JAVMA News

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IN SHORT

AVMA PROVIDES RESOURCE ON AFRICAN SWINE FEVER

African swine fever has been reported in seven of the top 10 pork-producing countries, and U.S. pork producers, swine veterinarians, and government officials are working hard to keep it out of the United States through surveillance and prevention efforts.

ASF is a severe viral disease affecting domestic and wild pigs. It kills about 90% of affected pigs and is highly contagious. Outbreaks have occurred mostly in Asia and Eastern Europe. There is no treatment or vaccine for the disease, so prevention is key to protecting pigs from it.

A new online resource from the AVMA is aimed at small animal and mixed-animal veterinarians, who also can play a role in preventing ASF from coming to the U.S. The African swine fever page on avma.org does the following:

  • • Helps veterinary team members communicate with clients about African swine fever.

  • • Provides reporting information and prevention guidelines.

  • • Outlines biosecurity measures related to travel and animal importation.

  • • Outlines the roles of companion animal and mixed-animal veterinarians in preventing the spread of the disease.

The page is available at jav.ma/AVMAandASF.

AVMA OFFERS RESOURCES FOR PET DENTAL HEALTH MONTH

The AVMA has developed a variety of resources for National Pet Dental Health Month in February that also are available year-round to promote dental health in cats and dogs.

Resources for pet owners are at avma.org/petdental. The materials consist of an overview of pet dental health, a video on periodontal disease, a quiz on pet dental health, a page about anesthesia, and a video on toothbrushing.

Also at avma.org/petdental is a link to a veterinary toolkit on pet dental health, available only to AVMA members. The toolkit starts with clinic materials and tools such as a flyer, handout, and brochure. Publicity and marketing tools are under the headings of “Stress-Free Ways to Celebrate in Your Clinic,” “Promotion and Marketing Ideas,” “Publicity Tools,” and “Talking Points for Media Interviews.”

Content for social media and websites includes posts for Facebook and Twitter as well as images to share on social media such as Facebook, Instagram, and Pinterest. The veterinary toolkit also provides links to content from Partners for Healthy Pets for Facebook, Twitter, and websites.

WSAVA CERTIFICATE PROGRAM FOCUSES ON COMPANION ANIMALS IN ONE HEALTH

The One Health Committee of the World Small Animal Veterinary Association has launched a free certificate program focusing on the role of companion animals in one health.

While the general one-health concept is well understood in relation to the interactions between production animals, wildlife, the environment, and humans, the WSAVA believes that the growing significance of the bond between humans and companion animals in one health is not yet fully appreciated.

The 20 modules in the certificate program cover all aspects of one health as it relates to companion animals. The American Association of Veterinary State Boards’ Registry of Approved Continuing Education has certified the modules for CE credits.

The Colorado State University Center for Companion Animal Studies is collaborating on the certificate program. The modules available at press time in late December covered the one-health concept, zoonoses, domestic violence, comparative aging, and leptospirosis.

The certificate program is online at jav.ma/onehealth.

Once more around the track

Racetrack-led coalition created to address horse racing deaths, safety concerns

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The Breeders’ Cup Classic in 2018 (Courtesy of Churchill Downs)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

By Kaitlyn Mattson

A cluster of horse racing deaths in 2019 has led to increased calls for safety-related reforms and standardization in the industry.

Conversations among racetrack organizations, horse owners, the public, and equine veterinarians across the U.S. led to the creation of the Thoroughbred Safety Coalition as well as other efforts such as the Horse Integrity Act introduced in Congress.

The coalition comprises six racetrack organizations: The Breeders’ Cup, Churchill Downs, the Del Mar Thoroughbred Club, Keeneland, the New York Racing Association, and The Stronach Group. The TSC, which launched Nov. 19, 2019, aims to make operational, medical, and organizational changes to the racing industry.

“As doctors of veterinary medicine, the AAEP (American Association of Equine Practitioners) commends the Thoroughbred Safety Coalition for its wide-ranging initiatives to ensure the safety of the sport's equine and human athletes,” said 2019 AAEP President Dr. Jeff Berk in a statement. “Everyone in the horse racing industry shares responsibility for safety, from veterinarians and trainers to breeders, owners, racetracks and state regulators. The focused and collaborative effort of the coalition promises meaningful safety reforms in the years ahead.”

The AVMA endorses the AAEP policy on therapeutic medications in racehorses, which includes a recommendation that all racing jurisdictions adopt the uniform medication guidelines set forth by the Racing and Medication Testing Consortium Inc. The AVMA and AAEP work closely on horse racing and other issues. The full policy can be found at jav.ma/horseracing.

The coalition has proposed some of the following reforms:

  • • Increase the withdrawal time for nonsteroidal anti-inflammatory drugs to 48 hours before a race.

  • • Prohibit concurrent use of multiple NSAIDs.

  • • Mandate direct daily reporting by veterinarians to regulatory officials.

  • • Perform random, out-of-competition testing on horses without limitation.

  • • Create an electronic veterinary reporting system and a centralized database.

  • • Collect racing surface data, and merge information with existing databases.

Dr. William Farmer, equine medical director of Churchill Downs, said the creation of the coalition is a big milestone.

“Track management and track owners are coming together to help push this through, which is something very different,” he said. “Traditionally, it has been regulators trying to push medication reform, not the tracks themselves.”

Dr. Farmer, who is also a racetrack veterinarian, worked with the coalition on its medical reforms while he was under contract with the Breeders’ Cup.

THIS SEASON

Dr. Stuart E. Brown II, a partner at Hagyard Equine Medical Institute in Lexington, Kentucky, said there has always been an emphasis on the need to control the atmosphere on the racetrack for the safety of horses and riders.

“A lot of effort goes into making sure, especially from an integrity standpoint, that we make the sport as safe as possible,” he said. “We never want to take a horse death lightly.”

According to data from the Equine Injury Registry, which is maintained by the Jockey Club, the number of fatalities per 1,000 starts has decreased in the last 10 years (see chart, next page). But despite the overall decrease, the recent cluster of injuries has led to questions about safety.

The Equine Injury Registry isn't expected to release official numbers on fatalities per starts for 2019 until this spring. According to media reports, however, there were more than 400 racing-related deaths of horses across the U.S. in 2019.

Specifically, Santa Anita Park in Arcadia, California, saw 40 deaths, including one during the Breeders’ Cup Classic. The majority of the fatalities at Santa Anita, a track operated by The Stronach Group, have been attributed to the weather in California. The state received an abnormally large amount of rain in early 2019.

In December, Santa Anita installed a positron emission tomography scanner to support diagnosis of preexisting conditions in horses that could contribute to breakdowns. It is the first to be installed in a horse racing facility.

An official report from the California Horse Racing Board about the deaths at Santa Anita had yet to be released at press time in late December.

RACING HISTORY

Dr. Farmer said the industry is united in its goal to make the sport safer, more open, and more transparent.

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The Thoroughbred Safety Coalition is proposing a three-tier plan to reform the horse racing industry. (Courtesy of the Thoroughbred Safety Coalition)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

“We have made a lot of changes, we still have a lot to make, and we are actively making them, in all tenses of the word—past, present, and future,” he said.

Horse racing dates back as far as 1665 in the U.S. and Canada, said Dr. Kathleen Anderson, AAEP past president. Historically, horse racing was seen as a local or state event, but it evolved into a national and international sport as transportation improved. Technology, more recently, has also changed the way the public can interact with the sport.

“In an age where the individual matters, horse racing injuries have found increased scrutiny from a populace that sees the sport through a different lens,” Dr. Anderson said. “To address this, the racing industry has sought to improve the oversight of the sport. The implemented policies vary from state to state and from track to track, thus the conundrum we face with how to achieve uniformity of regulation and safety within the budgets of a wide spectrum of racing venues and racing ownership.”

An earlier effort for self-regulation within horse racing came in 2013 from the Racing Medication and Testing Consortium, the industry's scientific advisory organization, and the Association of Racing Commissioners International, the association of state racing regulators, which develops model rules it encourages its members to adopt. The hope was for pari-mutuel regulators for the 38 U.S. horse racing commissions to adopt these uniform national reforms involving medication regulation and enforcement. Now known as the National Uniform Medication Progress, it introduced a controlled therapeutic medication list, the Multiple Medication Violations Penalty System, restrictions on the use and administration of furosemide, and the RMTC code of laboratory accreditation and minimum standards. Adoption by states hasn't been consistent. A map showing the states that have adopted the four facets of the NUMP can be found at jav.ma/NUMP.

