Four years after our original antibiotic myth-busting episode (Ep 60), we’re back with Dr Riati Scarborough to talk antibiotic prescribing habits. This time we’re joined by fellow stewardship expert Dr Laura Hardefeldt, and this time we’re asking the harder question:

Have we actually changed?

The good news? Some prescribing habits are shifting. We’re seeing shorter courses and less ‘just in case antibiotic usage.

But let’s not pat ourselves on the back too quickly. Because some of our most entrenched habits are still alive and well, like how we treat skin disease, and our ongoing love affair with amoxiclav.

This episode is a practical, clinically grounded update on what the evidence says in 2026 - and how to make realistic changes without compromising patient care.

We cover:

• Why skin disease remains the single biggest driver of antimicrobial resistance in small animal practice, and what to do about it
• Amoxicillin vs amoxiclav: when de-escalation is not just safe, but smarter
• Why convenience (you know the brand we’re talking about right…) is not a clinical indication
• Trimethoprim-sulphonamide and the real story on KCS risk
• Dentals, heart murmurs, and what prophylaxis actually looks like in 2026
• Simple in-clinic stewardship strategies that genuinely shift prescribing behaviour

This isn’t about perfection. It’s about progress.

If you’d like effective antibiotics to still exist in five to ten years…

This episode is essential listening.

Find out how we can support you in your vet career at ⁠⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Grab one last handful of spots in the Maldives for our surf/dive vet conference with ⁠Vets On Tour⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Tips and Timestamps

• 3:03 Progress in prescribing habits including UTI durations and surgical prophylaxis
• 4:55 Skin disease as the biggest problem area in small animal practice
• 7:01 Topical therapy versus systemic antibiotics for skin conditions
• 9:28 Deep pyoderma and the new consensus statement
• 11:00 Gut bacteria as a source of resistant infections
• 12:41 Rise of MRSP, methicillin-resistant Staphylococcus pseudintermedius
• 14:00 Amoxicillin-clavulanate overuse
• 16:47 Vets on Tour conferences advertisement
• 18:08 Pharmacology refresher on amoxicillin, amoxicillin-clavulanate, and cefovecin
• 19:45 Why cefovecin is classified as high importance, vs the convenience argument for cefovecin in cats
• 22:56 Long-acting amoxicillin injections as an alternative
• 24:00 Getting amoxicillin back on the shelf
• 24:53 Communicating antibiotic choices to clients
• 29:32 Dental antibiotics and debunking the heart murmur myth
• 34:07 Subclinical bacteriuria and stopping cultures in asymptomatic patients
• 38:30 Reassessing the dry eye risk of trimethoprim-sulfonamide
• 41:43 Antimicrobial stewardship trial using colour-coded pharmacy shelves

Veterinary life can feel like a treadmill with no off-switch: 15-minute consults that always run over. Emotional labour no one trains you for. A schedule that swings from slow to chaos - in minutes.

Sound familiar? You’re not alone.

In this raw and refreshingly real episode, productivity coach Demir Bentley (Life Hack Method) live-coaches GP vet Dr Ray Gates, tackling the uncomfortable truth of veterinary medicine:You’re expected to be clinically excellent… while running on empty.

This isn’t a listicle of “10 productivity hacks.”This is about reclaiming 1% wins that actually work in the chaos of clinical life.

You’ll learn:

• Why productivity isn’t about doing more - it’s about protecting your energy
• How “chaos as the default” leads to burnout (and how you can change the system, not just yourself)
• How to lower your cognitive load and reduce admin fatigue
• The art of setting goals that don’t become another source of stress
• Small upstream shifts that stop downstream disasters
• How to finish a shift and still feel like you

Whether you’re buried in charting, stuck in overbooked consults, or silently wondering if you’re just not “resilient enough” - this conversation will show you another way.

You don’t need another motivational quote.You need practical tools to get your time, headspace, and energy back.

And it starts here.

Raise your hand here to find out more about our AI for clinics Mastermind

Find out how we can help you build you in your vet career at ⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Topics and Time Stamps

10:56 The problem

23:04 The revenge binge

26:10 Taking back the 1%

35:52 Upstream changes to prevent downstream chaos

41:31 Expectations vs reality

52:05 You are not powerless

Ever feel like your anxiety or fear of failure is just... who you are?

The perfectionism. The overthinking. The constant pressure to “get it right.”

It can feel like it’s wired into your DNA.

But what if it isn’t?

Dr Rod Irwin, vet, former clinic owner and author tells us how who went from panic attacks in an empty vet clinic to a completely rewired life - thanks to neuroscience.

