Good morning. I'm Larry Heaton, I'm the CEO of Zomedica. I'd like to thank you for the opportunity to present today, and to our many shareholders who may be watching the webcast. We appreciate your ongoing support of Zomedica. I encourage you to take a look at our safe harbor statements at your convenience.
Small-cap investors, meet Zomedica, a high-growth animal health company addressing multibillion-dollar markets. An innovative therapeutic and diagnostic platform, driving double-digit revenue growth as the company moves towards profitability. Zomedica, growing organically and through acquisitions. Small-cap investors, to learn more, visit zomedica.com. Zomedica, stock symbol ZOM, listed on the NYSE American.
I suppose I could stop with that, but I've got these slides, so... At Zomedica, we compete in the large, growing, and economic downturn-resistant animal health market. Very similar to the human health market, biotech markets, except for the exclusion of FDA from a regulatory standpoint, and no need to go to CMS for codes and get reimbursement because it's a cash business. Into this market, we've introduced highly differentiated, in many cases, the only product of its kind, technology, both diagnostics and therapeutic devices, to help veterinarians do the things that they really love to do: improve the quality of care for pets and the satisfaction of pet parents. As well as to help them do the things they really need to do, which is to improve the workflow, cash flow, and profitability of their practices.
We've built a very strong management team over the long course of the last two years, executing on our plan to cash flow positive and profitability. As evidence of that, we're generating margins at 69% year to date, and we expect that to continue, if not improve, as we move forward. We've grown significantly by acquisition. Over the last two years, we've made five acquisitions, but what we're proudest of is what's happened after the acquisition. Once we've acquired and integrated it, we're growing it, as evidenced by our first two acquisitions, with revenue up 34% year to date after a great year last year, and 70% of that revenue comes from consumables, which really gives credence to the idea that we're building a foundation for continuous, persistent growth.
We've got plenty of cash on hand, $118 million as of September 30th, although I would caution, or I would point out, that we made an acquisition in early October for $11.3 million. Two years ago, we had really no products on the market. Today, we're commercializing five product lines, and as we look at products, we look primarily at the annual recurring market opportunity, which has now been built to $2.5 billion if everyone would simply use our products. The market itself is significant. $100 billion worldwide, over $60 billion in the United States. The fastest growing subsegments in this market, diagnostic devices at the point of care and therapeutic devices that can be used by the veterinarians, and those are the exact segments that we participate in.
This market was growing before, and during the pandemic, 23 million puppies and kittens were brought into households in the United States. The youngest among us were the most prolific in terms of adopting these animals, and the pets, as they grow, will not only need the well-patient visits, but they'll have increasing need for our services over time. So this is not only a growing market, but a growing market with legs. Actually, mostly four legs. And the other thing about this market that's unique is that pets are part of the family, and as it turns out, there are a whole lot of things that people would give up before they would not take their sick or injured pet to the vet. And so you have a large growing market that's resistant to an economic downturn.
Into this market, our mission is to bring innovative diagnostic and therapeutic products, technologies to veterinarians to help them improve the quality of care that they deliver, the satisfaction of their pet parents, and the workflow, cash flow, and profitability of the business. We're joined today by Peter Donato, our Chief Financial Officer, and our Head of Investor Relations, Elif McDonald. We've got a very robust team beyond that, all of which are experienced in commercializing devices in human health and animal health, or in many cases, both. Our acquisition record began in October of 2021, when we acquired our first acquisition, PulseVet Veterinary Technologies.
This was a company that was a great company with growth and had become a standard of care in the equine vet market, and yet it was at an inflection point because it hadn't yet entered the small animal market, which is 30x larger than the equine market. That's one of the reasons that we acquired it, the primary reason. As we look at each of the other acquisitions that we've made, culminating in now $2.5 billion in annual recurring revenue market opportunity, we continue to be on the hunt for new, acquisitions, but we're really focused on growing the revenues to the point where we become not only cash flow positive, but profitable in the near term. Our devices are separated into two segments, therapeutic devices and diagnostics.