Race-day administration of medications is a key topic in horse racing safety conversations. Furosemide is the only medication that can be given on race day and is used to treat exercise-induced pulmonary hemorrhage. Although furosemide is widely used in the U.S., most countries have prohibited its use on race day because of its role as a potential performance enhancer.

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Statistics by age and year from the Equine Injury Database (Courtesy of the Jockey Club)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

REFORMS AND REGULATIONS

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Dr. Kathleen Anderson, past president of the American Association for Equine Practitioners, during a press conference announcing the Thoroughbred Safety Coalition (Courtesy of Keeneland)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Meanwhile, others in and out of the horse racing industry have proposed their preferred changes to the sport.

The Horseracing Integrity Act (HR 1754) was introduced in the 116th Congress. The legislation would establish the Horseracing Anti-Doping and Medication Control Authority as an independent, private, nonprofit organization that would develop and administer a program for Thoroughbred, Standardbred, and Quarter Horse racing. The Federal Trade Commission would have oversight. Similar bills have been introduced in previous Congresses over the past decade, but none have passed.

The Jockey Club, the Coalition for Horse Racing Integrity, and others have come out in support of this most recent iteration of the bill.

“The Jockey Club believes that horses should race only when free from the effects of medication, and the Horseracing Integrity Act would achieve that goal,” said Shannon Luce, the director of communications at The Jockey Club. “We can significantly improve equine health and reduce fatalities, but to do so, we need one set of anti-doping and medication rules across the country, a system that the Horseracing Integrity Act will create.”

Another recent effort is the 2019 Mid-Atlantic Strategic Plan to Reduce Equine Fatalities. It is the result of a collaboration among racing jurisdiction stakeholders in the mid-Atlantic region. They have produced a strategic plan with five defined goals that could serve as a template for other jurisdictions going forward. The goals include developing regional safety best practices, increasing awareness and understanding of conditions associated with injury, and developing improved methods to identify horses at increased risk of injury.

States have also started making their own reforms.

The Kentucky Horse Racing Commission and racetracks in the state adopted new medication rules in December intended to reduce the use of pre-race medication. The plan would also eliminate race-day use of furosemide in 2-year-old horses. As of late December, Kentucky Gov. Andy Beshear had not approved the proposal.

The California Horse Racing Board also approved a series of reforms to be presented to Gov. Gavin Newsom in December.

Dr. Gregory Ferraro, the new CHRB chairman, said in a board meeting in November that there will be changes under his leadership.

“The days of permissive medication are over,” he said during the meeting. “We will gradually eliminate medications and keep them away from racing and training.”

Dr. Anderson said that the loss of any horse in competition is of great concern to the racing industry and equine veterinarians.

“The visionary goal is zero catastrophic injuries, hence the reforms that move us closer to the goal. Both the Thoroughbred Safety Coalition and the Horseracing Integrity Act are tackling this from different camps but using the same bottom line: Uniformity is paramount. It is the key to national safety and the general welfare of the horses.”

African, US veterinarians have meeting of minds

Twinning program brings small animal veterinarians together for shared learning

By Malinda Larkin

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Dr. Olatunji Nasir, medical director and CEO of Truthmiles Animal Hospital Ltd. in Ikeja, Nigeria, is his country's ambassador for the African Small Companion Animal Network. Nigeria only has 9,000 veterinarians in a country with 190 million people. (Courtesy of Dr. Nasir)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Dr. Olatunji Nasir is an ambitious man. He dreams of having veterinary clinics in all the major cities in his country in the next five years—all with the same standard of care. He is CEO and medical director of Truthmiles Animal Hospitals Ltd. in Ikeja, Nigeria, which has two locations. He's been successful at tapping into the burgeoning dog ownership in southern Nigeria.

In the past, owners preferred dogs such as pit bull–type dogs, Mastiffs, and Doberman Pinschers, mostly for security purposes. But he's begun to see more small dogs in recent years.

“This has to do with millennials. More younger people are owning pets,” he said. “These owners spend more, too. The older folks say, ‘I don't even do this for my kids.'”

To help further elevate his practice, Dr. Nasir is taking part in a pilot clinic-to-clinic twinning program that connects select companion animal veterinary clinics in member countries of the African Small Companion Animal Network with clinics in the U.S. led by AVMA members. The program, coordinated by the World Small Animal Veterinary Association Foundation, began in 2018 with funding from Zoetis, thanks to Dr. Eileen Ball, the company's global associate medical director for commercial development and life cycle innovation.

Dr. Nasir and two other veterinarians from Nigeria, Drs. Abubakar Bala Muhammad and Kunle Abiade, have partnered with three practitioners from Caring Hands Animal Hospital Inc., which has eight clinics in Virginia.

“What is happening in the U.S. is light years ahead. You look at the possibilities, and we're limiting ourselves (in Nigeria). But the clients are not as rich where I am. People spend more on their pets in the U.S., but it's still possible to raise the standard of care in practice,” said Dr. Nasir, who is the ambassador for AFSCAN in Nigeria. “It has brought hope to me to do better.”

MAKING CONNECTIONS

Dr. Kevin Stevens, who owns Ballito Animal Hospital on the east coast of South Africa, is coordinator of the pilot AVMA-AFSCAN Twinning Project and an AFSCAN board member. He said the project seeks to promote sustained relationships and mutual learning that will help veterinary professionals better understand one another's perspectives, challenges, and needs and enhance companion animal health and welfare and understanding of disease surveillance and control.

He and a working group composed of representatives from each of the sponsoring organizations manage the pilot program, which in its first year also includes veterinarians at the nonprofit DoveLewis Emergency Animal Hospital in Portland, Oregon. DoveLewis veterinarians are partnering with a group of veterinarians from Kenya, Namibia, and South Africa.

The goal is for twinned practices to do virtual grand rounds monthly and connect informally between scheduled rounds to talk about anything practice related, be it business management or general case management questions, for example. Going forward, U.S. and AFSCAN veterinarians at all of the twinned clinics in the pilot program, plus Dr. Stevens and other members of the program management team, plan to come together four times a year to hold virtual grand rounds. Dr. Nasir even had a chance to meet his U.S. counterparts last year face-to-face at the AVMA Convention in Washington, D.C. The pilot program management group hopes to facilitate a first face-to-face meeting of all AFSCAN and AVMA member practitioners at AVMA Convention 2020 in San Diego.

The AVMA-AFSCAN Twinning Project not only helps make global connections and promotes the one-health concept but also develops a network among the African clinics to connect and share practical advice. This network helps enhance the clinics’ business practices and the veterinary profession overall in AFSCAN member countries.

“We're starting to build by country to country and encourage individuals to engage with each other,” Dr. Stevens said, adding that two practices in Zambia have started twinning with two clinics in the U.K. in a second pilot program being administered in partnership with the British Small Animal Veterinary Association.

Communication usually happens via GoToMeeting, WhatsApp, email, and DropBox, working around different time zones and schedules. Occasionally, issues crop up because of internet and electricity outages, which aren't uncommon for parts of Africa.

Veterinary medicine varies widely from one AFSCAN member country to another—or even from city to city. In Nigeria and Kenya, practices may have first-class medicine and all the equipment a typical U.S. practice may have, Dr. Steven said. But in countries such as Zambia, Namibia, Ghana, and Mozambique, clinicians might not even have a microscope. They also likely have to send blood to laboratories in South Africa and wait days for the results. Dr. Stevens, in South Africa, has a video endoscope and digital X-ray machine, but practices just miles away hardly have any equipment, let alone the latest technology.

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Dr. Shana O'Marra (left), chief medical officer at DoveLewis, demonstrates a thoracic-focused assessment with sonography for trauma. She says the twinning project is a great fit for the nonprofit, which offers online training videos and other content that is starting to gain greater international attention. “This is in line with what we're trying to do with raising the standard of medicine throughout the world, not just locally,” she said. (Courtesy of DoveLewis)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

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Dr. Ladan Mohammad-Zadeh (left), a critical care specialist and intern director at the nonprofit DoveLewis Emergency Animal Hospital in Portland, Oregon, is one of the participants in the AVMA–African Small Companion Animal Network Twinning Project. She is partnering with Drs. Derick Chibeu of Sercombe Veterinary Surgeons in Kenya; Alexandra Marko of Rhino Park Veterinary Clinic in Namibia; Adriaan Adank, previously at Windhoek Veterinary Clinic in Namibia; Susan Mbugua of St. Austins Veterinary Clinic in Kenya; and Lilyan Mathai at the University of Nairobi Faculty of Veterinary Medicine in Kenya. (Courtesy of DoveLewis)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

“You have to respect the different levels of practice,” Dr. Stevens said.

