Veterinarians try to protect teams, maintain services during pandemic
As COVID-19 infections forced nearby veterinary clinics to cut services, patient volumes rose at the lone 24-hour animal hospital in Fargo, North Dakota.
Dr. Tanya Borud, co-owner of Red River Animal Emergency Hospital and Referral Center, said in late November case numbers were up 25%-30%—causing prolonged delays for examination and treatment of the most stable patients, whose numbers had already been up since the start of the pandemic. She attributes the rise in cases to a mix of absences at other veterinary practices and increased attention to pets as people worked from home.
The hospital has had its own absences because of COVID-19 infections and exposures, although no outbreaks were documented within the building, Dr. Borud said. But hospital leaders have developed plans for how to continue running, even in a limited capacity, and what types of cases they should take if more veterinarians and staff members become infected amid the surge of COVID-19 infections.
Dr. Borud is among the veterinarians and veterinary association leaders who have described difficulties in protecting veterinary teams from the virus and continuing to treat patients as the number of confirmed COVID-19 cases rose sharply in the U.S. during the fall. By early December, the nation was recording 200,000 cases daily and had exceeded 15 million cumulative infections.
In North Dakota, at least 83,000 people had been infected and more than 1,000 had died by early December, according to the Coronavirus Resource Center at Johns Hopkins University. More than 35,000 of those infections and 400 of those deaths occurred in November.
Dr. Derine Winning owns Valley Veterinary Hospital in Fargo and is a partner in Red River Animal Emergency Hospital and Referral Center. In her clinic of 25 people, she said, a few employees have been out with COVID-19 and more have taken leave because of exposure to people with the disease. Those who developed the disease had mild symptoms and recovered, and she thinks they all contracted the SARS-CoV-2 virus outside the practice.
“Sometimes, we have limited staff because there are people out with exposure or with COVID, and so we have to adjust as each day comes,” Dr. Winning said. “And we're still trying to treat illness. We're still trying to prevent pain and suffering in our patients. We're still practicing preventive health care, especially in light of public health concerns.”
Public health veterinarians and veterinary association leaders indicated that little information is available so far to show how often COVID-19 has spread in veterinary settings, especially as public health departments struggle to keep up with contact tracing. At least one state—Illinois—collected local health department reports on outbreaks among veterinary clinic employees, with employees at 16 clinics identified by Dec. 9, 2020.
Dr. Connie Austin, state public health veterinarian and infectious disease epidemiologist for the Illinois Department of Public Health, said the state collects occupation-related infection data from 94 local health departments, which collect workplace data through contact tracing and, to a lesser extent, calls from business managers seeking advice.
“Certainly, the local health departments are trying to keep up with interviewing all the cases,” she said.
Each outbreak in a veterinary clinic involved two to 10 infections, and the outbreaks were spread across the state. In late October, the state changed the definition of an outbreak to at least five infections, and none were recorded for November or early December at veterinary clinics. The available outbreak data relate to transmission between employees at practices, and the IDPH has not received any reports on transmission between veterinary clinic staff members and clients, Dr. Austin said.
Health officials and VMA leaders from several other states likewise said they knew of infections among employees at veterinary clinics but none involving transmission between employees and clients. Complaints to federal safety authorities also mostly reflect concerns about actions by co-workers.
From Jan. 15, 2021, JAVMA News
Denmark culling mink in attempt to eliminate SARS-CoV-2 variant
Government authorities and mink breeders in Denmark have depopulated millions of mink partly in an attempt to contain a SARS-CoV-2 variant seen as a danger to humans.
That variant contains mutations that Danish officials said could make it less susceptible to antibodies against other SARS-CoV-2 strains. The country had already depopulated mink on hundreds of farms with SARS-CoV-2 infections before discovery of the variant.
All SARS-CoV-2–infected mink and mink in risk zones have been depopulated, according to a Nov. 27, 2020, press release from the Danish Veterinary and Food Administration. The mink population previously totaled an estimated 15 million.
Danish authorities worked with mink breeders to depopulate and dispose of approximately 11 million mink on 288 properties with infected mink and 446 properties in the risk zones. In addition, most mink breeders outside the risk zones stated they have depopulated their mink.
