BACK TO BASICS
Veterinarians Look to fundamentals to help the underserved afford care
By Malinda Larkin
An owner brings his Beagle into a clinic after seeing it eat rocks. On examination, the veterinarian feels that the stomach is bloated, but the owner has only $100 for veterinary care. Should the doctor even bother recommending surgery? Consider another veterinarian's options when examining a backyard horse that's lame. Should she do a full work-up, knowing that the owner still hasn't paid his bill from the last visit? Or would it be better to simply recommend a wait-and-see approach?
Veterinarians today are able to provide better and more advanced medical care for pets than ever before, but the cost of that care makes it out of reach for many owners. The growing gap between underserved pet owners and veterinary service providers has consequences for overall pet health.
Fifty-six percent of U.S. households owned a pet as of year-end 2011, according to the 2012 edition of the U.S. Pet Ownership & Demographics Sourcebook published by the AVMA. Results also showed that 44.9 percent of cat owners did not take their cat or cats to a veterinarian in 2011, up from 36.3 percent in 2006. Among dog owners, 18.7 percent did not take their dog or dogs to a veterinarian during 2011, up from 17.3 percent in 2006. Further, 21.5 percent of cat owners and 29.3 percent of dog owners who did not visit a veterinarian said they could not afford it.
Findings such as these raise concerns that the current veterinary health care system may not be able to address the needs of all animals. Meanwhile, small animal practitioners in low-income areas say they're learning to adjust to their clients' financial constraints while still providing an adequate level of care and maintaining profitability. The AVMA's top economist says even veterinarians in high-income areas should pay more attention to what they provide and at what cost, lest they lose their current clients or miss out on potential new ones.
Crisis in the making
Veterinarians are well-known for doing what they can to help animals, said Dr. Michael Blackwell, chief veterinary officer for the Humane Society of the United States.
“I don't know any veterinarian who hasn't on many occasions adjusted a fee or tried alternative means to treat a problem,” he said. At the same time, some of the public believes that veterinarians are more concerned about making money than treating animals, he said. That sentiment has resulted from a confluence of trends.
For one, the price of providing medical care has risen along with the costs associated with materials and drugs, veterinary education, and running a practice. At the same time, the public has made it clear that it expects the quality of veterinary medical care to be on a par with that seen in human medicine, especially with regard to companion animals, Dr. Blackwell said. Meanwhile, economic recovery from the Great Recession continues to be slow, particularly in certain parts of the country. The median household income in 2015 was $56,500, up 5.2 percent from the previous year but still 1.6 percent lower than in 2007, after adjusting for inflation. The percentage of people living in poverty also remained high at 13.5 percent, although that's down from 14.5 percent in 2013.
“When you put these three together, it starts to help us understand where some of the tension and concerns surface around access to veterinary care,” which is a crisis in the making, Dr. Blackwell said.
He says while veterinarians have done a great job serving the needs of most of the public, “We have a large sector of the American population who frankly are poor and can't afford private care. Some veterinarians say if you can't afford them, you shouldn't have pets. The fact is, pets are in these homes and need care as we speak. It's there, and it has to be dealt with. The model the profession built—this robust private veterinary industry, in all of its glory—is not a panacea. It is not complete in its ability to address the needs of all animals.”
Dr. Blackwell is part of a coalition that is advocating for shelters and nonprofit clinics to supplement and complement the veterinary industry by addressing unmet needs. Its first step is to gather more information on how many of these low-cost providers are out there and whether they are taking business away from private practices, as some veterinarians say (see sidebar).
Dr. Jeffrey F. Powers owns two veterinary clinics in a low- to moderate-income area in northern Michigan that's three to four hours from a referral center. By circumstance, he's learned to encourage clients to pay for medical care for their pets by offering more economical choices. Take, for example, how he addresses cranial cruciate ligament rupture in dogs. He gives clients the option of taking the dog to a clinic that performs tibial plateau leveling osteotomy or tibial tuberosity advancement, or of seeing a boarded specialist. Many times, however, the clients, especially those with low incomes, can't afford the $2,500 to $3,000 for the procedure, so he'll present the option of doing a modified retinacular imbrication technique with lateral suture stabilization at his clinic for half the cost.
“We always want to recommend the gold standard, but should we do silver and bronze to reduce euthanasia and treat lower-income clients' pets?” Dr. Powers asked. He believes that charging less for some services not only enables more clients to agree to veterinary care but also attracts more clients in general, increasing caseload and income overall.
At his clinics, Dr. Powers will run a full blood profile for $110; a practice where he did relief work charged more than $200. He says many of that practice's clients would balk at the full profile because of the cost, even though many were in a higher income bracket.
Another method Dr. Powers employs to increase the use of veterinary services is to offer prepayment plans. He also works with local nonprofits that are willing to help pay for part or all of the cost of services for in-need clients.
On a national level, the American Veterinary Medical Foundation's Veterinary Charitable Care Fund provides veterinarians with a way to offer charitable services to clients facing personal hardships (see JAVMA, Sept. 15, 2016, page 576). There is no enrollment fee for AVMA members. The AVMF accepts donations from an enrolled clinic's clients and disburses payments directly to the clinic for charitable care it provides. Donations are tax-deductible, an advantage over the angel funds at many practices. In addition, any donor can contribute to the general AVMF Veterinary Care Charitable Fund, without directing the gift to a particular clinic.
In the Knoxville, Tennessee, area, Dr. Sam Meisler has taken basic care to another level. He owns two full-service hospitals as well as three walk-in wellness clinics dedicated to making preventive care affordable and convenient. Each PetWellClinic offers veterinary services in four areas: wellness care, care for minor illnesses, care for chronic conditions, and laboratory testing.
“We shaved off the radiographs, surgery, and skill level of the support staff and hospital so everything else can be offered cheaper,” says Dr. Meisler, who likens the clinics to Walgreens Take Care clinics. “Our mission is to serve as many pets at as many levels as possible.”
He doesn't always require heartworm testing, as he sees the cost as a barrier to owners seeking care. Going one step further, he doesn't require an examination prior to vaccination—something he and the other doctors at his practices have debated at length.
“We know an annual examination is probably the most important thing a veterinarian can do, followed by rabies vaccination, then fecal test. We know, medically, it's the most appropriate, but it doesn't always work out,” Dr. Meisler said.
