Get to Know Dr Sam Stewart: Bringing Global Innovation to the Referrals & Diagnostics Theatre

Q: You're making your BVA Live debut this year in the Referrals & Diagnostics Theatre - what made now the right time to get involved, and what do you hope to bring to the programme? 

A: This is a two-fold answer. Firstly, I am a director of a non-profit veterinary research group in the US (Ethos Discovery) that conducts clinical trials focused on developing novel innovations to address unmet clinical needs experienced in daily veterinary practice. We are always seeking to increase awareness of the research we do and the impact that it has on the profession. While we have a significant presence at many of the US veterinary conferences, we now strive to start having our work become more recognised internationally.

Secondly, I am in the process of building a new veterinary referral hospital in London (Veterinary Emergency and Specialty Hospital - VESH), due to open in late 2026, for which I also seek to start increasing awareness about and make sure that the veterinary community knows that we're coming. I intend to have a charity-based research programme at VESH, similar to Ethos Discovery. Therefore, I also aim to begin familiarising the UK with this type of research and, in doing so, generate excitement about the clinical trial options that will soon be available to patients in the London area.

Q: One of your key interests is advancing the diagnosis and treatment of sepsis in small animals. Can you give us a snapshot of the current challenges in this space, and what innovations you're most excited to share with the BVA Live audience?

A: Sepsis is a severe systemic condition that carries a high morbidity and mortality risk. Even though there has been significant research into improved ways to treat patients with sepsis, there has not been any real improvement in patient outcomes in the last 3-4 decades, both in humans and in veterinary patients. This highlights significant unmet needs associated with the care of septic patients, both on the diagnostic and treatment side. When it comes to diagnostics, there are currently no rapid point-of-care tests available to diagnose sepsis, leading to it being a diagnosis of exclusion based on other clinical findings. Additionally, there are no tests available to determine disease severity or how a patient is responding to treatment, meaning that you must wait until you see clinical compromise in the patient first to know that the treatment plan needs to be adjusted rather than being able to make these changes before the compromise develops. Additionally, there are no targeted therapies for sepsis. The primary driver of morbidity and mortality in sepsis is the systemic inflammatory reaction that it causes. Targeted therapies that can blunt this inflammatory reaction without over-suppressing the immune system or causing other deleterious effects are badly needed to improve survival amongst this patient population.

Q: You've had a unique career path that blends hands-on critical care with science consultancy and clinical trial design. How has this dual focus shaped your perspective on diagnostics in veterinary practice?

A: It has allowed me to recognise the shortcomings of many of the diagnostics that we have available to us in veterinary medicine. There are many conditions for which no diagnostic tests exist for which we must make a diagnosis based on the exclusion of other conditions that we are able to test for. Additionally, in other areas, we rely on tests with less than acceptable sensitivity/specificity, primarily because it is the best option that we have. It highlights the fact that although there are a lot of groups working to develop new diagnostic tests in areas that are already decently served by the available testing modalities on the market (i.e. tick-borne disease testing, pancreatitis, kidney disease), there are many diseases that don't have any diagnostic options (i.e. unmet needs), for which, in my opinion, it is more worthwhile for groups to be spending their time investigating.

Q: From CBD in pain management to translational science, you're clearly passionate about future-facing veterinary medicine. What areas of research do you think are ready for greater clinical integration over the next five years?

A: I think there are many areas. Within my research groups we focus on areas of science that will not only inform how we can better care for our veterinary patients, but what we learn will also inform collaborators that work with us on the human side. The data that we develop in our clinical trials is used to inform and support similar trials that are being conducted in humans (i.e. One Health). Due to the many similarities in the biology of diseases between dogs/cats and humans, our veterinary patients are ideal models to assess novel innovations to validate their use and support them being advanced to human trials. There are many areas where I see greater clinical integration over the next five years, however the field of oncology is certainly one that is more at the forefront of this movement. Within Ethos Discovery, one of our main areas of focus is hemangiosarcoma (and angiosarcoma, the equivalent in humans). We have been investigating this cancer for close to 10 years and are starting to see improvements in patient outcomes with the novel treatment approaches that we are using. We hope to soon start seeing many of these novel approaches being instituted around the world and go from this cancer being considered a death sentence to one that could potentially be curable.

Q: When you're not immersed in clinical science or emergency medicine, how do you like to spend your time?

A: I am very much a homesteader and like to make as many things from scratch as I can. Most of the food that I eat I make myself from base ingredients (i.e. pasta, bread, tofu, cheese, etc). I am also an avid gardener, growing a large variety of fruits and vegetables, all of which I start from seed myself. I also fill my free time with hobbies like sewing, hiking, and travelling.