“However, the Danish Veterinary and Food Administration does not expect all mink to be killed before the new law banning the keeping of mink enters into force,” stated the release, as translated from Danish. Therefore, new infected herds may continue to be detected through ongoing surveillance.
A working paper from the Danish government indicates the SARS-CoV-2 variant of most concern has changes to its spike surface glycoprotein that could make it less recognizable to antibodies created in response to infection with or vaccination against another SARS-CoV-2 strain.
The effect appears to be modest, and the variant is worth attention but not panic, said Gary R. Whittaker, PhD, a professor of virology at the Cornell University College of Veterinary Medicine, who studies the structures and genetic functions of coronaviruses.
Condensed from Jan. 1, 2021, JAVMA News
Getting ahead of osteoarthritis in pets
In dogs, osteoarthritis actually tends to start at a young age. In cats, osteoarthritis is exceedingly common. Yet, the disease often goes undiagnosed and untreated in pets.
Dr. B. Duncan X. Lascelles, professor of surgery and pain management at North Carolina State University College of Veterinary Medicine, spoke at the AVMA Virtual Convention 2020 in August on “When and How, Treating Canine OA Effectively.”
Dr. Lascelles was part of the group that developed the new Canine OsteoArthritis Staging Tool, available at jav.ma/coast. The first step of COAST is to grade the dog through owner assessments and a veterinarian's evaluation of the dog's static posture and motion. The second step is for the veterinarian to grade the problematic joint. The last step is to assign a numerical stage from 0-4.
Dr. Lascelles said the pillars of treatment for osteoarthritis in dogs are an effective analgesic, weight optimization, diet optimization, and exercise.
Dr. Elizabeth Colleran, owner of Chico Hospital for Cats in Chico, California, spoke at the American Association of Feline Practitioners' virtual conference in October 2020 about “Pouncing on Pain: Managing Feline Osteoarthritis Cases.”
To evaluate pain in cats with osteoarthritis, Dr. Colleran uses the Feline Musculoskeletal Pain Index out of North Carolina State University. She said the FMPI is an evaluation of common behaviors and activities that take place in the household. Cat owners also can use a smartphone to record a cat at home to allow a veterinarian to evaluate the cat's motion.
Dr. Colleran said components of a treatment plan for osteoarthritis in cats can include weight loss, pharmaceuticals, environmental enrichment or modification, and a special diet or omega-3 supplements.
Condensed from Jan. 1, 2021, JAVMA News
FDA urges collaboration as dilated cardiomyopathy afflicts more dogs
Food and Drug Administration officials have received 1,100 adverse event reports of dilated cardiomyopathy in dogs since January 2014.
Dr. Steven M. Solomon, director of the FDA Center for Veterinary Medicine, told attendees of a scientific forum in September 2020 that the disease accounts for more than half of the adverse event reports related to cardiac conditions, according to a written version of his opening remarks. The disease, which has emerged in animals often without known genetic predisposition, has presented a “scientifically complex, multifaceted issue,” but he noted that data from those cases have shown associations between the disease and grain-free foods, particularly those high in peas, lentils, or both.
The meeting in September was a forum on DCM, hosted by Kansas State University, and included presentations by pet food company representatives, university-based researchers, and FDA CVM officials who provided an update on data collected by the agency from January 2014 through July 2020. During that time, reports of 1,100 dogs and 20 cats with DCM were shared with the FDA, and the FDA Veterinary Laboratory Investigation and Response Network analyzed records from 161 dogs.
Of 121 dogs with DCM reports sent to the FDA between January 2018 and April 2019, 23 had full recoveries and 84 had partial recoveries.
“All dogs that fully recovered received a diet change,” the presentation states. “Nearly all dogs were also treated with taurine and pimobendan. Over half of the dogs also received an ACE inhibitor, whereas additional treatments and supplements varied.”
The Food and Drug Administration's update on nonhereditary dilated cardiomyopathy is available at jav.ma/DCMupdate.