Clients can opt for various wellness packages that include vaccinations. For dogs, the cost ranges from $65 to $160; for cats, from $65 to $105. All the packages are available without an examination for $30 less than the listed price. Plus, any of the vaccinations and elective laboratory tests can be purchased individually. For example, a rabies vaccination costs $10, and canine DAPPv or feline FVRCP vaccination is $26.
Another way Dr. Meisler has saved clients money is through the use of communication technology. Clients can use the clinics' site to register their pet's information ahead of time, choose the appropriate wellness package, and even buy the package they want ahead of time. More recently, the clinics started a system by which clients can get in line for service virtually from home using the website.
“Anywhere we can save time for the client and for us, we can ultimately save on costs which are passed on to the client,” Dr. Meisler said. “It's not about doing wellness in the traditional way—as in making appointments by telephone, having a receptionist there to answer, using veterinary assistants and technicians who are being constantly interrupted by more pressing cases, and lots of waiting time for the client. Rather, it's about thinking of new ways to deliver the business of care at lower cost without sacrificing quality.”
He says the PetWellClinics attract two groups of clientele: people who can't afford as much and are looking for a cheaper way to treat their pet, and people who can afford more but like the convenience and features the clinics offer. Dr. Meisler maintains that the clinics create new demand; ear infections are an example. “Since our services are so affordable, we do a lot more ear cytologies and ear cultures than some traditional hospitals. I would argue this allows us to do higher-quality medicine.”
Price sensitivity is something all veterinarians need to understand and pay attention to, not just those in low-income areas, according to Michael Dicks, PhD, director of the AVMA Veterinary Economics Division. He wrote in his essay “Supply and Demand” this past May—available at http://jav.ma/supplydemandessay—that low-cost care providers, including spay-neuter and nonprofit clinics, enter the market and establish themselves because they can, even in areas where clients can afford higher prices.
“Those clients who have been able and willing to pay, because they feel obligated to provide care to their pets, may no longer be seen as willing when presented with a lower-cost alternative for the same perceived level of services. So the new low-cost clinic can capture those who were unable to pay and those who felt obligated to provide care but were troubled by the price of the services.”
He continues, “Once a low-cost provider has entered the market and gained a foothold, recapturing lost clients is an uphill battle. The key then is to maintain market share by understanding demand and addressing each segment of the market so that the low-cost practice is unsuccessful in establishing a presence. This multi-tiered pricing structure occurs in many markets: Car dealerships sell low- to high-cost vehicles, spas charge for various levels of services, banks have different types of credit cards and bank accounts, and cellular service providers offer multiple plans.”
That's why veterinarians must understand what services they can provide to maximize the health and wellness of pets and be willing to provide that set of services at prices each segment of the local population is able and willing to pay. Establishing one level of service and one price for those services will only net one segment of demand, Dr. Dicks wrote.
Echoing those sentiments, Dr. Meisler encourages veterinarians to consider whether the way they've always charged for their products and services actually makes sense for today's clientele.
“For example, I would challenge everything we as veterinarians are taught to do in an exam room with a client during a pet visit. One of the things we veterinarians love to do is to educate our clients. But there are other ways to deliver information, make the visit more efficient, and treat more pets affordably,” he said.
Dr. Powers calls for veterinary colleges to better teach students how to adapt protocols to the circumstances of the areas where they practice while maintaining an acceptable standard of care. More academic institutions have started to partner with shelters and nonprofit organizations to give students hands-on training while providing care to underserved pets. These include Louisiana State University School of Veterinary Medicine (see JAVMA, Dec. 1, 2013, page 1490), the University of Wisconsin-Madison School of Veterinary Medicine (see JAVMA, Dec. 1, 2015, page 1194), and Tufts University Cummings School of Veterinary Medicine and its Tufts at Tech Community Veterinary Clinic, a student-run veterinary clinic providing low-cost care for family pets in underserved communities in central Massachusetts (watch for a story on the clinic in the Dec. 15 JAVMA News).
Dr. Powers says educating students about shelter medicine and various levels of care “opens their eyes to the fact that there is more than just the gold standard in treating everything. The more advanced and technical, and in turn, costly, the gold standard becomes, we have to be cognizant not to eliminate the greater percent of animals needing treatment.”
Coalition wants veterinary access for economically at-risk pets
An ongoing concern voiced by some in the profession is that nonprofit organizations providing veterinary services are competing with private practitioners and stealing their clients.
Dr. Michael Blackwell, chief veterinary officer for the Humane Society of the United States, has a vested interest in the issue and says hard data are needed rather than anecdotes.
“Everybody has heard the story of veterinarians driving by a low-cost spay-neuter clinic and seeing their client's car parked outside, the lady with the Mercedes. She's all over the country. We really want to find out what her name is and why she is doing that,” Dr. Blackwell said.
“It's fair to say there are people who will go to whatever lengths they can to cut costs in ownership, but to what extent is that going on? Is it at a level where it's eroding the financial well-being of practices? I don't think so, but we'll see. I haven't seen private practices financially hurt because a nonprofit is trying to help those in need. But that's something that hasn't been objectively measured.”
He is a member of the Access to Veterinary Care Coalition, a group formed by the Humane Society VMA to bring together veterinary, animal welfare, and social services professionals, including representatives of for-profit and nonprofit veterinary service providers. Its goals are as follows:
• Foster development and promotion of methods for providing access to veterinary care for the millions of pets currently without it.
• Respond to legislative, regulatory, and other efforts designed to interfere with nonprofit practices' ability to serve pet owners, and work to pre-empt and avoid such action whenever possible.
• Improve collaboration among private nonprofit and for-profit veterinary service providers as well as relevant social service providers to promote access to veterinary care for all pet owners.
• Provide guidance to the veterinary profession regarding ways it can help promote access to veterinary care for all pet owners.
The group's first task is to study how effective programs operate to ensure sustainable access to veterinary care. The coalition will study target populations and the type of services provided, in addition to exploring how humane care may be provided under economic hardship circumstances. The coalition will report its findings by July 1, 2018, according to an HSVMA press release.
“One of the key things we're trying to address and understand is to what extent or how often is it that people who can pay for private medical care are seeking to go to a low-cost nonprofit to have their pet seen.
Anecdotal data suggest that's not really happening. When people can afford private care, that's what they will go and acquire. The analogy is most people who have the ability to afford physician care don't go to their city health department or to ministries to get medical services,” Dr. Blackwell said.
