 15 years of experience, why should the client choose you? You need a different value proposition. 6) Pet-Tech and Wearable Technology One of the most exciting parts of the talk was technology, because the pet industry is rapidly copying human health technology. Examples include: smart feeding bowls (that open only when the correct animal approaches) health-monitoring collars glucose sensors for cats and dogs (such as Freestyle Libre) anxiety vests, automatic litter boxes, behavior trackers Production in Türkiye is still extremely limited. That is why the speaker offered a recommendation: “Partner with engineers and build pet electronics and pet-tech startups.” This field is particularly well-suited for younger generations. 7) Halal Pet Food and the Middle East Market: An Untapped Gold Mine Türkiye already exports large volumes of pet food to the Middle East. But the speaker pointed to a market gap that almost no one is addressing: halal-certified dry pet food. The Middle East wants it. There is some supply in cat food, but halal dry dog food is almost nonexistent because: halal-certified production infrastructure is costly dry food technology requires investment But the upside is: You do not have to build it alone. The speaker emphasized angel investment and startup culture: With strong feasibility studies, investment can be secured. 8) Pet Dietetics and Cellular Therapies Two additional high-potential niches: Pet dietetics / clinical nutrition Just as dietetics exploded in human health, there is a major gap on the pet side. Owners are feeding homemade diets without guidance. Veterinary dietetics—especially in large cities—could become a powerful business model. Cellular and molecular therapies PRP, stem cells, exosomes, immunotherapy, targeted chemotherapy, DNA/RNA-based approaches… Very few clinics currently offer these. Building a dedicated “cellular therapy center” could become a serious specialization and competitive advantage. 9) Health Tourism + Pet Tourism Türkiye is already strong in human medical tourism. The speaker described a new “combined model”: A person travels from abroad to Türkiye for a cosmetic or medical procedure. They bring their cat or dog with them. While the owner receives treatment, the pet stays at an animal hospital. Within 10 days, both human and pet medical needs are addressed—often at one-third of the cost of Europe. One clinic in Antalya has already launched this concept. This may become one of the highest-income customer channels of the future. Closing: “You Are Standing on the Edge of All Possibilities” The talk ended as a call that blended hope and responsibility: Know yourself. Understand what kind of life you need. Choose the field that will allow you to build that life. You are not obligated to follow the traditional path. Veterinary medicine is no longer a single road—it is hundreds of roads. And perhaps the most critical sentence of all: “Do not rinse yourself with the same water you washed in. The world has changed—so must you.” We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key highlights from the session titled “My Dog Suddenly Fainted While Walking in the Park! Cardiology Emergencies”, presented by Prof. Dr. Yücel Meral, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation. The Fear of ECG in Veterinary Cardiology: Life-Saving Knowledge in 30 Seconds in the Field In veterinary medicine, there are topics that feel “difficult and distant” in school but become immediate reality once you enter clinical practice. Cardiology is exactly one of those fields. Heart disease does not always progress as a “slow process.” Sometimes a patient arrives and you truly have only 30–40 seconds. Is the heart beating? Is the rhythm lethal? Where should intervention begin? All of that must be determined within that time frame. Prof. Dr. Yücel Meral’s talk in Session 6 of New Horizons in Veterinary Clinical Sciences focused precisely on this reality. Rather than presenting cardiology as a pile of theory, he explained it as a clinical discipline that must become an instinctive reflex. The main message was clear: “You cannot say you examined the heart without an ECG. Some nights, your only chance is the ECG.” 1) The Heart Is Not Just a “Pump”—It Is a Self-Operating Muscular System The first misconception that must be corrected is this: The heart is not a simple pump. It is a miraculous muscle system that operates on its own, controlled by the autonomic nervous system. It beats 60–100 times per minute (or even more in some species), carrying the entire body’s oxygen, nutrient, and waste circulation. That is why even a small electrical disturbance can rapidly turn into collapse affecting breathing, circulation, and the brain within minutes. Once you recognize this in real cases, cardiology stops being “a difficult subject” and becomes “the foundation that holds life.” 2) Cardiology Is Not a One-Device Job: The Logic of “Holistic Cardiology” Prof. Meral presented an excellent framework: cardiac evaluation cannot be completed with a single method: ECG: electrical conduction and rhythm Echocardiography: structure, valves, chambers, flow Radiography: cardiac size and pulmonary impact Angiography / CT: vessels and advanced imaging He describes combining these as holistic cardiology, because in real clinical cases, you often need to press more than one button at the same time. 3) The First Question in Emergency Medicine: “Is the Heart Beating?” When a patient arrives after fainting, the reflex in many clinics is: “Let’s take an X-ray, let’s do an echo.” But the speaker’s warning is clear: Every step that wastes time can cost a life. That is why the fastest and most practical tool in the field is the ECG. Within seconds, an ECG tells you: Is the heart beating? Is the rhythm regular or irregular? Is this rhythm potentially fatal? Even this information alone can guide you toward the correct intervention. 4) A Fearless ECG Reading Sequence (Because Without a Sequence, There Is Chaos) ECG lines are not difficult—the difficult part is not having a structured approach. Instead of a list of rigid rules, the speaker described a fixed sequence that works in real-life emergency settings: 1. Is the rhythm regular? If RR intervals are equal, it is regular. 