A UNIVERSAL EXPERIENCE

Dr. Shana O'Marra, chief medical officer at DoveLewis, recalls one of the first cases she presented to her twinning partners. It involved a CT scanner, which the African veterinarians didn't have in their clinics, forcing her to take a step back.

“It's a good mental exercise to think about a case without the tools we normally rely on, like an ultrasound that is immediately available to us on the ER (emergency room) floor,” Dr. O'Marra said. “The biggest lesson I've learned is focusing on the core of veterinary practice and not relying on the bells and whistles, when most of the information we can get through pretty low-tech means,” such as a comprehensive physical examination and repeated assessments.

She enjoys being exposed to different infectious disease processes or discussing how to approach an unknown toxicosis. In particular, Dr. O'Marra is impressed at how skilled her African counterparts are at blood film evaluation. The discussions are a way for everyone to step outside their local pattern recognition and talk about the basics of medicine in a clinically applicable way.

“It's not as if the American veterinarians have a leg up on the African vets. It's very much a meeting of the minds,” Dr. O'Marra said.

She quickly noticed similarities when she brought up professional wellness and how to foster that in a hospital setting. The African practitioners said they shared many of the same struggles, from difficulties in setting personal boundaries to burnout.

“It was really interesting to hear from them that it's all universal,” Dr. O'Marra said. “It's not all about workplaces, because they are so different. We are veterinary providers, and we all have the same tendency to give of ourselves till we're depleted.”

Her goal is to meet with her counterparts at the AVMA Convention and host them at DoveLewis as soon as this year.

ONE-ON-ONE TIME

At AVMA Convention 2019 this past July in Washington, D.C., Drs Stevens and Nasir met with Dr. Beth Sabin, AVMA director of global outreach, and others on the pilot program management team to discuss how to measure the success of the AVMA-AFSCAN Twinning Pilot Program and how to proceed as it moves into its second year. In addition, Drs. Nasir and Stevens met with Drs. Brian Neumann, Jeff Newman, and Karen Murphy, the lead twinning program veterinarians at Caring Hands. They also had a chance to attend continuing education sessions. Zoetis and AFSCAN paid for the travel expenses, and the AVMA covered convention registration for Drs. Nasir and Stevens.

“The big challenge nowadays is it's a virtual world. It can bring a global veterinary perspective in vet practice,” Dr. Stevens said. “But to meet people face-to-face makes a huge difference. To participate in a procedure and see it yourself in practice is totally different from the virtual world. We're trying to do relationship building to where it becomes a face-to-face relationship, and there is interaction. It makes the experience that much more real.”

Dr. Stevens hopes more participants can meet at AVMA Convention 2020 in August in San Diego. In the meantime, the twinning pilot program just kicked off its second year with a call for a limited number of additional U.S. clinics, led by AVMA member veterinarians, to twin with three practices in Tanzania.

The pilot program, as approved by the AVMA Board of Directors, will run at least through December 2021, with potential to continue two more years.

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Dr. Nasir's clinic is one of a few small animal practices participating in the AVMA-AFSCAN Twinning Program. Here, Dr. Nasir (center) is performing an eye enucleation. (Courtesy of Dr. Nasir)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

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Dr. Nasir (left) looks on as his “twin,” Dr. Brian Neumann (right), medical director of Caring Hands Veterinary Clinic of Alexandria, Virginia, talks about a 3D model. In the back is Dr. Jeff Newman, co-owner of Caring Hands and president of Caring Hands Animal Support and Education, a nonprofit established by Caring Hands dedicated to increasing awareness of and providing support for animal welfare initiatives.

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

APPLICATIONS BEING ACCEPTED FOR TWINNING PROGRAM

As the AVMA–African Small Companion Animal Network Twinning Project enters its second year, it will expand to include more clinics, veterinarians, and animal health care team members. Clinics in the U.S. or AFSCAN member countries interested in participating in the twinning program can submit an online application form at avma.org/career/international.

Twinning program requirements and expectations for clinics are as follows:

  • • Be predominately or exclusively focused on companion animals.

  • • Identify one or two veterinarians who will be the point people for the twinning program and manage activities for that clinic.

  • • Develop goals for participating in the twinning program.

More information is available at avma.org/career/international.

The deadline for submission for a limited number of new clinics to join the pilot twinning program in its second year is April 1.

FDA WARNS COMPANIES ILLEGALLY SELLING CBD PRODUCTS

The Food and Drug Administration announced in November 2019 that the agency had issued warning letters to 15 companies for illegally selling cannabidiol-containing products in ways that violate federal law. Many of the products are intended for animals, particularly pets.

One product, sold by Apex Hemp Oil LLC, is intended for food-producing animals. The agency says it's concerned about the safety of human food products from animals that consume CBD, as there is a lack of data establishing safe CBD residue levels.

The FDA also published a revised consumer update that more broadly details safety concerns related to CBD products. Given the lack of scientific information supporting the safety of CBD in food, the FDA is also indicating that it cannot conclude that CBD is generally recognized as safe to use in human or animal food.

The actions come as the FDA continues to explore potential pathways for various types of CBD products to be lawfully marketed. This includes ongoing work to obtain and evaluate information to address outstanding questions related to the safety of CBD products, while maintaining the agency's rigorous public health standards.

“As we work quickly to further clarify our regulatory approach for products containing cannabis and cannabis-derived compounds like CBD, we'll continue to monitor the marketplace and take action as needed against companies that violate the law in ways that raise a variety of public health concerns,” said FDA Principal Deputy Commissioner Amy Abernethy, MD, in a statement.

“In line with our mission to protect the public, foster innovation, and promote consumer confidence, this overarching approach regarding CBD is the same as the FDA would take for any other substance that we regulate,” Dr. Abernethy explained.

The companies receiving warning letters are as follows:

  • • Apex Hemp Oil LLC of Redmond, Oregon.

  • • Bella Rose Labs of New York City.

  • • Daddy Burt LLC, doing business as Daddy Burt Hemp Co., of Lexington, Kentucky.

  • • Healthy Hemp Strategies LLC, doing business as Curapure, of Concord, California.

  • • Infinite Product Co. LLLP, doing business as Infinite CBD, of Lakewood, Colorado.

  • • Koi CBD LLC of Norwalk, California.

  • • Natural Native LLC of Norman, Oklahoma.

  • • Noli Oil of Southlake, Texas.

  • • Organix Industries Inc., doing business as Plant Organix, of San Bernardino, California.

  • • Pink Collections Inc. of Beverly Hills, California.

  • • Private I Salon LLC of Charlotte, North Carolina.

  • • Red Pill Medical Inc. of Phoenix.

  • • Sabai Ventures Ltd. of Los Angeles.

  • • Sunflora Inc. of Tampa, Florida/Your CBD Store of Bradenton, Florida.

  • • Whole Leaf Organics LLC of Sherman Oaks, California.

The FDA has previously sent warning letters to other companies illegally selling CBD products in interstate commerce that claimed to prevent, diagnose, mitigate, treat, or cure serious diseases, such as cancer, or otherwise violated the Food, Drug, and Cosmetic Act. Some of these products were in further violation because CBD was added to food, the agency explained, and some of the products were also marketed as dietary supplements even though products that contain CBD do not meet the definition of a dietary supplement under the Food, Drug, and Cosmetic Act.

According to the FDA, some of the products outlined in the more recent warning letters raise other legal and public health concerns. For instance, some of the products are marketed for infants and children, a vulnerable population that may be at greater risk for adverse reactions because of differences in the ability to absorb, metabolize, distribute, or excrete a substance such as CBD.

The agency has requested responses from the companies stating how the companies will correct the violations. Failure to correct the violations promptly may result in legal action, including product seizure or injunction, according to the FDA.

According to market research firm Packaged Facts’ 2019 Survey of Pet Owners, 11% of dog owners and 8% of cat owners have used cannabis supplements or treats for their pets.

PIG EARS STILL A SALMONELLA RISK DESPITE INTERVENTIONS

By Greg Cima

Pig ear treats remain a source of Salmonella after decades of illnesses.

