Veterinary licensing in US waters outside of state jurisdiction

As members of the AVMA Aquatic Veterinary Medical Committee, we would like to clarify components of the new AVMA policy “Veterinary Licensing in US Waters Outside State Jurisdiction,” which the AVMA Board of Directors approved during its April 2016 meeting.¹

Veterinarian involvement is a key factor in the health and welfare of aquatic animals raised in the United States and in waters outside of state jurisdiction. Throughout the United States, veterinarians are required for diagnosing diseases, prescribing drugs, issuing veterinary feed directives and international health certificates, and performing other duties required as a part of commercial aquaculture. The AVMA recognizes that uniform, standardized licensing of veterinarians for the practice of veterinary medicine in offshore waters is urgently needed, especially given recent federal regulations enabling the introduction of aquaculture production systems in these waters. For these reasons, the AVMA holds that state-licensed and federally accredited veterinarians must be used in aquaculture production settings in US waters that are outside of state jurisdiction.

The new policy approved by the AVMA BOD recommends the following criteria be used to identify veterinarians eligible to practice veterinary medicine in these waters:

• • The veterinarian is licensed and in good standing to practice veterinary medicine in any state in the United States.

• • The veterinarian holds a USDA Animal and Plant Health Inspection Service category II veterinary accreditation that includes completion of the USDA's aquatic animal health modules.

• • The veterinarian has a valid veterinarian-client-patient relationship with the facility where he or she is practicing veterinary medicine.

Furthermore, the AVMA recommends that USDA Veterinary Services be the lead agency for oversight of the health of commercially cultured aquatic animals in waters outside state jurisdiction.

It is the AVMA's opinion that use of veterinarians who are licensed and in good standing to practice veterinary medicine in at least 1 state and who hold category II veterinary accreditation (including completion of aquatic animal health modules) is essential for the prevention, control, and eradication of aquatic animal diseases in such commercial aquatic animal systems.

The Aquatic Veterinary Medical Committee also wishes to express its support for engagement between veterinarians and other aquatic animal health professionals, such as fish health inspectors and pathologists certified by the American Fisheries Society, to help advise and guide the commercial aquaculture industry on issues important to aquatic animal health and aquaculture. A collaborative spirit and partnership between veterinarians and nonveterinary professionals will serve to strengthen aquatic animal health in the United States and further expand aquaculture growth and trade.

Grace A. Karreman, vmd

Aquatic Life Sciences/Western Chemical/Syndel Labs

Nanaimo, BC, Canada

Larry Hanson, phd

Department of Basic Sciences

College of Veterinary Medicine

Mississippi State University

Mississippi State, Miss

Myron Kebus, dvm

Wisconsin Department of Agriculture

Madison, Wis

Gregory A. Lewbart, ms, vmd

Department of Clinical Sciences

College of Veterinary Medicine

North Carolina State University

Raleigh, NC

Thomas P. Loch, phd

Aquatic Animal Health Laboratory

Department of Pathobiology and Diagnostic Investigation

College of Veterinary Medicine

Michigan State University

East Lansing, Mich

A. David Scarfe, phd, dvm

World Aquatic Veterinary Medical Association

Bartlett, Ill

Prospective studies necessary to answer critical questions about neutering

Nearly 30 years ago, Dr. Leo Lieberman¹ challenged the veterinary profession to study the risks and benefits of neutering puppies and kittens at various ages. After reading recent studies^2,3 published on this topic, I believe our profession has not adequately answered this challenge. The short- and long-term risks and benefits associated with neutering dogs and cats should be critically evaluated. Studies need to consider diverse populations of dogs (eg, pet, shelter, working, and breeding animals) and multiple breeds with different risks for specific diseases (eg, cancer, orthopedic disorders, and behavioral issues), with similar studies evaluating unique issues for cats. Although retrospective studies provide clues, they are inherently deficient in regard to completeness of information and cannot control for some important variables, such as owner intent. Among the possible biases associated with retrospective studies, some animals may be neutered at an early age because owners already had information about the animal's risk for a specific disease and did not wish to perpetuate the disorder in future offspring. Additionally, we now recognize that there are not only breed-specific risks for certain cancers and other disorders, but also variations between certain genetic lines and countries, suggesting health outcomes are influenced by genetics, environment, diet, and other factors. Extrapolation of results from retrospective studies may not be appropriate for developing blanket clinical protocols. As veterinary medicine advances to consider personalized (ie, precision) medicine for companion animals, we need precise and accurate information on how to best advise our clients. The authors of various retrospective studies have given us important clues, but we should now design and conduct prospective studies to answer critical questions. We can no longer accept a one-size-fits-all approach when determining the ideal age to neuter dogs and cats. The Morris Animal Foundation is conducting a lifetime study of 3,000 Golden Retrievers that holds the potential to answer some of these questions for a popular breed with a relatively high incidence of cancer. The University of Washington is designing a longitudinal study that will include up to 10,000 mixed-breed dogs with the goal to study aging. Some of our nation's guide dog schools have valuable information on the risks and benefits of neutering genetically similar dogs at different ages. Likewise, shelters could gather follow-up information on animals neutered at their facilities. Hoffman et al⁴ conducted a retrospective study comparing causes of death among 40,000 neutered and sexually intact domestic dogs. These authors also called for future research to critically determine the physiologic consequences of neutering dogs that influence both cause of death and lifespan. While it might take substantial effort to answer these questions, it is important to obtain the best information possible for advancing the health and longevity of our companion animals. I hope we are not still trying to answer Dr. Lieberman's basic question in another 30 years.

Patricia N. Olson, dvm, PhD

Fort Collins, Colo

No evidence early neutering causes joint disorders in German Shepherd Dogs

I am writing to express my concern over the headline of a recent JAVMA News story,¹ “Early neutering triples risk of joint disorders in German Shepherd Dogs.” The headline implies that a cause-and-effect relationship was found, when in fact, no such conclusion can be drawn from the study in question.²

The study retrospectively examined the occurrence of joint disorders and cancers in sexually intact and neutered German Shepherd Dogs examined at the University of California-Davis. However, because the decision to neuter the dogs was not made randomly, the study would have been subject to selection bias between the examined groups. For example, breeders often require that dogs with less-than-ideal conformation be neutered, and veterinarians may be more likely to recommend neutering of dogs if the parents had not been screened for genetic disease. As a result, orthopedic disease may have occurred more frequently in the neutered group.

Likewise, differences in usage between groups could have caused differences in the rate of orthopedic disease. Of the 1,170 cases examined, 705 were male, of which 245 were neutered and 460 were sexually intact. The high number of sexually intact male dogs leaves open the possibility that a large number of dogs used in military or police work were included in the study. If so, then the higher number of physically fit, genetically screened dogs in the sexually intact group would also have likely affected the results.

Ralph D. Pratt, dvm

West Greenwich, RI