You’re More Capable Than You Think: POCUS, Failure & the Future of Vet Med | Serge Chalhoub DVM, DACVIM (SAIM)

Season 2 is here, and we’re kicking things off with Dr. Serge Chalhoub: internal medicine specialist, professor at the University of Calgary Faculty of Veterinary Medicine, co-founder of the Calgary Veterinary POCUS Academy and, apparently, Prince of the Nephrons.

Serge’s path through vet med wasn’t exactly linear. After vet school, he thought he’d become a general practice owner. A near-fainting incident during a dog spay, a detour through emergency medicine and a habit of calling ER clients a week later to see how their pets were doing eventually pointed him toward internal medicine, and a career built around teaching.

We get into why point-of-care ultrasound (POCUS) has become such a valuable tool in veterinary medicine, why Serge believes RVTs and DVMs alike can learn to use it, and how it could change the way we triage and care for patients.

We also talk kidneys (obviously), the ethics of feline kidney transplants, raw diets, AI and innovation in veterinary practice, burnout, boundaries, staffing shortages and what Serge thinks needs to change as the profession moves forward.

And near the end, Serge shares something he hopes every veterinary student learns: think critically, challenge your assumptions, and stop being so afraid to fail.

Plus: kidney dad jokes, techno, questionable dancing and the official crowning of the King of the Nephrons.

Welcome back to Don't Call Me Catty.

🎙️ In this episode:
• Finding the right career path when your first plan doesn’t fit
• Why Serge chose internal medicine and teaching
• What POCUS can actually do in everyday veterinary practice
• How RVTs can use ultrasound in triage
• Kidneys, nephrology and feline kidney transplantation
• AI, innovation and reducing workload in vet med
• Burnout, boundaries and the changing veterinary workforce
• Why veterinary professionals need permission to make mistakes

About Dr. Serge Chalhoub

Dr. Chalhoub graduated from the DVM program at the Faculté de médecine vétérinaire (FMV) of the Université de Montréal in 2004. Serge followed this with a one-year rotating small animal clinical internship at the same institution. After working for two years as a general practitioner and emergency veterinarian in Montreal, Serge pursued a residency in small animal internal medicine at the Animal Medical Center (AMC) in New York City. Once his residency completed in 2009 he stayed on at the AMC as their first renal/hemodialysis fellow and then as a staff doctor.

Dr. Chalhoub has been a faculty member at the University of Calgary’s Faculty of Veterinary Medicine (UCVM) since 2012 and currently holds the rank of Professor (Teaching). He was the recipient of the 2021 and 2013 Canadian Veterinary Medical Association’s Teacher of the Year Award, the 2015 University of Calgary Team Teacher of the Year Award, the 2017 Carl J. Norden Distinguished Teacher Award, and is a 2024 3M National Teaching Fellowship recipient recognizing Canada’s outstanding teachers. Serge is the coordinator of a community outreach-service learning program (UCVM-CUPS Pet Health Clinic) for disadvantaged Calgarians. He has authored and co-authored numerous scientific articles and book chapters on veterinary point of care ultrasound, renal and urinary medicine, and lectures around the world on these topics. He was a member of the National Issues Committee (NIC) of the Canadian Veterinary Medical Association (CVMA) (2016-2024) and also the President of Alberta Veterinary Medical Association (ABVMA) from 2024-2025.

Get in Touch

Email: serge.chalhoub@ucalgary.ca

Calgary POCUS Academy

Transcript

Speaker 2 0:00

So we are live today at the CVMA 2026 convention in PEI in Charlottetown. Today we are very excited to have Serge Chalhoub. He is an internal medicine specialist. He's also a professor at the UCVM. On top of that, he is co-founder of the Calgary Veterinary POCUS Academy. So welcome.

Speaker 1 0:20

Thank you. Thank you very much. I'm excited to finally finally let me put it one more. Finally be here. But you are our first guest of season two. First guest, but I was supposed to be the first guest ever. You are still our favorite. All right, well, thank you. That makes up for you. Thank you.

Speaker 2 0:36

Yeah, we didn't have our poop in the in our in a group on season one. So we couldn't have the esteemed selge without having the proper equipment.

Speaker 3 0:48

We needed it to be perfect. Yeah. Because the sound was pretty bad.

Speaker 1 0:52

I love the pronunciation of the R, by the way. That is Selge. Yeah. Yeah.

Speaker 3 0:56

I love it. Yeah. Um, I mean, it did deserve. Serge was on Switzerland or in Switzerland. And I texted him to be like, Sue.

Speaker 2 1:06

Did he text you back?

Speaker 3 1:07

Of course he did. Like while he's back.

Speaker 1 1:10

I try to be efficient on everything. Yeah. Yeah. But you're right, I should have had my phone.

Speaker 3 1:14

Well, I was I was thankful because I'm like, we need to have Serge. And Serge gets first pick of time because we we really messed up last year.

Speaker 2 1:23

Well, thank you.

Speaker 1 1:23

Thank you. All right. All is forgiven.

Speaker 2 1:25

Yeah. All right. So you're an internal medicine specialist. I want to know what got you into internal medicine to begin with. And did you all did you know when bed school you were going to go into?

Speaker 1 1:36

Oh no, not at all. So when I when I finished bed school or close to finishing vet school, I actually didn't know what I wanted to do. Um someone talked to me about an internship, and I was like, okay. I thought that sounded good. I stayed on the University of Montreal, did an extra year of my internship.