In the spring of 2015, the coalition agreed on the following basic principles: All animals deserve veterinary care, many pets in the United States are not getting the veterinary care they need, and veterinarians should have the freedom to provide a spectrum of care for their patients. Regarding the last point, the group defined that to mean the following:
• Veterinarians should have the flexibility to offer proven, effective treatments for their patients, with the understanding that those options may not involve the use of the most expensive, technologically advanced, or state-of-the-art equipment or techniques.
• Veterinarians should be able to consider pets' individual circumstances and their owners' living situations when determining proper courses of treatment.
• Veterinarians should have the legal protection and professional approval to provide appropriate care to underserved animals, whether that is in for-profit or nonprofit practice settings.
• Nonprofit veterinary practices should not be required to limit the scope of services they provide or perform means testing or other income screening of clients simply because of their nonprofit status.
These fundamental principles, known as the Guiding Principles to Ensure Access to Veterinary Care, are posted at http://jav.ma/accesstovetcare.
“It takes a diverse group of individuals and diverse approaches to meet the needs of pets in America,” Dr. Blackwell said. “To the extent that we can not only appreciate that but also seek to collaborate with one another, we will do a better job of meeting the needs of pets, especially the unmet needs that are there today.”
Free training offered in suicide prevention
On Nov. 19, the AVMA launched a training program to help members identify and aid individuals who may be contemplating suicide, as part of its ongoing well-being initiative.
QPR, which stands for question, persuade, and refer, is a method that can be used to recognize the warning signs of someone in crisis. Through this 90-minute, self-guided online program, individuals will also learn how to establish a dialogue and assist those in crisis to seek professional help. It is not intended to replace professional assistance.
In partnership with the AVMA PLIT and AVMA Life, the Association is opening up a limited number of free registrations for AVMA and Student AVMA members. The launch date coincides with National Survivors of Suicide Loss Day.
The hope is to build a wellness community among those who sign up for the training. That will happen through the newly established AVMA Wellness and Well-being Group on LinkedIn, where individuals can continue the conversation and discuss current wellness issues and techniques to help deal with stressors in the veterinary profession. Mental health professionals have signed on to provide additional resources for these topics.
“This pilot program demonstrates the AVMA's commitment to moving forward in helping our profession become more healthy,” said Dr. Marci Kirk, assistant director for recent graduate initiatives at the AVMA.
The idea for offering QPR training first came about during the veterinary profession wellness roundtable, held this past March in Schaumburg, Illinois, and convened by the AVMA. The 35 participants talked about major causes of wellness issues among veterinarians, strategies to promote wellness among veterinary professionals, barriers to implementing wellness programs, and tactics to overcoming these barriers. In addition, one of the priorities that roundtable participants highlighted was exploring the creation of more support communities for veterinarians.
AVMA announces members' annual meeting
The 2017 annual meeting of AVMA voting members will be held Friday, Jan. 13, from 8–10 a.m. CST at the Hyatt Regency Chicago, 151 E. Wacker Drive. As determined by the AVMA Board of Directors, the meeting will be held in conjunction with the regular winter session of the House of Delegates, during the plenary session of the AVMA Veterinary Leadership Conference.
The meeting will include reports from the treasurer and AVMA staff, a message from the president, a speech by the candidate for president-elect, and other information as determined by the Board.
The article “Webinar explores how to transition to corporate medicine,” which was published in the Nov. 15, 2016, issue of JAVMA, on page 1114, misspelled the name of Stacy Pursell, who is founder and CEO of The Vet Recruiter.
Nominations open for Excellence in Veterinary Medicine Awards
The AVMA is accepting nominations for the following Excellence in Veterinary Medicine Awards. The awards program recognizes contributions to the veterinary profession.
The AVMA Award
The Association's pre-eminent award recognizes an AVMA member who has contributed to the advancement of veterinary medicine in its organizational aspects.
AVMA Meritorious Service Award
This award recognizes a veterinarian who has brought honor and distinction to the veterinary profession through personal, professional, or community service activities outside organized veterinary medicine and research.
AVMA Advocacy Award
This award recognizes an individual for advancing the AVMA legislative agenda and advocating on behalf of the veterinary profession.
AVMA Animal Welfare Award
This award recognizes an AVMA member for accomplishments in the field of animal welfare in leadership, public service, research, education, or advocacy.
AVMA Clinical Research Award
This award recognizes a veterinarian's achievements in patient-oriented research.
AVMA Humane Award
This award recognizes a nonveterinarian for accomplishments in the field of animal welfare in leadership, public service, research, education, or advocacy.
AVMA Lifetime Excellence in Research Award
This award recognizes a veterinarian for lifetime achievements in basic, applied, or clinical research.
AVMA Public Service Award
This award recognizes an AVMA member for outstanding public service while an employee of a government agency or for education of veterinarians in public service activities.
AVMA XIIth International Veterinary Congress Prize
This award recognizes an AVMA member who has contributed to international understanding of veterinary medicine.
AVMF/Winn Excellence in Feline Research Award
The AVMF and Winn Feline Foundation established this award for a Winn grant recipient who has contributed to feline research.
AVMF/AKC Career Achievement Award in Canine Research
This award honors a candidate's long-term contribution to the field of canine research.
The deadline is Feb. 1, 2017, for award nominations. Award information and nomination forms are available by visiting www.avma.org/awards, emailing firstname.lastname@example.org, or calling 800-248-2862.
NIFA awards $2.3 million to relieve veterinary shortages
The Department of Agriculture's National Institute of Food and Agriculture on Oct. 17 announced 12 awards totaling $2.3 million to help relieve shortages of veterinary services through education, extension, training, and support for new or existing veterinary practices in designated rural areas.
The fiscal year 2016 competitive grants are funded through the new Veterinary Services Grant Program authorized by the 2014 Farm Bill.
“The new Veterinary Services Grant Program will enable training and retention initiatives to support veterinarians and veterinary technicians so they can continue to provide quality services in rural areas,” said NIFA Director Sonny Ramaswamy. “It also supports the expansion of existing veterinary educational programs and facilities, including mobile services.”
Veterinary Service Grants fund work by universities, veterinary associations, and state, local, or tribal agencies to help relieve veterinary workforce shortages in the U.S. food and agriculture sector. Funds may also be used to support the establishment or expansion of veterinary services in eligible rural areas.
