As 2019 comes to a close, here are some of the top Off Label Pet and Veterinary Trends we’ll be talking about in 2020. So grab a pint of kale, snuggle up with your 10 kilogram canine and a bowl of oats, have your banker on speed dial and conference in your virtual vet. It’s time for takeoff! 

Welcome back to Off Label Veterinary News. Your source for commentary on animals, medicine, and practice life. It's no secret my favorite holiday is New Year's Day. I’ve written and lectured about this, and my wife and I even raised our two daughters practicing an annual goal-setting session to reflect on the past year and chart a path for the next. I know New Year Resolutions get a bad rap, but I firmly believe it’s because they’re done poorly, without much self-analysis, and even less accountability. With that in mind, I hope you’ll set aside some time during the quiet hours of this season to get real about what you’ve done and what you want to do. Life slows for no one, so take charge and dig deep for what brings you joy and ignites your passion. Make those things your focus for the new year. 

But enough of my blathering, self-help, fortune cookie platitudes. Let’s get into my annual “What Veterinary Professionals Will Be Obsessing about Next Year!” forecast. Whether you agree or not, choose to ignore or acknowledge, or even give a flying flip about any of these issues, these are but a few of the questions and concerns I predict pet owners will be asking you, or at least Dr. Google, in 2020.

#1 - Plant-based pet foods - Ok, sure, just because I co-founded a really cool plant-based pet food company a couple of years ago called Wild Earth, have a hot book out called, “The Clean Pet Food Revolution: How Better Pet Food Will Change the World” and I’m a bit obsessed with researching fungal and cellular agriculture proteins, doesn’t automatically qualify this topic as Google-worthy. I can totally understand how you might conclude I’m a little biased about this topic, but all of those things happened because this IS a super-hot pet trend you’re going to see more of over the next couple of years.

In 2020, you’re going to have a lot of questions about whether or not animal meat has some sort of magical nutritional properties (Spoiler alert, Veterinary Colleagues: It doesn’t. Good health is based on nutrients, not ingredients, just like we were taught in veterinary medical school.). This plant-based pet food trend is being led by pet parents who are increasingly concerned about climate change, all of the potentially harmful chemicals, hormones, and antibiotics pumped into the cows, chickens, pigs, and fish we eat and feed our pets, and growing awareness about the inhumane conditions of industrialized animal  farming. If you don’t want to believe me, I’d love for you to read the book I co-authored with my animal ethicist and biohacker friends, Alice Oven and Ryan Bethencourt, and pore over the 27 pages of scientific papers we based our findings on. Regardless of your personal pet food philosophy or whether you’re more keto than kale, pet parents want to know our opinions and how veterinarians are helping fight climate change, improve animal welfare, and extend longevity and quality of life for pets.

(Amazon book link)

#2 - Grain-free Blowback - It’s been two years since a couple of veterinarians proclaimed the canine cardiac sky was falling, and despite considerable research and regulatory might from the USDA, FDA and every veterinary school from sea to shining sea, we’re no closer to knowing what, or even if, there’s a link between certain pet foods and dilated cardiomyopathy. We’re now beginning to see both pet food manufacturers, veterinary nutritional experts, and pet parents push back. If you haven’t yet, I’d encourage you to check out our weekly podcast, the Veterinary Viewfinder, and episode 150 with Dr. Ryan Yamka and the DCM controversy.

What I’m most concerned about is the emerging public plot line that describes veterinarians as uninformed puppets of the big pet food industry, obediently adhering to a narrative that’s out of synch with science and pet owners. I’ve personally always been a fan of grains, but I am worried this is yet another assault on our professional credibility and integrity. I will go down fighting to retain the veterinary voice as the ultimate authority in all things related to pet care.

Like many of you, I’ve lamented the loss of pet behavior to uncredentialed, and unlicensed dog- and cat-whisperers, anointed by secret whispers in thunderstorms and divine interventions bestowing mystical auras to a chosen few. Pet behavior is incredibly complex and requires a complete medical approach to succeed.

But back to the DCM debate. Will we allow this latest dilemma to drive another nail in the proverbial coffin of nutritional credibility for veterinarians, or will we focus on facts and less on fear-mongering in 2020? Stay tuned, my veterinary peeps, and put down that hammer. Look up; the sky is still there. 

#3 - Humanization and Everywhere Pets - Ok Boomer, your time as the dominant driver of the veterinary and pet industry is officially over. All hail the Millennial Pet Owner! Long live Generation X! And Generation Z, how about sharing the long life ahead of you with an adorable puppy or kitten?