Speaker 2 1:49

Like a rotating internship?

Speaker 1 1:50

Yeah, rotating internship at the at the bed school in Montreal. And um, I was pretty burnt out after my goal was actually to become a general practice owner and become a shareholder. Which um I joined a team uh near my parents' house um and thought I'd be a shareholder. They they had promised that. Within a few months, first of all, I did my first big dog spay and almost fainted. I'm not even kidding. Um quickly realized, yeah, it's surgery was not meant for me at all. Uh I'd have panic attacks, wouldn't sleep the whole shebang. Um and then I started doing emergency shifts on the weekends and really liked that. So within six months, I made the switch to emergency. Um during my time in emergency for two years, uh I'd call my clients a week later and see how they were doing, their pets. And my coworkers like, why are you doing that? We don't do that in emergency. That's called internal medicine. And the idea was born, and sure enough, I applied to residency and got in in New York.

Speaker 2 2:44

Wow, okay. So you're kind of similar to our friend Lisa Shear, where she didn't go directly out of school. Like she did GP for a little bit, and then yeah, went into it. Ah, interesting.

Speaker 3 2:55

I actually know a few doctors that that was their route.

Speaker 2 2:57

Yeah.

Speaker 3 2:57

Like they've done GP and then they're like, uh, I need something more, or something just isn't right. Yeah. And then they go back.

Speaker 1 3:05

And honestly, I felt dumb in GP. I felt I couldn't keep up with the work, I couldn't keep up with the demands, the surgery. Um, I definitely wasn't a good dentist, you know. So at the end of the day, I had to end up being good at just one thing, which was internal medicine, instead of being, you know, the omnipractice.

Speaker 2 3:21

A jack of all trades, then.

Speaker 1 3:23

Yeah, exactly.

Speaker 2 3:24

Ah, well, I mean, and we met in an emergency setting. Like I think I can't remember, like, because you used to do some ER shifts.

Speaker 4 3:32

Yeah, that's right, on the weekends.

Speaker 2 3:34

I can't remember if it was that or when you brought some students through. But I don't know if you remember this.

Speaker 4 3:40

Uh-oh.

Speaker 2 3:40

It's a funny story. So when I first met you, I was so intimidated by you because you're well, you're just so smart, but you're also like like really like uh charming and charismatic, and you like like you can get someone to understand a point so well, and I was like like whatever you're teaching, and I'm like, oh my god, this guy is like I'm so intimidated by him. And I I forget what procedure I was doing with you, but I did something and then he asked me, you're like, um, oh no, I asked you a question, like something something to do with one of your internal medicine patients. And then I I think you just didn't hear me or or were you know paying attention to something else, and you're like, What is your background? And I assumed you meant to remember that. I assumed you meant like my educational background. And I was like, oh my god, I just asked a stupid question. And so I was like, Oh, I'm I'm registered, I went to school. I yeah, I sorry, I'm and you were like, No, I mean your ethnic background. I was like, oh, okay.

Speaker 1 4:38

I actually do remember that. I actually very much and and the funny thing is, well, I'm glad the facade was working, you know, the facade. I'm like, yeah, uh, but no, if anything, uh I'm I mean, I was intimidated by you. I mean, no joke, it's still to this day. I mean, look at this right here.

Speaker 3 4:52

I mean, both of you are I have a first meeting story about Leilani. Oh, I'd like to hear that. And you too, actually.

Speaker 1 4:59

Um, but I I do remember that because I was thinking your last name was um um Japanese Egyptian, exactly. Yeah, Middle Eastern.

Speaker 2 5:07

You were like, oh, you have an Egyptian last name, and I was like, uh yes, but uh well, it's funny because I'm like, my first name is Hawaiian, but I'm not Hawaiian, and my last name is Arabic, but I'm not Arabic. Yes. My middle name is French and I'm not French.

Speaker 3 5:18

I do remember all yeah, I've although you speak fluent French.

Speaker 2 5:21

Well, so not like you do, but yeah, yeah, yeah, yeah. I can say the R's. Yeah.

Speaker 3 5:28

I actually didn't know you were French, sir. I didn't know. Oh, he's from Montreal. I didn't know you that I did not know.

Speaker 1 5:37

Did you think my first name was Russian, Spanish, Eastern European for sure?

Speaker 3 5:42

All right, perfect. Yeah, yeah, yeah. Okay, that makes sense. Yeah, yeah. Yeah.

Speaker 1 5:45

You know, I love it.

Speaker 3 5:47

It's not like I sit here and go like, so you got to teach.

Speaker 1 5:53

Clearly I did. Yeah.

Speaker 2 5:56

Okay, so so that's how you got into internal medicine. And then what about the teaching? What made you want to teach?

Speaker 1 6:02

Great question. So when I went to New York at the Annual Medical Center, um, it's it's a nonprofit specialty hospital. Teaching is actually one of the big mission statements. So as a resident, um, and then a fellow and then a staff doctor, one of my big jobs is teaching. And I loved it. Um, after EMC, I went to Charleston, South Carolina for a year and a half, where I was very lucky to meet my future partner. And um, she was a vet tech there, right? That's right, she was a vet tech, and uh yeah, and within a year and a half there was clear that that job wasn't gonna work out. Um, and uh CERN Boys and actually told me that there was jobs opening up at the new vet school in Calgary and the rest of his sister. I mean, I fell in love with teaching, it was clear that that was my passion in life, and uh here I am today.

Speaker 2 6:45

Well, and your students love you. I mean, you've won awards, and you're yeah, you're you're such a great teacher.

