Month: July 2022

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Treating Bladder Cancer: Latest Advancements in Care

Treating Bladder Cancer: Latest Advancements in Care

Toward the end of the 19th century, a New York Town surgeon named Dr. William Coley purposely injected just one of his sufferers with streptococcal microorganisms. Coley wasn’t crazy. He hoped the bacterial an infection would encourage an immune reaction that would sluggish the unfold of his patient’s cancer, which was inoperable. The experiment labored the patient’s tumor shrank.

For the following 40 several years, Coley and his exploration collaborators would test comparable remedies on more than 1,000 most cancers people. They experienced failures but also quite a few successes, in particular amid persons with bone or delicate-tissue cancers. These days, Coley is occasionally termed the father of immunotherapy, which is a branch of drugs that tries to activate or modify a person’s immune system in means that assistance take care of ailment.

Cancer remains 1 of the most lively locations of immunotherapy study, and people with bladder cancer are between all those who stand to gain most from these medicines. “Bladder most cancers is a single of the cancers—along with melanoma, head and neck cancers, and kidney cancer—that are very responsive to immunotherapy,” claims Dr. Joaquin Bellmunt, director of the Bladder Cancer Application at the Harvard-affiliated Beth Israel Deaconess Medical Centre in Boston.

Bellmunt suggests that bladder most cancers is characterized by a large variety of tumor mutations. The human overall body tends to regard these kinds of mutations as “antigens”—meaning unwelcome threats that would generally instigate an immune reaction. Even so, most cancers cells have capabilities that permit their mutations to fly underneath the radar and evade the immune system’s antibodies. Immunotherapies perform in part by counteracting these defenses. In Bellmunt’s words, they “release the brakes” that prevent the immune technique from launching a much more formidable assault.

Any dialogue of new treatments for bladder most cancers ought to spotlight the latest immunotherapies, which have been sport changers. But professionals say that other the latest advancements—including refinements in chemotherapies, radiation solutions, and surgery—are bettering prognoses for people today identified with bladder most cancers.

Right here, oncologists and other bladder-most cancers specialists describe the newest breakthroughs, as properly as areas of investigate that could yield larger advancements in the potential.

The hottest in immunotherapy

Immunotherapy for the treatment of bladder cancer is not new. Since the 1970s, medical practitioners pursuing intently in Coley’s footsteps have given some bladder-most cancers sufferers injections of bacillus Calmette–Guérin, or BCG, a bacteria that triggers a handy sort of irritation. “BCG has been conventional treatment method for non-invasive bladder cancers”—meaning early-phase cancers that have not distribute over and above the bladder—“for the past 40 yrs,” Bellmunt says. “But when BCG failed, we had practically nothing still left but cystectomy,” or bladder elimination surgery.”

The problem was a lot the very same for men and women with state-of-the-art bladder cancers that had metastasized to other areas of the system. If chemotherapy didn’t work, there have been number of choices. (Even when these therapies do work, the median survival time tends to be calculated in months, not decades.)

The most recent immunotherapies are encouraging rewrite the script for men and women with both early-stage and later-stage bladder cancers. “2016 is the yr the newer immunotherapies display up, and quickly some of these drugs were being conditionally authorised based mostly on Stage 1 and 2 trials,” Bellmunt states.

Numerous of these rather new immunotherapies are recognised as checkpoint inhibitors. They reduce (or inhibit) the motion of specific immune pathways that would in any other case block a far more strong immune response. Also regarded as anti-PD-1 or anti-PD-L1 medicines, these remedies have “changed the cure landscape” for persons with state-of-the-art bladder cancers, according to a 2020 analyze in the New England Journal of Medicine (NEJM).

“With immunotherapy, if you really seem at the all round gains, it is very modest,” states Dr. Simon Crabb, a bladder-cancer professional and affiliate professor in clinical oncology at the University of Southampton in the U.K. To his level, that 2020 NEJM research located that, in comparison with normal cure (like chemotherapy), immunotherapy lengthened regular overall survival duration by about 7 months. “But in a minority of clients, it’s possible 20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} to 30{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, you see outstanding responses,” Crabb suggests. “I’ve bought folks who’ve been on these drugs for 4 or five yrs.”

Figuring out why this happens—why some answer so substantially far better than many others to immunotherapy—is a focal place of present-day study initiatives. “Something we have arrive to fully grasp is that this isn’t one sickness, it is a subset of diseases that can be divided up dependent on genetic subtypes,” he describes. By mapping the genetic properties of distinct bladder cancers, professionals hope to achieve a -stronger being familiar with of how every responds to the present-day therapies—whether that includes a solitary immunotherapy medication or, as is getting to be additional widespread, immunotherapies combined with chemotherapies or other prescription drugs.

Researchers are also actively discovering the use of immunotherapies in earlier-stage bladder cancers. For example, there is some hope that administering these medicines before bladder-removal surgical treatment may possibly be helpful. “A extensive time ago, we found out that you can improve survival by offering chemotherapy before medical procedures, but it’s quite toxic,” states Dr. Yair Lotan, main of urologic oncology at UT Southwestern Health-related Middle at Dallas. “Now we’re wanting at utilizing immunotherapy, or a mix of immunotherapy with focused therapies, to keep away from the require for systemic chemotherapy.”

Immunotherapies, like all medicine, have their downsides. The aspect-outcomes of the procedure can be difficult to predict. “If the immune procedure is overstimulated, almost any organ process can be impacted,” Bellmunt says. Skin reactions—dry or itchy pores and skin, rashes—are the most frequent grievance among men and women on these drugs. A smaller sized proportion of sufferers, 5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} or a lot less, acquire inflammation of the bowels, lungs, or thyroid. This irritation can induce indications like diarrhea, shortness of breath, or body weight obtain. “In rare situations we’ve even observed cardiovascular toxicity the place individuals made myocarditis [heart inflammation] and died,” he suggests. In this article yet again, scientists are doing the job to much better understand—and greater predict-—how a particular person will react to these remedies.

Whilst loads of function remains, these medicines have provided a lifestyle-conserving action forward for some. “Once you strengthen the immune method, there are clients whose immunologic memory helps prevent the tumor from recurring,” Bellmunt states. “These people have a clear improvement in survival.”

Go through Far more: Changing Cancer Treatment, So Patients No Extended Really feel Like a Number

New improvements in qualified therapies

Despite the enjoyment and progress involving immunotherapies, chemotherapy stays the to start with-line treatment for highly developed bladder cancers. There, as well, clinical researchers are generating development.

The cells of bladder-most cancers tumors consist of a substantial range of surface antigens, which are molecules capable of triggering an immune response. These antigens are the purpose immunotherapies can be efficient for the therapy of bladder cancer, and these antigens also help the action of newer chemotherapy medications regarded as antibody-drug conjugates. “These medication use these very clever molecules that have an antibody on one particular end—something that will hopefully bind on to the antigens on cancer cells in a selective manner—and a chemotherapy agent on the other,” Crabb says.

The huge problem with common chemotherapy, he points out, is that it struggles to differentiate in between typical cells and most cancers cells. Rapidly-developing cells that resemble most cancers cells—such as those people of the bone marrow, digestive tract, mouth, and scalp—typically draw friendly fireplace. This is why people today on chemo often knowledge various intense aspect-results, which include hair decline, exhaustion, nausea, and sores. Antibody-drug conjugates, by selectively binding to antigens on bladder most cancers cells, can decrease this form of collateral injury. “What it does is lock the chemotherapy on to this molecule that exists on major of the most cancers cells, which with any luck , spares the standard cells the direct publicity to chemotherapy,” Crabb suggests.

Bellmunt likens these medicines to -microscopic taxis that have a bomb strapped into the passenger seat. “The taxi drives to the most cancers cell, which internalizes it, and then it releases the bomb,” he states. “This is a new way of providing chemotherapy that allows stay clear of side consequences, and some trials have also proven a survival edge in contrast to typical chemotherapy.” Right now, he suggests these prescription drugs are utilised as a “third-line” treatment method, or only in situations where by regular chemotherapy and immunotherapy fall short. But there is hope that improvements in these medicines may well soon press them increased up in the pecking get.