2020 will mark the beginning of the “Boomer Pet Bust,” as both ownership and pet spending of this generation plummets over the next five years.

Pets are accompanying people everywhere, and that means veterinarians need to help them in innovative ways. Over the past decade, I’ve been pushing for less “dog training” and more “social training.” I’ve had tremendous success teaching young pet parents the skills they need to be able to confidently walk their dog in public, travel, or dine with their increasingly smaller dogs.

I call dogs under 22 lbs or 10 kg “Everywhere Dogs,” because you can take them, well, everywhere. My pet loving people, take this trend seriously and create opportunities to insert the veterinary profession into this trend. Specialized socialization, diagnostic testing, small dog food and treats, supplements for healthy aging, and even vaccines and preventives specifically formulated for smaller dogs will be in demand over the next couple of years. Everywhere pets, accessibility to care and commerce, and healthy aging will largely define the next wave of pet innovations. 

#4 - Consolidation - Consolidation, corporatization, rolling up - all of these terms are applied to independent veterinary practices being purchased by or integrated into larger businesses. My prediction from three years ago remains unchanged: At least 25% of US veterinary practices will be consolidated by 2023. We’re already nearing 20% in the US, and the UK is probably greater than 50% consolidated.

But the percentage consolidated isn’t why I keep screaming to my colleagues to pay attention to this. The real news is that I predict, along with many in the industry, that about half of all veterinary transactions will be performed in corporate-owned clinics by 2023. That’s stunning - and alarming - news for many of my colleagues who own their own practices. If you’d like me to go deeper into this topic and why it matters to every veterinary professional, leave me a comment below. While you’re at it, subscribe to both this channel and our red-hot weekly podcast, the Veterinary Viewfinder, on your favorite podcast player. We’ve been covering these sort of topics every Wednesday for the past three years. You’re welcome. 

#5 Super-combo Parasiticides - There is so much to talk about in my top trends and topics. As a reminder subscribe to my channel and hit that notification bell. Number 5 this year is Super-combo Parasiticides! Yes, I know I said this in 2017, but apparently the FDA watched that video and slow-rolled big pharma. But no more, my brethren, will you have to wait to prescribe a combo-parasiticide that combats the common intestinal invaders, heartworms, and fleas! Bravecto Plus for cats is the first is a solid lineup of emerging combo products that leverage legacy compounds in the recently relaxed regulatory environment. Zoetis will drop Simparica Trio soon, and then I think it gets really exciting. By the way, Zoetis is the hot company to watch in 2020 for pets and veterinary professionals (by the way, this is my personal opinion and unsponsored). Zoetis has so much innovation, ambition, and expertise along with tremendous momentum that I think 2020 is going to be momentous for them. Zoetis is making huge strides in every animal sector, but I’m most excited to see what they do with African Swine Fever vaccine and laboratory diagnostics.

Back to super-como parasiticides, love’em or hate‘em, these products are soon coming to a prescription pad or online pharmacy near you. 

#5.1 Veterinary Teletriage and Telemedicine - But wait, there's one more thing we veterinarians will be arguing about. Let’s call it call it #5.1 - Teletriage! No longer are venture capitalists and human health care castouts pursuing telemedicine, they’re all in on “teletriage!” What’s the difference, you ask? Telemedicine actually does something for pet parents while teletriage tells you they can’t do anything for your pet!

Yes, Off Labellers, it’s back to the future and it’s 1992 again and I’m carrying my hypertension-inducing belt-mounted pager! Only this time, I pay someone to take that beeper to tell my clients, “Go to the ER or make an appointment in the morning!”

And who gets paid? Yes, colleagues, we’re waking up in 1988 and the Big Money Men are getting paid! And who is paying these teletriage tycoons? The independent veterinarian!

I don’t wish a pager on any of my young colleagues, but I think we need to get the VCPR figured out so we can actually provide better care than repeating “Go to the ER,” “Or it can wait until the morning” for pet parents. We can all recite anecdotes about how an individual pet owner felt relieved knowing it wasn’t a true emergency or how the teletriage service saved a pet’s life, but I think very soon the pet-owning public will rightfully demand more. I can already consult virtually with my physician’s office, a presumptive diagnosis made, and any prescriptions called in to a pharmacy or delivered to my home.

I’m not anti-teletriage, I’m pro-telemedicine. Veterinary telemedicine is arguably more complicated than human medicine, but complicated never equals impossible. Let’s make 2020 the year we get serious about solving the dilemma. If we don’t expect a force outside our profession to make it happen. Wolves of Wall Street, anyone?