2. What is the heart rate? For regular rhythms, use the large-box method: RR interval = 3 large boxes → 300/3 = 100 bpm 2 large boxes → 150 bpm 1 large box → 300 bpm 3. Is there a P wave, and does every P lead to a QRS? This helps evaluate atrial–ventricular conduction. 4. Is the QRS complex wide or narrow? A wide QRS is an alarm sign for ventricular origin. 5. What does the ST–T segment show? ST elevation or depression → consider ischemia/infarction T wave changes → electrolyte, oxygenation, or conduction abnormality warning With this sequence, ECG interpretation becomes a clinical language rather than a confusing image. 5) “Killer Patterns”: ECG Findings That Require Immediate Action This was the most critical part of the seminar. The speaker emphasized clearly that these are lethal ECG patterns. If you see anything other than normal sinus rhythm—such as: ventricular tachycardia ventricular fibrillation atrial flutter / atrial fibrillation supraventricular tachycardias torsades de pointes asystole (a flatline) then the ECG is no longer a diagnostic step—it becomes the button to start intervention. Because death may follow. 6) The First Move: Vagal Maneuvers—Simple but Sometimes Shockingly Effective A step often overlooked in veterinary practice but reflexive in human medicine: vagal maneuvers. The speaker demonstrated this with a live example: In an SVT patient, a correct vagal maneuver can reduce the rhythm from 180–200 bpm down to 90–100 bpm. The most practical method in veterinary practice: Carotid artery massage / gentle stroking Can be used in many species and may lower rhythm within seconds. Oculocardiac reflex (gentle pressure on the eyes) Applying pressure for 15–20 seconds can cause a dramatic reduction in heart rate. Even if the success rate is only 30–40%, in critical moments this is the cheapest and fastest chance available. 7) If Vagal Maneuvers Fail: The “Lidocaine Reflex” in the Field Here, the speaker spoke directly from real practice: “Lidocaine is my favorite—I apply it immediately.” The logic is practical: inexpensive available in most clinics quick response in acute tachycardia Administration: bolus or infusion ECG monitoring you can literally watch the rhythm drop in real time After stabilization, options like diltiazem or beta-blockers can be considered. However, a critical warning was emphasized: Because of hypotension risk, medications should never be given blindly without blood pressure monitoring. 8) Adenosine = “Resetting the Heart” The speaker described adenosine as a “turn-off and restart” mechanism because it: blocks the SA–AV node for 8–10 seconds the heart briefly stops then the system restarts the goal is a return to sinus rhythm If there is no response, the dose is increased stepwise. Although the effect may not be as predictable in animals as it is in humans, it can be life-saving in appropriate cases. 9) The Defibrillator Myth: It Is Not Only for Asystole A defibrillator is not used only to “restart a stopped heart.” Its primary role is in: ventricular fibrillation severe tachyarrhythmias A correct shock can restore life within seconds. And if the clinic does not have the device, the missing element is not only technology—it is preparedness culture. Closing: Knowing ECG Means You Are Not Alone in the Field The key reality this session left behind is this: Cardiology is a vast world, but the ECG is the fastest survival language in that world. Even if you know that language only at a basic level: panic decreases when a patient collapses you start intervention on time you reduce the risk of losing the patient in front of your eyes And the simplest yet most life-saving question in the clinic is: “What is the heart doing right now?” A clinician who can read the answer through ECG moves cardiology out of the realm of fear and into the realm of reflex. We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

As part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held with the sponsorship of Kito Healthy Pet Food Ecosystem, we have compiled the key takeaways from the session titled “Ozone Therapy in Companion Animals with Veterinarian Batuhan Natur.” We sincerely thank Dr. Natur for his valuable presentation. During the seminar, Dr. Batuhan Natur covered both the scientific foundations of ozone and how it should be applied in clinical settings in a correct and safe manner. The core message of the session was clearly summarized in two essential statements: Ozone therapy is not the same as “room ozonation” or “air disinfection.” Medical application is fundamentally different. Dosage is everything. When the dose is correct, it is therapeutic; when incorrect, it can be toxic. What Is Ozone? Why Is the Term “Medical Ozone” Emphasized? Ozone (O₃) is a gas composed of three oxygen atoms and has strong oxidative properties. Due to its unstable structure, it rapidly decomposes into O₂ and releases a free oxygen atom. This free oxygen atom is the primary source of ozone’s biological effects. Key characteristics include: A distinct sharp odor (often described as the “earthy smell” after a thunderstorm). Approximately 10 times higher solubility in water compared to oxygen. A short half-life; at room temperature, it loses activity within 20–30 minutes. 📌 For this reason, ozone is not prepared in advance and stored; it must be generated immediately before administration, next to the patient. Critical safety note: The only area where ozone must not be applied is the respiratory system and lungs. Inhalation is toxic. Brief Historical Overview 1839: Discovery of ozone 1840s: Use in operating room disinfection World War I: Significant role in the management of gangrene One of the key pioneers of modern medical ozone therapy: Bocci A Medical Ozone Generator Is Essential (Industrial Devices Are High-Risk) One of Dr. Natur’s strongest warnings concerned device safety: ✅ Medical ozone must be generated using certified medical-grade equipment. ❌ Industrial ozone generators or concentrator/air-based devices are not appropriate for medical use. Why? When ozone is produced from ambient air, nitrogen oxide derivatives may form, which can cause both respiratory and systemic toxicity. A proper medical ozone device should: Operate using a medical oxygen cylinder. Deliver a controlled and measurable concentration range. Safe concentration range: ✅ 1–80 gamma (µg/mL) Key risk point: Industrial devices often produce ozone in grams, which may reach lethal levels. 