Antibody-drug conjugates are just a single of various new “targeted” remedies for bladder cancer. A further is a variety of drug known as a tyrosine kinase inhibitor. “This is a drug that is able to swap off a genomic result in identified in the tumor,” Bellmunt points out. Switching off this trigger is handy because, in some circumstances, it may perhaps be contributing to the development or progression of that tumor.

Scientists are hunting at tyrosine kinase inhibitors and connected precision medication along with chemotherapy or immunotherapy solutions. Combining these medicines may possibly lead to therapy breakthroughs in the a long time to arrive. “We all hope that the proper blend might change the long term,” Bellmunt provides.

Read Additional: 4 Essential Measures to Get Soon after a Cancer Analysis

What is future in bladder-cancer treatment?

The breakthroughs mentioned listed here are among the most promising, but there are loads much more.

For illustration, new imaging methods could shortly make radiation solutions more specific. Genetic sequencing of cancer cells is also a hot spot of study. “We’re finding better at pinpointing biomarkers of the condition that allow for us to tailor our techniques,” Lotan states. “In just the previous 3 or 4 several years, we have moved ahead in pinpointing underlying signatures of cancers and gene expressions that can support us personalize treatment method selections.”

Lotan notes that quite a few in his industry are also hopeful that the long term will generate exact screening protocols for bladder cancer. “From a detection standpoint, there has not been any main advancement,” he states. “Newer detection solutions use panels of RNA or DNA, which are far more advanced, but so much we have not accomplished the large scale studies necessary to display medical utility.” All those trials include thousands of men and women and “a lot of funds,” he provides, and will ideally transpire quickly.

“It may be achievable to use urine as a screening solution, and there’s pretty a good deal of perform heading on in that spot,” Crabb adds. He’s optimistic this do the job will sooner or later bear fruit. “I assume urine screening is the way forward,” he suggests. “It’s all effectively and fantastic to acquire these pricey new remedies, but avoidance, or at the very least early detection, would be much better.”

There was a time when cancer experts hoped for a solitary breakthrough treatment that would, by by itself, eradicate any and all cancers. As their being familiar with of the illness has broadened, all those hopes have pale. Now, most affirm that cancer is far too variable to succumb to any silver bullet, and so the path forward will be paved with a various array of customized solutions. The very good news for persons with bladder cancer is that just about every new yr seems to generate meaningful strides in healthcare science’s capability to battle the illness. The photograph now is radically transformed from what it was 10 or even five yrs back. Men and women with bladder most cancers are dwelling lengthier and with fewer side results than ever right before. There is explanation to assume more enhancements in the near long run.

Far more Have to-Browse Stories From TIME

Get hold of us at letters@time.com.

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Heart Tumor Found After Apple Watch Atrial Fibrillation Alert

Heart Tumor Found After Apple Watch Atrial Fibrillation Alert

Kim Durkee commenced putting on an Apple Enjoy two decades back to monitor her measures and get assist in case she fell.

She in no way envisioned it to detect the first indications of a daily life-threatening problem that required open-heart surgery to stop a stroke.

“I did not have a single single trace that there was some thing improper in my system, not one,” Durkee, 67, who life in Solon, Maine, informed Right now.

“Doctors claimed I was like a silent time bomb.”

No trace, that is, till her Apple View out of the blue started buzzing on her wrist in the center of the night time in late Might. Durkee, who wore the gadget when she slept, woke up to a information warning her that she appeared to have an irregular heart rhythm that instructed atrial fibrillation.

Also acknowledged as AFib, the condition comes about when the higher chambers of the coronary heart aren’t coordinated with the reduce chambers, producing the coronary heart to beat also little by little, also immediately or irregularly, according to the Facilities for Condition Command and Prevention. That can guide to blood clots, stroke and heart failure, the American Heart Association warned. At the very least 2.7 million People are living with AFib, it observed.

At very first, Durkee imagined the alerts must’ve been a fluke. She said she did not come to feel her coronary heart racing or accomplishing nearly anything unusual, and she was respiratory fine. Even now, when the exact notify saved waking her up 3 evenings in a row, with 5 separate messages from midnight to 4 a.m. on the third night time by yourself, she resolved to get clinical assist.

On June 3, Durkee went to the crisis space of her local medical center and stated to the medical professional on duty that her smartwatch informed her to get checked out.

“And he looked at me, like, ‘Really, your watch advised you you have AFib?’ Everyone in the healthcare facility was surprised. I was like the chat of the clinic,” she recalled.

“He did some assessments and he mentioned, ‘Your enjoy is right, you are in AFib.’”

Durkee was active and had no signs of heart trouble before her diagnosis.
Durkee was energetic and had no signs of heart difficulties ahead of her analysis.Courtesy Kim Durkee

‘I believe that it saved my life’

But there was significantly much more to the tale. When medical doctors ran checks, they located some odd readings and carried out an echocardiogram, a exam that makes use of ultrasound technologies to generate images of the heart.

That is when they learned that Durkee had a tumor increasing in her heart. The prognosis: myxoma, a non-cancerous growth in her still left atrium. Indicators can include respiration challenges, chest discomfort and dizziness. It is not distinct what brings about most of these tumors, but they’re exceedingly uncommon, with considerably less than .02{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of people today influenced, scientific tests have located.

Nonetheless, a cardiac myxoma is the most widespread key heart tumor in older people and can be lifestyle-threatening if it interferes with heart purpose, according to the Cleveland Clinic.

That’s what was occurring in Durkee’s circumstance, she claimed. The tumor was in the way of her heart’s regular rhythm, disrupting the standard contraction-peace cycle and leading to an arrhythmia. She wanted surgical treatment at a Boston clinic to take out the tumor.

When Durkee questioned her surgeon what would have occurred if she did not get the smartwatch inform and did not get checked out, since she experienced no indications, “he claimed, ‘You possibly would have had a substantial stroke and died,’” she recalled.

The five-hour open up-coronary heart surgical treatment took location on June 27. 1 thirty day period later, Durkee is recovering well and donning her smartwatch 24/7.

“I believe it (saved my everyday living) 100{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc},” she mentioned. “It by no means arrives off. … It’s like my stability guard.”

Smartwatches are a ‘double-edged sword’

Study findings on how much people today profit from their Apple View detecting atrial fibrillation have been combined. When researchers at Cedars-Sinai in Los Angeles analyzed details from a lot more than 2,000 people who synced their Apple Watches to digital health documents, they found only .25{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of them competent for treatment to reduced their stroke danger — even if the gadget had flagged AFib.

That is since most of the wearers tended to be youthful, nutritious and at very low risk for a stroke, in accordance to the research, revealed this year in the Journal of the American Professional medical Informatics Association.

“Identifying patients with suspected AFib does not automatically warrant setting up a medication to support avoid a stroke,” claimed Dr. Joshua Pevnick, co-director of Informatics at Cedars-Sinai and co-author of the paper, in a statement.

A large analyze funded by Apple identified the likelihood of getting an irregular pulse notification from the watch was small: Only .52{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of the virtually 420,000 individuals enrolled been given that notify. In that team, 34{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of persons have been later on found to have atrial fibrillation.

Dr. Andrew Freeman, a cardiologist at Countrywide Jewish Well being in Denver, Colorado, beforehand informed Currently that he regarded smartwatches a “double-edged sword” due to the fact they can acquire significant well being details, but also guide to information and facts overload for sufferers and their medical professionals.

Continue to, “if you do notice that your crucial indications are at any time out of whack … it is excellent to get them checked out,” he said.

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Dual action of ketamine confines addiction liability

Dual action of ketamine confines addiction liability

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    PETMED EXPRESS : QUARTER ENDED JUNE 30, 2022 CONFERENCE CALL TRANSCRIPT – Form 8-K

    PETMED EXPRESS : QUARTER ENDED JUNE 30, 2022 CONFERENCE CALL TRANSCRIPT – Form 8-K

    PETMED EXPRESS, INC.