The most recent outbreaks linked with pig ears ended in October 2019 after at least 154 illnesses with 35 people hospitalized. Companies recalled treats imported from Argentina, Brazil, and Columbia.

Pig ear treats have been linked with illness outbreaks since at least 1999, when epidemiologists said the products likely sickened at least 30 people in Canada. U.S. authorities blocked entry of the implicated products.

Through epidemiological investigations and product testing, Food and Drug Administration authorities since have expanded the list to include pig ear treats and similar products sold by 90 firms from 23 countries.

Dr. Colin Basler, who is a veterinary epidemiologist in the Foodborne Outbreak Response and Prevention Branch at the Centers for Disease Control and Prevention, said the CDC investigators who searched for the origins of the 2019 outbreak looked into where people buy pig ear treats, where they feed them to pets, and whether they wash their hands afterward. The results indicate more people should take precautions after handling the treats, he said.

“Some people might not realize that the things they feed their pets could be contaminated with Salmonella and that there are things they can do to reduce their risk of getting sick,” Dr. Basler said.

That includes storing human food away from all pet food, not just treats, Dr. Basler said. He noted that 50 people reported illnesses during a 2012 Salmonella enterica serotype Infantis outbreak linked with dry dog food produced at a plant in South Carolina, for example.

Pet food companies made changes to reduce Salmonella contamination since that outbreak, he said. But he has seen recent illnesses connected with raw pet foods contaminated with Salmonella, Escherichia coli, Campylobacter, and Listeria.

“We have had two major outbreaks last year that were associated with raw turkey and raw chicken products, and both of those outbreaks had subclusters of cases that had gotten sick from handling raw pet food products that had the outbreak strain in those raw pet food products,” he said.

During the 2019 outbreak, some stores sold each pig ear treat in its own packaging. Others sold them in bins, with new ones added to old, Dr. Basler said.

“Salmonella can stick around in the environment for quite some time,” he said. “Being able to trace back for those bulk bin purchases was a bit more difficult because, if a store was getting pig ears from different sources, it was harder to identify how that bin may have been contaminated or even when that bin may have been contaminated with Salmonella.”

Tim Schell, PhD, director of the FDA Center for Veterinary Medicine Office of Surveillance and Compliance, said Salmonella contamination is possible in any slaughter facility. Pet treat makers likely reduced illnesses when they began irradiating pig ear treats following the 1999 outbreak in Canada, and CVM inspectors have seen little contamination in their monitoring since.

In the most recent outbreak, the contaminated products found in the U.S. indicate at least some companies making pig ear treats lacked sufficient pathogen controls, Dr. Schell said. FDA representatives reminded pig ear treat makers that they are responsible for the safety of their products, and agency officials are considering follow-up inspections to check pathogen controls.

An agency announcement indicated investigators found seven Salmonella serotypes, some resistant to multiple antimicrobials.

Dr. Schell said the 2019 outbreak shows the connections between pet food safety, pet health, and human health and the need to control pathogens in pet foods.

In the June 1, 2011, issue of JAVMA, a scientific article on Salmonella contamination in pet foods, treats, and nutritional products indicates U.S. and Canadian pet owners bought more than 200 million pig ears each year despite reports that identified contamination with Salmonella (J Am Vet Med Assoc 2011;238:1430–1434).

DRUG-RESISTANT BACTERIA HURT MORE PEOPLE THAN PREVIOUSLY REPORTED

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Extended-spectrum beta-lactamase-producing Enterobacteriaceae

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

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Methicillin-resistant Staphylococcus aureus (Images courtesy of CDC)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Antimicrobial-resistant bacteria sicken more people than previously known, although improved infection controls are reducing deaths.

Officials with the Centers for Disease Control and Prevention reported in November 2019 that people in the U.S. acquire about 2.9 million drug-resistant infections each year, killing about 36,000 of them. People in hospitals face higher risk, although infection prevention programs have reduced the number of hospital-acquired antimicrobial-resistant infections by 27% from 2012–17.

“Nonetheless, without continued action and vigilance these gains will only be temporary,” the report states.

The report, “Antibiotic Resistance Threats in the United States 2019,” follows up on a 2013 report that indicated antimicrobial-resistant infections then sickened more than 2 million people each year and killed at least 23,000. Using methods revised for the 2019 edition, CDC officials estimate the true burden at the time of the 2013 report was closer to 2.6 million drug-resistant infections and 44,000 deaths.

Those revised numbers indicate drug-resistant infections have risen even though the number of deaths has declined.

“Antibiotic resistance can affect any person, at any stage of life,” the report states.

The report describes the dangers and effects of the most deadly drug-resistant pathogens. Methicillin-resistant Staphylococcus aureus killed an estimated 10,600 people in 2017, extended-spectrum beta-lactamase–producing Enterobacteriaceae killed 9,100, vancomycin-resistant enterococci killed 5,400, drug-resistant Streptococcus pneumoniae killed 3,600, and multidrug-resistant Pseudomonas aeruginosa killed 2,700.

The report also notes that, in addition to the 36,000 deaths from drug-resistant infections, about 12,800 people died in 2017 from Clostridioides difficile infections. C difficile infections tend to occur among people during or after antimicrobial treatments, which can wipe out microbes that protect against infections.

The report indicates 84% of U.S. hospitals use antimicrobial stewardship programs that meet CDC guidance on such programs. Antimicrobial prescribing in outpatient settings also declined 5% from 2011–16, and outpatient prescribing for children declined 16% from 2011–17, the report states.

The report authors urge use of public health interventions such as improving hygiene, increasing vaccination rates, adding biosecurity on farms, and improving responses to contain germs with unusual genes.

The authors also said veterinarians can help reduce selection pressure for drug resistance by preventing disease and improving antimicrobial use. The recommended interventions include improving vaccination rates, using proper animal husbandry and biosecurity, washing hands, disinfecting equipment, maintaining records of treatments and outcomes, using diagnostic tests to assess antimicrobial needs, following prescribing guidance and standards, disposing of unused or expired drugs, and committing to drug stewardship.

DOG OWNERSHIP AND VETERINARY VISITS BY INCOME BRACKET

Analysis by the AVMA Veterinary Economics Division

WHAT?

The chart below draws on results of the 2017 Pet Demographic Survey performed by the AVMA and shows the following:

  • • Share of dog-owning households by annual income category.

  • • Percentage of dog-owning households that don't take their dog to a veterinarian at least once a year, by annual income.

  • • Percentage of dog owners who said price or affordability was the main reason why they didn't take their dog to a veterinarian, by annual income.

SO WHAT?

There are several takeaways from this chart:

  • • The largest share of dog-owning households, about 25%, fall in the $60,000-$99,000 income category. The smallest share of dog-owning households, at about 13%, is in the lowest income category of less than $20,000.

  • • According to the 2017 Pet Demographic Survey, 18% of dog owners overall say they don't see a veterinarian once a year. However, this chart reveals a lot of variation by income category. Over 30% of dog owners in the lowest income category reported not seeing a veterinarian once a year. This percentage declines moving up the income ladder, with only 7% of dog owners in the highest income category of $100,000 or more reporting not seeing a veterinarian at least once a year.

  • • Similarly, an income trend is apparent for price or affordability being the primary reason not to go to a veterinarian, with nearly 45% of respondents in the lowest income category stating that price or affordability is the primary reason they don't see a veterinarian at least once a year. This percentage falls over the income ladder to 17% of respondents in the highest income category reporting that price or affordability was the primary reason for not seeing a veterinarian.

NOW WHAT?

Several actionable insights come from the chart:

  • • With more than half of dog-owning households having an annual income of less than $59,000, addressing the needs of these dog owners is critical to the success of the veterinary profession and to the ability to deliver the best possible veterinary care to all animals.

  • • A potential approach for expanding access to care is by creating models of veterinary medicine that support a spectrum of care, delivering care at levels other than just the gold standard.

  • • Business models and financial instruments such as pet health insurance, short- and long-term loans, wellness plans, and other tools that smooth spending for veterinary care for pet owners may help incentivize more interactions with dog owners and more frequent treatment of pets by veterinarians for households facing tough economic times.