Speaker 3 6:50

Well, I actually did uh like mini interviews at the UCVM trade fair day. Oh yeah, and I asked who was their favorite teacher, and you got like accolades all the time.

Speaker 1 7:01

All the time. And honestly, they're they're the ones that make my job the best. It's just cheapest.

Speaker 2 7:07

Yeah, and and I say all that because I taught for a while, I taught for nine years actually as well. Um and I always like when people ask me why I like teaching, I'm like, I like I came to this realization, same thing, when I was working in in uh clinic, that like I really love the mentoring and the teaching, but the part that I loved the most was like seeing these people that I taught, then caring for animals. And I was like, it like clicked in my brain that like every vet professional that I teach how to care for an animal, I help exponentially more animals than I could on my own.

Speaker 1 7:38

Yes.

Speaker 2 7:39

So that was like the the switch, the switch for me that I'm like I want to go teach.

Speaker 1 7:43

Yeah, yeah, yeah. And I remember you very much so teaching one of your own places.

Speaker 2 7:47

Yeah, like when you would bring your your students out, and yeah, yeah, yeah. Well back in the day when we had when we were a little bit more cowboys, and I would do like standing sisters on cats and the pulling of the alcohol on the belly and what now? Or you know, us non-DDMRVT people taking taking uh urine out of a bladder with a needle while the cat's standing, yeah, blind.

Speaker 1 8:10

Yeah. But I mean by feeling. But I mean our dexterity was so much better back then, right?

Speaker 2 8:15

I was gonna say, like, honestly, like sometimes it's easier for me to feel than it is to see it on an ultrasound. And I don't know.

Speaker 3 8:21

100%.

Speaker 2 8:21

I'm probably gonna get in trouble for saying that.

Speaker 3 8:24

No. Well, you should have a disclaimer actually. Yeah, I have to have a disclaimer on everything I do. Oh man. Oh, geez. Oh gosh.

Speaker 2 8:35

So so you um I'm curious because you've been in how long have you been in like when did you graduate?

Speaker 1 8:43

Uh graduated in 2004.

Speaker 2 8:45

In 2004. Okay, so you are 22 years in.

Speaker 1 8:48

That's right.

Speaker 2 8:49

Yeah, you're pretty like we're pretty close. I'm 19 years in this year. Yeah. Yeah, yeah. So we're we're pretty close there. But what like we hear so much about burnout, etc. Um, what has kept you passionate about that myth? Are you still in it?

Speaker 1 9:02

That's a great question. I mean, um working in university has been great. It's been a great um balance between clinics, time teaching, also time off, boundaries, sabbatical as well. So it it's been great, honestly. And it and I do love my job. It it's been, I think for everyone, you know, you learn what your boundaries are, you learn how to respect them. And um, I it's been a journey, really, to get to where I am now where I can feel mostly balanced. Yeah.

Speaker 2 9:28

Great.

Speaker 1 9:29

I don't even know what that would feel like.

Speaker 2 9:31

Well, we're in the thick of it right now. Are we?

Speaker 3 9:34

Yeah, you totally are. I don't even know if we're like in the thick or in the thing.

Speaker 2 9:37

And we start to keep on adding stuff. Yeah. Julian and I just joined the Tales of Health board as well.

Speaker 3 9:42

No way. Yeah. Oh my god. They see us and they're like, oh yeah, we need that hot mess. We're like, are you sure? Are you sure? There was one part. Leilani sent me on the minutes. Yeah, and we're highlighted.

Speaker 2 9:58

I highlighted the meeting minutes that we got sent. And I was like, I am howling at these meeting minutes.

Speaker 3 10:04

It says, like on the steady gauge shirts, there's dog balls and cat balls.

Speaker 2 10:08

It says vetmed takes balls.

Speaker 3 10:10

It says vetmed takes balls. Oh, that's amazing. The whole conversation, like the whole scripting was like, everybody wants to buy things with balls on them.

Speaker 2 10:17

It was like minutes, and then it's like Jillian. It's like everybody will buy something with balls on it.

Speaker 3 10:23

Oh, that is brilliant. And what are we selling here today? Oh my god. Okay, so you talk about boundaries. I have none. Leilani has none for sure. He'll give some.

Speaker 2 10:38

Yeah, I was gonna say probably a bit more than you do. More than I do.

Speaker 3 10:41

Uh yeah. So, I mean, you love your students. We know your students love you. What would the students be shocked to know about you?

Speaker 1 10:49

Shocked. Um that I was a bar manager uh before vet school and almost considered staying honest bar manager instead of going to vet school.

Speaker 3 10:58

That's for cash tips.

Speaker 1 10:59

Yeah, yeah.

Speaker 3 10:59

Imagine if clients would give you guys cash tips. Yeah. As a financial advisor. Totally. I cannot endorse that. But that'd be amazing.

Speaker 2 11:09

Yeah, that would be amazing.

Speaker 3 11:10

Thanks for doing such a good job.

Speaker 2 11:11

I mean, keeping my animal up.

Speaker 3 11:14

Here's a 20.

Speaker 1 11:15

Where do you want me to put it?

Speaker 3 11:16

No, too much. I'm a two-far, sir.

Speaker 2 11:19

Although I have done that. I remember reaching for this little dog with this lady with the low cutting. Fully put my hand in her bra and I was like, you would. I just didn't know what to say. I got on the show.

