Show Notes 231: From Bootstrap to Breakthrough: How VetCT Is Building the Future of Veterinary AI
What does it take to build a global technology business without venture funding? And how do you introduce AI into clinical decisions without losing sight of the patient?
In this episode of the Cambridge Tech Podcast, hosts Faye Holland and James Parton meet Dr Victoria Johnson, founder and CEO of VetCT. Victoria shares how she turned a shortage of veterinary radiology expertise into an international business, why she bootstrapped for around 15 years, and how the company is exploring AI with radiologists firmly in the loop.
From early product experiments to the pressures of industry consolidation, this is a conversation for founders and investors interested in defensible data, sustainable growth and technology with a clear purpose. There is even a penguin with an unexpected appetite for Lego.
Inside the episode
Spotting the opportunity: As digital imaging and animal CT scanners became more accessible, vets needed specialists who could interpret the results. VetCT built a service that connects veterinary practices with radiologists working remotely.
Technology meets expertise: Vets send digital images to VetCT, where radiologists interpret them and return reports to support patient care. The model depends on both specialist knowledge and a platform that makes the process work smoothly.
Building without venture capital: Victoria initially funded the business by carrying an ultrasound machine between practices in East Anglia. She explains how bootstrapping offered freedom and control, while requiring each stage of growth to pay for itself. VetCT took minority investment in 2023 to support technology and growth.
Making data useful: VetCT has retained anonymised imaging data and expert reports dating back to 2009. Working with the University of Cambridge and its own AI team, it is exploring how that resource could support diagnostic insights and faster case triage.
Keeping humans central: Victoria says AI tools will support radiologists rather than replace them. She describes patient safety and accuracy as essential benchmarks, alongside the potential to prioritise urgent cases.
Navigating a changing market: Consolidation has brought larger veterinary contracts, but also pressure on margins and payment terms. Victoria reflects on rapid international growth, pandemic disruption and the challenges of scaling a specialist service.
Finding the right ecosystem: Collaboration with Cambridge researchers has helped VetCT access expertise it could not easily build alone. Victoria also makes the case for bringing more bootstrapped founders into the wider innovation community.
In Victoria’s words
“The human in the loop here is the radiologist.”
“Anything that we bring in has to have a positive impact on patient health first.”
“It does have to be a really great solution to a really great problem. Otherwise, people won’t use it and you won’t make money and it won’t grow.”
Listen to the full episode for an honest look at building a global business, finding value in specialist data and applying AI where accuracy matters. Subscribe to the Cambridge Tech Podcast for more conversations with the people building and backing the next generation of technology.
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Episode Transcript
Welcome to the Cambridge Tech Podcast. Talking all things technology from the heart of the UK's tech capital. Here are your hosts, Fay Holland and James Parton.
Hi, I'm James. And I'm Faye. I've been trying to get today's guest on for quite a long time. I think actually we planned this episode about six months ago, but it shows that patience works, right, James?
Absolutely. It's a really great conversation. So today we're talking to Victoria Johnson of Vet CT. So Victoria, thanks so much for taking the time to come onto the show today. Very much appreciated. Absolute pleasure to be here. Thank you very much. We always like to start with getting to know our guests. So maybe you could just give us a little bit of background in terms of your career path, what's led you to Vet CT?
Great. Yeah, sure. So I didn't expect to end up where I am now, that's for sure. I started out as a sort of very keen 13-year-old wanting to be a vet with lots and lots of pets and wanting to go and hang out on farms and things like that. Ended up becoming a vet and then went into veterinary radiology, which is the specialist subject, just like in human imaging, whereby you become an expert in reading CT scans, MRI scans and x-rays, but for animal. And then from there, I worked in various different countries. And in particular, in the US, I could see the rise of veterinary teleradiology, where remote interpretation of imaging was performed by radiologists. I ended up going back to the UK and thinking, I could do that. I could start that over here. So that's where it all came from. And so, Victoria, it kind of then emanated, I guess, out of passion that you really wanted to do this. Talk us through a little bit more about why you wanted to set it up and why this was needed.
You came back to the UK.
Yes, I can do it.
What were you actually trying to solve? What was that big crux for you?
So the interesting thing at the time was there was the advent of digital imaging, enormous change from cameras to digital cameras, the same thing was happening with x-ray films and PPs and MRIs, so all digital imaging. So that was one sort of major change that was happening. And obviously the veterinary industry is always behind the medical industry, but that was coming for us as well, that change. So there was a need that didn't exist and an ability to transfer digital images that didn't exist. The second thing really was the rise of the CT scanner for animals. So when I first started my training as a radiologist, there was only one CT scanner for animals in the whole of the UK. There were a few more than that in the US at the time, but it really is something that's massively taken off. And now we believe there's around about 300 CT scanners in the UK, and lots of animals all have access to them. You've got countries like Spain that have over 600, 700 CTs. That it's become a really big thing, CT imaging. And people were buying the scanners, but they had absolutely no idea how to read the images. And that's where we came in, the ability to interpret and to obviously receive the digital images.
