Cone of Shame 347 - When Care Can't Wait: Being Prepared for Critical Cases

Julia Sosa, Chief Experience Officer at Pumpkin Pet Insurance, joins Dr. Andy Roark for a must-hear conversation on what happens when care can't wait. Ever had that moment in clinic when a pet’s situation is critical and the client is staring at an estimate, panicked and unsure what to do? This episode dives headfirst into the chaos of urgent cases and how we, as veterinary professionals, can better support clients in the middle of that emotional storm. Julia shares how Pumpkin’s new urgent-pay service, Pumpkin Now, is transforming how pet insurance works in those high-stakes moments, giving owners financial clarity within minutes and helping vet teams stay focused on care, not claims.

Dr. Andy and Julia unpack why pet insurance is often misunderstood, what it really means to be “hospital-centric,” and how to streamline workflows without overburdening teams. Whether you’re skeptical of insurance or already a fan, this episode brings new insight into making emergency care more accessible. Gang, let’s get into this episode.

PumpkinNow Expedited Payment Terms: Qualified customers with eligible claims for treatments $1k or more could be paid in 15 minutes after submitting a request if their bank accepts real-time payments. For full terms & conditions, visit www.pumpkin.care/pn-terms. For pet insurance terms and conditions, visit: https://www.pumpkin.care/sample-plan/. Products are underwritten by either Independence American Insurance Company (NAIC #26581), or United States Fire Insurance Company (NAIC #21113), and produced by Pumpkin Insurance Services Inc. (“Pumpkin”) (NPN #19084749; CA License #6001617).

Pumpkin Care for Veterinarians: https://www.pumpkin.care/for-veterinarians/

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Julia Sosa is a Design Leader whose lifelong love of animals led to her passion and focus in the pet care and veterinary industries. As a founding member and Chief Experience Officer of Pumpkin, one of the fastest-growing pet insurance companies in the United States, Julia leads UX research, strategy, and product design for their member and veterinary experiences. In January 2024, she started coursework to become a Veterinary Technician and explore her dream of becoming a late-in-life veterinarian.

Julia is an active member of the rescue and shelter community and a devoted foster and adoption counselor for the ACC. She is the proud pet mom to two small dogs, two large cats, three chickens, and over 112+ foster kittens (and counting).

Dr. Cory Woliver, DVM, emergency and critical care lecturer at the University of Florida, joins Dr. Andy Roark to discuss venomous snake bite management in veterinary practice. Ever wondered how many vials of anti-venom to give when a copperhead or rattlesnake strikes? This episode cuts through the guesswork on coagulation testing, anti-venom dosing strategies, pain control options, and when to hospitalize versus treat as an outpatient. Dr. Woliver explains why steroids, NSAIDs, and routine antibiotics often miss the mark and how early, aggressive anti-venom is your best defense against tissue necrosis. You’ll learn practical tips on evaluating bite severity, setting client expectations, and choosing between strong opioids like methadone or hydromorphone for pain relief. Whether you see one snake bite a season or dozens, this one-stop shop equips you with the science and experience to act confidently under pressure. Let’s get into this episode.

National Snake Bite Support Website: https://www.nationalsnakebitesupport.org/

Facebook Group: https://www.facebook.com/groups/national.snakebite.support/

Snake Bite Foundation Website: https://www.snakebitefoundation.org/

Dr. Know-It-All Card Game: https://drandyroark.com/product/dr-know-it-all-card-game/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

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Cory Woliver is a veterinarian practicing as a Clinical Lecturer in Emergency and Critical Care at the University of Florida College of Veterinary Medicine. He earned his BS in biology at SUNY Stony Brook and his DVM at Ross University School of Veterinary Medicine. During his 18-month emergency and critical care-focused internship at Colorado State University, he treated a large number of snake envenomations. He has also earned a certificate in hemodialysis through the University of California – Davis.

After his postgraduate training, Dr. Woliver spent several years in private practice in New York before coming to the University of Florida in 2019. His clinical interests include snakebites (especially coral snake envenomations), acute kidney injuries, and extracorporeal therapies. He is currently the PI for the clinical trial using Varespladib in coral snake envenomated patients.

What if improving your clinic’s communication could reduce turnover, boost job satisfaction, and enhance medical quality? Dr. Jason Coe is back on the podcast with brand-new research that shows how “relational coordination” (aka how roles within your team communicate and collaborate) impacts everything from psychological safety to employee retention. In this episode, Dr. Coe and Dr. Andy Roark dive into the findings from a cross-industry communication model now being applied to veterinary teams. They explore what high vs. low relational coordination looks like in real life, how communication systems like impactful rounds and EMR notes can move the needle, and why this data matters for improving not just morale but also patient outcomes. Whether you're a practice owner, a manager, or just someone who wants your team to function better, this episode offers both inspiration and real takeaways. Gang, let’s get into this episode!