Speaker 3 11:31

Do you know how many times she's hit my? Oh, yeah. All the time. Be fair. It's a pretty easy target. Oh my god. Oh my god, poor search. Okay, back to teaching. Back to teaching. Pivot, pivot.

Speaker 2 11:46

Well, I want to talk about pocus academy.

Speaker 3 11:48

Okay, but I'm gonna have to ask the question first. Oh, okay. What does POCUS actually stand for? It stands for point of tear ultrasound. Oh, that makes so much sense. I literally was like Hocus Pocus.

Speaker 1 12:02

Well, magic is what we do Hocus Pocus. No.

Speaker 2 12:05

Okay, I I have this phone to pick with you guys. Like why? It's more of a marketing thing. Yeah. Because like every time I watch, I'm like waiting for you to hold the ultrasound like a magic wanna do something with Hocus Pocus in it.

Speaker 3 12:16

Totally. Yeah. Yeah.

Speaker 2 12:18

Maybe we can we can figure we'll we'll talk. Okay. I've got some ideas for how we're gonna fit that in.

Speaker 1 12:23

It is pretty much just CERN and I, so any ideas would be fantastic. Remember CERN has a say in this too, Leilanda?

Speaker 2 12:29

Yeah, yeah.

Speaker 3 12:29

Okay somehow I'm gonna get roped into this too. Yeah, totally.

Speaker 2 12:33

Um, so I mean, maybe this is a good time since I just gave the example of how I used to do blind sistos all the time.

Speaker 1 12:39

Yep.

Speaker 2 12:40

Like, why has POCUS become such an important tool in veterinary medicine now?

Speaker 1 12:45

Well, it it goes back years. Um, you know, to probably when you and I graduated. They're back in the day, ultrasound was not a very common modality for general practitioners or technicians to use at all. Like often we weren't allowed to use the machines. And rightfully so, these machines were hundreds out hundreds of thousands of dollars. The radiologists were really the only ones trained to use it. During my residency, we had ultrasound machines that we could use, but they were the old ancient collecting dust that didn't work very well, and no one taught us very much how to use them. Um so honestly, when I started private practice, I wanted to learn ultrasound, and I did. So I started doing my own ultrasounds for my clients. Moved to the University of Calgary, sir, and I started teaching together. He's essentially the founder of Point of Care Ultrasound. He published the very first paper on FAST, which is Focus Assessment, Personography of Trauma, um, which is kind of the precursor to POCUS. And it kind of took off. We thought he was already teaching and developing. I became his robin to his Batman. And we just wanted to spread the word of what this is. It's essentially a tool that anyone can use, general practitioners, technicians. I mean, we teach technicians the same thing that we teach veterinarians when it comes to point of character sound because we strongly believe it's an extra tool in the toolbox that anyone can use, and it's very beneficial to your patients.

Speaker 3 14:01

So do you go because I know you do lots of work with the schools and the students, but you also do work with I mean at conferences, like with practicing DVMs. But there's I mean, I have a friend who's dogged in an ultrasound. It was like a three-week wait to get the ultrasound done. Yes. So that is that are you finding that what you do is helping those wait lists because more DVMs are becoming confident in that?

Speaker 1 14:26

Maybe. I mean, that's a hope. It is a different modality. You know, they're waiting for full general abdominal ultrasound by a specialist. And what we teach is really to give more tools to the general practitioner or the technologist technician to find out what's going on. Hey, the Sanibel that's not we think quite right. Oh wow, there's plural effusion. Well, that changes the whole ball game and they can do some more diagnostics or at least inform their clients to make the best decision for them. Same thing with the abdomen, same thing with the heart. A lot of things that people can do that they honestly don't know they can actually do, and it doesn't take that much training, is what it comes down to.

Speaker 2 15:04

Well, and on that point, so how quickly can um a a tech or a DBM become comfortable with POCUS? Like how long is the training?

Speaker 1 15:13

That's a great question. I mean, the training is variable depending on the course you take. What we offer is eight hours of online continued education now through our website, which by the way is 100% free for any students around the world. Wow. Including technician students. Absolutely. 100% free. And that was our original goal is to develop a platform so that we can have our videos on there and our training for students, our own students, first and foremost, and also for students around the world. That was our original goal. And um, but honestly, within an hour and a half to two hours of just some online training, we we have a kind of a core basic um training, which is about an hour and a half, two hours, and then some practice. You know, honestly, with the first couple scans, people can start becoming comfortable answering some very basic questions. Is there a free fluid in the abdomen? Yes or no? Is there a plural effusion? Yes or no? Some of the big, big conditions.

Speaker 2 16:01

Okay.

Speaker 3 16:01

Are you a part? I would assume you're a part of like a lot of aha moments for students, like when they're learning something. Oh yes.

Speaker 2 16:08

Yeah, like what's the biggest breakthrough experience you see during the training?

Speaker 1 16:12

Honestly, probably the biggest thing um is the heart. For some reason, everyone's like, we can't do the heart. That's reserved for cardiologists. Well, sure. There's no doubt if you want to do, you know, fractional shortening, all the things that a cardiologist does, yeah, that's that's called cardiology for a reason. But if you want to look at the left atrium and determine is that patient is congestive heart failure, that's always been the biggest aha moment for our students and uh practitioners when they take our course, because they're like, I never in a million years thought I can do this. And within five minutes of a lab, they can do it.

Speaker 2 16:45

What so for for the RVTs who are taking the course, like how do they use this in clinic? Like, where do you see this fitting into their day-to-day in the same aspects as the veterinary?