Yeah, so walk us through the actual product itself then. Sounds like you're not working at the hardware level. It's very much more the software and interpretation and process around that. So walk us through what that product looks like.
Yes, that's right. We've completely tried to keep this to a really light touch and not become a hardware provider, though we do interact with hardware providers and distributors enormously and the original equipment manufacturers, as you can imagine. The actual business model is that any vet who has a piece of imaging equipment that's digital, which is most vets these days, take an image of a patient. It's a DICOM image, which is exactly the same as in human medicine. It's a standard format of that image with the metadata embedded. That then gets sent to us. We, on our servers, our radiologists log in from all over the world, interpret those images, write a report, and that gets sent back to the vet for B2B. All of our clients are veterinary practices in hospitals. And apart from that, we don't really have a lot of direct contact with the actual patient. We talk to the vet, we issue them with a report, and then the vets themselves use that report to make really great decisions on how to manage patient care.
Okay, so that's really interesting. You've got this kind of the software and tech side of the business, but you actually have a roster of experts that are actually interpreting the scans as well.
Yes, it's a wonderful sort of juxtaposition of service industry and tech. We have to have both working in tandem. And actually, the more we do this, the more tech becomes increasingly important, which I can talk about later. But certainly, fundamentally, especially in the early years, we were putting together a professional services business, a stable of amazing people. World-leading radiologists who work online. They live in countries all over the world, so around about 26 countries we have radiologists in. And then the client base is all over the world as well. We have some very key regions that we service, but we have a very widespread of countries, 28 overall. The majority of our work, about 50% comes from the USA, about 25% from Asia Pacific, and about 25% UK and Europe. That's really interesting. So from a kind of sales or go-to-market perspective, I assume the answer to this question is both, but is it the functionality of the software or is it the roster of expertise that you can tap into by working with Etsy to...
Both. Absolutely, you nailed it. It's both. The big USP for us has been the quality of the work that we do and the type of people that we employ. That's always been really important, but we've had to have a very seamless technological platform in order to receive the images, distribute them and enable the radiologist to do the work that they do in a really great way. As time goes on, we are now focusing increasingly, as everybody does these days, on how we can improve our efficiencies and workflows, make everything as lean and sleek as possible with the use of AI. So we're looking at AI in two different ways, one of which is for clinical diagnosis and the other one of which is for streamlining processes and improving systems. So let's just go through both of those, if we may.
Can we talk about what's happening with AI in the diagnostic clinical practice side, first of all?
Yes, this is absolutely fascinating. It might be interesting just to give you a little bit of background on the veterinary side of things and adoption of things like AI. So the veterinary industry always runs a little bit behind the human industry. But something that's very different to veterinary medicine and human medicine is that in terms of tools, Products like AI, so software as a service that we see being adopted increasingly for all sorts of different uses in veterinary medicine, we are virtually unregulated. So in veterinary medicine, veterinary practices and surgeons, surgeons currently veterinary surgeons, and increasingly soon to come will be veterinary practices and businesses, That's regulated, veterinary medicines are regulated, but actually things like technology in veterinary medicine, even if it's being used for clinical diagnosis, is currently unregulated and unlikely to change. So we have an environment where there can be very fast adoption of technology, which is super cool and very exciting, but there's also a huge onus on the veterinary technology producers, people like us, to self-regulate and create very good AI tools that are robust and secure and safe for patients. I mean, it's ultimately the most important thing. So you've got this sort of environment whereby technology can be easily adopted and rolled out, but you've also got that who are very busy. They're incredibly busy people. They're usually rushed off their feet. If you imagine that some vet practices, if you imagine the sort of computer stuck in the corner of the room filled with cat fluff and things like that, they're not always the most modern technology environment. So the sort of opportunity, but also the things that get in the way of adopting those opportunities. It's going to be interesting to see how that changes. So education has always been a real core part of VET CT. So do you see your role also being educating the vets on how to adopt AI so that they can use the systems as well?