    QUARTER ENDED JUNE 30, 2022

    CONFERENCE CALL TRANSCRIPT

    JULY 25, 2022 AT 4:30 P.M. ET

    Operator

    Welcome to the PetMeds conference call to review the financial results for the first fiscal quarter ended June 30, 2022. At the request of the Company, this conference call is being recorded. Founded in 1996, PetMeds is Your Trusted Pet Health ExpertTM, delivering prescription and non-prescription pet medications, and other health products for dogs, cats and horses direct to the customer. PetMeds markets its products through advertising and promotional campaigns, which direct customers to order online or by phone, and which are intended to increase the recognition of the “PetMeds” brand name. PetMeds provides an attractive alternative for obtaining pet medications in terms of convenience, price, ease of ordering and rapid home delivery. At this time, I would like to turn the call over to the Company’s Chief Financial Officer, Mr. Bruce Rosenbloom.

    Bruce Rosenbloom

    Thank you and I would like to welcome everybody here today. I would also like to remind everyone that the first portion of this conference call will be listen-only, until the question-and-answer session, which will be later in the call. Also, certain information that will be included during this call may include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 or the Securities and Exchange Commission that may involve a number of risks and uncertainties. These statements are based on our beliefs, as well as assumptions we have used based upon information currently available to us. Because these statements reflect our current views concerning future events, these statements involve risks, uncertainties and assumptions. Actual results could differ materially from those projected. The company undertakes no obligation to update these statements based on subsequent events. We have identified various risk factors associated with our operations in our most recent annual report and other filings with the Securities and Exchange Commission.

    Let me now introduce our CEO & President, Matt Hulett – Matt.

    Matt Hulett

    Thanks, Bruce. Good afternoon and thank you for joining us for our fiscal 2023 first quarter call. As a reminder, PetMeds pioneered the online pet prescription business over 26 years ago and this is a legacy of which everyone at PetMeds is very proud. As I approach the one-year mark since taking over as CEO and President, I continue to believe that PetMeds is a terrific company with a talented and dedicated workforce serving a large and loyal customer base that supports our vision that “every pet deserves to live a long, happy, healthy life.” My commitment to all of our stakeholders is to be open and transparent, particularly as it pertains to our progress with engineering the transformation of this iconic company.

    Today I will break the call into four themes: 1) an update on our core business 2) an update on our partner strategy 3) a major change to our management team and 4) the progress on our business transformation. So let’s start with an update on our core business. As we mentioned in our last call, we saw a slow start to flea and tick season due to seasonally colder temperatures, which continued into the early part of the most recent quarter. Due to the high concentration of our business in flea and tick and heartworm medications, the slower sales of these products in the month of April in particular had a material impact on the quarter. Once warmer temperatures returned to much of the country, stimulating more normal flea-and-tick and heartworm medication demand from pet parents, we saw the expected rebound of our repeat base later in the back half of the quarter.

    First quarter sales were $70.2 million compared to sales of $79.3 million for the same period the prior year, and while we are disappointed with the overall sales results for the quarter, we are encouraged by the sales generated from our returning base of customers in mid-May and June. Adjusted EBITDA for the first quarter was down 10{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} year-over-year. We haven’t produced the results in net new customer growth, but I remain optimistic that the combination of the new team, new media allocation, and refreshed creative will start to stimulate profitable new customers. Expanding from a business that was primarily optimized to market to existing customers, to a business that also includes a focus on generating new customers, will take some time. The slow start to our flea-and-tick season this spring also had an impact on our ability to attract new customers; there were simply fewer buyers for our seasonally sensitive product catalog. However, we did start to see improvements in new customer acquisition towards the end of the quarter.

    Exhibit 99.1 Page 1 of 10

    We continue to invest in our infrastructure, including processes, systems and people, and you will note that general and administrative expenses increased on a year-over-year basis. These are very targeted investments which we strongly believe will grow long-term shareholder value. In fact, we have partnered with a number of well-seasoned third-party resources, known and trusted by me and my team, particularly with regard to turnarounds, to cost efficiently and quickly improve our e-commerce site delivery, usability testing, data analytics capability, and more. For instance, we have just enabled a new data warehouse (that we call PetHouse) that gives us deep insights into our first party data that spans our 26 years.

    On the marketing front, we have intentionally kept our variable marketing spend relatively flat year-over-year. Again, since April was slower due to unseasonably low temperatures, we determined that it wasn’t prudent to spend against slower demand. Our LTV:CAC number will be dynamic but profitable as we test-and-learn. Our new customer count for the quarter was approximately 69,000 and our LTV:CAC for the quarter was 1.5X. To reiterate, we believe LTV:CAC is a more meaningful measure of the marketing value creation versus using PetMeds’ traditional ROAS metric. We expect to see this LTV:CAC number grow as we migrate more of our returning customers to our AutoShip subscription program, and as we expand Average Order Value over the life of our customers. Our AutoShip program continues to grow. Approximately, 34{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of our revenue was recurring revenue derived from our AutoShip subscription program during the June quarter. We will be announcing some exciting new enhancements to our subscription program that we will address later on.

    During our last earnings call, we discussed our recent investment and partnership with Vetster, a pet telehealth company that connects pet parents with licensed veterinarian professionals all over North America. Today, we are even more excited about this partnership and are making a ton of progress on our go-to-market and partner integration. I will spend some more time detailing the progress later on in this call. We are rapidly moving on the execution of our pet health expert strategy, with the first building block of this strategic pillar being telemedicine. We have many other initiatives and partnerships underway that we plan to disclose at a future date.

    Lastly, I would like to announce a significant new addition to the team and executive to the company. Over the last several quarters, we have spent a great deal of time discussing our new strategy, processes, product, and people. In terms of people, we have invested in an expanded leadership team that has experience with both digital transformation and scaling a company. We have added several new executives in the last 6 months. I am pleased and excited to announce the latest member of my team, Christine Chambers, who officially joins us as PetMeds’ new Chief Financial Officer on August 3rd. You will get the chance to hear from Christine on our next call, as of course she will be participating in our earnings calls going forward. Christine is a seasoned finance professional with extensive experience transforming public and private companies. She was most recently the Chief Financial Officer at RealNetworks. Prior to this, Christine and I worked together closely when she was the Senior Vice President of Finance at Rosetta Stone Inc. She has extensive and relevant experience that I am confident will help PetMeds start to regain growing market share, and I am personally delighted that Christine is joining our executive team.

    The Board of Directors and I would like to thank Bruce Rosenbloom for his myriad of contributions to PetMeds for over 20 years. With an intense dedication to the company, Bruce has made a substantial impact as the Chief Financial Officer for over 20 years. The Board of Directors and all of the team members at PetMeds thank him for his service. Bruce will be officially staying on for several months in a consultative capacity to ensure a smooth operational handoff. Thank you, Bruce, for all you have done.

    Now let us dive deeper into the details with the presentation material. As always, we like to feature pictures of our customers’ and employees’ pets in our slide decks. You will see many original pictures throughout this presentation, starting with this slide which features my dog Harry, a PetMeds customer since he was 8 weeks old.

    Let us start with a look at the current market and our perspective on the overall opportunity. As we covered in our previous earnings calls, PetMeds operates in a very large and growing addressable market. The total U.S. pet market is over $100 billion in annual sales, and it is expected to reach $120 billion by 2024. The addressable pet medication market where we participate today is approximately $10 billion and also growing rapidly. We are actively working on improving and growing our core business in that addressable market, while also setting our sights on expanding our addressable market into the broader wellness market which is estimated to be over $30 billion.

    Today, we are one of the leading and most trusted pet pharmacies. PetMeds is also an important part of the strategy of many of the pet platforms and players in the industry. As I have learned, there are not many truly reliable online prescription providers for these pet platforms and players to partner with, which puts us in an enviable position. Our core asset and demonstrated competency around prescriptions enables us to move much more quickly to execute on our broader pet health expert strategy.