Speaker 1 16:56

You know, um, I think the quickest, easiest one to see is in triage. You know, I mean Leila. Yeah, you know, better than I do. Sometimes there's six, eight hours wait, and you're triaging these patients, they're coming in, you're listening to the hearts, getting a blood pressure, doing a quick exam. Well, think about can you put that probe on that animal that collapsed at the dog park be like, okay, hey surge, this is a hemoabdomen, or surge, this is a pericardial effusion, you know, pleural effusion. You can track the patients to a hey surge. This patient that's getting a lot of fluids has bee lines now, which means there's you know fluid into the lungs. You know, I mean, again, there's there are so many indications for it. And of course, the easiest one to think about is on emergency on triage, but honestly, you know, cystocentesis and you know, tracking your fluid therapy, et cetera, et cetera.

Speaker 2 17:44

I love that because I love finding ways to work as a team and like when your DVM is just like has their plate full, like especially on a really busy emergency day, yeah, to be able to be like, hey, I triage this patient, this is their primary survey, this is their TPR, and so this is why I put an ultrasound probe on, this is what I found. I'm actually bumping them up on the triage acuity. Exactly. And yeah, so I love that.

Speaker 1 18:08

Yeah, it's great. You know, we potentially will lose less patients or they'll be less critical by the time they come to us, you know, we'll be able to triage them faster. Yeah. I mean, we always hear these stories in human medicine, right? Where people wait in the waiting room, they're not doing well, eight, ten, twelve, fourteen hours, two days later, they unfortunately pass away. And you know, I always wonder if those teams had ultrasound, point of care ultrasound, could that make a difference?

Speaker 2 18:31

You know, I think it would. Like, well, you know what a triage nerd I am. Um just like quick assessment of those major body systems, but then you've got your modifiers that'll bump up acuity if the primary survey and secondary survey is all normal. So those are normally things like blood pressure, pain, a toxin. Yes. But it'd be great. Now we're gonna have to talk after this. It'd be great to add POCUS on there. 100%.

Speaker 1 19:06

Yeah, totally. 100% agree with you.

Speaker 2 19:08

I would I I gotta I'm gonna check and see. Do you know if they have that on the human side?

Speaker 1 19:11

I I don't think in their triage. Yeah, I mean, I've I've been to the yard, I'm sure we've all been to the yard. I've sat in the waiting room, I've never been triaged with ultrasound.

Speaker 2 19:20

Yeah, I know for sure it's not in the Canadian triage acuity scale as a modifier, but okay, we should take you should test this theory on humans.

Speaker 3 19:28

There you go. Do you know how many I have clients that were declined because they test their own stuff, like what they use their own tools on themselves, and then they find abnormalities, and then they have to go for testing. So the insurance companies decline them and they're all normal. It's just they don't know what they're doing. So they've like done like a like they'll put like um like a heart rate monitor, yeah, they'll like test on themselves, and then it shows like a abnormality. Okay, and now they have to go to a cardiologist, and the insurance company's like, what do you mean there's something wrong with you until you get a cardiologist to review it? Right. Oh, yeah, yeah. Because everyone's playing with the equipment. Yeah, right.

Speaker 2 20:05

Oh, yeah, we all do that.

Speaker 3 20:06

I know, yeah, totally. Yeah, but my world, you guys mess my world up, do we? Yeah, totally. But you should try this with human doctors. Yeah, 100%. I think so.

Speaker 1 20:14

Yeah, yeah, yeah. I think we should just walk into the RRCs with ultrasounds if you can. How are you feeling?

Speaker 3 20:20

Can you just try this? We'll record this, we'll podcast it.

Speaker 2 20:23

I feel like it's hit or miss with human practitioners. Like some of them really respect us and are like, we'll like listen to you. And then others are like, what are you talking about? Like my daughter, um, I we were just playing a game listening to each other's hearts when she was really young. And um, I was like, Oh shit, you have a murmur. Uh like we would just like I just had my head on her chest. And so I take her to the GP and she's like, Well, you there's no way you would have heard a murmur without a stethoscope. I'm like, if it's loud enough, I would. Like, I have ears.

Speaker 3 20:54

Well, you also know what you're listening for. Yeah, totally.

Speaker 2 20:57

But she didn't believe me because she's like, Well, it's not like a dog heart. I'm like, it's a it's a heartbeat. It's the heart. Anyway, she ends up, she has like this super rare condition. She has a quadric crestpid valve.

Speaker 21:07

Are you kidding me?

Speaker 2 21:11

Oh my god. Anyways, well sidebar. Sidebar.

Speaker 3 21:15

Do you know how many times we sidebar the? I love it. Yeah.

Speaker 2 21:19

Um, okay, so we can't have you on the podcast without talking about your passion for kidneys. You love kidneys. Why? What where did this come from?

Speaker 1 21:30

Well, so during my uh residency at the Annual Medical Center, I finished in 2009.

Speaker 2 21:35

Yeah.

Speaker 1 21:35

And it was the economic downturn back back in the day. Remember?

Speaker 3 21:39

I remember. I I can't forget that. Right?

Speaker 1 21:41

I work in finance. There was no joke, eight, no, nine internal medicine jobs in all of North America. That's it. So I honestly couldn't get a job. I mean, I had traveled, I interviewed, and you know, that there was no jobs. Um, one of my mentors at the Annual Medical Center, her name was Kathy Langston, and she's known as uh the queen of the nephron. And she's just world famous for kidney stuff. And she turns around to me one day and she's like, you know what, Surge? I like you. You're funny. And I think I want to keep you around for another year. Do you want to be my first ever neprology urology fellow? I'm like, okay Wow, I did not know this.