USDA AWARDS $2.9M IN 2019 TO SUPPORT RURAL VETERINARY SERVICES

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Flyin’ 3 Veterinary Service Inc. in Eureka, Kansas, was hit by a tornado in June 2018. A grant through the Veterinary Services Grant Program will allow the practice to purchase equipment while finishing renovations. The photo at left shows the cattle pens after the tornado destroyed the barn over them. The photo at right shows the practice in December 2019. (Photos courtesy of Dr. Kailey Fitzmorris)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

The Department of Agriculture's National Institute of Food and Agriculture announced in December 2019 that it had awarded 16 grants totaling $2.9 million to support rural veterinary services and relieve shortages of veterinarians in parts of the United States.

Among the recipients, Flyin’ 3 Veterinary Service Inc. in Eureka, Kansas, received a grant to purchase equipment. The practice serves counties in the heart of beef country, said Dr. Kailey Fitzmorris, who owns the practice. She said the grant couldn't have come at a more perfect time.

“We were hit by a tornado in June of 2018, one year after I had purchased the practice,” Dr. Fitzmorris said. “We are currently adding on and rebuilding the practice, so we are reinvesting the clinic income into renovations instead of equipment. The grant has given us the ability to get some much-needed equipment that we would not have been able to get for quite a while.”

The practice will use the grant money to purchase an in-house cattle chute, a portable cattle chute, a practice vehicle with a veterinary box, updated computer software, and blood analysis machines.

The Veterinary Services Grant Program supports two funding categories. Education, Extension, and Training projects are open to universities and state, national, or regional organizations. Rural Practice Enhancement projects are open to for-profit or nonprofit organizations and practices that aim to provide veterinary clinical services in rural areas designated as having a shortage of veterinarians—for example, shortage area CO197 in northeastern Colorado.

The grants are as follows:

EDUCATION, EXTENSION, AND TRAINING

  • • University of Illinois, $236,750, “A multi-audience online educational program for rural practitioners and veterinary students entering rural veterinary practice.”

  • • Iowa State University, $236,750, “Telehealth for swine medicine: Tools to support shortage situations, expand surge capacity, and teach students with less biosecurity risk.”

  • • Kansas State University, $111,000, “Summer program for aspiring rural Kansas (SPARK) veterinarians.”

  • • University of Kentucky, $236,750, “Advanced diagnostic training for food animal veterinarians and veterinary technicians.”

  • • University of Missouri, $236,750, “Veterinary education and training in beef cattle reproduction and genomics.”

  • • Oklahoma State University, $236,750, “Integrated beef cattle program for veterinarians to enhance practice management and services.”

  • • Lincoln Memorial University, $236,750, “Delivering a comprehensive food safety database to support early career veterinarians in rural, large animal practice as an Amazon Alexa skill.”

  • • Virginia Tech, $236,750, “Training the veterinary public practitioner.”

  • • Food Armor Foundation Inc., $236,750, “Food Armor veterinary student educational and outreach program: Building on-farm antimicrobial stewardship plans.”

RURAL PRACTICE ENHANCEMENT

  • • Cattleman's Resource Inc., Brush, Colorado, $125,000, “Expanding veterinary care for food and fiber animals in designated rural veterinary shortage region CO197.”

  • • Central Veterinary Clinic PC, Sioux Center, Iowa, $125,000, “Iowa 163—Central Veterinary Clinic mobile IVF unit.”

  • • Flyin’ 3 Veterinary Service Inc., Eureka, Kansas, $125,000, “This grant is to purchase veterinary equipment to allow for new and more complete services to be added to our under served community.”

  • • Solomon Valley Veterinary Hospital PA, Beloit, Kansas, $125,000, “KS196 rural practice enhancement—Solomon Valley Veterinary Hospital.”

  • • Betsy the Vet Inc., Hardin, Montana, $125,000, “Grant for equipment to expand service in MT166.”

  • • Stillwater Veterinary Clinic PC, Absarokee, Montana, $125,000, “Rural practice enhancement: Addressing veterinary shortage in south-central Montana (MT 176).”

  • • Clover Acres Livestock Veterinary Services LLC, Mount Holly, Vermont, $125,000, “Improving access to imaging diagnostics for farm animal veterinary patients in rural southern Vermont.”

CAMPYLOBACTER OUTBREAK LINKED WITH PET STORE DOGS

A Campylobacter outbreak linked with puppies and pet stores sickened at least dozens of people and hospitalized four in 2019.

At least 15 of those sickened had contact with Petland stores and five were Petland store employees, according to the Centers for Disease Control and Prevention. Since January 2019, CDC officials learned of 30 illnesses from the outbreak strain that were serious enough to warrant medical care and reporting.

The outbreak is the second connected with Petland stores since 2016. The C jejuni strains from both outbreaks appear to be closely related, according to CDC information published Dec. 17. The prior outbreak involved 113 reported illnesses with 23 people hospitalized, from January 2016 through January 2018.

Officials with the CDC and state public health agencies continued investigating the latest outbreak into December 2019. Investigation into the previous outbreak ended without identification of a common breeder or location where the puppies became infected.

SENATE DESIGNATES JANUARY ‘NATIONAL ONE HEALTH AWARENESS MONTH'

The U.S. Senate unanimously passed a bipartisan resolution on Dec. 19 proclaiming January 2020 as “National One Health Awareness Month” to promote collaboration among public, animal, and environmental health scientists.

“By using the ‘One Health’ approach, global health problems including antibiotic resistance and the spread of infectious diseases can be more easily addressed,” said California Democrat Sen. Dianne Feinstein, who co-sponsored the Senate resolution with Arizona Republican Sen. Martha McSally, in a Dec. 20 release.

“Our resolution will hopefully draw attention to the need for holistic approaches to addressing human health that take into account changes in environmental and animal health,” Feinstein continued. “With diminishing resources and a growing human population, fighting problems with a ‘One Health’ approach must be encouraged now more than ever.”

“The health of our population is dependent on the interconnection of people, animals, and the environment,” McSally said. “I was glad to join Senator Feinstein in introducing this resolution designating January as National One Health Awareness Month to promote ‘One Health’ and its growing collaboration in order to make our world a healthier place.”

Dr. Deborah Thomson is the 2019–20 AVMA Fellow working in Feinstein's office. Each day, she uses her clinical veterinary knowledge and one-health background while working on a range of federal policies, including animal welfare, public health, and environmental issues.

The text of the Senate resolution reads as follows:

Designating January 2020 as “National One Health Awareness Month” to promote awareness of organizations focused on public health, animal health, and environmental health collaboration throughout the United States and to recognize the critical contributions of those organizations to the future of the United States.

Whereas One Health is a collaborative, multisectoral, and transdisciplinary approach, working at the local, regional, national, and global levels, with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment;

Whereas the mission of One Health is to establish closer professional interactions, collaborations, and educational opportunities across the various medical, veterinary, and environmental health professions and their allied science professions to simultaneously improve public health, animal health, and environmental health;

Whereas the increasing threats posed by emerging diseases shared between animals and people, foodborne, vector-borne, and waterborne diseases, and other environmental factors may support the need for an integrated effort by professionals from multiple disciplines, including health, science, technology, and engineering;

Whereas, according to the Centers for Disease Control and Prevention, up to 75 percent of new or emerging infectious diseases in people are spread by animals;

Whereas, each year, International One Health Day is November 3; and

Whereas One Health is essential to combating and strengthening the surveillance of emerging and reemerging diseases: Now, therefore, be it

Resolved, That the Senate designates January 2020 as “National One Health Awareness Month” to:

  1. 1.promote awareness of organizations that focus on One Health efforts to improve the quality of life for people and animals;
  2. 2.recognize the efforts made by such organizations in using a One Health approach to prevent epidemics; and
  3. 3.recognize the importance of using the One Health approach to simultaneously protect the health of people, animals, plants, and the environment in the United States.

BIG THREAT

Ticks responsible for most U.S. vector-borne diseases

By R. Scott Nolen

Standing in a New England forest on a summer day, you wouldn't suspect you're surrounded by dozens—possibly hundreds—of ticks wanting to feed on you.

“Most people don't see ticks. If they did—if they saw how many are waiting on twigs and leaves and in the brush—they would never go outside again,” observed entomologist Thomas Mather, PhD, director of the Center for Vector-Borne Diseases at the University of Rhode Island.

Seven of the 17 vector-borne diseases reportable to the Centers for Disease Control and Prevention are tick-borne. Nine species of tick found throughout North American are known vectors for these pathogens. Of these, Ixodes scapularis, the blacklegged or deer tick, is the most medically important tick species. Not only is the blacklegged tick a vector for five of the six pathogens, but it is also the primary carrier of the bacterium Borrelia burgdorferi responsible for causing Lyme disease in humans as well as dogs, horses, and cats.