On the therapeutic side, we have the PulseVet, which is used in the clinic by the veterinarian, and then the Assisi Loop, which is sent home by the vet with the pet parent to involve them in the continuum of care. On the diagnostic side, we have a diagnostic laboratory analyzer that does assays that no other company can do at the point of care. The TRUVIEW microscope, which is the only microscope in the world that preps the slide for the technician, and the first and only wireless touch-free vet monitoring system, which is the VetGuardian. Each of these products has a consumable revenue component to it, ranging from the PulseVet, which the consumable is $2,000 every 50 treatments that are done, to the VetGuardian, which is a $600 and some dollar annual subscription fee for the cloud-based monitoring.
70% of our revenue today comes from the consumables, which we think gives us great confidence as we look forward, because we've got a great base of business that continues to grow with each installation of our various products. In addition to the recurring revenue, we also have the opportunity, in two of the cases, our razor and blade model, we sell the razor for PulseVet and VetGuardian, all of which contribute significantly to revenue and future cash flow positive and profitability. From a revenue standpoint, we've been doing pretty well. From $0 million in 2020 to $4 million in 2021, to just shy of $19 million last year, and this year we're, in the first three quarters, we're just about $18 million. So as you might imagine, we're already sort of over where we were last year. Got good growth coming.
10%-15%, maybe 20% of our revenue comes from international, but that's only two of our products on the market. We have plans in 2024 to bring the other three products into international markets as well. We continue to look for new opportunities, and of course, the five pillars, which you've heard me talk about a couple of times, quality of care, pet parent satisfaction, workflow, cash flow, profitability. These are super important. We look at no products or no acquisitions unless they meet these pillars. But as we move from the first stage of our acquisition strategy, which was to build the infrastructure and the team and get a cadence of product launches set, now as we look for additional acquisitions, we're focusing on those that will be accretive to earnings in the near term, as our primary focus is to get to profitability.
The laboratory analyzer, TRUFORMA, is the first of our diagnostic products. We generate revenue here by the sale of cartridge-based tests or assays. We currently have six on the market. We just launched the newest one for the equine market, first into that market with a great opportunity. There's 5 million horses in the U.S. that would benefit from a screen with our new eACTH assay, which is only available at the point of care from Zomedica. As we look to a little bit later this year, we'll be launching our first GI assays, which is one of the top three reasons that vets that pet parents bring their dogs to the vet, is they have vomiting and diarrhea. Currently, there are no assays for CPL, cobalamin, and folate at the point of care. We look forward to this launch in the fourth quarter.
And we have a whole roster of additional assays that we'll be developing and launching in the years to come. I should point out that we recently acquired Qorvo Biotechnologies, that previously was the partner that did all the R&D, the development, the manufacturing, and the whatnot, for these products. But now that we acquired it, we take over the R&D and the manufacturing, and we can use our capital resources to accelerate the development and launch of these assays. We look forward to significant impact on growth as we move forward.
The TRUVIEW microscope not only gives the best image available in animal health and really in a lot of human health applications because of its unique liquid lens technology, but also it is the only microscope available that preps the slide for the tech, saving 5-10 minutes off of each slide prep, improving workflow, and almost as importantly, reducing errors. The biggest issue in getting a good slide image is getting good slide prep. The TRUVIEW microscope does it for you perfectly every time. We put this device out into the marketplace on a monthly subscription, and then we charge for remote pathology services. So again, we have good, steady, consistent growth opportunity as we increase the installed base. The VetGuardian wireless monitoring system is unique. No touching the patient at all. Instead, it's picking up the vital signs through video camera, thermal imaging, and Doppler radar.
This is a brand-new category in the monitoring space, and we are alone in it today. We sell it for $4,500. We get an annual subscription fee of $600 per year, but actually the recurring revenue comes when they buy a second and a third, and a fourth, and an nth unit. Our first acquisition was PulseVet. Shock wave therapy had become standard of care in the equine market, penetrating almost 50% of equine vets. We saw the opportunity to bring it into the small animal market, and we have done so over the last two years, because that's 30 times bigger. We sell the device for $32,000, and after every 50 treatments or 60 treatments, depending on whether it's horses or small animals being treated, we resell them that same handpiece for another $2,000.