Speaker 2 22:16

Yeah. So I I didn't know that was even a fellowship.

Speaker 1 22:19

Yeah. Okay. Back then there was only um two fellowships, UC Davis and AMC. Yeah. But AMC I was the first one. And now there's fellowships um multiple institutions. But yeah, so it was their first nephrology urology fellow. So of course I fell in love with the kidneys here and you forged the way. Yeah I mean they they named me the uh the prince of the nephron you know so not well who's the king there there was no king.

Speaker 3 22:42

Yeah how about now we have crowns here we can crown you can we'll crown you yeah yeah yeah yeah we'll crown you the king of the nephrons yeah okay so tell us your your best kidney joke or pun.

Speaker 1 22:55

Well um so um there's a kidney um a kidney a kidney itself uh it's up on stage and giving a speech and uh tells to the audience uh thank you all for coming you're in the right place oh that's like a dad joke for kidneys oh yeah and I'm good at the dad jokes yeah oh tell us your best dad jokes no I can't even think about it right now okay okay only my dad or daughter laughs at them so how old is your daughter like five oh my gosh I know she's so she's growing oh thank you yeah every time you post her I'm like oh yeah so so Prince of the nephron yeah um tell us what advances in nephrology um are you most excited about right now that's a great question I mean the there it's it's been a slow grind I think we've done a great job now of standardizing um care for the chronic kidney disease patient starting to get better about diagnosing early acute kidney injury which as you know again on triage is has always been a difficult thing yeah it's it's all very slow there hasn't been a massive breakthrough um you know renal anemia there's some new treatments but still questionable um we've gotten pretty good with diets blood pressure proton urea etc etc I mean the list is long and you know probably boring to some degree but I think we're we're doing really good at standardizing our therapy whereas before it was kind of like well maybe we could do this do that this and that I don't know yeah are there can we do kidney transplants we sure can um there is a ethical uh dilemma I was gonna say um because and very few places do it now okay so uh the way it works is that um there's a donor cat and they're often um the source is always different but um the two main places that do it um often they're cats that they've adopted like Humane Society cats that they've adopted and so that cat has to donate a kidney obviously and there's there's the question living donor we can only do living donors exactly okay the problem with kidney transplants is most cats will tolerate the kidney for about two to three years. That's about it. So you're essentially extending life for two to three years until there's rejection um they do mostly okay the problem is the donor cats now have one kidney and we know that cats 30% of them will develop chronic kidney disease after the age of nine and now we've only given one kidney to deal with that. So there's a lot of ethical issues they also have to adopt the donor cat by the way the those who have the but yeah so it's not done in Canada in the US there's maybe just a couple places now that do it. And exclusively cats yeah it does not work in dogs they reject it pretty much really yeah we can't find the right balance of rejection medications and then tolerating as yeah okay and I guess any other species would be again same ethics that you'd be correct worrying about but it'd be a lot harder than a cat or a dog to adopt that's your pig yeah yeah totally did you clone?

Speaker 2 25:57

I mean Sunday who knows right I think I mean there there are clones like like I don't know if I was richer and more eccentric maybe I would clone my I don't think you need to be more eccentric I think we're there I we have leopards on us that's awesome but I I who was I talking oh Dave Eisenberg I was talking about I was joking because my cat was in uh I mean my dog my chihuahua close enough yep was close enough was in the hospital and I was like oh he's so perfect uh and I said that I was like if I was richer and more eccentric I would clone him and he's like the clones only last two or three years I'm like we have clones apparently we have okay we were talking about cloning the other day yeah what's the goat's name or the sheep's name Dora Dolly Dolly Dolly did Dolly die after two years I don't remember I'm not quite sure I think she had an accelerated she didn't live as long as expected but I can't remember yeah yeah okay I would clone I would clone yeah the Labradors oh that's what I mean like I don't think you've met my chihuahua have you not asked about Ranger like you're like you wouldn't ask I wouldn't clone Ranger Ranger is wild I don't think the world can have this is the one that we that Gillian adopted when we were on our road trip to San Francisco last week gotcha yeah and I found him in a parking lot where he was about to be sold to like a fighting ring. Yeah and I what I love about Gillian is she's like she's like has the same mindset of me like she's down like I I broke up the fight because they were fighting he was fighting in the parking like well it was like the dog he lived with in the marriage it was yeah it was two dogs fighting there but then I found out he was selling this dog to fight to a fighting ring. So I was like no we're not doing that and I turned to Gillian and I was like Jillian you know we can't leave this parking lot without this dog she's like yeah I know and I just took the dog and walked away after two hours of listening this guy tell us about his sad story. And then so we put the dog in the Audi and now he lives on Gillian's ranch. He went from living in a car in a parking lot this dog has no manners.

Speaker 3 28:01

He's 135 pounds my husband he has the best like no one could ever judge me for mistreating animals.