Dr. Mather was studying ticks before 1981, when Lyme disease was first identified as a tick-borne pathogen. Since then, he has seen the discovery of several new blacklegged tick diseases, including anaplasmosis, Powassan virus disease, and ehrlichiosis. And in that time, he has seen the tick's habitat in the Northeastern, mid-Atlantic, and upper Midwestern regions of the United States expand as a result of human activities.

“Ticks are in more places, and that's true for blacklegged ticks in particular,” said Dr. Mather, who oversees TickSpotters.org, an online, crowd-sourced tick survey.

CASE REPORTS

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Blacklegged ticks are widely distributed across the eastern United States and are vectors for Lyme disease, anaplasmosis, relapsing fever disease, ehrlichiosis, babesiosis, and Powassan virus disease. (Photos by James Gathany/CDC)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Among the estimated 50,000 human cases of vector-borne disease reportedly acquired in the U.S. each year, approximately 80% are associated with ticks, according to the CDC. Lyme disease is by far the most common of the tick-borne diseases and is among the fastest-growing infectious diseases in the United States with 33,666 cases reported in 2018, although the real number of cases is thought to be far higher.

Veterinarians are seeing more cases of Lyme disease, as well. According to the Companion Animal Parasite Council, the number of canine Lyme disease cases increased from 245,971 in 2015 to 336,200 in 2019. Increases in the numbers of other tick-borne diseases were also reported, including canine anaplasmosis, up from 117,203 in 2015 to 207,825 in 2019, and canine ehrlichiosis, up from 107,985 in 2015 to 186,075 in 2019.

“That's been the pattern for the last few decades, and we're seeing that trend in dogs as well as in people,” confirmed Dr. Susan Little, co-director of the National Center for Veterinary Parasitology at Oklahoma State University. “We've seen a dramatic increase in the number of cases, not just in Lyme disease but in human anaplasmosis, human ehrlichiosis, and Rocky Mountain spotted fever.

“It's almost an exponential increase in identified cases of infection and associated disease.”

In its 2018 Lyme Consensus Statement, the American College of Veterinary Internal Medicine states that most dogs exposed to Borrelia burgdorferi will develop subclinical infection. The small number of dogs that develop acute Lyme borreliosis may present with fever, shifting leg lameness, swollen joints, enlarged lymph nodes, lethargy, depression, and anorexia. Affected dogs typically recover following treatment with doxycycline.

While pet owners have the option of vaccinating dogs against Lyme disease, the six-member panel of ACVIM and European College of Veterinary Internal Medicine diplomates that authored the consensus statement were split on the issue. Duration of immunity, cost, and lack of controlled studies are some of the objections raised by three panelists.

The ACVIM found no evidence linking B burgdorferi with illness in cats.

With horses, it's more complicated. In a separate 2018 statement, the ACVIM emphasizes that a positive blood test result only indicates past or current exposure to the bacteria and not whether an animal will develop clinical signs of the disease. The tissues most commonly affected by B burgdorferi in horses include the nervous system, ocular tissues, and skin. Because many other diseases can cause clinical signs similar to those seen with Lyme disease, the ACVIM strongly recommends ruling out other diseases that could be responsible for a horse's clinical signs rather than relying on response to treatment to conclude that a horse has Lyme disease.

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The telltale bull's-eye rash, caused by the Borrelia burgdorferi bacterium from the bite of an infected blacklegged tick, does not appear in every human case of Lyme disease, making the disease difficult to diagnose in some cases.

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

SELECTED TICK-BORNE DISEASES REPORTED TO THE CDC IN 2016

Each dot represents one human case. Cases are reported from the infected person's county of residence, not necessarily the place where they were infected.

No cases of tickborne illness were reported from Hawaii in 2016; Alaska reported six travel-related cases of Lyme disease and one case of tularemia.

During 2016, babesiosis was reportable in Alabama, Arkansas, California, Connecticut, Delaware, Illinois, Indiana, Iowa, Louisiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wisconsin, and Wyoming.

Anaplasmosis and ehrlichiosis were not reportable in Colorado, Idaho, New Mexico, Alaska, and Hawaii in 2016.

Spotted fever rickettsiosis was not reportable in Alaska and Hawaii in 2016.

Horses are not to be treated for Lyme infection solely on the basis of a positive blood test result, the ACVIM advises, but if treatment is pursued, tetracycline and beta-lactam antimicrobials should be considered.

INSIDIOUS INFECTION

Prior to 1970, the blacklegged tick was not considered an important vector of human pathogens.

What changed?

Blacklegged ticks were restricted to the Northeast and upper Midwest following decades of deforestation to accommodate agriculture. Plus, excessive hunting and habitat loss nearly wiped out white-tailed deer, the primary host for the blacklegged tick.

Beginning in the second half of the 20th century, suburbia increasingly crept into forested portions of the Northeast. Moreover, farmland was reforested, and deer populations recovered. These factors, in conjunction with milder winters, earlier springs, and longer, warmer summers because of climate change mean blacklegged ticks are succeeding in new geographic areas.

“These are the factors we think are driving the expansion of the blacklegged tick as well as the expansion of Lyme disease and the other diseases that are carried by this tick,” said Ben Beard, PhD, deputy director of the CDC's Division of Vector-Borne Diseases. Dr. Beard is the CDC representative on the Tick-Borne Disease Working Group, an advisory committee that makes recommendations on ways the federal government can address this public health threat.

Dr. Beard said the CDC estimates the actual number of Lyme disease infections in people to be eight to 12 times the number reported each year. Lyme disease is notoriously difficult to diagnose. Apart from the bull's-eye rash, which may or may not be present and lasts for around a month if it is, clinical signs of Lyme disease are subtle and often misdiagnosed. Current tests for the disease are based on antibody response. Consequently, false negative findings are common in early infection.

Because of this, the CDC recommends that physicians in Lyme endemic areas don't wait for the test results to treat suspected cases of Lyme disease. “We encourage physicians not to wait for test results to start treating patients suspected of Lyme disease if the patient lives in or has traveled to an area where Lyme is common,” Dr. Beard said.

Last October, the advocacy group Center for Lyme Action launched to lobby Congress for additional federal funding to accelerate the development of new drugs and diagnostic tests for Lyme disease. That same month, the Senate Health Committee passed legislation introduced by U.S. Sens. Susan Collins of Maine and Tina Smith of Minnesota to improve research, prevention, diagnostic testing, and treatment for tick-borne diseases. The bill—the Kay Hagan Tick Act (S 1657)—is named in honor of the former U.S. senator from North

Carolina, who died Oct. 28, 2019, of complications from Powassan virus disease.

Although no vaccine for Lyme disease is currently available for humans, Dr. Beard said one is expected to enter into phase two clinical trials in the near future.

ONE HEALTH IN ACTION

Dr. Mather believes everyone should be better educated about ticks and able to identify the small number of tick species in the United States that threaten human health. “Different ticks carry different diseases in different parts of the country,” he explained.

Concerning the blacklegged tick, adult males and females are active October through May so long as the daytime temperature remains above freezing. Nymphs are active May through August and are most commonly found in moist leaf litter in wooded areas or at the edge of wooded areas. Both the nymph- and adult-stage blacklegged ticks can transmit infectious diseases.

Veterinarians play a part in preventing Lyme disease infections, according to

Dr. Little.

“I always encourage veterinary students to think about controlling ticks as a public health service,” she explained. “If you have a dog maintained on tick control, the ticks the dog encounters are killed, and they're not in the home or in the environment and able to transmit infection. It's a perfect example of one health.”

People

CONGRESSMAN TED YOHO TO RETIRE

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U.S. Rep. Ted Yoho speaks to the AVMA House of Delegates after receiving the AVMA Advocacy Award in 2019. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

U.S. Rep. Ted Yoho, a veterinarian who represents Florida's 3rd Congressional District, announced in December that he will not seek reelection.

The Republican was first elected in 2012 after he ran as a Tea Party member and vowed to change up the political machine. Florida's 3rd Congressional District encompasses Gainesville, Palatka, and other parts of northern Florida.

Dr. Yoho believes that being a veterinarian helped prepare him for his work in Congress, as previously reported by JAVMA News in 2019. Dr. Yoho owned and operated several large animal veterinary practices for 30 years before getting into politics.