The AVMA was instrumental in pushing Congress to authorize and fund the program. “It is gratifying to see the first dozen Veterinary Services Grant Program awards made. Each grantee will enhance access to a full array of veterinary services benefiting rural America,” said AVMA CEO Janet Donlin, “These grants are the outcome of AVMA's sustained advocacy efforts over the past eight years.”
Fiscal year 2016 grantees are as follows: the American Association of Bovine Practitioners ($224,136); Colorado State University ($238,251); the University of Georgia ($236,243); Kansas State University ($239,656); the University of Minnesota ($238,346); Betsy the Vet Inc., Hardin, Montana ($124,462); Lewistown Veterinary Service, Lewistown, Montana ($116,036); Town and Country Veterinary Clinic, Auburn, Nebraska ($124,760); Utah State University ($236,619); the University of Wisconsin-Madison ($237,327); the Wisconsin VMA ($238,429); and Squared Circle Veterinary, Evanston, Wyoming ($104,000).
The AABP will use its grant to host two workshops to educate veterinarians practicing in underserved areas to better manage their practices as businesses and improve the service that they are providing to their clients. Among the others, Kansas State University will fund training and networking opportunities for rural production animal veterinarians. Town and Country Veterinary Clinic in Nebraska will expand its mobile veterinary practice service radius an additional 20–40 miles with the help of its grant.
Report: Similar rises in human, pet health care expenses
By Greg Cima
Household pet health care expenses have risen in patterns similar to those seen in human health care, despite any influences of insurance coverage and public sector reimbursement on the former, according to recent economic analysis.
The nonprofit National Bureau of Economic Research published the report, “Is American pet health care (also) uniquely inefficient?” in September. Its title is based on a 2008 Journal of Economic Perspectives article, “Is American health care uniquely inefficient?”
The authors of September's article—Liran Einav, PhD, and Atul Gupta of Stanford University's Department of Economics and Amy Finkelstein, PhD, of the Massachusetts Institute of Technology's Department of Economics—wrote that human health care expenses in the U.S. are higher and rising more quickly than expenses in other developed countries without being associated with better outcomes. The rise has been attributed to insurance coverage that shields patients from the costs of their decisions and government reimbursement that provides little incentive for efficiency, the report states.
Similar changes in pet health spending indicate other factors are influencing the demand for and supply of health care, it states.
“It should give us pause before attributing the large and rising healthcare costs in the US solely to the prevalence of insurance and government involvement,” the report states. “The similar growth patterns in US human and pet healthcare may also suggest that technological change in human healthcare may have spillover effects on related sectors, including perhaps pet healthcare or human care in other countries.”
The report compares data collected for the Bureau of Labor Statistics Consumer Expenditure Survey on pet-related expenses, human health care, housing, and entertainment.
The pet-related expenses include categories of veterinary services and pet purchases and medical supplies. Human health care includes insurance premiums and out-of-pocket expenses, and the authors state that housing and entertainment costs were chosen because of their likely correlation with income.
The authors found that housing and entertainment spending had little change from 1996–2012, pet spending rose about 60 percent, and human health care spending rose about 50 percent.
The data show that pet owners with more than $70,000 of annual household income spent more than twice as much on pets than did owners with less than $20,000 annual household income. And the authors indicate the data show a similar pattern for human health care expenses, despite their expectations health insurance would mitigate that connection with income.
Employment data examined by the authors also indicate the supply of people employed in physicians' offices was 40 percent higher in 2013 than in 1996, and the supply of people working in veterinarians' offices almost doubled in that time.
The report authors also examined health care expenses on 23 dogs that died of lymphoma at a California pet hospital between 2011 and 2014 and for 125 Medicare patients with lymphoma who died between 2008 and 2011. Both data sets showed an end-of-life spike in expenses, most in the last month for dogs and the last three to four months for humans.
But the authors noted that the pet spending data came from a pet hospital that likely draws clients with higher incomes than typical dog owners.
The report is available from the NBER at www.nber.org/papers/w22669.
Roth elected to National Academy of Medicine
Iowa State professor has spent decades researching animal diseases
By R. Scott Nolen
Dr. James Roth, a distinguished professor at the Iowa State University College of Veterinary Medicine, has been elected to the National Academy of Medicine for his research of the immunology of infectious diseases of livestock and management of foreign animal disease outbreaks.
Election to the prestigious academy, formerly the Institute of Medicine, is one of the highest honors in the fields of health and medicine. The organization works with the National Academy of Sciences and the National Academy of Engineering to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions.
The Clarence Hartley Covault Distinguished Professor of Veterinary Microbiology and Preventive Medicine, Dr. Roth is the first of Iowa State's veterinary college faculty granted membership in the organization. He is the only U.S. veterinarian among the 79 professionals inducted into the academy this year, according to the academy's Oct. 17 announcement.
“I am especially proud of receiving this recognition after having received all of my education and spending my entire career in Iowa,” he said. “I benefitted from being part of an excellent land-grant institution, a college of veterinary medicine with a strong tradition of excellence in infectious diseases of food animals, and the opportunity to collaborate with the U.S. Department of Agriculture National Centers for Animal Health in Ames.”
New members of the academy are elected by active members through a selective process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care, and public health. The newly elected members raise the academy's active membership to 1,947 and the number of international members to 146.
“These newly elected members are outstanding professionals who care deeply about advancing health and health care in the U.S. and globally,” said NAM President Victor J. Dzau. “Their expertise will help our organization address pressing health challenges and improve health, science, and medicine for the benefit of us all.”
In addition to his professorship, Dr. Roth oversees Iowa State's Center for Food Security and Public Health and the Institute for International Cooperation in Animal Biologics. He has testified before Congress on agroterrorism and foreign animal disease preparedness and served on a number of advisory panels and committees for the National Research Council of the National Academies of Sciences.
Dr. Roth received a DVM degree from Iowa State in 1975 and a doctorate in veterinary microbiology four years later. He spent two years practicing veterinary medicine before returning to Iowa State as a faculty member in 1977.
After 9/11, Dr. Roth established the Center for Food Security and Public Health in 2002 to develop strategies for protecting the nation's livestock and the food supply from acts of agroterrorism and other threats. Today, the center's mission is more focused on preventing foreign animal disease threats, and the center is partnering with the USDA, state animal health officials, and industry to develop plans for a secure food supply.