    Exhibit 99.1 Page 2 of 10

    We also operate in a market that is growing with underlying behavioral trends that are favorable to digital retailers, and it is a great time to be in the pet business. We also know that the pet vertical is more resilient than other verticals when there is a financial downturn. In particular, it is a great time to be a retailer that is focused on essential consumables. U.S. household pet ownership has increased over time, and today 7 out of 10 U.S. households have a pet. In a post-Covid world, those pet parents are going to need, and will seek out, health and wellness care provided by a trusted brand. PetMeds is uniquely positioned to take advantage of this trend.

    Pet parents see their pets as an extension of their own families, and they are increasingly demanding more healthy pet care options. We see this as a positive trend for PetMeds and an opportunity for growth. Similarly aligned with the trends in human health, pet parents are thinking through the entire spectrum of their pet’s care, from diet to veterinary services, and from infancy through old age. While some well-known retailers entered the market by means of pet food first and then expanded, PetMeds started first in the most difficult Rx end of the market, and we are now expanding out. To that end, we intend to move much more aggressively this year in expanding our product assortment and catalog. We see significant compounding upside in the form of increasing recurring sales, increasing customer loyalty, and increasing share of wallet by providing a broader non-medication product assortment to pet owners.

    Lastly, the pandemic accelerated the increasing trend for the digitization of healthcare. Specifically in the pet market, regulations related to in-person veterinary visits and prescription fulfillment were temporarily waived for the first time during COVID and these services moved online in unprecedented ways. PetMeds is ahead of the curve on this trend with our strategic partnership and investment in pet telemedicine with Vetster. With this groundbreaking partnership, we believe we are enabling the first real mainstream pet telemedicine platform, and the one that will prove to be an accelerator of widespread adoption of pet telemedicine.

    During the last earnings call, we discussed some key PetMeds differentiators. I want to reiterate those because they are important, and I believe they provide a real edge for our company’s transformation. First, our brand is both widely known and trusted. Our own market research indicates that 55{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of U.S. pet parents are aware of the PetMeds brand. Having a strong brand takes years to develop and our customers look to PetMeds as their trusted pharmacy and pet medication expert. We will be leaning more into the brand in our external communication with more dynamic and relevant messaging and new channels to take advantage of our large brand goodwill.

    Second, we have strong operational and quality efficiency as a pharmacy. The customer care integration with our pharmacy is world-class, which ensures that customers get their products delivered as promised, quickly and accurately. Additionally, our vet partners reliably receive quality service delivered through our vet platform. We will be looking to expand our vet network and provide enhanced service to them with new technology delivered through our partnership with Vetster.

    Our deep experience with the vet community is a significant competitive advantage. We have one of the largest direct-to-consumer vet networks in the online retail space with over 70K veterinarians that we have worked with over the company’s history. Currently, our online vet portal has 17K active veterinarians and vet clinics. As I have said in earlier earnings calls, this is a core capability and a unique asset because it enables us to expand our fulfillment capability as we scale our business. Our intent is to drive incremental revenue through a powerful platform offered to our vet partners in the near future. We view vets as our partners in jointly providing a greater array of pet health services to pet parents. To that end, we will continue working together holistically to improve vets’ ability to care for pets. Ultimately, we believe if we help vets, the profits-for both the vets and for PetMeds- will follow.

    Our pet pharmaceutical category expertise is something that I view as a towering strength. Many retailers can sell dog food, but few can provide medication and sound health advice at scale. As I have said before, being a differentiated pet medication provider allows PetMeds to excel in our health and wellness offering and continue to be viewed as trusted pet health experts, especially as the market continues to become even more competitive. PetMeds currently enjoys a close and strategic bond with our many supply partners and those relationships have developed over time to become even more strategic. We have direct relationships with all of our major suppliers, and we work together closely to effectively market their products to our customer base.

    Our customer service and overall customer centricity ethos permeates our culture and is demonstrated throughout our team. We provide a 100{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} satisfaction guarantee, and we go the extra mile for our customers with truly empathic and expert service. We don’t just have a transactional interaction with our customers, we have built trusting, genuine relationships. Our customers view PetMeds as their trusted pet health expert, and we take that responsibility seriously. I recently had the pleasure of receiving an email directly from a customer concerning a phenomenal interaction with one of our Customer Care reps….here’s what they had to say:

    Exhibit 99.1 Page 3 of 10

    Dear Mr. Hulett, The purpose of my letter is to bring your attention to my experience with a member of your team, Jennifer, during my call with your company yesterday. Having the need to re-order Riley’s, my dog, monthly meds, I called your company yesterday and was connected to Jennifer. Her knowledgeable, professionalism, and patience with me were outstanding. Being disabled, without income and living on my savings, I had a lot of questions about different meds and the different ways I might be able to save some money.

    I am sure my time with Jennifer probably extended past company policy regarding time as most places you call, they rush you on and off the phone, only wanting to take an order and get to the next customer. This was not the case; I had a lot of questions and Jennifer was so patient and kind and assured me she was there to help me and that she was going to do it!

    Her time with me on the phone yesterday was a great example of her dedication to Pet Meds and her love for helping others. I am very impressed and thankful for her time and patience with me.

    Again, thank you for your company’s outstanding service. With the many different choices that are available to us to choose our meds for our animals, I can tell you, it’s the folks like Jennifer that will keep them coming back. Should I have an opportunity to refer others, be assured its PetMeds, where I will be sending them too.

    Jennifer is a perfect example of our employees’ dedication to our customers and their pets’ wellbeing, and I’m delighted to share this story and recognize Jennifer and all her colleagues for their exemplary customer service.

    PetMeds has historically been a somewhat low growth, yet high dividend-based company, and we are proud to have created and returned so much value to our shareholders. We are intent, however, upon becoming a higher growth company to create even more value, and believe we are in a great position to do that:

    ●

    PetMeds is profitable with a pristine balance sheet. We do not have any debt, we have approximately $105.4 million in cash and cash equivalents as of June 30, 2022, and we are cash flow positive.

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    PetMeds is moving much of our business from a transactional direct-to-consumer model to a subscription business. Subscription businesses are clearly compelling business models due to their predictable and stable recurring cash flows. As I mentioned at the beginning of the call, we ended the June quarter with approximately 34{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of our customers enrolled and ordering via our AutoShip and Save subscription program.

    ●

    We continue to have a large base of returning customers which is an indication of the quality service and the value that we deliver. We are fortunate to have a large base of 2 million pet parents that have purchased from us over the last two years.

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    We have over 26 years of experience as a pure-play pet pharmacy, fully licensed in 50 States, delivering outstanding service and value. This domain experience is what I would call the more complicated part of the pet ecosystem which makes our progression into other segments much easier.

    ●

    Our customers just love our brand and our service. Our NPS score is over 80 which puts us in the upper quartile along with some of the most beloved brands in the world.

    Now, I would like to have Bruce review our financials for the quarter.

    Bruce Rosenbloom

    Thanks, Matt. During the review of our financial results, we will compare our first fiscal quarter which ended on June 30, 2022 to last year’s quarter that ended on June 30, 2021. I would also like to highlight that we introduced new “Non-GAAP” financial metrics during our last fiscal year, adjusted EBITDA and adjusted EBITDA per share. We decided to include these new metrics because they are key measures used by management and by our Board to evaluate our operating performance, generate future operating plans, and make strategic decisions regarding the allocation of capital. Additionally, adjusted EBITDA and adjusted EBITDA per share provide a more accurate picture of our underlying profitability and also take into account the more recent increases in non-cash stock-based compensation and other expenses.

    Throughout our most recent fiscal year, we faced a unique situation comparing two totally different environments, between 2020 (pandemic) and 2021 (mostly post pandemic). As we move forward into our current fiscal year, the year ending March 31st, 2023, with our new marketing partnerships, agencies, and processes, we expect to be much more efficient with our variable marketing spend with improved results, and with many of our highlighted initiatives firmly in place.