His work in office includes co-founding and co-chairing the Veterinary Medicine Caucus with U.S. Rep. Kurt Schrader, a veterinarian and Democrat who represents Oregon's 5th Congressional District. The caucus has worked to highlight animal-related legislation. Dr. Yoho is also a member of the House Agriculture Committee.

“Since Congressman Yoho took office, he has been a tireless advocate for veterinary medicine,” said Dr. Kent McClure, AVMA chief government relations officer. “From championing legislation like the PAST (Prevent All Soring Tactics) Act and the Veterinary Medicine Loan Repayment Program Enhancement Act to meeting with veterinary students, Rep. Yoho has been incredibly generous with his time and support. The veterinary profession is immeasurably better off thanks to his work.”

In 2019, Dr. Yoho received the AVMA Advocacy Award for his work to advance veterinary-related legislation.

Dr. Yoho said in a statement about his retirement that he believes in term limits.

“I ran on a pledge to serve four terms—eight years and come home. Many told me I was naive and they're probably right. I was told the district has changed three times and so the pledge isn't binding and I could rationalize that. However, I truly believe a person's word is their bond and should live up to their word. I also meant that after eight years I would come home and pass the baton on to a new generation,” he said. “Now, I am doing that. My goal now is to serve the remainder of my term for the next year and do the best job I can for district three, the state of Florida and our great nation. It's time for a new representative to take over the helm guiding our nation into the future.”

Dr. Yoho's office could not be reached for comment at press time in mid-December.

Dr. Yoho has sponsored and co-sponsored several pieces of animal-related legislation over the last eight years, including the following:

  • • U.S. Senator Joseph D. Tydings Memorial Prevent All Soring Tactics Act of 2019 (HR 693).

  • • The Horseracing Integrity Act (HR 1754).

  • • Transporting Livestock Across America Safely Act (HR 487).

  • • Sustainable Shark Fisheries and Trade Act (HR 788).

  • • Shark Fin Sales Elimination Act of 2019 (HR 737).

“My goal was to leave this country a little better off for the next generation and to set a standard for the next congressman from this district,” Dr. Yoho said in the retirement statement. “Those results will be judged by history.”

VIRGINIA-MARYLAND NAMES NEW DEAN

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Dr. M. Daniel Givens will be the fifth dean of the Virginia-Maryland College of Veterinary Medicine. (Courtesy of Auburn University)

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

After a national search, the Virginia-Maryland College of Veterinary Medicine has named Dr. M. Daniel Givens as its new dean. He will take over the position in June.

Dr. Givens (Auburn ‘94) is currently the associate dean for academic affairs at the Auburn University College of Veterinary Medicine and a professor there in the Department of Pathobiology. He is also a diplomate of the American College of Veterinary Microbiologists and the American College of Theriogenologists.

Dr. Cyril Clarke, Virginia Tech executive vice president and provost, said in a press release that Dr. Givens is a respected researcher, clinician, and academic leader and his collaborative approach will advance Virginia Tech's strategic mission. Dr. Clarke was dean of the Virginia-Maryland veterinary college before he stepped into his new role.

Dr. Givens has received multiple teaching awards during his time at Auburn University since 2000, including the Carl J. Norden–Pfizer Distinguished Teacher Award and the Student AVMA Teacher of the Year.

Dr. Givens’ research into infectious diseases that affect reproduction in cattle has resulted in the publication of more than 85 peer-reviewed scientific manuscripts and also produced two international patents. He is also an AVMA Council on Education site visitor.

Dr. Givens will succeed Dr. Gregory B. Daniel, who has served as interim dean since 2017, when Dr. Clarke left the position. Dr. Daniel will return to his faculty position in the Department of Small Animal Clinical Sciences when Dr. Givens takes over as dean.

JOINT PATHOLOGY MEETING

EVENT

American College of Veterinary Pathologists, American Society for Veterinary Clinical Pathology, joint annual meetings, Nov. 9–13, 2019, San Antonio

AWARDS

Mid-Career Excellence in Diagnostics Award

Dr. Bente Flatland (Georgia ‘93), Knoxville, Tennessee. Dr. Flatland is an associate professor of clinical pathology and director of the Clinical Pathology Laboratory at the University of Tennessee College of Veterinary Medicine. She is a diplomate of the American College of Veterinary Internal Medicine.

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Dr. Bente Flatland

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Mid-Career Excellence in Education Award

Dr. Ana Alcaraz, Pomona, California. A 1987 veterinary graduate of the National Autonomous University of Mexico, Dr. Alcaraz is a professor of anatomic pathology at Western University of Health Sciences College of Veterinary Medicine.

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Dr. Ana Alcaraz

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Mid-Career Excellence in Research Award

Dr. Piper Treuting (Louisiana State ‘96), Seattle. Dr. Treuting is a professor in the Department of Comparative Medicine at the University of Washington. Her research interests include gastrointestinal diseases, comparative pathology, and the science of aging.

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Dr. Piper Treuting

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Harold W. Caseky Memorial Scholarship Award

Dr. Megan Caudill (Georgia ‘16), Gainesville, Florida. Dr. Caudill is an anatomic pathology resident at the University of Florida College of Veterinary Medicine.

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Dr. Megan Caudill

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

ACVP Honorary Membership

Drs. Anne Avery, Fort Collins, Colorado; and H.L. Shivaprasad, Davis, California

ACVP Distinguished Membership

Drs. K. Paige Carmichael, Athens, Georgia; Linda Lowenstine, Davis, California; N. James MacLachlan, Davis, California; and Paul Stromberg, Columbus, Ohio

ASVCP Lifetime Achievement Award

Dr. Karen Young (Pennsylvania ‘78), Madison, Wisconsin. Dr. Young is a professor of clinical pathology at the University of Wisconsin-Madison School of Veterinary Medicine. She also serves as chief of staff of diagnostic services at UW Veterinary Care and is co-administrator of UW Veterinary Care's clinical pathology laboratory.

ASVCP Educator Award

Dr. Darren Wood (Prince Edward ‘94), Guelph, Ontario. Dr. Wood is an associate professor and a veterinary clinical pathologist at the University of Guelph Ontario Veterinary College. During his tenure, he has mentored students and clinical pathology residents.

ASVCP Early Career Award

Dr. Mary Leissinger (Louisiana State ‘10), Gainesville, Florida. Dr. Leissinger is a clinical assistant professor of clinical pathology in the Department of Comparative, Diagnostic, and Population Medicine at the University of Florida College of Veterinary Medicine.