With funding from the USDA, the center created a course on emerging and exotic animal diseases, available to every U.S. veterinary college. The center also received USDA support to develop and deliver continuing education for 60,000 USDA-accredited veterinarians. Much of the center's work has implications for human health, especially recognition and prevention of zoonotic diseases.
“I have been fortunate to have an amazing team of professionals working with me in the center,” Dr. Roth said.
Controversial Texas veterinarian's license suspended for a year
By R. Scott Nolen
The Texas Board of Veterinary Medical Examiners suspended the license of Dr. Kristen Lindsey for one year in response to her infamously boasting on Facebook about killing a cat with an arrow.
The state licensing board also ordered the 33-year-old veterinarian to serve four years of probation and to complete animal welfare training and other education.
The Oct. 18 ruling was quickly criticized as too lenient by animal advocacy organizations such as Alley Cat Allies, which pushed for harsh punishment for Dr. Lindsey, filed an amicus brief, and offered testimony in the case (see JAVMA, Aug. 15, 2015, page 334).
“Only a permanent revocation of Kristen Lindsey's license is an acceptable ruling given the level of contempt for animals she has demonstrated,” said Misty Christo, Alley Cat Allies' lead attorney on the case, in an Oct. 18 press release. In April, she had expressed shock at hearing testimony “confirming that (the cat) was still alive” in the Facebook picture‥
Dr. Lindsey did not respond to an email request for an interview.
A photo posted on Dr. Lindsey's Facebook page had shown her holding an orange and white cat with an arrow through its head. “My first bow kill lol,” read the April 17, 2015, post. “The only good feral tomcat is one with an arrow through it's head! Vet of the year award … gladly accepted.”
The image immediately went viral, sparking outrage and condemnation. A short time later, Dr. Lindsey was fired from the small animal clinic in Brenham, Texas, where she'd been employed.
An Austin County, Texas, grand jury found insufficient evidence to charge Dr. Lindsey with animal cruelty. Sheriff's investigators lacked probable cause to obtain a search warrant, as they weren't able to determine where or when the incident occurred. Subpoenas to Facebook failed to produce usable evidence because Dr. Lindsey's Facebook account had been deleted.
Investigators could neither prove the cat was killed in Texas nor confirm that the animal was a pet named Tiger.
AVMA records show Dr. Lindsey's Association membership ended Jan. 1, 2016. The 2012 veterinary graduate of Colorado State University can practice veterinary medicine in Texas again in October 2017.
Veterinary emergency, critical care groups hold symposium
Event: 22nd International Veterinary Emergency and Critical Care Symposium, Sept. 7–11, Grapevine, Texas
Program: This year's symposium, conducted jointly by the Veterinary Emergency & Critical Care Society, American College of Veterinary Emergency and Critical Care, and Academy of Veterinary Emergency and Critical Care Technicians, focused on sepsis in emergency and critical care. Dr. Anand Kumar, University of Manitoba, presented the Knowles Memorial Keynote Lecture, “Optimizing Use of Antibiotics in Septic Shock.” The symposium served as the venue for the annual meetings of the American College of Veterinary Anesthesia and Analgesia, Academy of Veterinary Technicians in Anesthesia and Analgesia, Veterinary and Emergency Critical Care Foundation, and International Veterinary Academy of Pain Management.
Awards: Ira M. Zaslow VECCS Distinguished Service Award: Dr. Pam Wilkins, Champaign, Illinois. A 1986 graduate of the Cornell University College of Veterinary Medicine, Dr. Wilkins is section chief and chief of service for equine medicine and surgery at the University of Illinois. She is a diplomate of the American College of Veterinary Internal Medicine and ACVECC. Hill's Dr. Jack Mara ACVECC Achievement Award: Dr. Larry D. Cowgill, Davis, California, for his work relating to “the critical kidney.” A 1971 veterinary graduate of the University of California-Davis, Dr. Cowgill is a professor in the Department of Medicine and Epidemiology at the UC-Davis School of Veterinary Medicine. He is a diplomate of the ACVIM. T. Douglas Byars Equine Emergency & Critical Care Educator of the Year, sponsored by Boehringer Ingelheim: Dr. Diana Hassel, Fort Collins, Colorado. A 1993 graduate of the University of California-Davis School of Veterinary Medicine, Dr. Hassel is associate professor of equine emergency surgery and critical care medicine at the Colorado State University College of Veterinary Medicine & Biomedical Sciences. She is a diplomate of the American College of Veterinary Surgeons and ACVECC. VECCS Practice Manager of the Year, sponsored by Nationwide Insurance: Brandee Crowder, Fresno, California, was the charter recipient of this award. Crowder works at Fresno Veterinary Specialty and Emergency Center. She was recognized for her leadership, strength during difficult situations, and dedication to the practice. ACVECC Research Grant Award ($6,935): Dr. Thomas Edwards, Dr. Amie Koenig, LeNae Pecenka, and James Edwards, PhD, University of Georgia, for “Preparation of purified canine albumin by heat denaturation of stored plasma.” VECCF Research Grant Award ($9,980): Drs. Carley Allen, Benjamin Brainard, Jaime Tarigo, and Dana LeVine, University of Georgia, for “Platelet number and function in response to a single dose of intravenous vin-cristine as assessed by flow cytometry and turbidimetric aggregometry.” Small Animal Resident Abstract Award, sponsored by Elanco: A $500 stipend was awarded to Dr. Andy Carver, Michigan State University, for “Evaluation of vitamin D, calcitriol, and ionized calcium levels in dogs with sepsis.” Large Animal Resident Abstract Award, sponsored by Mila International: A $500 stipend was awarded to Dr. Jamie Kopper, Michigan State University, for “Gastrointestinal permeabiilty in obese horses.” ACVAA Resident Abstract Award, sponsored by Smiths Medical and Surgivet: First place, small animal—Dr. Carrie Davis, University of Tennessee, for “Effect of fentanyl on the minimum infusion rate of propofol preventing movement in dogs”; large animal—Dr. Heidi Lehmann, Murdoch University, Perth, Australia, for “Lidocaine or meloxicam analgesia decrease nociception as indicated by cardiovascular response of halothane-anaesthetized Bos indicus bull calves during surgical castration.” Case Report Award: A stipend of $300 was awarded to Dr. Amy Brida, Tufts University, for “Compartment syndrome where?” Technician Case Report Award, sponsored by Animal Blood Resources International: A stipend of $300 was awarded to Veronica Lopez, Veterinary Referral and Critical Care, Manakin-Sabot, Virginia, for “Twisted: a case of uterine torsion.” Poster Abstract Award, sponsored by Abaxis: A stipend of $500 was awarded to Dr. Samuel Stewart, Massachusetts Veterinary Referral Hospital, Medford, Massachusetts, for “The effectiveness of ampicillin-sulbactam continuous infusion versus intermittent infusions at maintaining therapeutic serum antibiotic concentrations in canine septic peritonitis.”