After hitting breaking point, a chance encounter with neuroscience set him on a 15-year journey into neuroplasticity and positive psychology - and ultimately changed how he led.

Together, we unpack how our brains are shaped by past experiences, why vets are particularly vulnerable to negative belief loops, and how we can deliberately rewire our thinking to reduce anxiety, improve performance and build healthier workplace cultures.

We explore:

• Why early experiences like bullying and perfectionism hardwire us for burnout
• What neuroplasticity actually means, and why this isn't just “positive thinking”
• How emotions strengthen or weaken your neural pathways
• Dr Irwin’s first 3 practical steps to start rewiring your brain
• Why your identity is the key to lasting change
• How clinic leaders unconsciously set the emotional tone for the entire team
• And how reconnecting to purpose and values can transform your culture

This is a science-backed, practical conversation on mindset, leadership and wellbeing – tailored to the veterinary world.

Because your brain isn’t broken.It’s just wired by experience - and you can change the wiring.

⁠⁠

Learn about all 12 keys here, or here if you're a practice owner, or book a chat with Rod here.

Find out how we can support you in your vet career at ⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Grab one last handful of spots in the Maldives for our surf/dive vet conference with Vets On Tour⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, or go all in on surgery with our collaboration with Sydney University's ⁠⁠⁠CVE Surgery Course.

Welcome to episode one of our new Tech Tools series, where we cut through the noise to bring you real insights into the latest veterinary tech that could genuinely make your day‑to‑day vet life easier.

In part one VetRec founder Kevin Cohen helps me put this AI scribe through its paces to show us why veterinary AI software is rapidly moving WAY beyond just note taking.

Highlights :

• What an AI scribe really is and how it saves vets hours of documentation time
• Beyond scribing - new tools to speed up your workflow with increased reliability and context
• VetRec’s clinical support tool: D.A.V.I.D. (Diagnostics Assistance for Veterinary Insights and Differentials)
• Team workflows — how receptionists, nurses and vets can collaborate in the same platform

This one involves a bit of screen sharing, so if you want to follow along - watch the video for this on Spotify.

Note: This episode isn’t a promotion or an ad — it’s the first of many deep dives into the tools you might be considering. If you have a software that you’d like us to explore, let me know at info@thevetvault.com

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, or go all in on surgery with our collaboration with Sydney University's ⁠CVE Surgery Course. ⁠

Find out how we can help you build you in your vet career at ⁠⁠⁠thevetvault.com⁠⁠⁠.

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Join us in person for our epic adventure CE events at ⁠⁠⁠⁠⁠⁠⁠Vets On Tour⁠⁠⁠⁠⁠⁠⁠. (Next up: Japan snow conference!)

Topics and Time stamps

• 04:05 – New Features 2025
• 05:19 – Add to Visit
• 07:46 – DictationFeatures
• 08:35 – A Cut Above Promo
• 10:08 – Snippets
• 12:15 – Insights & Recommendations
• 13:59 – Integrations
• 16:06 – EzyVet Chrome Extension
• 17:05 – Custom Templates
• 17:58 – Phone Call Recording
• 21:38 – Multi-Pet Support
• 22:33 – Client Handouts
• 24:07 – Analysis Features
• 28:38 – David AI Assistant
• 38:03 – Records Recap
• 41:09 – Team Access
• 42:29 – Best Recording Practices

Stop scrolling - I know what you’re thinking: “I don’t want to listen to someone preaching to me about antimicrobial resistance - it’s boring, and it just makes me feel guilty!”

Here's a promise: you'll find nothing boring or preachy here. What you will get is interesting science, practical tips, and zero guilt trips.

Dr Kate Worthing is a senior lecturer in veterinary microbiology, practising clinician and passionate antibiotic resistance researcher, and she’s about to change how you prescribe.

Together we unpack why the way you use antibiotics in general practice is more than a clinical choice - it’s a responsibility that affects your patients, your team, and your future cases. From unseen pathways of resistance to pragmatic stewardship strategies you can implement this week, this is essential listening for all veterinarians.

You’ll learn:

• Why antimicrobial resistance is not just a global issue - it’s personal, and it’s already in your consult room.
• How selection pressure works beyond the infection: across the microbiome, the patient, and the environment.
• Why MRSA isn't really the problem you should be worried about (and where you SHOULD point your attention).
• Where resistance risk is highest in small animal practice.
• What “good prescribing” looks like in real life
• How to find and apply trustworthy prescribing guidelines without slowing down your workflow.