Linkedin: https://www.linkedin.com/company/relationship-centred-veterinary-medicine-at-the-ontario-veterinary-college

University of Guelph: https://rcvm.uoguelph.ca/

Dr. Know-It-All Card Game: https://drandyroark.com/product/dr-know-it-all-card-game/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

Dr. Jason Coe is a Professor at the Ontario Veterinary College in Guelph, Ontario, Canada. After graduating from the College in 2001, he returned from mixed-animal practice to complete a PhD in the area of veterinary communications in 2008. In the same year, Jason joined the Ontario Veterinary College in the Department of Population Medicine where he has established an active research program examining the human-animal bond as well as the role of interpersonal communications on the outcomes of veterinary care. In his current role at the College, he coordinates the clinical-communication curriculum across all 4 years of the veterinary program and is involved in teaching students about the relationships that exist between people and animals.

Over the past two decades, Jason has established an international reputation for his leadership in veterinary communications, primary-care veterinary education and understanding the human-animal bond. He has published over 100 peer-reviewed journal articles, contributed to several book chapters, and is regularly invited to speak nationally and internationally at scientific and continuing-education conferences. Jason currently holds the VCA Canada Chair in Relationship-Centred Veterinary Medicine (2021-2026), at the Ontario Veterinary College, dedicated to research and education in communication and relationship-building to improve the outcomes of veterinary care. In 2021, Jason was honoured with the American Veterinary Medical Association’s Bustad Companion Animal Veterinarian of the Year Award for his notable contributions to the veterinary profession and in 2022, he founded the research program Relationship-Centred Veterinary Medicine at the Ontario Veterinary College (https://rcvm.uoguelph.ca/).

What do you do when your big, lovable diabetic cat suddenly develops renal disease? You call in the nutritionist cavalry! In this episode, Dr. Andy Roark is joined by boarded veterinary nutritionist Dr. Caitlyn Getty to tackle a real-world “hot mess express” case: Claudia, an obese diabetic cat who’s now showing signs of kidney issues. Together, they dig into the complexities of nutritional management for cats with multiple chronic conditions. Dr. Getty breaks down why common diets can conflict with one another in cases like this, and how Hill’s Prescription Diet Multi-Organ Feline can help bridge the gap. They cover protein and phosphorus challenges, insulin dosing concerns, fiber benefits, and the power of a slow and steady transition when switching foods. Whether you’ve got cats with combo problems like diabetes and kidney disease or just love nerding out over nutrition, this episode is full of practical takeaways and clinical insight. Let’s get into this episode.

Check out the downloadable team training worksheet and follow along together! Empower your team to educate clients using the notes and discussion questions.

This episode is brought to you by Hill's Pet Nutrition!

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ABOUT OUR GUEST

Caitlyn is a Board Certified Veterinary Nutritionist® and Scientific Communications Senior Specialist on the US Professional Veterinary Affairs Team at Hill’s Pet Nutrition. She spent 13 years at the University of Illinois completing her BS, DVM, and PhD in Nutritional Sciences. During veterinary school and her PhD, she became very interested in nutrition education of veterinary students and the power of nutrition in health and disease. She completed a rotating small animal medicine and surgery internship on the north side of Chicago and then moved to Raleigh, NC to complete her Small Animal Clinical Nutrition residency at North Carolina State University. She currently lives outside Indianapolis with 4 cats, 2 dogs, and her fiancé!

Dr. Lance Roasa, a veterinarian and practicing lawyer, who is the founder of Roasa Law Group joins Dr. Andy Roark. They dive into two key lawsuits shaking up the veterinary world: LMU Lincoln Memorial University suing the AVMA for anti-competitive practices and veterinary interns launching a class action lawsuit against the Match program and some vet schools. Dr. Roasa breaks down both cases, discussing the reasons behind them, the arguments involved, and the potential impact on the profession. They also touch on broader issues like the influence of venture capitalists and the evolving landscape of veterinary medicine. Let's get into this.

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Guest Bio:

Dr. Roasa is a 2008 graduate of Texas A&M who has practiced in small

animal, mixed animal and emergency settings and has bought, operated and sold over a dozen veterinary practices. He has completed a law degree from the

University of Nebraska, is the past president of the American Veterinary Medical

Law Association. Dr. Roasa is a consultant for VIN and is a founder of Drip Learning Technologies, a veterinary continuing education provider. He also lectures in 13 veterinary colleges on the legal aspects of employment contracts, medica record keeping, veterinary malpractice and veterinary business as part of the curriculum. He serves as a national co-advisor to the Veterinary Business

Management Association and regularly lectures to regional VBMA chapters and to the national association on the topics of growth, business metrics, and technology implementation. Dr. Roasa also owns Santa Rosa Ranch, home to the largest registered Brangus cow herd in the United States.