Veterinary Emergency and Critical Care Society
Business: It was announced that membership numbers have increased, and finances have been strong. The Journal of Veterinary Emergency and Critical Care increased its page count per issue last year, and that has decreased the lead time from manuscript acceptance to publication. The society now certifies 32 level 1, 24 level 2, and seven level 3 facilities, with several beginning the recertification phase.
Officials: Dr. Robert Messenger, Charlotte, North Carolina, president; Dr. Linda Martin, Pullman, Washington, president-elect; Dr. Chris Gray, East Lansing, Michigan, treasurer; Kenichiro Yagi, Los Altos, California, recording secretary; Dr. Scott Johnson, Austin, Texas, immediate past president; Dr. Gary Stamp, San Antonio, executive director; and members-at-large—Drs. Julie Dechant, Davis, California, and Steven Epstein, Davis, California
American College of Veterinary Emergency and Critical Care
Program: The ACVECC conducted its certification examination and held its annual business meeting.
New diplomates: Forty-eight individuals passed the certification examination. They are as follows:
Jonathan M. Babyak, Shrewsbury, Massachusetts
Christa Bernhard, Albuquerque, New Mexico
Susan Blades Golubovic, Annapolis, Maryland
Andy Carver, Gainesville, Florida
Ana Courtney Crane, Towson, Maryland
Christine A. Culler, Worthington, Ohio
Tara J. Fetzer, Bethlehem, Pennsylvania
Virginia M. Frauenthal, Carpinteria, California
Michelle Griego-Valles, Brooklyn, New York
Adam R. Grochowsky, Aurora, Colorado
Liz-Valérie Guieu, Chatenay-Malabry, France
Jack Hardy, Kansas City, Missouri
Brittany Heggem Perry, Spring, Texas
Justin A. Heinz, Upland, California
Jessica R. Heuss, Mesa, Arizona
Mara C. Hickey, Leichhardt, Australia
Jennie L. Hiratzka, Naperville, Illinois
Clare E. Hyatt, Phoenix
Laura Ilie, Arlington Heights, Illinois
Mary Jackson, Melbourne Beach, Florida
Stephanie M. Johnnides, Coral Gables, Florida
Casey J. Kohen, Davis, California
Selena L. Lane, Athens, Georgia
McGee Leonard, Los Angeles
Nyssa Levy, East Lansing, Michigan
Efa Llewellyn, Swansea, Wales
Leonel A. Londono, Newberry, Florida
Whitney Long, Morristown, Tennessee
Jennifer Mahon, Dallas
Megan Marquez, Lafayette, Colorado
Erin McGowan, Bedford, Massachusetts
Christopher McLaughlin, Coral Springs, Florida
Peggy McMahon, Los Angeles
Alicia Niedzwecki, San Antonio
Cassandra Ostroski, Lambertville, New Jersey
Courtney Peck, Watertown, Massachusetts
Ayla R. Preston, Windsor, Colorado
Christin L. Reminga, Brier, Washington
Joshua Rosenbaum, New York
Mallory C. Salcedo, St. Paul, Minnesota
Dustin Schmid, Laguna Hills, California
Joshua Smith, Madison, Wisconsin
Michael R. Smith, LaPlace, Louisiana
Meredith von Roedern, Bellmore, New York
Rebecca A. Walton, Ames, Iowa
Annie Wayne, Needham, Massachusetts
KimMi Whitehead, Philadelphia
Jarred M. Williams, Athens, Georgia
Officials: Drs. Elisa Mazzaferro, Stamford, Connecticut, president; Daniel Fletcher, Ithaca, New York, president-elect; Deborah Silverstein, Philadelphia, vice president; Scott Shaw, Oxford, Massachusetts, treasurer; Armelle de Laforcade, North Grafton, Massachusetts, executive secretary; Elizabeth Rozanski, North Grafton, Massachusetts, immediate past president; and regents—Drs. Daniela Bedenice, North Grafton, Massachusetts; James Barr, College Station, Texas; Marie Kerl, Columbia, Missouri; Karl E. Jandrey, Davis, California; Garret Pachtinger, Levittown, Pennsylvania; and Justine Lee, St. Paul, Minnesota
Academy of Veterinary Emergency and Critical Care Technicians
Program: The academy, celebrating 20 years since inception, conducted its 19th certification examination and held a pinning ceremony and reception for the class of 2015.
Business: Committee reports were presented and ratified. Dr. Gary Stamp, San Antonio, was named the first honorary member of the academy. All the charter members of the academy were honored as Technicians of the Year.
Officials: Amy Newfield, Tewksbury, Massachusetts, president; Louise O'Dwyer, Manchester, England, president-elect; Kenichiro Yagi, Los Altos, California, treasurer; Angela Thorp, Chandler, Arizona, executive secretary; Trish Farry, Gatton, Australia, immediate past president; and members-at-large—Andrea Steele, Guelph, Ontario; Jess Kerr, Clifton, New Jersey; and Katy Waddell, College Station, Texas
American College of Veterinary Anesthesia and Analgesia
Program: Twenty-seven abstracts were presented as well as lectures. Among the lectures, Dr. Heidi Shafford, Portland, Oregon, presented “Challenges for Anesthesiologists in Private Practice,” and Drs. Michele Sharkey and Jean Recta, Food and Drug Administration, presented “Hurdles to Analgesic Drug Development.” Dr. Maxime Cannesson, University of California-Los Angeles, delivered “Cardiovascular Physiology Applied to the Perioperative and Critical Care Environments,” “Fluid Responsiveness and Hemodynamic Optimization,” and “Systolic Function Physiology and Assessment.” Dr. Jeff Mogil, McGill University, presented “What's Wrong with Animal Models of Pain,” “Mice are People, Too: Social Modulation of and by Pain in Mice and Humans,” and “Sex Differences in Pain from Both Sides of the Syringe.” Drs. Theodore Price, Richardson, Texas, lectured on “Pathophysiology of Pain Review” and “New Pharmacologic Agents for Targeted Analgesia;” Todd Kilbaugh, Philadelphia, lectured on “Neuroanesthesia and Preoperative Neurosurgical Critical Care”; Alessio Vigani, Raleigh, North Carolina, lectured on “Local Regional Analgesia for Critically Ill and Septic Patients”; Alonso Guedes, St. Paul, Minnesota, lectured on “Chronic Pain Management on Felines”; and Amy DeClue, Columbia, Missouri, lectured on “Immunomodulary Effects of Opioids.” The 2016 ACVAA Career Achievement Award was given posthumously to Dr. E. Wynn Jones (see obituary, page 1242). A diplomate of the ACVS and a founding diplomate and a past president of the ACVAA, Dr. Jones was professor emeritus at the Mississippi State University College of Veterinary Medicine.
