Boarded veterinary neurologist Dr. Jennifer Rich returns to Diagnostic Tails for round three, and this time she's making the case for general practitioners to take on more neurologic workups than they think they can. Hosts Dr. Amy Armentrout and Dr. Lon Hays walk through real cases with her — idiopathic epilepsy, old dog vestibular disease, FCE, disc rupture, and a heartworm that ended up somewhere it had no business being — to map out exactly when a GP can manage a neuro case solo, when a phone call to a specialist is enough, and when a patient needs to go straight to a traditional referral center. Dr. Rich also breaks down how to read MRI and spinal tap results in context and why "just image everything" isn't the answer.

Audio Timestamps

00:00 - Reaching out to colleagues for help outside your specialty

00:29 - Welcome to Diagnostic Tails, Animal Imaging's podcast

00:58 - Meet your hosts, Dr. Amy Armentrout and Dr. Lon Hays

01:22 - Welcoming back Dr. Jennifer Rich for episode three

02:39 - Today's theme: bringing the neurologist to the general practitioner

03:18 - Rethinking what GPs are capable of handling in-house

04:54 - When a patient needs traditional hospitalization vs. when they can stay with their primary vet

08:56 - Case 1: the idiopathic epilepsy patient just outside the typical age range

11:26 - The traditional referral pathway - and why the wait can cost time

12:58 - Neurolocalizing before you image: ruling out reactive causes first

13:55 - Why a "whole body MRI" isn't the right approach

16:12 - Reading results: how a radiologist and a neurologist look at the same MRI differently

16:57 - When the MRI comes back normal - and what to check next

20:04 - Steroids: when to start, when to hold off, and when urgency changes the call

21:31 - Case correction: white cell count in the vestibular/otitis case

22:06 - Case 2: the "old dog vestibular" that turned out to be inflammatory brain disease

24:37 - Case 3: waxing-and-waning vestibular signs that pointed to a brain tumor

25:00 - Vascular disease in the brain: cerebrovascular accidents and ischemic strokes

26:12 - Paradoxical vestibular signs, explained

27:43 - Managing idiopathic vestibular cases with supportive care

28:45 - Spinal strokes: what FCE (fibrocartilaginous embolism) actually is

30:08 - Disc disease and the neurologic grading scale that guides treatment

33:29 - Building a decision framework: refer out or manage in-house?

35:17 - The 48-hour rule for loss of deep pain - still holds

36:18 - Old dog vestibular: when lack of improvement means it's time to image

42:41 - Case 4: the Chihuahua with neck pain - and a heartworm in the spinal cord

45:06 - A horse case: ear ticks mimicking neurologic disease

45:49 - Wrap-up and where to find Dr. Rich

Guest

Dr. Jennifer Rich, boarded veterinary neurologist based in Dallas, Texas, with over 10 years in practice and ongoing locum work across other states. Her consulting service is built around phone- and video-based case support for general practitioners working up neurologic patients. Find her at www.virtualvetneurology.com.

Animal Imaging Veterinary Radiology Specialists

https://animalimaging.net/

(972) 869-2180

info@animalimaging.net

Facebook https://www.facebook.com/AnimalImaging/

Linked In https://www.linkedin.com/company/animalimaging

Instagram https://www.instagram.com/animalimaging/?hl=en

In this episode of Diagnostic Tails, hosts Dr. Amy Armentrout and Dr. Lon Hays welcome Dr. Amanda Cairncross, founder of Vet Vitals Veterinary Mentoring, for an honest conversation about the challenges veterinarians face beyond clinical medicine.

Drawing from her own experiences in practice and her work as a veterinary mentor, Dr. Cairncross discusses imposter syndrome, perfectionism, burnout, compassion fatigue, and the importance of having a trusted mentor throughout your career. Together, they explore how mentorship helps veterinarians build confidence, navigate difficult client interactions, develop healthy boundaries, and create sustainable careers.

• Why imposter syndrome is so common in veterinary medicine
• What effective mentorship looks like beyond clinical training
• How to distinguish burnout from compassion fatigue
• Practical strategies for managing stress and difficult client interactions
• Why setting healthy boundaries is essential for career longevity
• How confidence develops through experience - not perfection
• What new graduates should look for in a mentorship program
• Why asking for help is a strength, not a weakness

Timestamps:

00:00 - Introduction

00:32 - Meet the Hosts

00:58 - Dr Amanda Cairncross

01:17 - Vet Vitals Mentoring

03:44 - Early Career Struggles

06:20 - Understanding Imposter Syndrome

08:04 - Mentorship Then vs Now

12:43 - What Good Mentoring Looks Like

13:57 - Teaching the Process

19:14 - Boundaries and Burnout

23:12 - Grounding in Emergencies

24:57 - Counting Back By Sevens to Ground

25:30 - Loving The Chaos: Emergency Mindset Reframe

27:32 - Hypervigilance and Patterns

29:25 - Rewiring Triggers

31:55 - Burnout Vs Compassion Fatigue

36:42 - Social Media Pressure

39:55 - Mentoring for Tough Clients

43:46 - Advice to New Grads

48:59 - How to Get Mentoring Help

50:14 - Wrap Up and Thanks

• Strong mentorship provides more than clinical guidance - it creates a safe space to build confidence, process challenges, and continue growing throughout a veterinary career.
• Imposter syndrome and perfectionism are common among high-achieving veterinary professionals, but they can be managed through support, experience, and self-awareness.
• Burnout and compassion fatigue are different challenges that require different solutions, making it important to recognize the source of stress.
• Small habits - such as celebrating daily wins, practicing grounding techniques, and setting healthy boundaries - can improve resilience over time.
• New graduates should seek practices with structured mentorship plans, clear expectations, and regular opportunities for feedback.
• Confidence doesn't come from having every answer - it comes from knowing how to think through problems, ask questions, and continue learning.
• Creating a culture where veterinarians feel supported ultimately benefits practitioners, patients, clients, and the profession as a whole.

Whether you're just beginning your career or mentoring someone else, this episode reinforces one core idea: great veterinarians aren't built through perfection - they're built through guidance, resilience, and a willingness to keep learning.

Vet Vitals Veterinary Mentoring offers one-on-one confidential virtual mentoring sessions. Connect with Dr. Amanda Cairncross and/or book a 15-minute confidential complimentary phone call at: https://vetvitalsmentoring.com/

Animal Imaging Veterinary Radiology Specialists

https://animalimaging.net/

(972) 869-2180

info@animalimaging.net

Facebook

Linked In

Instagram