    For the current year, first quarter sales were $70.2 million compared to sales of $79.3 million for the same period in the prior year, a decrease of 11.5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}. As Matt mentioned, earlier, while we were disappointed with the sales decline year over year, we were encouraged by the sales trends we saw later in the June quarter. Reorder sales decreased by 7.8{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} to $63.3 million for the quarter ended June 30, 2022, compared to reorder sales of $68.7 million for the same quarter the prior year, using a consistent 36-month definition of a new customer.

    Exhibit 99.1 Page 4 of 10

    With the increasing AutoShip subscription adoption, we see more opportunities to continue to build our relationships with our loyal customer base. We will also look to continue to improve our reorder sales by marketing to our customer base with increased product offerings and services. During the June quarter we made a change to the methodology on how we calculate the percentage of our revenue that was generated by our AutoShip & Save program. Going forward, we will report AutoShip, net of discounts and credits, and we will also report the average of our AutoShip attainment over the quarter (versus the last month of the quarter). Please note that this change to the calculation resulted in a decrease to the AutoShip percentage that was previously reported by only a few percentage points. We believe that this change reflects a more accurate representation of our subscription business for stakeholders to gauge its performance. We are encouraged by the adoption of this program and have seen an increasingly positive trend over the last several quarters since we launched this program. For example, our quarterly AutoShip percentage increased from 20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} in the December quarter to 31{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} in the March quarter and averaged 34{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} for the most recent quarter ended June 30, 2022.

    For the first quarter of Fiscal 2023, our Gross Profit as a percentage of sales increased by approximately 95 basis points to 28.4{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} compared to 27.5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} for the same period a year ago, as some of the major manufacturers shifted their funding from cooperative marketing rebates and discounting product costs to funding discount promotions which support our AutoShip and save subscription program. There may be an opportunity to improve gross margins in fiscal 2023, if the shift to prescription medications continues, and we can grow future sales with appropriate price promotions.

    Net Income was $2.8 million, or $0.14 diluted earnings per share, for the first quarter of fiscal 2023, compared to $4.4 million, or $0.22 diluted earnings per share for the same quarter last year. Adjusted EBITDA for the first fiscal quarter was $6.3 million, or $0.31 on a diluted basis, compared to $7.1 million, or $0.35 on a diluted basis for the same quarter last year. Adjusted EBITDA and adjusted EBITDA per diluted share add back certain non-cash expenditures, including stock compensation, interest income and expense, income taxes, depreciation and amortization, and other expenses like the investment banking fee relating to the Vetster partnership. Again, adjusted EBITDA and adjusted EBITDA per share are “Non-GAAP” key measures used by management and our Board to evaluate our operating performance, generate future operating plans, and make strategic decisions regarding the allocation of capital. We will continue to disclose these financial measures in our future filings.

    As a result of the intentional and strategic investments in headcount and infrastructure made over the past year, we have seen double digit percentage increases in general and administrative expenses. We strongly believe that these investments are necessary for our transformation, and we intend to continue to make prudent investments in the business to fuel and support future growth. In the June quarter we spent approximately $982,000 in capital expenditures with the majority of the spend related to the customization of our ecommerce platform and our new data warehouse. We expect to see a continued investment in capital expenditures to the tune of approximately $4.0 million for the remainder of fiscal 2023, which will be utilized to further customize our ecommerce platform and IT infrastructure.

    We had $105.4 million in cash and cash equivalents, and $22.6 million in inventory with no debt as of June 30, 2022. The Company continues to be committed to returning capital to our stockholders. As such, the Board of Directors declared a quarterly dividend of $0.30 per share on the Company’s common stock that will be payable on August 19, 2022, to shareholders of record at the close of business on August 12, 2022. Also, please note that the declaration and payment of future dividends is discretionary and will be subject to a determination by the Board of Directors, each quarter.

    Now, I would like to hand the presentation back over to Matt.

    Matt Hulett

    During our last earnings call, we revealed our long-term strategy with some degree of specifics. PetMeds is moving from being just a leading pet medication retailer to being a market leader in expert pet healthcare. We envision a world where the majority of vet services and pet care move digitally. We are in the early days of this digital transformation. But it is coming — rapidly. We believe that a digitally enabled and data-driven future will be the preferred mode of delivery for pet parents.

    We have taken important steps towards executing on our long-term strategy, starting with our recent announcement that we made in the telemedicine space. The strategic pillars that we will be executing on are: nutrition, medications, wellness, and care, with data both driving and being at the heart of our services.

    Our recent announcement with Vetster is the first building block of our ‘care’ offering. During the last call we discussed how this partnership is a real unlock in both technology and e-commerce integration which provides a powerful combination that has never been introduced in the pet category. We see a panoply of upsides and opportunities, including:

    Exhibit 99.1 Page 5 of 10

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    First mainstream launch: We believe we are the first company to introduce pet telemedicine to the mainstream, connecting 2 million pet parent customers with over 70K veterinarians in the PetMeds network.

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    “Close the loop”: Direct connect access to a telemedicine experience that ‘closes the loop’ between a pet parent and a vet so that prescription medication can be prescribed directly to a pet parent in many cases without the need of an in-office visit.

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    New revenue streams: this partnership creates new revenue streams within PetMeds and the potential for new revenue streams from traffic driven from Vetster’s platform

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    Go-to-market acceleration: unique investment and partnership terms allow PETS to accelerate our go-to-market on our new strategy. For example, PetMeds will leverage the Vetster platform to provide virtual vet clinic services embedded with our pet medication and retail platform directly into their platform.

    ●

    Climbing up the sales funnel: we believe that offering telehealth will enable us to acquire new customers and to create more incentives for PetMeds subscribers. PetMeds customers will be able to get instant care,whether that is via text or live video chat with your vet, or with any vet provider through an exclusive vet marketplace accessed on your smartphone or desktop 24/7.

    ●

    Veterinary alliance: We think that this partnership is a huge win for vets, too. We believe this partnership will allow us to provide attractive capabilities and additional revenue streams and work flexibility to our core vet network and beyond.

    Since signing our agreement just several months ago, we have already moved very quickly towards integrating PetMeds’ and Vetster’s core technologies. We have already integrated two services into each other’s platform, which include:

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    PetMeds integration: PetMeds catalog, Rx, and e-commerce capability is now directly integrated into Vetster. That means that now, for any customer that has a direct veterinary relationship or resides in a state that allows for digital prescription fulfillment, any vet on Vetster will be able to triage, diagnose, and then prescribe medication directly from a computer or mobile device. This level of integration happens directly as a virtual appointment. The data from the prescription and the overall appointment is integrated into the pet parents’ personal pet health dashboard. This innovation means that as virtual care increases for pets, PetMeds can become the engine that powers the e-commerce transaction behind this trend.

    ●

    VetLive™: VetLive™ is a new experience that will be rolling out over the next several months, and the first of many services that will be launching over the quarter. VetLive™ is an exclusive veterinarian marketplace integrated directly inside of PetMeds. VetLive connects pet parents to thousands of licensed veterinarians ready to provide the best online vet services through video chat appointments 24/7.

    I think about virtual care the way some entrepreneurs thought about the app store as a potential to reach out to a global audience – instantly. The companies that didn’t have the foresight to take advantage of a platform change like this missed out on a huge value unlock. Direct access to an exclusive network of extraordinary vet care providers is a very high engagement and high value proposition for pet parents and we believe will be a very sticky offering. And this is just one of many examples of how we believe we are building a very compelling platform for the next big trend in pet health.

    We have made substantial and measurable progress on our transformation of the business over the last several quarters, and we remain laser focused on execution. Now that we have the majority of the new people, process, and strategic elements of the business underway, here is what you can expect from us over the next couple of quarters in terms of our organic and inorganic growth focus:

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    Improvement in new customer growth. We will be expanding and accelerating our new customer acquisition efforts which are critical to our long-term success.