Resources:

AMRVC

https://www.amrvetcollective.com/

https://www.amrvetcollective.com/home/guidelines/

WSAVA Infographics

https://wsava.org/committees/therapeutics-guidelines-group/

ISCAID

https://www.iscaid.org/guidelines

Understanding the mechanisms of resistance

Video

Visit thevetvault.com to join our Vet Vault Nerd community for more clinical confidence and better patient outcomes, get help with your tricky cases in our specialist‑support space, and subscribe to our newsletter for clinical gems and a bit more.

We scrutinise one of the most practical yet under‑examined advances in veterinary practice: AI‑based radiology interpretation tools.

I sit down with veterinary radiologist and Vedi entrepreneur Dr  Steve Joslyn to unpack the rise of AI-powered radiology tools in general practice. But this isn’t just opinion: Steve reveals the findings from his team’s recent study that put 6 commercially available AI radiology softwares in the spotlight - or up on the light box - to assess whether they deliver on what they promise.

From how these systems are trained, to where they shine (and where they fail), this conversation gives a no-nonsense look at what AI can actually do for your diagnostic imaging workflow.

What You’ll Learn:

• How these tools are built: Neural networks, down-sampling, and the truth behind “ground truth”.
• The data dilemma: Why most AI tools perform best in theory, not in general practice.
• Where they fall short: From image quality issues to breed bias and external validation gaps.
• New accuracy data: Insights from Dr Joslyn’s pilot study comparing six commercial AI tools.
• A decision-making playbook: When to trust AI, when to double-check, and when to avoid it entirely.
• Ethics and workflow impact: Who’s responsible? What do you tell clients? Can AI triage be trusted?
• How to stay future-ready: What’s coming next – and how to adapt without compromising care.

🎧 Listen now for the tools to ask better questions about AI in your clinic.

Find out how we can help you build you in your vet career at ⁠thevetvault.com⁠.

Check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠⁠⁠.

Get case support from our team of specialists in our ⁠⁠⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠⁠⁠.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Join us in person for our epic adventure CE events at ⁠⁠⁠⁠⁠Vets On Tour⁠⁠⁠⁠⁠. (Next up: Japan snow conference!)

Did you know that a brachycephalic dog with BOAS has a 433% higher anaesthetic risk than a dog with a normal nose?

Let me rephrase that: that Frenchie you’re spaying later this week is more than four times more likely to die on her surgery day than any of your other patients. 😳

Do we have your attention?!

Thanks mainly to the rising popularity of the French Bulldog, you’re probably anaesthetising these kinds of patients all the time.

So how do we reduce that risk? How do improve patient safety while decreeing your stress levels?!

At the Brachycephalic Care Unit, surgeon Dr Abbie Tipler and her team have polished brachycephalic anaesthesia down to a fine art, and in this episode, she shares all the gold.

From the days leading up to anaesthesia to selecting the safest mix of premed and anaesthesia agents, all the way to a calm, well-oxygenated recovery, this episode is the ultimate masterclass in brachycephalic anaesthesia.

Hit us up for the full show notes for this episode, as well as Dr Abbie’s brachycephalic pre-surgery history template, here.

This episode is one of more than 600 from our subscriber-only clinical podcasts. If you like this style of learning, where I dig for all the pro tips and updates from some of the best specialists in the world, then you’ll love our clinical feed. Go check it out at thevetvault.com

Oh, and if you’d like to join me in Japan in February or the Maldives in April for the most fun you’ll ever have at a vet conference - have a browse at vetsontour.com

Topics Covered:

Before the big day

• Structured history taking: airway, gastrointestinal, sleep, and anxiety indicators
• Understanding the link between upper airway obstruction and GI dysfunction
• Assessing regurgitation, silent reflux, and aspiration risk
• Pre-treatment protocols: omeprazole, metoclopramide, and diet adjustments
• Identifying when to delay elective procedures for optimisation
• Using C-reactive protein and radiographs to assess for aspiration pneumonia
• Managing anxiety pre-hospitalisation with trazodone

Plan for the day of surgery

• Fasting times and timing surgeries for optimal recovery monitoring
• Strategies for minimising stress in brachycephalic patients pre-op
• The role of early premedication and pain relief
• Drug choices: the “Goldilocks” approach to sedation
• Reducing regurgitation risk
• Your pre-op pro tips
• Extubation and recovery: positioning, monitoring, and oxygen weaning
• The impact of cage-side nursing and owner-assisted recovery