📌 Device calibration is also critical: A deviation of ±1 gamma may be acceptable; anything beyond that is considered unsafe. Therefore, annual servicing and calibration are mandatory. How Does Ozone Act in the Body? When ozone is introduced into the bloodstream, two key “messenger” groups are generated: ROS (Reactive Oxygen Species) LOP (Lipid Oxidation Products) These substances activate the NRF2 pathway within cells and stimulate antioxidant defense gene expression. ✅ Primary Clinical Effects of Ozone Induces controlled oxidative stress → Activates and strengthens endogenous antioxidant defense mechanisms. Enhances circulation and oxygenation Facilitates oxygen release from hemoglobin → improved tissue oxygenation. Increases nitric oxide release from the endothelium → supports microcirculation. Modulates immunity (dose-dependent) Low dose → immune activation and antioxidant reinforcement High dose → cytokine suppression and immunosuppressive effect Supports tissue repair Enhances collagen synthesis → accelerates wound healing May increase mitochondrial ATP production → supports general recovery and well-being Dosage Principles (The Most Critical Segment of the Seminar) Dr. Natur categorized clinical dosing as follows: 10–20 gamma: Oxygenation, tissue repair, support in gangrene/ischemia 20–30 gamma: General recovery dose, organ damage support, systemic rehabilitation 40–50 gamma: Antiviral/antimicrobial effects; autoimmune and allergic conditions 60–70 gamma: Severe viral burden + acute rectal bleeding control >80 gamma: Cytotoxic → not used therapeutically 📌 Cancer cases: In his clinical practice, Dr. Natur typically stays at 10 gamma and does not exceed 20 gamma. Routes of Administration Ozone can be administered through multiple routes except via the lungs. Major Autohemotherapy (Ozonation of Blood) 50–250 mL of blood is drawn Mixed with an equal volume of ozone gas Immediately reinfused intravenously Requires 8–15 sessions (2–3 times per week) Clinical applications: infections, circulatory disorders, oncology support, autoimmune diseases, organ insufficiencies, diabetes. Important materials note: Ozone-resistant tubing and syringes must be used (glass/teflon/siliconized). Standard plastic syringes and infusion sets may pose a microplastic release risk. Rectal Insufflation (Systemic and Practical) One of the most practical systemic approaches in small animals. More sessions may be required compared to major autohemotherapy. Recommended volumes: Cats: 20–30 mL Small dogs: 30–60 mL Medium–large dogs: 60–150 mL 📌 Rapid administration or excessive volume may increase the risk of colon distension or rupture. Minor Autohemotherapy (“Ozone Vaccine”) 2–10 mL of blood is drawn Mixed with an equal volume of ozone Administered SC/IM This may be considered a nonspecific immune-supportive approach and may be preferred for allergic, viral, and dermatologic autoimmune conditions. Bag/Cup Ozonation (Local Application) Commonly used for chronic or infected wounds. The wound and the interior of the bag are moistened (ozone is ineffective on dry surfaces). The bag is vacuum-sealed. Ozone is introduced for 15–20 minutes. Dosage strategy: Infected phase: 70–80 gamma Healing phase: 20–30 gamma Local Injections May be administered intramuscularly, perilesionally, paravertebrally, or at acupuncture points. Typically 10–20 gamma in small volumes (0.1–0.3 mL). Intra-articular applications: Used for OA, arthritis, meniscal conditions, etc. For acute cases, ozone is recommended first, followed by PRP. Dr. Natur noted that combining PRP with ozone may enhance PRP efficacy. Intradiscal / Foraminal Ozone (Notable in Neurology) This was one of the most striking sections of the seminar. Within the intervertebral disc, ozone may: reduce inflammation decrease disc volume by facilitating dehydration reduce pain Dr. Natur shared cases where paraplegic dogs regained the ability to walk within weeks, including a chronic paraplegic case of six months’ duration that stood again within 45 days. Protocol approach: First-line: paravertebral/foraminal ozone (less invasive) If no response within 3–5 days → intradiscal ozone (general anesthesia + fluoroscopic guidance) Where Can Ozone Therapy Be Effective? Ozone therapy has a wide range of clinical applications in veterinary practice, including: Viral diseases (e.g., parvovirus, distemper) Dermatology (atopic dermatitis, chronic otitis, wound management) Orthopedics (OA, tendon and meniscal disorders) Neurology (disc herniation, epilepsy support) Diabetic wounds and gangrene Supportive care in kidney/liver insufficiency Autoimmune and rheumatic diseases Gynecological infections such as mastitis and endometritis (supported in the literature) Critical Warning Regarding “Ozonated Serum” At the end of the session, Dr. Natur emphasized an important caution: ❌ Ozonating isotonic solutions/serum is not true ozone therapy. When ozone reacts with isotonic fluids, sodium hypochlorite may form, shifting the procedure toward a chemical effect (similar to bleach-like reactions) rather than biological ozone therapy. Conclusion: Ozone Is Not “Alternative”—It Is a Powerful Clinical Tool When Used Correctly The clinical impact of ozone therapy can be substantial when applied under appropriate conditions: ✅ With the right device, correct dose, and proper materials, ozone may: help control infections support circulation accelerate regeneration reduce pain modulate immune function ❌ With an incorrect device or uncontrolled dosing, it may: become toxic cause more harm than benefit The clinical summary of the seminar was captured in the following statement: “Ozone is not a cure-all, but with the right protocol it can provide significant support in many conditions.” We will continue sharing key takeaways from VetSummit 2025 sessions under the sponsorship of Kito Healthy Pet Food Ecosystem. We look forward to meeting you again in upcoming content designed to support your clinical practice. For more information about Kito, please visit www.kito.pet, follow us on social media, or contact us at info@kito.pet.