Condensed from Jan. 1, 2021, JAVMA News
Regulatory standards on pet health insurance being developed
The Pet Insurance Working Group of the National Association of Insurance Commissioners is working on a model law on pet health insurance. The new model law will likely impact the pet insurance industry, depending on whether and how states adopt the model law, and may also change how veterinarians discuss pet insurance with clients. The NAIC working group is currently developing the draft model and likely won't release the final version to the public until late this year.
Ray Farmer, NAIC president and South Carolina Department of Insurance director, said the pet insurance industry is an emerging one.
“The goal of the model law is to establish clear rules for the sale of pet insurance and provide important disclosures to pet owners purchasing this product,” Farmer said. “States would have to adopt the model law for this regulatory framework to apply to the industry in their state.”
States do not have to adopt the model law and, even if they do, can decide to adopt only portions of the model law in their statewide statutes.
The pet insurance industry currently comprises about 20 companies across the United States and Canada, according to the 2020 State of the Industry Report from the North American Pet Health Insurance Association. The report, compiled by actuarial consultants at Willis Towers Watson, provides insights into key industry metrics. For example, there were nearly 2.82 million dogs and cats insured at the end of 2019 in the U.S. and Canada, an increase of about 19% from the previous year.
Condensed from Jan. 15, 2021, JAVMA News
Certificate in the works for veterinary first responders
It can be difficult for veterinarians to hit the ground running when they volunteer to serve on a local or regional disaster response team. One reason is that there are no national training standards for veterinary disaster and emergency first responders.
To fill this gap and to build on the legacy of AVMA efforts in disaster relief, the American Veterinary Medical Foundation board of directors voted at its November 2020 meeting to provide $80,000 in funding to create an AVMA certificate program for veterinary first responders.
Members of the AVMA Committee on Disaster and Emergency Issues will first identify core competencies reflecting the basics that every veterinary responder should know. That work is expected to be finalized this spring, after which organizations, including the AVMA and veterinary colleges, can develop new or modify existing courses and submit them to the CDEI for an assessment as to whether they satisfy one or more of the core competencies required for certificate completion, according to background material that the committee submitted to the AVMF.
Initial classes could be available on AVMA Axon as soon as fall 2021, and the program could be fully operational by spring 2022. The idea is that once veterinarians or veterinary students complete courses that meet all core competencies, they will be issued the Basic Veterinary Responder Certificate.
Dr. Warren J. Hess, an assistant director in the AVMA Division of Animal and Public Health who also serves as the AVMA's disaster coordinator, will oversee the program.
The AVMA and the Association of American Veterinary Medical Colleges announced in November the creation of a commission to coordinate diversity, equity, and inclusion efforts.
The Commission for a Diverse, Equitable, and Inclusive Veterinary Profession will work to drive change within the veterinary profession, expand the pipeline to include more people from diverse backgrounds, and encourage welcoming workplaces.
“Sustainable, long-term change can only come about if dedicated and influential partners from across our profession, including academia and industry, join together to identify challenges and implement solutions,” said Dr. Douglas Kratt, president of the AVMA, and Dr. Mark D. Markel, president of the Association of American Veterinary Medical Colleges, in a joint statement. “The commission will establish actionable goals that promote DEI throughout the veterinary community.”
The commission is co-chaired by Dr. Ruby L. Perry, AAVMC secretary and dean of Tuskegee University College of Veterinary Medicine, and Dr. Christine Jenkins, chief medical officer and vice president of veterinary medical services and outcomes research of U.S. operations at Zoetis.
Other organizations involved in the effort include the American Animal Hospital Association; the Veterinary Medical Association Executives; 10 affinity organizations with a focus on diversity, equity, and inclusion, including the Multicultural VMA; the National Association of Veterinary Technicians in America; the Veterinary Hospital Managers Association; and the Student AVMA. Each group chose one representative for the commission.
Condensed from Jan. 15, 2021, JAVMA News
Harassment, discrimination policy revised along with others
The AVMA Board of Directors approved revisions to a number of policies at its Nov. 18-19, 2020, virtual meeting.