Speaker 1 28:08

Right I just have probably too many of them anyway anyway um what would be a kidney's best friend oh the bladder for sure oh yeah of course yeah I guess besties besties yeah can't live without each other yeah and what's the best thing for kidneys the best thing yeah uh TLC water water yeah water yeah totally but how do you okay water and diet I think a lot of people don't realize how much diet actually affects the kidneys I was gonna be a little bit controversial here go for it so raw food diet yeah actually oh like good for the kidneys yeah are you asking if it affects the kidneys yeah I'm being sarcastic yeah um but a lot of like okay so for Canadians who like feed their dogs uh huh raw food diets it's a trend does that have an impact to their kidneys well of course you know as a a veterinarian and certainly internal medicine I I just can't recommend raw yeah I know it it does seem to work for some dogs and it's probably and cats it's probably more the novel protein in it that really helps them you know often they talk about allergies or GI issues it's often the protein source I mean for kidneys specifically those diets being so high in protein and phosphorus which actually is the biggest problem for those kidneys um especially when you have kidney disease I mean no if anything it's it's not good at all for those kids yeah so then when dogs are um this I should probably know this but do can we give dogs electrolytes?

Speaker 3 29:36

Like I can give my horses electrolytes if they're dehydrated or it's gonna get extra hot. Sure. Can you do the same thing for dogs?

Speaker 1 29:41

Yeah I mean we can um depending on the dog with advanced kidney disease often we'll give them um subcutaneous fluids which will contain their electrolytes you know there's some oral solutions too but yeah but if I can't put an IV to my own dog yeah because I'm not you two mean like oral oral yeah oh yeah yeah like I can't put a bag on them I think there's really I mean we can sometimes use the human products but yeah yeah often nothing more specific than no yeah yeah yeah that's just my random yeah that's a good random I'm like wait can I do this?

Speaker 2 30:15

Yeah so before we close out here I want to I want to ask you a few questions about vetmed today because I also forgot to say in your introduction you're past president of the Alberta Veterinary Medical Association and so I I feel like you've got a pretty good handle on what's going on in the industry. You're from Quebec and you came to Alberta you've also practiced in the states so you've got a good handle on what's going on right now. So I've got two questions.

Speaker 1 30:44

So what excites you the most about the future of NetMed and what concerns you the most what excites me I mean honestly the first thing that comes to to mind is um organizations or companies like Animal Help them. Helping I know and I'm being honest I mean innovation helping veterinarians and technologists remove that burden of feeling like we have to do it all. You know and I think that's you know five ten years ago that was that I mean it was a big problem right I think that led to a lot of burnouts. You know feeling that responsibility of having to keep the phone lines on, having to come in, having to take care of things you know 30-50% of those calls weren't really needed to come in. You know um so innovation is a big thing. I think with artificial intelligence we always you know have to be careful with the usage of that but I I've seen you know AI programs truly save people 30-50% time in clinics when it's supposed to write time on medical records. But also reviewing medical records that are coming in. As an internal medicine specialist sometimes I have a hundred to two hundred pages of records to review. And now with some of these AI programs I could truly feed those records as long as I am comfortable going through them and making sure it passes you know muster. But um it's incredible the time that I can save which then gives me back time you know to go for a run in the morning I don't have to go to work so early in the morning come back home earlier to you know my family, my awesome daughter and wife and yeah so innovation is exciting. I think the fact that we're talking about mental health so much more is is so important. You know I walk into our bed school now um you you two have been to our you know the new the new one you know um on the second floor there's a center for the students period where they can come and you know meet with professionals social workers psychologists talk to anyone just have a quiet space um places for you know yeah just personal spaces it's incredible I mean on the first floor we also have some quiet studies but things that we've never ever had before so I I'm I'm excited about what's coming I guess also for um the conversation around mental health and um you know healthy boundaries et cetera et cetera and what concerns you the most the same thing the same yeah I mean you know I mean the demands are there I mean uh you know I find that in general um the work has become quite more demanding our pets are living much longer there's so much more we can do but with that comes you know much more responsibility or also much more demand on our services um so it's certainly a big thing I think also with more healthy boundaries it also means we we need a uh a bigger more active workforce because back in the day you can have two veterinarians two technologists doing all the work well now we recognize that's bad so that's a 1416 hour day but then at the same time we have to staff the hospital more they make different you know financial situational social practices and um so I think it's you know it's a matter of figuring out what the just you know the the right balance is going to be do you think oh do you think that with the larger class sizes now that's going to improve? I think so. I mean there's no doubt there's there has been a shortage I mean the pandemic really highlighted it and a lot of people left during the pandemic. So I think that would help you know for us on the um school side one of our biggest missing pieces has always been the rural piece um with our expanded class size and also expanded pool of applicants. You know hoping very hopeful that that's gonna you know replenish the the huge lack of veterinarians in rural practice which overall is going to improve the health of the country.

Speaker 2 34:18

Yeah and I I remember I I think some of it too is like the pet culture like like in a very short period of time because when my mom was a kid pets had a purpose like like I wouldn't even call them pets right like the cat was the mouser yes the you know the dog was you know guarding or herding or whatever. And then just like one generation now they're babies. They're babies and um it's it's like and I think we haven't caught up to that yet. Like I I did a freaking peritoneal dialysis when I was like in ER and it was 16 hour shift because it was just so intense. But I don't know I have a little bit of a different perspective I think is what's kept me going in vetmed is that I see the pressure as a privilege right because it means that I get to practice in this amazing field and I get to do really cool things because pets are seen how they how they are seen as well yes totally 100% agree. So it's but it's a balance right like if you don't have the staff to be able to provide that then it it can be really tough.

Speaker 3 35:23

Yeah.

Speaker 2 35:23

Like I felt like I was working in a sweatshop.

Speaker 3 35:25

Oh totally you you do there are days that I'm pretty sure that's what happens like you have to think there's still situations where one person calls in sick in a practice and it throws the whole throws everybody off.