As part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held within the scope of the Healthy Pet Food Ecosystem and sponsored by Kito, we have compiled the key takeaways from the session titled “Veterinarian Batuhan Elifoğlu / Introduction to Oral and Dental Health in Cats and Dogs: Anatomy, Dental Charting and COHAT” in this blog post for you. We would like to thank our lecturer for his presentation. Two Things Happened at Once: Nutrition for Longevity and a Clinical Guide to Dental Medicine For veterinary students and clinicians, the 8th session of the October 2025 VetSummit delivered two experiences at the same time. On one hand, we listened to Kito’s story—an effort to reshape the answer to the question “What are we feeding our pets?” On the other hand, we explored an introductory veterinary dentistry session that provided a clinical answer to the question “How do we interpret the oral cavity?” In this article, we present both the big picture from the sponsor presentation and the practical clinical knowledge shared by Batuhan Elifoğlu on oral and dental health in cats and dogs—all in one smooth, blog-style flow. More Than a Pet Food Brand: Kito’s “Healthy Pet Nutrition Ecosystem” The session opened with Kito’s co-founder, Alper, being invited to the stage. From the very first minutes, the framework was clear: Kito positions itself not only as a pet food brand, but as a nutrition ecosystem designed to help pets live longer and healthier lives. Key strengths: Full control of meat sourcing Lamb and beef are produced antibiotic-free and GMO-free at the founders’ own farm, Karkas Farm. Other ingredients such as chicken, turkey, and salmon are sourced according to standards set by Kito. In other words: “Kito knows exactly what goes into the product.” Large-scale production through strong partners Dardanel is both an investor and a production partner. The sterilization and shelf-life technology (autoclave processing) comes from Dardanel’s experience in ready-to-eat foods and seafood. Kito’s growth story was explained chronologically. Initially, they wanted to launch fresh food products, but licensing processes took longer than expected. So they entered the market first with dry food and treats. Later, the fresh food line was launched—initially produced in their own kitchen, using frozen-shipping logistics with a capacity of 5 tons per month. As scaling became necessary, they moved into industrial production through the Dardanel partnership. This was followed by vitamins, international export operations (a distributor in Russia and a company in Dubai), and today’s point: a portfolio of 52 products. Kito Fresh: How Can “Human-Standard Fresh Food” Last Two Years at Room Temperature? The clear star of the presentation was the Kito Fresh series. Alper described it as “fresh, natural, human-grade ingredients.” The ingredient list resembles everyday grocery shopping: pumpkin, carrot, apple, peas, broccoli combined with protein options such as lamb, beef, chicken, and fish. This naturally leads to an important question: “How can fresh food remain stable for 24 months at room temperature?” The answer is simple but critical: the products are sterilized using Dardanel’s autoclave technology, eliminating microorganisms that would cause spoilage. Since the product is not exposed to air until the package is opened, spoilage risk is prevented. This creates a model that is both practical and long shelf-life, while still being fresh-food based. Another important point highlighted was the pricing segment. KitoFresh is a complete diet suitable for feeding alone, but it is a premium product. Under local economic conditions, Kito recommends a hybrid feeding model mixing it with dry food to adapt to different budgets. Their website includes a portion calculator algorithm where owners enter the pet’s age, weight, and breed to receive a daily feeding recommendation. Global trends were also emphasized: major corporations such as Nestlé and Mars are investing heavily in fresh pet food brands in the United States and Europe. Behind this trend are studies suggesting that fresh diets may reduce cancer risk and support cellular regeneration in pets. A Clinic-Exclusive Series: “Not Available Online Only Through Veterinarians” At a summit heavily attended by veterinary students, the clinic-focused question naturally came up: “If I have my own clinic tomorrow, why should I carry Kito?” Alper answered clearly: The Veterinary Series of Kito Fresh will be available only in clinics and will not be sold online. This provides two advantages for clinics: Commercial protection (no online price competition) A strong trust perception (transparent sourcing and a story that clients can connect with) One of the most memorable statements of the day was: “We are not Nestlé or Mars, but in a trust-based and emotionally driven space, we can deliver real value to clinics.” The Second Half of the Day: Facing Veterinary Dentistry After the sponsor segment, the stage shifted to Batuhan Elifoğlu. Although the title included the word “introduction,” the content was essentially a complete clinical guide: Oral and dental health in cats and dogs, anatomy, dental charting, and the QUAT/COHAT protocol. Elifoğlu’s approach was clear from the start: “You cannot interpret abnormal tissue unless you understand normal tissue.” That is why he began with skull types. Why Are Skull Types So Important? Clinically, we encounter three basic skull types: Mesocephalic: Labrador, Golden Retriever, domestic shorthair cats—standard reference type Brachycephalic: Pug, French Bulldog, Boxer highest risk group for oral disease Dolichocephalic: Collie-type long-nosed breeds In brachycephalic breeds, the number of teeth is the same, but the jaw is shorter. This causes crowding, rotation, and increased plaque/tartar accumulation in tight spaces. The result: even an oral cavity that looks “normal” externally may hide severe periodontal destruction deeper inside. A Critical Warning About Spring-Loaded Mouth Gags One of the strongest warnings from Elifoğlu was this: Spring-loaded mouth gags in cats can cause serious temporomandibular joint damage and even blindness. When the jaw is held open for long periods, the maxillary artery can become compressed, disrupting blood supply to the retina and brain. Therefore, passive devices that do not apply external force are recommended. The Triadan System: A Shared Language for Talking About Teeth Before moving into dental charting, Elifoğlu explained positional terminology and the Triadan numbering system. In summary: The mouth has four quadrants: 100–200–300–400 Deciduous teeth: 500–600–700–800 Dogs: 42 permanent teeth, 28 deciduous teeth Cats: 30 permanent teeth, 26 deciduous teeth This system allows clinicians to describe any tooth precisely, without relying on relative terms such as “upper right canine.” Dental Charting Cannot Be Done on an Awake Patient Charting is the documentation of a full-mouth examination. But one condition is essential: Dental charting must be performed under general anesthesia with endotracheal intubation. Accurate probing, measurement, and recording are not possible in an awake animal. Elifoğlu reminded attendees of the “four-handed rule”: one clinician calls out the measurements while an assistant records them. This reduces both time and error risk. The standard charting process includes: malocclusion check before intubation missing teeth or mass evaluation periodontal probing (at least 4 sites per tooth) treatment plan and procedure notes postoperative recording and photography Periodontal Indices: “Extraction or Treatment?” This section was one of the most clinically relevant. Periodontal disease is staged as follows: Stage 0: normal Stage 1: gingivitis, no attachment loss Stage 2: < 25% attachment loss Stage 3: 25–50% loss, root exposure possible Stage 4: > 50% loss, advanced mobility → extraction is often indicated Additional indices included in charting forms: calculus index (CL1–3) furcation stages (1–3) mobility grading (0–3) feline tooth resorption index (TR1–5) fracture classifications QUAT / COHAT: The Gold Standard Protocol Elifoğlu emphasized that this is how dental procedures should be performed. In summary, the QUAT/COHAT protocol includes: preoperative evaluation (ASA classification, testing, consent) endotracheal intubation pharyngeal packing (to reduce aspiration risk) antiseptic preparation local nerve blocks supragingival and subgingival scaling dental charting + treatment execution polishing (≤3000 RPM with appropriate paste) postoperative radiography safe extubation at-home care education and 6-month follow-ups The simplest takeaway was: “If you skip the standard, you skip the chance of successful treatment.” Closing: Same Day, Same Goal The most valuable part of this session was the dual perspective: On one side, a brand investing in the question “How can nutrition extend health and longevity?” On the other side, the gold standards for managing oral and dental health correctly in clinical practice. Both aim at the same goal: extending quality of life in companion animals. We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice. For more information about Kito, you can visit www.kito.pet, follow our social media accounts, or contact us at info@kito.pet.