New diplomates: Fourteen new diplomates were welcomed into the ACVAA. They are as follows:
Daniel Almeida, St. Paul, Minnesota
Annatasha Bartel, Davis, California
Alessia Cenani, Davis, California
Bonnie Gatson, Gainesville, Florida
Lane Johnson, Starkville, Mississippi
Yishai Kushnir, Rehovot, Israel
Claudio Natalini, Ithaca, New York
Jordan Nickel, Fort Collins, Colorado
Noah Pavlisko, Blacksburg, Virginia
Rachel Reed, Athens, Georgia
Daniel Sakai, Ithaca, New York
Rebecca Sayre, Magnolia, Texas
Leon Warne, Werribee, Australia
Melina Zimmerman, Keyport, New Jersey
Business: It was reported that in 2016, the journal Veterinary Anesthesia and Analgesia has received 246 submissions from 37 countries. The acceptance rate has been 43.7 percent, and the mean turnaround time from submission to final acceptance has averaged 16 weeks. Amendments were made to the constitution and bylaws involving changes in language with regard to certification requirements, membership, and duties of the Committee on Education. A pre-residency checklist was established listing all the prerequisites for entering an ACVAA-approved anesthesia residency program. Details on the certifying examination redesign plan were presented, describing the proposed changes. Discussions were held on the financial status of the college and financial projections. Nominees for the at-large and Region 3 director positions were announced.
Officials: Drs. Lesley Smith, Madison, Wisconsin, president; Chris Egger, Knoxville, Tennessee, president-elect; Lynne Kushner, Portsmouth, Rhode Island, executive secretary; and Khursheed Mama, Fort Collins, Colorado, immediate past president
Academy of Veterinary Technicians in Anesthesia and Analgesia
Program: The certification examination was conducted.
Business: The academy discussed issues facing the AVTAA and presented ideas and plans for changes in the coming year.
Officials: Kim Spelts, Colorado Springs, Colorado, president; Katy Waddell, College Station, Texas, president-elect; Lynette DeGouff, Cortland, New York, treasurer; Darci Palmer, Auburn, Alabama, executive secretary; Kristin Cooley, Madison, Wisconsin, immediate past president; and members-at-large—Brenda Feller, Fort Myers, Florida; Jody Nugent-Deal, Davis, California; and Brynn Schmidt, Los Angeles
Veterinary Emergency and Critical Care Foundation
Program: The foundation hosted its third annual K9 ER Care and CPR Course. More than 60 first responders, police officers, firefighters, emergency medical technicians, and border patrol officers attended the all-day course, which included hands-on instruction and lectures on anatomy, bandaging and wound management, CPR in the field, exposure to toxins, and common traumas. The foundation raised more than $12,000 and used some of the funds to cover the costs associated with the K9 ER Care and CPR Course; donated a portion to Ranch Hand Rescue, an animal sanctuary and counseling center in South Argyle, Texas; and designated money toward the Dougie Fund for Disaster Relief, established in honor of past VECCF board member, the late Dr. Dougie MacIntire.
Officials: Alyce D'Amato, Appleton, Wisconsin, president; Dr. Deborah Silverstein, Philadelphia, secretary; Dr. Gary Stamp, San Antonio, treasurer-administrator; and Dr. Bill Smith, Seale, Alabama, immediate past president
International Veterinary Academy of Pain Management
Program: The academy coordinated several pain management sessions. Dr. Karol Matthews, professor emeritus at the University of Guelph Ontario Veterinary College, presented a review on pain and the lectures “Analgesia for the Pregnant Cat and Dog,” “Analgesia for Nursing Mothers,” and “Pediatric Pain of Today Can Be Forever: Importance of Prevention and Treatment.”
Business: The academy reviewed current initiatives, provided progress updates, and identified future projects and goals.
Officials: Nancy Shaffran, Erwinna, Pennsylvania, president; Dr. James Berry, Fredericton, New Brunswick, president-elect; Dr. Douglas Stramel, Carrollton, Texas, treasurer; Mary Ellen Goldberg, Boynton Beach, Florida, executive secretary; and Dr. Bonnie Wright, Fort Collins, Colorado, immediate past president
AVMA member AVMA honor roll member Nonmember
Jack N. Armstrong
Dr. Armstrong (Washington State ‘60), 86, Carson City, Nevada, died July 3, 2016. He retired in 1996 as Nevada state veterinarian and chief of the Nevada Department of Agriculture's Division of Animal Industry. During his 25-year career with the NDA, Dr. Armstrong also served several years as supervisor of the Nevada Animal Disease Laboratory.
Following graduation, he owned a large animal practice in Livingston, Montana, for many years, followed by a research associateship he served at the Oregon Veterinary Diagnostic Laboratory, where he also pursued graduate studies in medical entomology. Dr. Armstrong was a member of the American Association of Veterinary Laboratory Diagnosticians, United States Animal Health Association, Nevada Cattlemen's Association, Western States Livestock Health Association, and Nevada VMA.
In 1995, he received the Nevada Farm Bureau Silver Plow Award. Dr. Armstrong was an Air Force veteran of the Korean War.
He is survived by his wife, Shirley; two daughters; four grandchildren; and three great-grandchildren. Memorials toward the Nevada Youth Range Camp, with checks made payable to the Nevada Section of the Society for Range Management, may be made to Nevada SRM, c/o Tim Rubald, President, 4591 Bigelow Drive, Carson City, NV 89701.
Gerald R. Donner
Dr. Donner (Brandeis Middlesex ‘47), 92, Newtown, Pennsylvania, died Aug. 27, 2016. In 1955, he established East Brunswick Animal Hospital in East Brunswick, New Jersey. Prior to that, Dr. Donner worked in large animal medicine for the state of New Jersey.