Dr. Petra Harms, veterinarian and founder of VetMaite, joins Dr. Andy Roark to tackle one of the most overlooked questions in veterinary AI: how do we know these tools actually work? AI scribes, chatbots and diagnostic aids are flooding into veterinary clinics, but who is testing their accuracy, safeguarding client data, or setting ethical standards? Petra is a big fan of AI (she’s not calling for chisels and stone tablets) but argues that without proper quality control, veterinarians and clients could pay the price. In this thought-provoking episode, you’ll hear why “data is the new gold,” what every practice owner should ask before buying an AI tool, and how to embrace technology responsibly without sacrificing patient care or privacy. If you’re excited about AI but also a little uneasy, this is the conversation you didn’t know you needed. Let’s get into this episode!

Dr. Petra Harms on LinkedIn: https://www.linkedin.com/in/petra-kos-harms/

VetMade: https://www.vetmade.com/about

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Dr. Harms works at the intersection of emerging artificial intelligence technology and practical small animal veterinary practice. She has spent more than two decades working in veterinary clinics, 15 of those as a veterinarian. She has practiced medicine through seismic shifts in the medical field, from the change from paper to electronic medical records and during the ongoing evolution of EMR's.

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She has practiced with fifteen veterinary medical clinics, taken part in three major technology transitions, one major facility transition, and is versed in five EMR systems. She has worked closely with a teams of highly trained emergency clinicians and specialists, and has also worked as solo practitioner in charge of day-to-day clinic operation.

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In the past year, Dr Harms has focused her education on learning about Artificial Intelligence and its significance to healthcare systems, obtaining certificates of specialization from Stanford and Harvard with more on the way.

Dr. Caitlyn Getty, DVM, PhD, DACVIM (Nutrition), is back on the Cone of Shame to tackle a classic hot mess express: the IBD dog who now has early kidney disease. In this “How Do You Treat That?” episode, Dr. Andy Roark presents Murph, a finicky Yorkie with a sensitive gut, a history of GI explosions, and renal values on the rise. The kicker? His current food is working, and his owners are terrified to change it.

Dr. Getty breaks down how to approach cases with conflicting nutritional needs and shares her checklist for diet selection when no one food seems perfect. They dig into the new Hills Canine Multi-Organ diet, why it might be a game-changer for dogs like Murph, and when it might not be the right fit. You’ll walk away with practical tips for food transitions, client communication, and managing complex patients without causing a GI disaster. If you’ve ever had a fragile pup with overlapping conditions and nervous clients clinging to the current food bag for dear life, this one’s for you.

Check out the downloadable team training worksheet and follow along together! Empower your team to educate clients using the notes and discussion questions.

This episode is brought to you by Hill's Pet Nutrition!

Hill's Vet

Hill's Veterinary Academy

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course

Dr. Andy Roark Charming the Angry Client Team Training Course

Dr. Andy Roark Swag

All Links

Caitlyn is a Board Certified Veterinary Nutritionist® and Scientific Communications Senior Specialist on the US Professional Veterinary Affairs Team at Hill’s Pet Nutrition. She spent 13 years at the University of Illinois completing her BS, DVM, and PhD in Nutritional Sciences. During veterinary school and her PhD, she became very interested in nutrition education of veterinary students and the power of nutrition in health and disease. She completed a rotating small animal medicine and surgery internship on the north side of Chicago and then moved to Raleigh, NC to complete her Small Animal Clinical Nutrition residency at North Carolina State University. She currently lives outside Indianapolis with 4 cats, 2 dogs, and her fiancé!

Dr. Stacee Santi, veterinarian, tech founder, and author of Stop Acting Like a Girl, joins Dr. Andy Roark for a conversation that challenges the norms women are handed and how those expectations shape careers in veterinary medicine and beyond. From the ER to the boardroom, Stacee has walked the walk, founding Vet2Pet, navigating startup negotiations, and now stepping into authorship and podcasting with her new show Everyday Wonder Women. In this episode, she shares the pivotal moment that inspired her book title, how generational beliefs shaped her journey, and why so many high-performing women still hesitate to speak up or negotiate their worth. This one’s for anyone mentoring women in the profession, raising daughters, or trying to build a more inclusive clinic culture. You’ll walk away with new insight on how to empower quieter voices, rethink staff meetings, and encourage decisive leadership.

Stop Acting Like a Girl Book

Stacee Santi on LinkedIn

Every Day Wonder Women Podcast

Dr. Know-It-All Card Game

Dr. Andy Roark Charming the Angry Client Team Training Course

Dr. Andy Roark Swag: drandyroark.com/shop

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Dr. Stacee Santi is a 1996 DVM graduate from Colorado State University and the founder of Vet2Pet, a tech platform for veterinary practices that was sold to Vetsource in 2022. With over 20 years in small animal and emergency practice, Stacee offers practical solutions for veterinary teams in tech, workflows, client service, and leadership. She’s also the author of Stop Acting Like a Girl, a book that encourages women to break free from outdated expectations and embrace assertiveness, confidence, and ambition. Stacee has served on multiple industry advisory boards, was past president of the Colorado Veterinary Medical Association, and was named 2021 Educator of the Year by the Western Veterinary Conference. She lives in Durango, Colorado with her husband, 6 horses, 2 dogs, 1 cat, 4 chickens, and dreams of a baby burro.