In this blog post, we have compiled the key takeaways from the session titled “Diagnosis and Treatment of Gastrointestinal Stasis/Obstruction in Rabbits – with Research Assistant Dr. Ebuderda Günay”, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Nutrition Ecosystem. We would like to thank our professor for the presentation. Gastrointestinal Syndrome in Rabbits: A Silent Start, a Rapidly Growing Clinical Challenge In exotic animal medicine, there are some diseases that are “very common, yet still not taken seriously enough.” Rabbit gastrointestinal syndrome (GI stasis/obstruction) is exactly such a condition. A quarter of the rabbits brought to clinics arrive with this complaint. Moreover, the problem usually doesn’t begin “all at once”; small factors such as improper feeding, dental problems, stress, and dehydration accumulate—and within 2–3 years, they can turn into a major clinical crisis. Our speaker explained this syndrome clearly, starting from rabbit anatomy and moving through current treatment approaches. The main message of the talk was: “If a rabbit’s gut stops, everything stops. If you catch it early you can save it; if you are late, the race becomes much harder.” A Rabbit Is Not a Rodent, but a Lagomorph: Everything Starts Here To understand GI syndrome in rabbits, the first correct fact is: A rabbit is not a rodent. Rabbits belong to the lagomorph group, and their digestion differs significantly from rodents. This is why “rabbit feeds” sold on the same shelves as rodent feeds in pet shops can cause chronic problems. Rabbit digestion is built on: high fiber + intense fermentation. When this system breaks down, the first thing to collapse rapidly is intestinal motility. The Cecum Is the Heart of the Digestive System When you look at a rabbit’s digestive system, the most striking feature is the enormous cecum: It makes up 40% of the total digestive system volume Fermentation happens here Energy comes largely from volatile fatty acids (acetate, butyrate, propionate) Vitamin K, B vitamins, and microbial protein synthesis occur here If the cecal flora becomes disrupted (dysbiosis): gas forms, toxins increase, energy production decreases, intestinal sluggishness begins. In other words, the main groundwork for GI syndrome is established in the cecum. Rabbits Cannot Vomit: A Small Detail With Huge Clinical Consequences Because of the strong cardiac sphincter at the stomach entrance, rabbits cannot vomit. What does this mean? Preoperative fasting is often unnecessary. But if the stomach–intestinal tract becomes obstructed even once, the contents cannot move back out. A bloated stomach rapidly worsens the animal’s condition. Also, because the stomach pH is very low (1–2): most standard probiotics die in the stomach, which is why probiotic use in rabbits is controversial. Cecotrophs: “Normal Mistaken for Diarrhea” and Owner Misinterpretation Rabbits produce two types of stool: Normal pellet feces (hard, like olive pits) Cecotrophs (soft, smelly, mucous; stick near the anus and are re-ingested) Owners often mistake cecotrophs for diarrhea and panic, bringing the rabbit to the clinic. The veterinarian should ask: “Have you seen the hard pellet feces?” If pellet feces are being produced, the rabbit does not have diarrhea. Most often the issue is diet + obesity + inability to eat cecotrophs. Explaining this correctly prevents unnecessary antibiotics and stops the cycle of improper feeding. Diet = The Number One Cause of This Syndrome Perhaps the clearest message of the seminar was this: 85–90% of a rabbit’s diet must be hay. The ideal ratio: 85% hay (alfalfa / grass hay, etc.) 10% leafy greens 5% pellet feed Hay is essential not only for nutrition, but also for: wearing down teeth, intestinal motility, balancing cecal flora. In diets high in carbohydrates and low in fiber: Clostridium species increase, toxins and gas are produced, digestive pain + appetite loss begin, the gut slows and eventually stops. In practice, GI syndrome is often “the explosion of an animal that has been fed incorrectly for years.” Risk Factors: Why the Syndrome Has No Single Cause Rabbit GI syndrome is multifactorial: Fiber deficiency / improper diet Dental disease Stress and environmental changes Pain and other systemic diseases Dehydration Trichobezoar (hairball) accumulation A critical point: Trichobezoars are not the cause—they are the result. When gut motility slows, hair clumps together, forms a mass, and causes blockage. Saying “I saw a hairball, so that must be the problem” is incomplete — the true issue is the loss of motility. GI Stasis or Obstruction? Making the Distinction Saves Lives There are two main conditions: GI Stasis: motility slows/stops but there is no full blockage Obstruction: mechanical blockage exists (hairball, foreign body, etc.) How to distinguish: Palpation + radiography. On X-ray: In stasis, the stomach is dough-like, full, but gas–fluid levels are not clearly defined. In obstruction, the stomach becomes extremely enlarged, with clear gas + fluid levels. (The speaker describes this as a “boiled egg appearance.”) Obstruction location is also classified: proximal (stomach exit) distal (end of small intestine) colon (very rare) This classification guides treatment decisions. Clinical Alarm Findings: When Does Prognosis Worsen?  