His wife, Leila; three daughters; and four grandchildren survive him. Memorials may be made to the American Lung Association, Donation Processing Center, P.O. Box 7000, Albert Lea, MN 56007, www.lung.org.
John D. Gregory
Dr. Gregory (Ohio State ‘83), 60, Northfield, Ohio, died April 30, 2016. A mixed animal veterinarian, he practiced at Slavic Village Animal Hospital in Cleveland for 27 years. Earlier, Dr. Gregory worked at Winona Veterinary Hospital in Winona, Ohio. His wife, Janice, and a daughter survive him
Memorials may be made to Conservancy for Cuyahoga Valley National Park, 1403 W. Hines Hill Road, Peninsula, OH 44264, www.cvnpa.org/trailsforever.
E. Wynn Jones
Dr. Jones (London ‘46), 91, Starkville, Mississippi, died April 8, 2016. He was professor emeritus at the Mississippi State University College of Veterinary Medicine since 1992. Following graduation and after earning a doctorate in equine anesthesia from Cornell University in 1950, Dr. Jones returned to the United Kingdom and joined the faculty of the University of Bristol School of Veterinary Sciences, where he served as a lecturer in surgery and published work on ruminant anesthesia.
In 1954, he was appointed assistant professor of veterinary medicine and surgery at Oklahoma State University's newly established veterinary college. Dr. Jones went on to serve as professor and director of veterinary research and graduate education at the college, helping to found the anaplasmosis laboratory at the university. He was later named professor emeritus of the veterinary college.
In the early 1980s, Dr. Jones joined the Mississippi State University faculty, where he was involved in the design of the facilities and program planning for the veterinary college. During his tenure, he served as professor, acting dean and vice dean of the college, and coordinator of clinical and biomedical research.
Known for making early contributions to the development of veterinary anesthesiology in the United States, Dr. Jones co-authored the textbook Veterinary Anesthesia and Analgesia. He was a charter diplomate of the American College of Veterinary Surgeons, a founding diplomate and a past president of what is now known as the American College of Veterinary Anesthesia and Analgesia, an honorary diplomate of the European College of Veterinary Anesthesia, and a fellow of the Royal College of Veterinary Surgeons. Dr. Jones was an affiliate member of the American Society of Anesthesiologists and a member of the Oklahoma Society of Anesthesiologists, British Veterinary Association, Conference of Research Workers in Animal Diseases, Mississippi VMA, American Academy of Pharmacology and Toxicology, and Society of Quality Assurance.
In 1973, he was a co-recipient of the Oklahoma Society of Professional Engineers' Outstanding Engineering Achievement Award for the development of a fluidically controlled ventilator that could also be used for sterilization procedures in animals, and the society's Wonders of Engineering Award for the design of a fluidic controller for an external heart massage device. In 2016, Dr. Jones posthumously received the ACVAA Career Achievement Award (see IVECCS article, page 1241).
Dr. Jones is survived by his daughter and granddaughter. Memorials may be made to the Mississippi State University College of Veterinary Medicine, P.O. Box 6100, Mississippi State, MS 39762.
Gregor L. Morgan
Dr. Morgan (Massey ‘76), 64, Stillwater, Oklahoma, died Aug. 14, 2016. After earning his veterinary degree and a master's in reproductive physiology (1978), both from Massey University in New Zealand, he moved to Stillwater, where he completed a residency in theriogenology and earned his doctorate in reproductive physiology from Oklahoma State University. Dr. Morgan then began his more than 30-year teaching career at the university's Veterinary Medical Hospital, focusing on production medicine and theriogenology.
During his tenure, he also served 22 years as chief of the food animal medicine section. A diplomate of the American College of Theriogenologists, Dr. Morgan was known for his expertise in embryo transfer in horses and cattle. He was a member of the Society for Theriogenology, American Association of Bovine Practitioners, American Association of Equine Practitioners, and American Embryo Transfer Association.
Dr. Morgan is survived by his wife, Dr. Sandra Morgan (Oklahoma State ‘80), a retired toxicologist and instructor at Oklahoma State University; two sons; and three grandchildren. Memorials may be made to Parkinson's Foundation of Oklahoma, 720 W. Wilshire Blvd. #109, Oklahoma City, OK 73116, or OSU College of Veterinary Health Sciences Student Scholarships (with checks made payable to the OSU Foundation), Oklahoma State University Foundation, P.O. Box 1749, Stillwater, OK 74076, www.cvhs.okstate.edu/giving/veterinary-student-scholarships.
John A. Newman Sr.
Dr. Newman (Minnesota ‘61), 82, Peachtree City, Georgia, died Aug. 6, 2016. A small animal veterinarian, he owned Southview Animal Hospital in Inver Grove Heights, Minnesota, prior to retirement. Dr. Newman's wife, Esther; three daughters and a son; seven grandchildren; and six great-grandchildren survive him.
David D. Roberts
Dr. Roberts (Missouri ‘86), 54, Glencoe, Missouri, died May 12, 2016. A diplomate of the American Board of Veterinary Practitioners, he was the founder of Manchester West Veterinary Hospital, a small animal practice in Ellisville, Missouri. Early in his career, Dr. Roberts worked in Framingham, Massachusetts. He was a member of the Missouri and Greater St. Louis VMAs.
Dr. Roberts is survived by his wife, Sharon. Memorials toward the Crown Ridge Tiger Sanctuary may be made to The Scott Foundation, Attn: Donations Department, 1065 Executive Parkway, Creve Couer, MO 63141, www.crownridgetigers.com.
Glen P. Rouse
Dr. Rouse (Minnesota ‘72), 68, Sedalia, Colorado, died July 28, 2016. He co-owned Colorado Veterinary Specialists and Animal ER in Littleton, Colorado, with his wife, Dr. Peg Wykes (Colorado State ‘79), until 2012. During his career, Dr. Rouse developed a surgical procedure using pins and cement for spinal stabilization in small animals. Early on, Dr. Rouse worked at the Colorado State University Veterinary Teaching Hospital. In retirement, he farmed and bred Red Angus cattle. He was a member of the Colorado VMA and Denver Area VMS. Dr. Rouse is survived by his wife. Memorials may be made to the Colorado Animal Rescue Foundation, P.O. Box 189, Sedalia, CO 80135.