A hundred percent. And a couple of years ago, actually, we produced our position statement on AI, which was very much built around safety, adoption, cautiously, making sure that was very much following guidelines in human medicine and human radiology. We really set out our store to try and do this exactly the right way. We then produced a white paper on AI in the veterinary industry, which has been widely cited and adopted. And actually a lot of regulatory boards and veterinary medicine, UK, New Zealand, Canada, have approached us to use that white paper and position statement to help them establish their policies around AI. We've also been involved in policymaking committees. I work a lot in Greece with the Royal College of Veterinary Surgeons and the British Veterinary Association as well. All of these organizations are looking at AI and how it can be safely adopted. There's a lot of discussion. The main tools in veterinary AI at the moment are really AI scribes that are being used a lot. They've been hugely successful in saving vets' time. So basically, as you come into the vet practice with your pet, and you're talking to the vet, there's an AI scribe listening that's writing down everything that's happening, making notes of the conversation, notes of the decisions around treatment and prescriptions, etc., things like that. So they've been very widely adopted. Started in the US, have come over here, but they're saving people a lot of time. Also in our practice management systems, which are the software tools we use to keep patient records under control, A lot of those now have, some of them have built-in AI systems that enable you to analyse clinical records, previous history of the patient, what it came in for before, etc, etc. Building on that theme, we've interviewed a number of companies on the podcast working in the field of human medicine and looking at how AI can... Really speed up the interpretation of scan data, for example.
So you've talked there about the use of AI in the veterinarian environment, more kind of admin style tasks.
Absolutely. So I assume that this would be a natural move into either supplementing your expert panel in terms of the interpretation of scan data. And I'm guessing you're actually building up a history of scan images that you could actually then train an LLM to process.
Yeah. 100%. So we have two areas of AI that we're investing in as a company at the moment, the first of which you've just mentioned. So we actually have an absolutely astounding set of data. The company's been running since 2009 and we have kept all of the data from the beginning. So we have all of the expert radiologists' reports and we have all of the DICOM images as anonymized data. And we have all of the intellectual property rights in those assets as well, really. So we've been working with the University of Cambridge and also an internal AI team that we're building up to essentially structure all of that data and then look at it as a potential foundation model using an LLM to help us surface diagnostic insights from our data and it's been absolutely incredible to see the results so far. We have some involvement of AWS currently who are helping us support the R&D build of some of the things that we're doing. And that's been a really exciting project and we hope to bring that out into production relatively quickly. We are very much a human first, radiologist first company. The human in the loop here is the radiologist and very much all of the tools and any tools that we use to support us in what we do will only be used with radiologists and as long as we're sure of a very high degree of accuracy. We currently measure our error rate. With humans alone, we have a very low error rate of less than 1%. And we actually are just producing a publication on that at the moment. That will remain our benchmark. And as we continue to utilize the data that we have to create clinical diagnostic tools in AI, we will always be benchmarking accuracy. And we don't ever want to see it go down. But that will be our very, very clear line in the sand. We would hope to only be able to improve accuracy over time and hopefully make diagnoses that we haven't been able to before even faster.
One of the key areas actually is triage. We receive a very large volume of imaging from all over the world 24 hours a day, several days a week. It would be wonderful to be able to triage those cases and select the ones that need to see a human radiologist first versus the ones that may be essentially normal or could wait a little longer. So that would be a wonderful use case for AI. We're very much about the impact. Anything that we bring in has to have a positive impact on patient health first. Technology moves fast, and now so can you.
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So, Victoria, if we can move on now and talk a little bit more about the company.
Yes, of course. Your journey has been like, so like you say, you've been going since 2009. Typically, when we talk on the podcast, we have these big conversations about investment, funding rounds, all of those types of things. But I believe your growth has really been from 2009.
Contracts and actually working with the businesses as opposed to getting funding. So can you tell us a little bit about that part of your journey?
Yes. So I started the business in 2009 and I bootstrapped for approximately the first 15 years or so. So what that really means is that it was self-funded from day one. The very start of that, I actually ran a different business. I had an ultrasound machine and I used to go with it in the back of my car, drive around all the vet practices in East Anglia, turn up at the vet practice and do ultrasound scans of their dogs for money. And I used that money to actually start this business. But I was also quite lucky to have a healthy client list from the start. I had worked in America and Australia. And the UK and various different specialist clinics and they knew that I was setting up a business and they asked me to do their work. From day one, it had to be profitable and making money the whole way through. It's a very different type of way of running a business, I think, bootstrapping compared to the venture backing. It throws your expansion a bit, I think, because everything has to pay for itself and it all has to work. And also, you don't have the sort of formality and structure of a board at the beginning. You don't have the same level of governance. So over time, we've had to bring in more and more governance. So it's been a really interesting journey. But you get a lot of freedom and ability and it's a different growth path. Obviously, the equity situation is different. The control of the company is different. But it does have to be a really great solution to a really great problem. Otherwise, people won't use it and you won't make money and it won't grow. And you'll end up having to close it down. We took investment in 2023 from a minority investor as patient capital. And we used that investment really to invest in technology and growth. We could see that the industry was changing and that we really need to be ahead of the curve.