If body temperature drops below 36.6°C, mortality risk increases. Blood glucose above 300–360 mg/dl strongly indicates obstruction. Above 444 mg/dl is a critical threshold: prognosis becomes seriously worse. Important note: High glucose in rabbits does not mean diabetes. Glucose rises sharply during stress and obstruction — it’s a metabolic alarm signal. Updated Treatment Paradigm: Medical First, Surgery Second Old approach: “Operate immediately.” New approach (2024–2025 literature): Start with aggressive medical therapy, and only proceed to surgery if there is no response. Backbone of medical treatment: Rehydration: 100 ml/kg/day fluids (SC if needed, mostly IV) Pain control: meloxicam, butorphanol Gas relief: simethicone Force-feeding (to prevent hepatic lipidosis): Critical Care / Oxbow-type formulas Prokinetic support: metoclopramide (effect debated but can be used) Lidocaine / FLK protocol: lidocaine shown to greatly increase motility FLK (fentanyl-lidocaine-ketamine) is strong, but fentanyl access is difficult in practice, lidocaine + ketamine + opioid combinations are effective Medical treatment success rates in many studies: 80–90%. When Is Surgery Needed? And Why Is It Always Risky? If after 24–48 hours of medical therapy: glucose does not decrease, X-rays show no progress, clinical improvement does not begin, then surgery is considered. But the reality of surgery is clear: average survival rate is around 47% if postoperative care is poor, this drops even further That’s why the speaker emphasized this principle: “Advancing the blockage is better than cutting the intestines.” Whenever possible, pushing the mass into the stomach/cecum and emptying it from there is preferred. Conclusion: Rabbit GI Syndrome Is a Battle of “Feeding + Motility” This seminar reminded us of the most critical lesson in rabbit medicine: A rabbit’s intestines do not tolerate stopping. No fiber → flora imbalance → increased gas → pain → motility stops → hairball forms → obstruction occurs. If caught early, it can largely be resolved with medical treatment. If caught late, even surgery cannot guarantee success. That’s why the simplest but most life-saving question in a rabbit patient is: “What does it eat, how much water does it drink, and what is its stool like?” A veterinarian who interprets these answers correctly can stop this syndrome before it even begins. We will continue sharing key insights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held under the sponsorship of the Kito Healthy Nutrition Ecosystem. See you in our next content that will contribute to your clinical practice. For more information about Kito, you can visit www.kito.pet and follow our social media accounts. To contact us, you can email info@kito.pet.

Held within the scope of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, organized under the sponsorship of Kito as part of the Healthy Pet Food Ecosystem, we have compiled the key takeaways from this session for you in this blog post. We would like to thank our esteemed speaker for his valuable presentation. Sonographic Interpretation of Kidney Diseases: A Roadmap for Clinical Practice In veterinary medicine, kidney diseases are among the most frequently encountered internal medicine problems, especially in cats and dogs. Ultrasonography is both a practical and a highly powerful tool in the diagnosis and follow-up of these conditions. However, the true value of ultrasound emerges not as a standalone diagnostic tool, but when it is interpreted together with the clinical picture and laboratory data. Why Is Ultrasonography So Important in Kidney Diseases? The prevalence of kidney diseases in cats and dogs is approximately 10–15%. The sensitivity of ultrasonography is particularly high in chronic kidney disease, with up to 86% of morphological changes detectable via ultrasound. In acute kidney injury, this rate ranges between 70–75%, and when Doppler imaging and the resistive index are included, the evaluation becomes much clearer and more accurate. The advantages of ultrasonography are quite distinct:  Non-invasive and painless Repeatable Easy to perform Provides guidance prior to biopsy A method that delivers rapid and reliable information throughout the clinical process The Right Device – The Right Probe – The Right Settings  The success of ultrasonographic evaluation does not depend solely on the operator; device and probe selection are also of critical importance. Probe selection:  Microconvex/convex probe in dogs (generally 5–8 MHz) Linear probe (the probe that provides the best renal detail; 7–12 MHz) Technical settings:  The focal zone should be positioned over the renal cortex  Gain (contrast) settings should be balanced according to liver echogenicity Depth should be adjusted so that the entire kidney fits within the imaging frame Normal Sonographic Anatomy of the Kidney  The first step in recognizing a pathological image is having a solid understanding of normal anatomy. In a normal renal ultrasound: The cortex has medium echogenicity (more hyperechoic than the liver, more hypoechoic than the spleen) The medulla appears more hypoechoic (darker than the cortex) The cortex-to-medulla ratio is approximately 1.5 The renal pelvis is mostly anechoic Right and left kidney sizes should be symmetrical  (the difference should not exceed 0.3 cm) It is very important to remember the echogenicity hierarchy:  Liver < Renal cortex < Spleen Do Not Mistake Artifacts for Pathology Many artifacts observed in urinary system ultrasonography can actually assist in diagnosis. However, some may be physiological. Commonly encountered artifacts include: Acoustic shadowing: a very valuable finding for stones/mineralization Posterior acoustic enhancement: interpreted in favor of fluid or cysts Twinkle artifact (color twinkling): when Doppler is activated, color noise over a stone; pathognomonic for urolithiasis with approximately 90% diagnostic accuracy Ultrasonographic Findings in Chronic Kidney Disease (CKD) The most important sonographic changes associated with CKD include: Decreased kidney size in cats usually <3 cm  in small dogs <5.5 cm Irregular contours (due to fibrosis) Hyperechoic cortex (increased fibrotic tissue) Loss of corticomedullary differentiation Small anechoic cysts (<5 mm) may be present Increased resistive index Marked cortical thinning Ultrasonographic Findings in Acute Kidney Injury (AKI) In acute processes, renal morphology behaves completely differently from chronic disease: Increased kidney size (approximately 0.35 cm enlargement) Hypoechoic cortex (darker appearance due to edema) Corticomedullary differentiation is preserved Perirenal fluid may sometimes accompany Hyperperfusion may be observed on Doppler imaging Resistive index is normal or low If the acute process becomes chronic (progressing to fibrosis), the imaging findings may reverse. Acute vs Chronic Differentiation Table (Practical Summary)  Findings Acute Kidney Injury Chronic Kidney Disease Size Increased