The Cone of Shame Veterinary Podcast

In the 420th episode of the Cone of Shame Veterinary Podcast, Dr. Andy Roark talks with Steven Satal about the state of cannabinoid medicine in veterinary care after the early surge of interest 8–10 years ago. Satal clarifies terminology and legal distinctions between hemp (≤0.3% THC) and cannabis/marijuana (>0.3% THC), noting the 2018 Farm Bill definitions may change. They discuss how the field has plateaued but become more normalized, with over 40 PK/PD dosing studies across species and increasing specialist referrals for cannabis consults focused on harm reduction, dosing, and product selection. Satal emphasizes cannabinoids are not a silver bullet; his main uses are chronic pain, epileptic disorders, and canine cognitive dysfunction, with some evidence for itch reduction in dermatology. He typically starts dogs/cats at 2 mg/kg CBD twice daily and adjusts, stresses variable product quality, cites brands with supporting studies, and outlines cautions with sedating drugs and liver monitoring; he does not recommend cannabinoids for pre-visit anxiety.Stephen Niño Cital holds a Masters in veterinary anesthesiology and is a veterinary technician specialist (VTS) in research anesthesia among other credentials. He has a passion for anesthesia, pain management, and integrative medicine. Stephen has authored numerous peer reviewed articles and contributed to several textbooks- including acting as the lead editor for the first veterinary cannabinoid medicine textbook and more recently a second edition of a pain management textbook. He has many exciting professional highlights but some of his favorites include being part the scientific team that discovered acidic cannabinoid forms are absorbed more efficiently than decarboxylated forms, discovered a common drug used in anesthesia causes a serious complication known as methemoglobinemia in monkeys, invented a smaller and more practical blood filter for animals during blood transfusions, and helped gain title protection for veterinary technician specialists. Stephen is a lab manager for HHMI at Stanford University in the department of neurobiology, and the Chief Veterinary Nursing Officer and director of the pain and cannabinoid medicine services at Remedy Veterinary Specialists. Additionally, he is the COO of the Veterinary Anesthesia Nerds, LLC., and Executive Director of the Academy of Laboratory Animal Veterinary Technicians and Nurses, and president of the California RVT Association. His current pursuits include completing another acupuncture certification and a VTS in neurology.

Dr. Andy Roark, host of The Cone of Shame Veterinary Podcast, flips the script and lets Kelsey Beth Carpenter run the show for the launch of a brand new six part miniseries, Cone of Shame Canada. The topic on the table: human pharmacies have entered the veterinary pharmacy business north of the border, and Andy walks through why that regulatory change is rattling Canadian practices, what the US already learned from its own online pharmacy shakeup years ago, and the three things he thinks matter most right now, protecting client trust, talking openly with the team, and evolving the business model in manageable phases rather than panicking. By the end, listeners get a clear-eyed roadmap for navigating pharmacy disruption, plus a sneak peek at the lineup of guests still to come in the series. Gang, lets get into this episode! This episode is brought to you ad-free by Boehringer-Ingelheim Canada! Kelsey Carpenter is a Registered Veterinary Technician with over a decade of experience working in emergency hospitals across California. She currently works as the Social Media Manager for DrAndyRoark.com and a Content Specialist for the Uncharted Veterinary Conference. Some of Kelsey’s passions include the open hospital concept, the power of creativity and humor, the overlap of science and art, and sharing lessons learned from living life with chronic illness. Kelsey is probably most known for two of her favorite hobbies: writing and performing comedic songs about veterinary medicine and acting as a full time stage mom for her Chihuahua mix, Birdie.

I’ve got Dr. Jules Benson on the podcast today and we’ve got a doozy of a topic for ya: The sad, sad state of research in vet medicine (my words, not his!) I am bothered by what seems to be a tidal wave of crappy, biased, cherry-picked research lately, and I ask Dr. Benson to get into it with me. How do we get our information in vet med? What do we believe and what do we not believe? How do we actually incorporate data and research into a future that’s feeling more cynical and less trusting? Let’s get into it!Dr. Jules Benson is the Principal at Tapetum Lucidum Consulting and the 2025 Chair at the Veterinary Innovation Council (VIC). With over two decades as a practitioner, industry executive, strategist, and data and technology leader, his focus lies in identifying and applying innovation that can improve the lives of pets, pet families, and veterinary healthcare teams.

Dr. Andy Roark welcomes Dr. Isaac Bott, an Utah practice owner and theriogenologist who works with reindeer, to discuss his run for AVMA president (election July 2027) and the profession’s sustainability challenges. They explore how rising cost of care intersects with the need to pay living wages and retain veterinarians, technicians, and support staff, arguing vet medicine is not overpriced even if care can be unattainable for some clients. Bott emphasizes retention through sustainable workplaces, burnout reduction, and clear development pathways that let team members fully use their training, including technician specialization and continued growth for veterinarians. They discuss burnout drivers such as student debt, emotional strain, call burden, and workplace dynamics, and advocate for unity through organized veterinary medicine so veterinarians keep a strong voice amid regulatory and industry changes. Dr. N. Isaac Bott was raised in the small town of Castle Dale, Utah. He is a 2009 graduate of Washington State University’s College of Veterinary Medicine. He owns and operates Mountain West Animal Hospital, a mixed animal veterinary facility in Springville Utah. He currently serves on several national and state veterinary boards. He is a past president of the Society for Theriogenology, an international group of veterinarians with expertise in animal reproduction. In 2023, he was Awarded the Dr. John Steiner Award for Practitioner Excellence. In 2024 he was given the Utah Veterinarian of the Year award. He has also served as a council member and chair of the American Veterinary Medical Association’s Council on Veterinary Service. He also has served as the co-chair of the Utah Veterinary Medical Association’s Legislative Committee. He currently serves as the American Veterinary Mecidcal Association (AVMA) delegate for the Society for Theriogenology. He also serves on the board for the AVMA Political Action Committee, the dean’s advisory board at Utah State University’s College of Veterinary Medicine, and as a member of Theriogenology Foundation board. He has extensive experience with strategic planning, legislative process and organizational leadership. He has also authored over a dozen peer-reviewed scientific articles, a dozen textbook chapters, and has traveled the globe providing theriogenology services for camelids and cervids. He is the proud father of three children: Kaycee, Kayden and Kendyn.

Dr. Chad R. Brown, DVM (Purdue), executive director of the Lloyd Veterinary Medical Center at Iowa State University, joins Dr. Andy Roark to tackle a gut-punch truth in veterinary medicine: good decisions do not always equal good outcomes, and outcome-based judgment can be brutal on clinicians. They unpack how hindsight bias and outcome bias trick us into “judging our past self with our future self’s information,” rewarding lucky medicine and fueling shame after tough cases. Chad argues for de-emphasizing outcomes and emphasizing decision-making processes we can control, like communication, diagnostics, anesthesia monitoring, and checklists, especially when training students, interns, and residents. They also discuss how outcome fixation can break good clinicians through overcorrection or apathy, and how focusing on process can reduce burnout and support spectrum-of-care thinking.