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    Continued migration of our business to a recurring subscription model.

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    More active deployment of our capital. There are exciting opportunities for us to leverage capital to accelerate our transformation through investments, partnerships, and acquisitions.

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    Full rollout of our pet telemedicine capability into the market. We will start to execute on the deployment and expansion of our integrations and partnership with Vetster.

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    Expansion of product catalog and services – this includes a much wider product assortment as well as adding more health and wellness services to our business.

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    Commitment to ESG – This year we initiated our environmental, social and governance (ESG) commitment. A great example of this is our Ukraine pet relief effort that we launched with IFAW, as well as our longtime continued support of many US-based pet rescue and humane organizations. PetMeds firmly believes that we cannot consider ourselves successful as a business if our team members, our communities, and our planet do not thrive as well. Our strategy is still in the early stages of development but at the heart of our commitment is giving back to pets, people, and our planet.

    Exhibit 99.1 Page 6 of 10

    I can’t stress enough that it takes time to transform a company, especially in a highly competitive market and in an uncertain economic environment, but our market opportunity is clear, and it is compelling. I am confident that the foundation that we have been laying will meet that market opportunity in unique and innovative ways and will lead to increased operating results and shareholder value. PetMeds’ brand, expertise, and reputation are unparalleled, our balance sheet is strong, our team is fantastic, and I am more excited about the future than ever. This ends our prepared remarks, operator, we are now ready to take questions.

    Operator

    Thank you.

    Our first question is from Erin Wright with Morgan Stanley. Please proceed with your question.

    Erin Wright

    Hey, thank you for taking the question. Can you give us an update on where we stand now with the flea and tick season? Were those sales just lost? Or does it shift to the next quarter? What are you seeing now on that front? I think you used to give that quarterly seasonal weighting of what was considered seasonal products. I guess what does that cadence look like? Or what do you expect it to look like this year compared to historical trends from a seasonal mix perspective? Thanks.

    Matthew Hulett

    Hi Erin, this is Matt. Thanks for the question. Great to hear from you. A couple of things about the quarter. It started out pretty slow, especially compared to March. We indicated that March was slow due to seasonality around, the temperatures being cold, and it continued into April. Then it really progressively rebounded on our returning business through May, through June and continues through July. So, we’re pretty confident the parasiticide business of PetMeds is recovering very nicely. That kind of maps to what we’ve seen in other supply chains and other partners that we’ve talked to. It’s very similar to what we’ve seen in the subsequent historical practices in the business since we’ve been around for 26 years. We have some-a lot of data around this. To answer your question in a point of way, we view this as an extension to the season. Typically, a six month season. We’re heavily weighted towards flea, tick, and heartworm and so we view the season being extended out versus contracting. Bruce, do you have any other follow-up comments?

    Bruce Rosenbloom

    No, Matt. I think you covered everything there.

    Erin Wright

    Okay. Got it. Thanks. Then more broadly, how are you thinking about pet spending and a tougher macro backdrop? And are you seeing any changes in customer behavior, for instance, in terms of trade down on products? Or are pet owners moving from six months flea and tick packs to three months? Or has anything else changed or would be indicative of a change in consumer?

    Matthew Hulett

    Yes. Erin, it’s a great question. We hope to changes in the future. As you know, we’re highly medication and heavily RX-focused. The good news about that is customers are very brand-specific and brand loyal, intend to not trade down. We’ve maybe seen a little bit of impact on people trading down in terms of dosage, but not much. At least this category, we’re seeing not a lot of movement there. I think as we start thinking about broader consumable products, maybe food and other items, we’ll see some of that trade down. But in terms of brand loyalty to RX, in particular, we have not seen a trade down behavior. Bruce, anything to add there?

    Bruce Rosenbloom

    Historically, when times have been tough, and again, I’ve been with the company through a few different downturns, you may see pet owners instead of buying a six-month supply, buying a three month supply. So, a trading down from that perspective or stretching out that medication. We haven’t seen that yet, but that’s some behaviors we have seen in the past. So, just something that we’ll keep tabs on. But as of right now, the data has not shown any significant changes.

    Exhibit 99.1 Page 7 of 10

    Erin Wright

    Okay. One just housekeeping question. Did you give new customer growth or total new customers acquired in the quarter?

    Matthew Hulett

    We did; 69,000.

    Erin Wright

    Okay, got it. Thank you.

    Matthew Hulett

    You bet. Add on to that, Erin, since we are so highly concentrated to RX, particularly flea, tick and heartworm, April, just to be blunt, was not a great month to be acquiring those customers since the earth was pretty cold. So, we were pretty, getting very optimistic actually, about our new customer acquisition initiatives underway, especially later in the quarter. So, we expect to see good improvements throughout our calendar year on new customer acquisition. We’re getting more optimistic there.

    Erin Wright

    Okay, thank you.

    Matthew Hulett

    Thanks, Erin.

    Operator

    Thank you. Our next question comes from Corey Grady with Jefferies. Please proceed with your question.

    Corey Grady

    Hi, thanks for taking my question. I wanted to follow up on your customer acquisition initiatives. You test a new creative across the new channels during the quarter. Can you give us maybe more detail on the results you’re seeing so far? Where you are in terms of the marketing transformation?

    Matthew Hulett

    Hey, Corey, this is Matt. Thanks for your question. Thanks for hosting us recently your conference. It was fantastic. I won’t go into the specific channels, but I think in the meta macro level, we’re definitely seeing rates get to more normal and/or, in some cases, lower rates year-over-year, which is great news. Which you typically see in some environments that get more macro challenge, but definitely on the performance marketing channels, we’re definitely seeing more stabilization in some cases, reduction of rates. Some channels are still high. I think we all know the issues around social, but we’re definitely seeing a rationalization in rates as I think growth-oriented companies have readjusted how they think about their media mix. I think that is only going to be a net beneficiary for PetMeds. Then that’s kind of the macro. The micro on us is, as you know, and we spent some time talking about this at PetMeds for a long time is focused on lower the funnel aka performance marketing to its returning base. Since we had a new CMO, and new partners starting about six months ago on a new strategy, we’ve definitely moved that shift to lean more into our brand, and we’ve seen really strong results there. We expect those to continue and over this calendar year, we expect to see net new customer growth due to those efforts, and we’re feeling more optimistic about them. Did that answer your question, Corey?

    Corey Grady

    Yes. It did. It’s really helpful. Then for my second question, I’m just following up on the flea and tick. So, given the known kind of flea and tick weakness coming into the quarter, how did the reorder sales come in relative to your expectations? Then have you guys seen any change in seasonality to the vet industry that would typically proceed a change in your reorder business?

    Exhibit 99.1 Page 8 of 10

    Matthew Hulett

    Yes. Corey, thanks a lot for that. The first-I’ll answer the first question first with-you asked me in April, how was I feeling about the quarter. I wouldn’t have been very optimistic. Then subsequently, May and June, got a lot more optimistic. So, the quarter recovered to where we were expecting it to be and that continues into July, on the returning side. Again, the new customer acquisition side was a little slow to warm up because the buyers weren’t there. In terms of the vet’s cycle, we do tend to look a lot like the vet cycle in terms of concentration of revenue, but also the patterns for consumers with PetMeds is that the vet typically gets the first prescription, and we get the secondary. We actually haven’t seen that as much as the things start to recover, that we are starting to see the similar cycles even with the seasonality with colder temperatures. So, I don’t think that’s going to be much of a headwind for us as we come into this next quarter. Corey, I don’t know if that answered your question or not?

    Corey Grady

    It did. That’s helpful. Thank you.

    Operator

    Our next question is from Anthony Lebiedzinski with Sidoti & Company. Please proceed with your question.