Decreased Cortical echogenicity Hypoechoic Hyperechoic Cortex/medulla differentiation Preserved Lost  Resistive index Normal or low High Clinical presentation Acute azotemia, vomiting PU/PD, weight loss, chronic symptoms Urine specific gravity Normal or mildly decreased Persistently low Findings in Urolithiasis and Obstruction Cases Key points to consider in stone and obstruction cases: Renal pelvis width >3 mm → mild dilation 5–10 mm or greater → evaluated as hydronephrosis Stones appear hyperechoic with acoustic shadowing and twinkle artifact Ureteral dilation >2.5 mm supports obstruction Prolonged obstruction leads to decreased cortical thickness Resistive Index (RI): Why Is It Important? RI is a measurement of vascular resistance against the main blood flow supplying the kidney. The basic formula is: RI = (PSV – EDV) / PSV Normal values: Cat: 0.55–0.70 Dog: 0.56–0.75 Conditions associated with increased RI: Obstruction Fibrosis Hypertension Chronic kidney disease Conditions associated with decreased RI: Inflammation Vasodilation Acute processes Important note: An increase of 0.05 in RI correlates with approximately a 15% decrease in GFR. Most Common Mistakes in Clinical Practice  Common errors that complicate diagnosis in renal ultrasonography include: Not using a reference organ (interpreting echogenicity without comparison to liver/spleen) Evaluating only one kidney (right and left must always be compared) Ignoring bladder filling (can mislead pelvis measurements) Mistaking artifacts for stones or vice versa Not using Doppler imaging Final Note: Ultrasound Alone Is Not Enough Ultrasound is a true compass in kidney diseases—but it is not the destination on its own. The most accurate approach includes: Clinical examination Laboratory data Urinalysis / UPC / SDMA Integrated interpretation of ultrasound findings With this approach, diagnostic accuracy can exceed 90%. We will continue to share key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held under the sponsorship of Kito as part of the Healthy Pet Food Ecosystem. We look forward to meeting you in future content that will contribute to your clinical practice. For more detailed information about Kito, you can visit www.kito.pet and follow our social media accounts. To contact us, you may email info@kito.pet.

In recent years, many dog owners have been turning to natural, additive-free options in feeding their pets. New-generation fresh dog foods have become increasingly popular due to ingredient control, freshness, and the idea of “human-grade nutrition.” Many people are also adapting to this shift by cooking or preparing food for their dogs at home. However, a comprehensive scientific study conducted recently suggests that the trend of home-cooked dog food may not be as safe as we think. How Balanced Is Homemade Food? 1,726 Homemade Diets Were Examined; Researchers (a joint study by the Dog Aging Project / Texas A&M University and Virginia-Maryland College of Veterinary Medicine) analyzed the nutritional value of 1,726 homemade dog food recipes prepared by owners. Although the ingredients varied, the study’s critical finding was striking: Only 6% of the recipes had the potential to meet dogs’ complete and balanced nutritional needs. In other words: 94% of homemade dog foods are nutritionally inadequate or unbalanced. These imbalances were especially concentrated in the following areas: Disrupted calcium–phosphorus ratios Vitamin deficiencies (A, D, E, etc.) Essential fatty acid insufficiency Trace mineral deficiencies Improper energy distribution Over the long term, these deficiencies may negatively affect vital systems such as bone health, immunity, metabolism, and skin/coat condition. Why Is Homemade Food Deficient? The main reason homemade recipes become problematic is that nutritional balance cannot be achieved through simple or intuitive methods. Ingredients being natural or seeming high quality is not sufficient on its own. Dogs’ biological needs differ from humans’, and these needs must be calculated according to professional nutrition standards. In addition, dog owners often make frequent changes to recipes reducing ingredient amounts, removing certain items thinking “it’s optional,” or using different oils. Even small changes like these can make a recipe deficient. What Should Those Who Want to Prepare Homemade Food Do? Researchers emphasize the following recommendations for people who prefer homemade diets: Recipes formulated by professional nutrition experts must be used. Altering recipes can disrupt nutritional balance. Vitamin-mineral supplementation should be planned if necessary. Homemade food can be much riskier for dogs with chronic illnesses or special needs. So What’s the Solution? The idea of homemade dog food often starts with love and good intentions. But good intentions alone are not enough to meet a dog’s biological needs. For a balanced and safe nutrition plan, scientific recipes, correct formulation, and professional oversight are essential. At this point, fresh foods prepared with special formulations stand out as a strong alternative that can eliminate the risks of homemade diets. How Does Kito Fresh Fit Into This Picture? Kito Fresh fresh foods take the positive aspects of the homemade trend (freshness, naturalness, no additives) while professionally completing the critical parts that require scientific formulation. Recipes are developed by veterinarian nutrition experts. The ingredient standard aims for human food quality. Vitamin-mineral balance and the calcium–phosphorus ratio are planned scientifically. No preservatives or artificial additives are used. For this reason, Kito Fresh offers dog owners who want natural nutrition and also want to meet all their dog’s nutritional needs completely a safe and balanced option that fills the gaps left by homemade food. Source: O'Brien JS, Lawson E; Dog Aging Project Consortium; Tolbert MK, Ruple A. Findings from the Dog Aging Project: home-prepared diets for companion dogs feature diverse ingredients, and few are nutritionally complete. Am J Vet Res. 2025 Aug 27;86(11):ajvr.25.06.0216. doi: 10.2460/ajvr.25.06.0216. PMID: 40865554.