Yeah, that's interesting because obviously if you're bootstrapping a business, controlling cost is everything.
Yeah. Were you hiring in-house software engineers and AI data scientists or outsourcing that? Has that changed over time? How did you approach that side of things?
Yeah. Great question. So we built our original platform by strapping together three bits of kit, really. One at the time, it was a long time ago, it was Dropbox. Another bit was Jira, which we used as, obviously, converted from a bug tracker. Each K became a bug, really. So we put those two together and we did that with an internal person and also an external consultancy who are based in London who were Jira experts. So that's how we built our original platform. Over time, we've now adopted a full internal tech team. So we have our own developers, AI developers, infrastructure, etc. So we run a sort of full stack team. We try to keep that quite lean. The relationship with the University of Cambridge, particularly through their Chimera group, which you may or may not have heard of, but definitely recommend them. They offer outsourcing of mathematical skills and AI team members, computer science, etc. So we've had a wonderful collaboration with them. And that's really helped us bring in some knowledge gaps that we didn't have. That's been extremely helpful, particularly with looking at the clinical diagnosis with AI and looking at how we can build potentially foundation models around that. That's expertise we definitely wouldn't have had if it hadn't been for collaboration.
And maybe just one final clarification question for me. When you think about your go-to-market and your potential customer base, maybe this is too simplistic in terms of how I've understood the model, but are you limited to just selling into vets that have a CT scanner? So you have a finite customer base or have you broadened that proposition out now?
Excellent question, because the name of that CT, there's been many times I've regretted that name, but it has stuck. So we've kept it and it hasn't, it seems to have not held us back particularly. But we only really did CT alone for the first probably three or four years. And after that, we really spread out into doing x-rays, radiographs and MRI scans as well. We also do all species. So weirdly, we do horses, penguins, cows, sheep, hamsters, you wouldn't believe it. Everything we do. There's a lot of dogs and cats. That's the main thing. But yes, my favourite one was a penguin that swallowed a bit of Lego. And we did a CT 3D reconstruction and you can see this piece of Lego and it's been tested. It's just wonderful. How does Lego and penguins come into contact? So I was next to Penguin Enclosure at Zoo, throws piece of Lego at Penguin. Yes, this is the one from a zoo. We have done all sorts of different things. Then really the market is enormous. Also, this is where regulation is different. So we can work across borders. So we are completely free to work with clients in any country, anywhere, really. So that's been fantastic. So anyone with an x-ray machine, which all vets have, really. Yeah. And so on that thought, then you've talked about you've got the legacy of working in Australia, USA, and you've got this global team now working in 28 countries. How has that been? I just kind of want to find out a little bit more of running the actual business.
What are some of the challenges and opportunities that you've seen?
Absolutely. And if this were a visual thing that we're doing right now instead of a podcast, I'd show you a graph of our growth, which basically would show a fairly flattish line for the first two, three years and then an absolute vertical spike for about the next five, six, seven years. And at the moment, we're a slight plateau and about to grow again, which will be unlocked by AI. Really, that's where we are. But that steep path of that curve was very challenging. And there's been challenges at all sorts of different times along this journey. It's hard at the beginning because you're trying to bring in the clients. You're trying to be all things to all people. So at the beginning, it's really tough. You're bringing in your early customers, trying to get adoption, recruiting your first radiologist, doing all the HR and employment contracts, which I had no clue how to do. But then that very rapid growth phase, It was so exciting, but also quite exhausting because then you're traveling all over the world, talking to clients, trying to bring on a sales team, trying to build your own technology, trying to bring functions internally. It's a lot of work at that stage and certainly huge pressure as well. We then had a really weird time around the pandemic. As you probably know, at the beginning, all vet practices were closed. Suddenly we had no work. Then after that, everybody bought an animal. Pets and dogs and everyone had that. So then we were more busy than we ever could have imagined. During that phase, we really scaled up because we thought that trend will last. Everybody's got all these pets. But what we've seen the last few years really is it's been really hard times, partly because not all of those people who bought a pet kept a pet, sadly. And some of those people just had an animal for a short period of time. They won't be dog owners in the future or cat owners because they maybe are not working from home anymore, would be one example. Also, we've seen the cost of living crisis and the Competition and Markets Authority have investigated the veterinary profession. It's been a tough time. And certainly for us, we saw a lot less demand and people were not going into vet practices as much, probably because the general economy was squeezed and maybe also some loss of trust in the veterinary industry as well. So when people don't go to the vet or they go to the vet and they decide not to have the x-ray or not to have the CT scan, that clearly impacts us. We've definitely had a tough few years. We're coming out of it now, which is really nice to see. And obviously unlocking the benefits of the data and where that can take us to is extraordinary. That's really the oil that we are digging for and will surface. I'm not tracking it closely, but my understanding is the veterinary industry, certainly in the UK, I don't know if this bears out in other countries, is going through like a period of consolidation with a lot of independent vets being acquired. Does that mean there's less contracts to win, but those contracts are just much more valuable?