The AVMA Council on Veterinary Services had received a request from the Board—originating with the AVMA House of Delegates—that the policy “Harassment and Discrimination-Free Veterinary Workplace” be reviewed again ahead of its regular five-year review. The council asked AVMA staff members in human resources and the AVMA's general counsel to review the document.
The policy is intended as a starting point for AVMA members and not as a definitive statement of the laws concerning harassment and discrimination, given that anti-discrimination and anti-harassment laws may differ greatly from state to state and from city to city.
In other Board actions, members endorsed the most recent version of the American Association of Swine Veterinarians' Basic Guidelines of Judicious Therapeutic Use of Antimicrobials in Swine. Among the changes, adjustments were made to better align the document with the AVMA policies on “Judicious Therapeutic Use of Antimicrobials” and “Antimicrobial Stewardship Definition and Core Principles.”
The Board also voted to revise the policy “Assessment of New Therapies for Alleviation of Pain in Animals.”
The AVMA Council on Research reviewed the policy in accordance with the five-year review cycle and felt that the policy should more clearly dissuade researchers from initiating pain studies that would include untreated control groups, when possible.
Nearly 180 individuals representing 32 universities and seven countries participated in the 20th annual AVMA Animal Welfare Assessment Contest, hosted virtually by the AVMA and North Carolina State University, Nov. 20-21, 2020.
The contest is modeled after traditional livestock, horse, and meat judging competitions. Student contestants evaluated scenarios involving animal species and then presented their findings to an expert animal scientist or veterinarian from the panel of judges. Species covered in the latest contest included captive cheetahs and domesticated turkeys.
Winners of the 2020 contest are as follows:
Veterinary Division: First place—Karen Yetman, University of Prince Edward Island; second place—Michelle Greenfield, Cornell University; third place—Julia Rose, The Ohio State University; fourth place—Lauren Bowers, University of Guelph; and fifth place—Olivia Child, Michigan State University.
Graduate Division: First place—Madeline Winans, The Ohio State University; second place—Shannon Kelley, The Ohio State University; third place—Alisa Light, Texas A&M University; fourth place—Gabrielle House, Texas A&M University; and fifth place—Rachel Park, North Carolina State University.
Undergraduate, Senior Division: First place—Liz Patton, University of Minnesota; second place—Brietta Latham, The Ohio State University; third place—Chaya Gangsei, University of Minnesota; fourth place—Ashley Dunn, Michigan State University; fifth place (tie)—Kaitlin Reiman, University of Wisconsin-Madison, and Xandra Meneses, Texas A&M University.
Undergraduate, Junior Division: First place—Jordan Smeby, Colorado State University; second place—Tatiana Thomas, Michigan State University; third place—Zoey Witruk, University of Illinois; fourth place—Addie Cullum, Purdue University; and fifth place—Madison Pinkerton, The Ohio State University.
Condensed from Jan. 15, 2021, JAVMA News
Education council schedules site visits
The AVMA Council on Education has scheduled site visits to 13 schools and colleges of veterinary medicine for 2021.
Comprehensive site visits are planned for North Carolina State University College of Veterinary Medicine, Feb. 21-25; the University of Glasgow School of Veterinary Medicine, March 7-12; Oregon State University Carlson College of Veterinary Medicine, April 4-8; the University of Minnesota College of Veterinary Medicine, April 25-29; the University of Melbourne, Melbourne Veterinary School, May 9-14; Massey University School of Veterinary Science, May 23-28; the University of Arizona College of Veterinary Medicine, July 18-22; Tuskegee University College of Veterinary Medicine, Aug. 29-Sept. 2; Utrecht University Faculty of Veterinary Medicine, Sept. 26-30; Long Island University College of Veterinary Medicine, Oct. 10-14; Virginia-Maryland College of Veterinary Medicine, Oct. 24-28; Mississippi State University College of Veterinary Medicine, Nov. 7-11; and The Ohio State University College of Veterinary Medicine, Nov. 14-18.
The council welcomes written comments on these plans or the programs to be evaluated. Comments should be addressed to Dr. Karen Martens Brandt, Director, Education and Research Division, AVMA, 1931 N. Meacham Road, Suite 100, Schaumburg, IL 60173. Comments must be signed by the person submitting them to be considered.