As a brand dedicated to the health and happiness of our beloved pets, we were delighted to sponsor VetSummit 2025 – New Horizons in Veterinary Clinical Sciences. A Platform Where Science and Experience Met Held online between October 13–24, 2025, VetSummit 2025 addressed current developments and practices in veterinary clinical sciences. During the event, participants attended evening sessions featuring experts in their fields, covering topics such as: Prof. Dr. Dr. Hakan Salcı – Thoracic, Cardiac, and Vascular Surgery in Cats and Dogs Prof. Dr. Duygu Dalgın – Looking Toward the Future in Veterinary Field Practice: Potentials, Opportunities, Making a Difference Prof. Dr. Pınar Saçaklı – The World Within Us: Gut Health and Nutrition Arş. Gör. Dr. Ebuderda Günay – Diagnosis and Treatment of Gastrointestinal Stasis/Obstruction in Rabbits Veterinarian Batuhan Nathur – Ozone Therapy in Companion Animals  Prof. Dr. Yücel Meral – My Dog Suddenly Fainted While Walking in the Park! Cardiology Emergencies Dr. Veterinarian Onur İskefli – Dilated Cardiomyopathy Veterinarian Batuhan Elifoğlu – Introduction to Oral and Dental Health in Cats and Dogs: Anatomy, Dental Charting, and COHAT  Dr. Öğr. Üyesi Pınar Can – Physical Therapy and Rehabilitation in Small Animals Dr. Veterinarian Başar Ulaş Sayılkan – Pulmonary Hypertension Dr. Veterinarian Erman Koral – Lower Urinary Tract Diseases in Cats and Dogs  Veterinarian Yusuf Sefa Dedeoğlu – Sonographic Interpretation of Kidney Diseases Participants had the opportunity to ask questions during the live sessions, and all recordings will remain available for replay for 60 days. Why Was Kito at This Event? At Kito, our mission is not only to offer high-quality, natural products, but also to actively support scientific advancements in pet health. In line with this mission, we: Contributed to the exchange of knowledge and experience among veterinarians, Shared our vision on nutrition and welfare grounded in scientific approaches with the veterinary community,  Had the opportunity to present our “human-grade pet food” philosophy to a broader professional audience. What Remains From the Event Throughout VetSummit 2025, hundreds of veterinary clinicians, academics, and industry professionals came together on the same digital platform. As Kito, we were proud to be part of a valuable community that integrates scientific perspectives with our brand. This sponsorship was not merely a promotional step, but an initiative that contributed to sustainable knowledge sharing in pet health. Thank You As the Kito family, we extend our gratitude to all instructors, participants, and partners who contributed to this organization. Guided by science, we will continue working to enhance the quality of life of our beloved animal companions. See you at future events!

"Homemade diets are a significant nutritional strategy that enhances overall health and quality of life in both healthy and sick dogs. The study demonstrates that homemade diets serve as an effective tool in veterinary practices, yielding successful results in symptom management." As awareness among pet owners about their dogs' nutrition grows rapidly, homemade diets are becoming increasingly popular. A recent study highlights the positive effects of homemade diets on dogs' overall health. In this article, we explore the importance, outcomes, and implementation details of homemade diets based on the findings of the study titled "Homemade Diet as a Paramount for Dogs’ Health." Objective and Scope of the Study This study was conducted on 167 dogs of various ages, genders, and health conditions. The participants included both healthy dogs and those with various pathological (diseased) conditions. The primary objective of the research was to evaluate the long-term effects of homemade diets and to assess the adherence rates of dog owners to these diets. The study particularly focused on the following health conditions: Gastrointestinal diseases (chronic diarrhea, vomiting, reflux) Dermatological issues (dermatitis, otitis, tear staining) Dogs experiencing both conditions simultaneously Data and Findings Participant Profile Total of 167 dogs: 30% mixed-breed, 70% purebred. Age range: 7 months – 14 years. 75% spayed females, 57% neutered males. Diet Types and Preferences Diet Type Initial (n) Final (n) Change (%) Homemade diet 55 (26 mixed) 104 (24 mixed) +62% Commercial food 112 63 -38%   A significant increase was observed in the number of dogs using homemade diets (p < 0.0001). The main reasons for discontinuing the diet were owner compliance issues (27%) and dogs not adapting to the new diet (15%). Observations in Healthy Dogs Coat Quality: 70% improvement in shine and softness. Defecation Frequency: 47% decrease. Overall Energy and Appetite: Stable. Observations in Sick Dogs Condition Improvement Rate Gastrointestinal diseases 95% Dermatological diseases 83% Dogs with both conditions 100%   Homemade diets were found to significantly alleviate symptoms, particularly in dogs suffering from chronic enteropathy (intestinal diseases) and dermatological issues. Features of Homemade Diets Homemade diets are tailored to meet the individual needs of each dog. The primary components include: Protein Sources: Chicken, turkey breast, beef. Carbohydrates: Rice, potatoes, couscous. Fats: Salmon oil, sunflower oil. Vegetables: Zucchini, carrots, peas. The meals are typically prepared by steaming or boiling with minimal water and are recommended to be served in two daily portions. Benefits of the Diet Significant improvements were observed in coat quality, energy levels, and appetite among dogs that adhered to the homemade diet. Parameter Odds Ratio (OR) p-Value Appetite 4.07 0.003 ** Energy Level 3.47 0.017 * Coat Quality 9.88 <0.001 *** Defecation Frequency 0.01 0.93 Defecation Consistency 0.01 0.97   Features of Homemade Diets Improved Digestive Health: A 95% improvement was observed in dogs with gastrointestinal issues. Natural and Fresh Ingredients: Prepared using human-grade food, preserving nutritional value. Reduction in Health Problems: 100% symptom improvement in dogs with both gastrointestinal and dermatological conditions. Challenges and Kito Fresh’s Solutions Owner Compliance: Preparing homemade diets can be time-consuming, requiring owner education and process simplification. / Kito Fresh can be stored at room temperature and served in its specially designed, easy-to-open packaging. Supplement Usage: 21% of owners discontinued supplements due to flavor incompatibility (93%) and difficulty in accessibility (7%). / Kito Fresh provides all necessary vitamins and minerals from its ingredients, eliminating the need for supplements. Conclusion Homemade diets are a significant nutritional strategy that enhances overall health and quality of life in both healthy and sick dogs. The study demonstrates that homemade diets serve as an effective tool in veterinary practices, yielding successful results in symptom management. Balanced diets tailored to individual needs should be recommended by veterinarians and nutrition experts for optimal outcomes. References Pignataro, G., Crisi, P.E., Landolfi, E., et al. (2024). Homemade Diet as a Paramount for Dogs’ Health: A Descriptive Analysis. Vet. Sci. 11(438). DOI: 10.3390/vetsci11090438.