    Anthony Lebiedzinski

    Yes, good afternoon and thank you for taking the questions. As far as-if I look at the traditional way of how PetMeds talked about advertising and new customer acquisition costs. So, that looks like about $92 for the quarter. How should we think about that number kind of going forward? I know, Matt, you talked more about LTV to CAC. But I guess just for old-timers, covered the stock for a long time, how should we think about that on a go-forward basis?

    Matthew Hulett

    Anthony, you’re referring to $92 the absolute number for CAC.

    Anthony Lebiedzinski

    Right. Yes, so if I take the advertising dollar amount divided by the new-number of new customers, which was just disclosed as far as-69,000 you said. So that comes out to $92.

    Matthew Hulett

    Yes. I just want to make sure we’re looking at the same song sheet. In terms of the absolute number for CAC, we actually are feeling better about that. If-you’re asking a directional question. So, it’s been higher for us, as you know, my first in a CMO for the business wasn’t the best quarter for CAC for the Company, and we handed that to a more prescient CMO. But the CAC number for us is stabilized and it’s actually decreased a little bit due to this medium mix. So, on a go-forward basis, we’re not thinking about and targeting CAC is a metric that we talk about. But since it’s easy to calculate, it’s actually been relatively stable and going down. The LTV number has been pretty stable as well. But we hope over time with recurring revenue and a broader catalog, that just goes up because we get more opportunity to sell more products and get more engagement and a broad array of products. So, I think LTV goes up over time. Then I think right now, Anthony, to answer your point on question, I think $92 it may be a little bit lower over time. It’s been going down as we’ve gotten smarter about our media mix. Also, I think the current macro environment hasn’t been increasing as much, which has worried us in the past. So, I hope that’s helpful. I don’t peg it. I can’t predict what absolute number is going to be other than we’ve seen market improvement month-over-month, week over week, and it’s starting to stabilize in terms of price increases. So, we’re feeling better about the CAC environment.

    Anthony Lebiedzinski

    Okay. That sounds good. Okay. So-and I know it’s still early as far as the relationship with Vester, but can you give us any sort of color as far as-I don’t know if you want to talk about the specifics, but as far as customers actually-your own customers using Vester or vice versa, Vester customers using PetMeds to fill their orders. Can you give us any sort of additional color or details on that?

    Exhibit 99.1 Page 9 of 10

    Matthew Hulett

    Yes. The first integration we did was to embed PetMeds as a private label inside of Vester. Vester is a start-up. So really, they have a small amount of traffic right now. But it was a good Watson are you there moment to determine whether it works or not. And a, it works, and b, customers are really delighted by the overall service, and I encourage everyone who’s listening to try it, it’s really fantastic. Secondarily, the big launch for us where volume will start increasing and also getting more exposure on the site, and our mobile products will be VETLIVE. VETLIVE will be the Vester marketplace, private label inside of our PetMeds properties, and that will come in the next several months. That will be the opportunity for us to really do some interesting things. The first part is just to engage with pet telemedicine appointment live on the site. The secondary component is there’s a whole host of other subservices that we’re going to be launching. Some will be in AutoShip, and the others will be extended from their current platform. But the first goal is to get, let’s say, in the next several months, VETLIVE up to our current customers. Then we’ll start seeing a lot of usage there, Anthony. So, first things first, we launched, and it worked. The second point is PetMeds should be getting that up live on our properties in the next three months.

    Anthony Lebiedzinski

    Got it. Okay. Then lastly for me. So, unlike a lot of other consumer companies where they’re dealing with bloated inventories, your actual inventory is lower than last year and lower on a sequential basis. So, that being said, I mean, do you feel like you have adequate inventory? Of course, there’s still ongoing supply chain issues that we’re hearing from other companies. So, can you just talk about that as well?

    Bruce Rosenbloom

    Yes. Anthony, I’ll take that question. This is Bruce. As you know, our inventory fluctuates from time to time, mostly due to opportunistic opportunities as far as buying. As we mentioned in the last call, at the end of the March quarter, we had an opportunity to take on additional inventory at a reduced price. So, we went ahead and pursued that. So, we definitely were stocked up as of March 31 and ales, although recovering through the quarter, were still fairly slow in April. So, I would say the inventory levels where they are right now, around $22 million to $23 million, probably a normalized level, maybe a little bit lower than maybe in past seasons, but not so off from where we’d like to be. Since we do have direct relationships with the manufacturers, lead times are cut, really short, based on how we used to procure. So, no concern there. We’re always going to be opportunistic if there’s going to be-if we have an opportunity to buy at a reduced cost, we’ll take advantage of that. Those usually come up traditionally at the end of the year, so around 12/31. We’ll see how it shapes up. But if there’s an opportunity, we’ll take advantage of it.

    Anthony Lebiedzinski

    All right. Terrific. Thank you, Bruce and thank you, Matt.

    Matthew Hulett

    Thanks Anthony.

    Operator

    Our question-and-answer portion of the call has ended. I would now like to turn the call back to Matt Hulett, the Company’s CEO, for his concluding remarks.

    Matthew Hulett

    Thank you, Operator. As you just heard, the future of PetMeds is much more expansive than just a prescription e-commerce company. We are building our strategy out and working hard to transform into a broader e-commerce and subscription brand that reflects and leverages our status as the trusted pet health experts. I will continue to detail our progress and look forward to providing you with updates in the not-too-distant future. As always, thank you to all of our employees, customers, partners, suppliers and investors for your continued confidence and support. Thank you for listening in. Operator, this ends the conference call.

    Operator

    This concludes today’s conference. You may disconnect your lines at this time. Thank you for your participation.

    Exhibit 99.1 Page 10 of 10

    Posted on

    5 Healthy And Easy Snacking Tips to Curb That 4pm Hunger Cravings at Work

    5 Healthy And Easy Snacking Tips to Curb That 4pm Hunger Cravings at Work

    As we prepare for a phased return to pre-pandemic normalcy amid business reopening, nourishment and your nutritional way of life perform a important purpose in obtaining our brain and body completely ready for the daily grind and snacking as a result of the day whether you are operating from home, or office contributes a substantial component of our day by day diet. Provided there is an urge to munch continuously through the day, snacks getting the commonly obtainable selections, unchecked and unhealthy consuming patterns take a toll on a lot of people’s all round health. It is because of to this reason it is important to be intelligent and mindful of your meals selections. Anchal Abrol, CEO and Founder of  Snaqary shared some smart snacking strategies for place of work staff.Also Read – Easy Exercises For Diabetics: 5 Routines That Folks With Diabetes Ought to Do In the course of Monsoon

    Retain By yourself Hydrated

    It is a acknowledged reality that the system desires an proper volume of hydration to hold you heading all over the working day, still the the greater part of us are likely to choose it lightly. It is essential to maintain consuming water and sustain fluid intake all through the day. The physique will get dehydrated even when you are sitting inside the house, so a person must establish a pattern of maintaining a drinking water bottle following to them and preserve sipping the drinking water. You can include other balanced drink alternatives in your working day as very well like coconut drinking water, buttermilk, lemon water, and infused detox water in your day by day regimen which will prove to be a nutritious hydrating solution that also tastes good. On top of that, it is crucial to be wary of sugary and carbonated drinks, canned juice, and many others, because they are not healthier, and will only have detrimental results on your well being. Also Go through – 5 Helpful Healthful Homemade Beverages to Treatment Fatty Liver

    Do a Meal Prep

    Meal prep is a way to get ready batch-cooking meals, snacks or components ahead of time, to make wholesome ingesting less complicated. In addition, when doing work from house, your day may perhaps be marginally less dictated by routine than when you are in the business. So, it is essential to routine and prepare set foods in advance whilst working from dwelling or on fast paced office environment days to stay away from overeating and harmful munching on commonly accessible objects. make a food program that coincides with your work agenda. Also Read – Diet Prepare For Excess weight Obtain: 5 Foodstuff To Obtain Pounds in a Healthful Way

    Include wholesome snacks over junk to your kitchen

    An crucial tip is not to inventory your fridge or pantry with harmful junk superior in poor fat and sugars. This can direct to consuming just out of a craving mainly because you can. Attempt your best to retain junk meals out of your property, specially meals you know can cause a binge for you, and as a substitute substitute processed food items for clean food items together with peanuts, chickpeas, seeds on salad and fruits. A person can also adopt healthful snack solutions like khakhra, jawar or quinoa puffs, corns, sprouts, baked bhakarwadi, roasted makhanas, and so on. These snacks are good to give relief to mid-operate starvation. One particular can love them without having messing up their food plan as they are packed with protein and fibre that assure immediate vitality. Smoothies topped with healthy roasted seeds are an additional healthier possibility that will tingle your flavor buds and are easy to make which will be certain you stave off these hunger pangs.