You are spot on. When I started this, because I've been doing this quite a long time, all those vet practices were independent practices. And then one day you get the call from a large corporate who says that we now own those hundred practices and we would like a very significant discount and much longer payment terms. But that's quite a hard thing as you're growing a business and definitely something I'd tell everyone to look out for. We've been through all of that change and we have excellent relationships, contracts with the corporate. But it does make the whole landscape quite different. They're very large, very high value businesses. Contracts as you say they're hard fought and hard won if you get one of those and certainly the impact on margin because of the control they have due to the volume it can be quite challenging i would say and things like longer payment terms for small businesses can be hard Luckily, we've really navigated that well. I'm really proud of how we've navigated that changing landscape because approximately, I think about 60 to 70% of the UK veterinary practices are part of a group now. So it's really changed very quickly. We don't see that everywhere, but certainly it's very pronounced in the UK and Europe and increasingly in the US as well.
Yeah, really insightful. Thank you. I think just as we start to wrap the episode, you found yourself back in Cambridge, you've built your business in Cambridge. Obviously, you've talked about the work with Chimera at the university, helping you with operational efficiencies. What's it been like actually building a business in Cambridge?
Cambridge is a wonderful address to how it really is. And actually, I do think sometimes that opens doors. It took us a long time, I think, to unlock collaboration and really get into the Cambridge ecosystem. And I think that's quite interesting, probably because we were bootstrapped. And I think if we'd come in a more traditional route, the VentureBad group, I think we probably would have managed to discover things like a wonderful Cambridge network and all sorts of things like this much, much earlier on. But actually, we were really very isolated for a long time. In recent years, we were actually on site at the Hauser Forum, opposite the Brewer's Building and very close to Cavendish. And that really unlocked relationships, I think, particularly with the maths department, who've just been fantastic. Particularly Professor Mike Roberts, who's been an awesome advocate for us and very helpful. That's been wonderful, but I wish it could have happened sooner. And I think as a bootstrapped company, Sometimes I think you're just a bit absent. And interestingly, a lot of female businesses are bootstrapped because females tend to receive less venture capital and therefore a lot of them take this sort of different route anyway. We never looked for venture capital. I didn't need it. But I do think identifying the bootstrappers in this environment, in the Cambridge ecosystem, would be amazing and trying to bring them in more. It would be really interesting to see who's out there and what they're doing.
Yeah, I would hope that the likes of Innovate Cambridge are helping to do that and change that now, but it's certainly something we should be watching out for. And I've got a really useless piece of information for you. Are you ready for this?
Yeah. I was at your previous home at the Hauser Forum recently, and there is still a VET CT cone there. So someone's still barking, thinking you're there.
Oh, that's brilliant. I wish I kept my car park pass. I could still get it to go.
The great central location for parking.
Oh, I've the cones there. I'm pretty sure when this episode goes out, that will disappear very quickly.
Sorry about that, Victoria. That's all right, don't worry. Just a shout out for Innovate Cambridge because they have recently hosted an event that I was involved in, which was all about bootstrapping. And it was really good. And they did a super job of hosting and it was all in the glass house, just at Botanic House. And that was great. And there was a lot of interest actually in the bootstrapping community. So thank you to them for that. That's been a fantastic conversation, really enlightening. It's been great to have you on.
Absolute pleasure. Lovely to meet you. Thank you for delving into the slightly odd area of veterinary medicine and veterinary technology. Thank you.
Today's show was produced by Joe Donaghy of Cambridge TV and supported by our media partner, Business Weekly. The Cambridge Tech Podcast is available on all major podcast platforms and on cambridgetechpodcast.com. If you've enjoyed this podcast, please give it a five-star review. It'll really help others discover the show. If you enjoy hearing about technology and innovation in Cambridge, try Oxford Plus. I'm Susanna Diaga, host, and I talk to founders about their journeys, investors about what they look for, and policymakers about how we can bring more capital into UK innovation so that companies can stay and scale here.
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