Speaker 2 35:39

But that's a problem right because like I I remember times when I was sick I probably really shouldn't have gone in but I just thought about the team and I was like I I can't I can't not go when I know that ICU is full.

Speaker 1 35:51

But that's also where the burnout starts yeah and it's emotional burnout yeah because you feel guilt you know yeah very much I know yeah oh man so we've got some closing questions for you here yeah there's one missing we're missing our most important one but okay oh yeah yeah but we're not there yet we're not there yet so um okay what do you hope that your students remember about you years after they graduate me yes you the king of the nephrons oh my god king of the nephrons we need our pirate sword until like we have I have a we have a crown there we go yeah I'll do the crown actually there it is yeah well there oh yeah this one yeah okay oh oh yeah better oh well how did this well that's okay that's more sparkly here up with it yeah see it's way more sparkly king of the nephrons it is adjustable is it yeah just I now know how's that is that holding on oh look at it look at it it's perfect it is it is okay there we go gotta get my head up a bit there it is I love it yeah that's gonna yeah that's gonna yeah okay that's gonna work temporarily from Star Trek yeah right Jordy totally that's gonna yeah all right well maybe maybe a better way of me asking this question is like what impact do you hope that your teaching has made on stupid I I mean all joking aside about the kidneys um clinical reason just to to stop and think about their case you know sometimes we put on blinders and um it's it's very easy to assume something or hear an owner or someone else say that and then just go on it or they get tunnel vision vision and using recipes or you know I I just would like them to think for a sec critically and just be like okay here's my case in front of me what's my problem list what's what are my possibilities here let let me try to work towards finding the answer and also that it's okay to fail.

Speaker 3 37:53

You know I think that's that's the hardest thing I see you know when I see students in clinics very afraid to fail afraid to make a mistake and you know knowing that making a mistake is okay right well I was teaching uh the like finance stuff last semester and they were all like super stressed like they weren't asking any questions like what is happening and they're like we're writing our navy in like a week or whatever and I'm like guys it's the navly you can always rewrite it if you fail and I thought they were gonna kill me. Like I was gonna have they're like don't say we're gonna fail and like guys don't put that juju out there I know but I'm like you get to write it again if you do and we're all gonna fail at something they are so afraid to fail. They're afraid to make mistakes they're afraid to like disappoint anybody right it's this wild well it I mean it's the type of people that are attracted to vet med honestly I know I work with all of you yeah you know us better than we do.

Speaker 2 38:52

Oh man like the amount of emotional weight I carry just because I worry about you all is like well you probably get a lot of the like venting and that sort of thing because it's it's sometimes scary to do it to another coworker because the community so very much yeah that you're like oh but I don't want this to get out that I'm struggling with whatever so I have a crying couch in my office.

Speaker 3 39:14

So there you go.

Speaker 1 39:15

I know yeah you know yeah yeah all right well we'll we'll ask our um our final question the final question okay Julian take care I'm a little worried about okay so we have a playlist yeah on Spotify I don't know if you listen but you should it's pretty good uh so what would be your walk-in song your win song and your funeral song um techno techno techno I love techno I know I know it's very strange I love it are you a dancer do you dance no god no you don't want to see me dance we kind of do actually but yeah we're we're actually gonna do a reel with you after this but in the notes when we were reading them yeah we were I was like oh my god surge is like all about tiesto totally yeah yeah very much do you listen to his club life I do listen to his club life yeah my husband is obsessed with it yeah yeah yeah have you have you gone to the raves with like the headphones on so I've been I've only been to one rave funny enough oh I've only been to one what and we're going and that's what kind of sold me on it I don't know what it was and since then there's been like a small part of me that always craves that kind of music yeah but it it's it's good music for me to do work great music to do exercise and I don't know it's just kind of motivating music um I mean it don't get me wrong I mean when I grew up it was it was YouTube Pink Floyd Rush like you know um I even love Sarah McLaughlin hey I'll be in the I love there you can um you know so I I do have that side of me but techno's always my go-to music to I I'm gonna send you some techno all right like EDM music oh man it's totally coming back I know I love it I love it Kaylee producer Kaylee loves loves uh some EDM too awesome Leilani listens to like gangster rap and then like death I don't know why I believe that but I know death metal I mean I mean we're millennials like you like Metallica don't you I do of course okay we were on a road trip here and Kaylee's like what do you want to hear?

Speaker 2 41:16

I'm like enter sandman and she's like I've never heard it I'm like you've never heard no I have I sang it Kaylee was like I've never heard yeah we were like no no no once it plays you'll get it but then she's just like do you want to see it showing sorry showing I'm like how have you not heard enter sand you want to do that song yeah see I don't know what that is I mean I know what it is but I is that touch metal I don't even know oh jeez that's there oh gosh well thank you so much for being on the show we love you thank you very much appreciating well worth the wait oh thank you I agree yeah yeah all right and uh where can people get a hold of you if they want to check out the Calgary Veterinary POCUS Academy honestly the easiest thing is to Google uh Calgary POCUS Academy POCUS training academy but even if they write Calgary POCUS I'm sure will come up pretty quickly.

Speaker 1 42:07

Yeah okay um yeah sorry I said that wrong okay Leilani's gonna help them with some random marketing I don't know um and uh I mean my email is public and you go to the University of Calgary's website and there I am so yeah always happy to take questions amazing well thank you again so much for being on the show thank you so much I really appreciate it thank you