    Concentration on True Foods

    Balanced, healthy meals will make us additional productive. It keeps you fuller more time and assists us focus. In order to undertake a wholesome life-style, it is also critical to realize that what one eats will also have an effects their temper and energy stage. As a result, when the up coming time you are emotion hungry and motivation to munch on anything you know is unhealthy, concentration on the influence the foodstuff would have on your overall body and head. Alternatively, direct your attention to protein, fibre, nutritious fats, fruits and veggies. Setting up a menu in advance of time will make it much easier to stay away from noshing on no matter what appears tastiest and quickest at the second.

    Part out snacks before feeding on

    Never consume out of the bag or unique container, as it is a great deal more challenging to command parts that way. Binge having, even on healthful foodstuff is detrimental to health and fitness, as a final result separating portions for snacks is needed. Consuming sufficiently, but not excessively, can ward off and command the urge to binge.

    Posted on

    Eating Only in Daytime Helps With Type 2 Diabetes

    Eating Only in Daytime Helps With Type 2 Diabetes

    A woman and a man eat sandwichesShare on Pinterest
    Industry experts say restricting our taking in to daylight hours can help with type 2 diabetes. Basak Gurbuz Derman/Getty Visuals
    • Researchers say proscribing consuming to a 10-hour window during daytime several hours can support folks with form 2 diabetic issues.
    • They reported this diet plan adheres to the body’s purely natural rhythms and can aid with blood-sugar concentrations.
    • Specialists say the plan is advantageous for most people with sort 2 diabetes, but people today with eating diseases, pregnant ladies, persons with style 1 diabetes, and young children need to speak with a medical professional before adopting it.
    • They add that individuals must select a diet program that they can control in excess of a extensive time period of time.

    Proscribing taking in to a 10-hour window in the course of the daytime could have effective health and fitness rewards for people today with form 2 diabetes.

    Which is in accordance to exploration printed today that studies that a time-restricted feeding on (TRE) protocol can outcome in advancements to metabolic health and fitness in older people with style 2 diabetes, like a minimize in 24-hour glucose levels.

    “A daytime 10-hour TRE program for three months decreases glucose ranges and prolongs the time spent in the standard blood sugar selection in grownups with kind 2 diabetic issues as when compared with spreading everyday food intake about at the very least 14 hours. These information highlight the opportunity advantage of TRE in kind 2 diabetes,” the research authors wrote.

    Earlier study has indicated that time-limited ingesting can have good metabolic effects in persons with obesity or who are obese. Scientists mentioned limiting having to a window of much less than 12 several hours can minimize blood sugar levels, increase insulin sensitivity, and raise body fat burning.

    The authors of the new analyze notice that in many Western nations, meals is available 24 several hours a day and a inclination to spread ingesting out above a prolonged time period of time can be problematic.

    “In Western modern society, most men and women are inclined to unfold their every day foods consumption over a bare minimum of 14 several hours likely resulting in the absence of a real, nocturnal fasted state. Restricting food intake to a predefined time window (generally a lot less than 12 several hours)… restores the cycle of daytime feeding on and prolonged fasting for the duration of the night and night time,” the analyze authors wrote.

    Dana Hunnes, PhD, MPH, a senior scientific dietitian at the University of California Los Angeles Professional medical Middle and an assistant professor at the UCLA Fielding School of General public Well being, claims feeding on irregularly can set strain on the physique.

    “Our bodies have a circadian rhythm. Like the Earth has a day by day rhythm, so too do our bodies. If we never align our taking in habits with the very best/healthiest rhythms, it can increase our possibility for continual conditions and swelling,” Hunnes informed Healthline.

    “When we have food available 24/7, a great deal of it remarkably processed, it is stress filled on our bodies, and it is not subsequent the healthy circadian rhythms/homeostasis our bodies like to be in,” she added. “So, when we take in out of rhythm, it’s really annoying, and decreases cardiometabolic health, and can affect our hormone response (like insulin) and worse wellbeing results, particularly for people today with style 2 diabetic issues.”

    Following a time-restricted feeding on protocol can counteract this damaging impression of taking in through the day by limiting the timing of meals intake and prolonging the period of time of fasting in the night and at evening.

    Dr. Marilyn Tan, a scientific associate professor of drugs in endocrinology, gerontology, and metabolic rate at Stanford University in California, claims a time-restricted ingesting protocol is advantageous for several men and women with type 2 diabetic issues. Even so, people with kind 2 diabetes who acquire insulin should really discuss with their health care provider initially.

    “For sufferers who are on diabetic issues medicines that do not have a possibility of hypoglycemia, it’s good to do intermittent fasting,” Tan explained to Healthline. “However, if a client is on insulin, long-acting insulin or insulin with meals, or equally, it is important to examine with your health practitioner for the reason that, for case in point, when you really do not try to eat usually we never want you to acquire the mealtime insulin. Or if you’re not eating possibly you may want significantly less lengthy-performing insulin.”

    Typically, when a particular person is not feeding on the body utilizes up glycogen to gasoline by itself.

    Glycogen is a form of saved carbohydrate discovered in the liver and also stored in muscle mass. When the overall body utilizes up the glycogen, it will then move on to cost-free fatty acids as the subsequent type of gas.

    This in change makes ketones, which may possibly lessen swelling, strengthen insulin sensitivity, and in the long run, improve glucose concentrations.

    “The target of intermittent fasting for individuals with diabetes is to gas the body’s vitality by burning excess fat suppliers and to get rid of excess body weight, increase insulin sensitivity, and decrease blood sugar amounts. The examine results are reliable with the goals of intermittent fasting,” Lauri Wright, PhD, RDN, the chair of the Department of Nutrition and Dietetics at the College of North Florida, advised Healthline.

    “For the most part, intermittent fasting is harmless. It is not correct for people today with type I diabetic issues, a heritage of feeding on disorders, expecting girls, or children underneath 18,” she noted.

    The Centers for Ailment Manage and Avoidance (CDC) advises that when it will come to dieting, it is crucial to locate a plan that can be followed for existence.

    A approach that is focused on healthier having and is also a little something that is sustainable is a good area to begin.

    The CDC has 12 ideas for balanced consuming. They contain anticipating situations of the working day when snacking may well be tempting, this kind of as after a hard function working day.

    Tan suggests her clientele have observed time-restricted ingesting to be one of the least complicated diet programs to adhere to, significantly for those who are chaotic.

    “A ton of my patients obtain this actually to be one particular of the most sustainable weight loss plans since you’re not so a great deal focused on the meals content, for every se, as you are just the timing,” she discussed. “And in fact, for active individuals time-limited feeding form of will work out better… you never have to be concerned about your meals all through the day. If you have this limited window to take in, a ton of individuals basically obtain it a great deal more simple and considerably a lot more sustainable compared to a good deal of really distinct diet programs.”

    “You don’t have to emphasis so much on the macronutrient breakdown of the diet program,” Tan included. “Whereas with certain diets, like a ketogenic diet, it may be really successful in the quick phrase to lose a big quantity of excess weight, it is very tricky to sustain that type of eating plan prolonged phrase. Whereas with time-restricted consuming actually, you’re just shifting the timing of your consuming. I do not see any significant fears for extensive-expression safety… as very long as you discuss your medicine timing and dosing with your supplier prior to you embark on a diet regime.”