About 65%-70% of our revenue from this product line comes from the consumables, which really shows that once the veterinarians adopt it, they use it on an ongoing and continuous basis. And the Assisi Loop product line, which is targeted pulse electromagnetic field therapy, been around for a long time. First recorded use, Albert Einstein's cardiologist used it on him. So it's been used in human health for many years. We're the only provider in the animal health market. It is sold by us to the vet, and then the vet to the pet parent. They make a nice margin. It's a disposable, so after about 150 treatments, it expires.
They need a new one, they can go back to the vet, or they can get it from any of our online channels, including Chewy, Amazon, Walmart, or our direct e-store. So when you take all of that and you boil it down, we have had very nice revenue growth. We're up 40% year to date over last year. Actually, last trailing twelve months, we're up 42%. Revenue growth has been strong, consistent, and steady. A little bit seasonal. We get most of our capital sales, or I should say, we get much higher capital sales contribution in the fourth quarter. We expect that in this fourth quarter as we sit here today. Sales revenue has been going up, margins have been staying strong.
69% reported year-to-date, you take out some of the one-time, impact of the various integrations that we've done, it builds it to 70%. We expect that 70% to continue on a persistent basis.
When you look at our P&L, $11 million loss year-to-date, but when you take into account the non-cash components of that OpEx, including D&A from the various acquisitions that we've made over the last two years, as well as the non-cash stock compensation that we've provided to our employees and management team as we built the management team over the last two years, it reduces it to about a $6 million adjusted EBITDA loss for the year to date through the first three quarters, which should give you some confidence, as we have, that we are on a pathway to cash flow profitability, and will soon beyond that, be looking at GAAP profitability as well.
To continue our efforts, both in growing organically as well as growing through acquisition, we have a nice cash balance, $118 million as of the end of last quarter. Subtract $11 million for the acquisition. That's a substantial cash war chest or a substantial cash runway, which we expect to continue to use in a productive manner. And so as we kinda sum up, we have a very experienced management team that has built a track record of identifying, acquiring, integrating, and growing acquisitions with substantial cash on hand to be able to continue that effort and achieve profitability. The market values our stock. We would suggest that now might be a good time to take a look yourself. And with that, I'm happy to answer any questions. Yes?
So, a question on the, what benefits do pet owners get with having some of these new markets offered as? How are they changing cater to care?
Yeah. So let's take a look at an assay for the GI assays, which we're launching now or shortly. There, you bring your dog to the vet, it's got vomiting, diarrhea. The first thing a vet wants to do is rule out pancreatitis before they begin any other endeavor. They also want to take a look at your general GI health. Today, they have to send those assays out, so it's gonna be two or three days. So you take your pet home, there's still no resolution to that condition, and then they have to then either come back or they have to make a call or what have you. And so by having it at the point of care, results within 15 minutes, you get a faster onset of treatment, and faster care, we think is better care, improved care.
On the equine side, you know, the big issue is PPID or equine Cushing's disease. It's debilitating. It leads to laminitis, which is the first or second cause of death among horses. Today, you wait for signs to appear, and then you test, because you have to send it to a university. It takes three, five, six days to get a result back. With this assay, not only you get results immediately, it can begin treatment sooner, but also when you take into account the fact that 30% of Cushing's horses never show signs, you don't know until they get laminitis, a screen here would be a significant boon to horse owners and veterinarians who take care of horses. Any other questions?
Sure.
Sure.
Have you given any longer range?
We have not yet provided guidance in terms of growth going forward, but if you take that sort of revenue ramp, take a look at it, and you continue it out, that's the trajectory that we expect to continue on as we move forward. Any other questions? I thank you for your attention. Have a great day.