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Dr. Darren Wood

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

NEW DIPLOMATES

Veterinary anatomic pathology

Elizabeth Alloway, Raleigh, North Carolina

Rachel Andrews, Clemmons, North Carolina

Kendra Andrie, Fort Collins, Colorado

Hannah Atkins, Hummelstown, Pennsylvania

Jessica Bailey, Grove City, Ohio

Laura Bassel, Guelph, Ontario

Michael Betley, Wentzville, Missouri

Ethan Biswell, Rio Rancho, New Mexico

Liam Broughton-Neiswanger, Pullman, Washington

Timothy Carlson, St. Paul, Minnesota

Sebastian Carrasco, Newton, Massachusetts

Argine Cerezo, Manhattan, Kansas

Leslie Charles, Debary, Florida

Laura Chen, Seattle

Chia-Ching Chien, Columbus, Ohio

Chad Clancy, Hamilton, Montana

Sarah Cook, Davis, California

Emily Corbin, Silver Spring, Maryland

Sarah Cudd, Gaithersburg, Maryland

Jeffrey Curtiss, St. Petersburg, Florida

Martha Dalton, Jackson, Mississippi

Camila Botacini das Dores, Miami

Elena Demeter, Ithaca, New York

Stephen Drew, Dunfermline, Scotland

Gordon Ehrensing, Lansing, Michigan

Olufemi Fasina, Knoxville, Tennessee

Alycia Fratzke, Bryan, Texas

Molly Friedemann, Edina, Minnesota

Lindsay Fry, Pullman, Washington

Naomi Gades, Rio Verde, Arizona

Marina Godoy Gimeno, Brownlow Hill, Australia

Randi Gold, College Station, Texas

Alexander Gray, Glasgow, Scotland

Nathan Helgert, Knoxville, Tennessee

Tiffany Jenkins, Columbus, Ohio

Alwyn Jones, Galashiels, Scotland

Nicole Kaiser, Charlottetown, Prince Edward Island

Byunghak Kang, Columbia, Maryland

Robert Kim, Ellicott City, Maryland

Britta Knight, Pierrefonds, Quebec

Graeme Knowles, Launceston, Australia

Amit Kumar, Dublin, Ohio

Alison Lee, Dublin, Ireland

Molly Liepnieks, Woodland, California

Ziyuan Lim, Bull Creek, Australia

Michelle Magagna, Portage, Michigan

Margaret Martinez, Powell, Ohio

Danielle Meritet, Raleigh, North Carolina

Sophie Merz, Berlin

Kristofer Michalson, Cherry Hill, New Jersey

Sunil More, Stillwater, Oklahoma

Rachel Neto, Champaign, Illinois

Ana Ortiz, Barleythorpe, England

Sonika Patial, Baton Rouge, Louisiana

Ursula Perdrizet, Saskatoon, Saskatchewan

Catherine Pfent, Bryan, Texas

Pedro Pinczowski, Elderslie, Australia

Jeanette Hannah Pischon, Berlin

Kara Priest, Ashford, Connecticut

Moritz Radbruch, Berlin

Emanuele Ricci, Neston, England

Michael Richardson, Columbia, Maryland

Stacy Rine, Lansing, New York

Monica Ronderos Herrera, Bad Fuessing, Germany

Sara Rostad, Madison, Wisconsin

Jonathon Sago, Warrenton, Oregon

Franziska Sebastian, Knoxville, Tennessee

Laura Setyo, Mulgrave, Australia

Christopher Siepker, Athens, Georgia

William Sills, Winston-Salem, North Carolina

Wesley Siniard, Knoxville, Tennessee

Panchan Sitthicharoenchai, Ames, Iowa

Mario Sola, West Lafayette, Indiana

Simon Spiro, London

Alan Stevens, Guildford, England

Justin Stilwell, Athens, Georgia

Lauren Stranahan, College Station, Texas

Alejandro Suarez-Bonnet, Hatfield, England

Olivia Swartley, Madison, Wisconsin

Jolanda Verhoef, Pointe-Claire, Quebec

Vanessa Vrolyk, Saint-Hyacinthe, Quebec

Tatiane Terumi Negrao Watanabe, Baton Rouge, Louisiana

Allison Watson, Knoxville, Tennessee

Katherine Watson, Davis, California

Laura Williams, Pullman, Washington

Hannah Wong, Cambridge, England

Tzushan Yang, Starkville, Mississippi

Rossalin Yonpiam, Las Vegas

Michael Zinn, Columbia, Missouri

Veterinary clinical pathology

Suzanne Bussey, Hatfield, England

Megan Caudill, Athens, Georgia

Ilaria Cerchiaro, Padova, Italy

Erica Corda, Saskatoon, Saskatchewan

Emma Croser, Gobbagombalin, Australia

Annie Deschamps, Saint-Jean-sur-Richelieu, Quebec

Samantha Evans, Fort Collins, Colorado

Brandy Kastl, Manhattan, Kansas

Rebekah Liffman, Kalorama, Australia

Cynthia Lucidi, Madison, Wisconsin

Courtney Nelson, Baton Rouge, Louisiana

Jose Cruz Otero, Ithaca, New York

Tatiana Rothacker, Columbia, Missouri

Emily Rout, Fort Collins, Colorado

Samantha Schlemmer, Fort Collins, Colorado

Kellie Whipple, Gainesville, Florida

Mary White, Columbus, Ohio

Veterinary anatomic and clinical pathology

Caroline Cluzel, Saint-Hyacinthe, Quebec

BUSINESS

The ACVP celebrated its 70th anniversary and unveiled a new logo. Discussions were held on the progress of strategic plans and recommendations of the Governance Task Force.

OFFICIALS

ACVP: Drs. Susan Tornquist, Corvallis, Oregon, president; Mark Ackermann, Corvallis, Oregon, president-elect; Amy Durham, Philadelphia, secretary-treasurer; Dorothee Bienzle, Guelph, Ontario, immediate past president; and councilors—Drs. Kirstin Barnhart, Alice, Texas; Jerry Ritchey, Stillwater, Oklahoma; Anne Provencher, Sherbrooke, Quebec; and Lauri Diehl, Foster City, California. ASVCP: Drs. Amy Warren, Calgary, Alberta; president; Darren Wood, Guelph, Ontario, president-elect; Melinda Camus, Athens, Georgia, secretary; Sarah Beatty, Gainesville, Florida, treasurer; Sarah Barrett, Blacksburg, Virginia, treasurer-elect; Julie Webb, Ithaca, New York, immediate past president; and board members—Drs. Erica Behling-Kelly, Ithaca, New York; Laura Snyder, Marshfield, Wisconsin; and Laura Cregar, Mattawan, Michigan

d1245742e1621

Dr. Susan Tornquist

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

d1245742e1629

Dr. Amy Warren

Citation: Journal of the American Veterinary Medical Association 256, 3; 10.2460/javma.256.3.269

Obituaries: AVMA MEMBER | AVMA HONOR ROLL MEMBER | NONMEMBER

JAMES R. ALLEN JR.

Dr. Allen (Georgia ‘55), 91, Mars Hill, North Carolina, died June 9, 2019. Following graduation, he worked in a research capacity with Central Soya Co. in Decatur, Indiana. After earning his doctorate in pathology in 1962 at the University of Wisconsin-Madison, Dr. Allen joined the faculty of the university's School of Medicine and Public Health, eventually becoming a professor. He also served as a senior scientist at the university's Wisconsin National Primate Research Center.

In 1980, Dr. Allen retired from the university and established a veterinary practice in Mars Hill, serving the community for more than 30 years. He was a Navy veteran of World War II. Dr. Allen is survived by three sons, five grandchildren, three great-grandchildren, and a sister.

DOYLE L. BEAVERS

Dr. Beavers (Texas A&M ‘67), 88, Fort Worth, Texas, died Sept. 18, 2019. He owned a small animal practice in Austin, Texas. Dr. Beavers was a member of the Texas and Capital Area VMAs. He was also a member of the Rotary Club of West Austin and a Paul Harris fellow. He served two years in the Army Veterinary Corps prior to enrolling at Texas A&M. Dr. Beavers is survived by his wife, Jo Ann.

LEROY E. FRIESEN

Dr. Friesen (Iowa State ‘68), 79, Menno, South Dakota, died Sept. 10, 2019. He owned Friesen Veterinary Clinic in Menno for over 45 years. Dr. Friesen is survived by his wife, Donna; two sons and two daughters; 13 grandchildren; and four brothers and four sisters. Memorials may be made to Menno-Olivet Care Center, 402 S. Pine St., Menno, SD 57045.

DAVID R. GLYNN

Dr. Glynn (Ohio State ‘62), 82, Rocky River, Ohio, died June 9, 2019. A small animal veterinarian, he owned Cleveland Animal Hospital in Cleveland until 2010. Dr. Glynn was a longtime member of the West Park Kiwanis Club. He was also a member of the Pennsylvania Historical Train Society. Dr. Glynn's wife, Ruth; a daughter; two grandchildren; and three brothers and a sister survive him. Memorials may be made to Rocky River United Methodist Church Endowment Fund, 19414 Detroit Road, Rocky River, OH 44116, or Cross Roads Hospice, 9775 Rockside Road, Suite 270, Valley View, OH 44125.

PATRICK E. KELLEY

Dr. Kelley (Cornell ‘55), 87, Horseheads, New York, died Sept. 3, 2019. He worked as a meat inspector for the Department of Agriculture's Food Safety and Inspection Service for five years prior to retirement. Earlier in his career, Dr. Kelley taught at the University of California-Davis and practiced small animal medicine in California and New York for more than 40 years.

His five sons and nine grandchildren survive him. Memorials may be made to Horseheads Community Animal Shelter, 150 Wygant Road, Horseheads, NY 14845, horseheadscommunityanimalshelter.com.

HAROLD A. KJAR

Dr. Kjar (Iowa State ‘43), 99, Auburn, Alabama, died Sept. 9, 2019. Following graduation, he owned a practice in Lexington, Nebraska, for 25 years. Dr. Kjar then joined the Auburn University College of Veterinary Medicine as an associate professor and head of the ambulatory unit. In 1978, he became part of the Alabama Cooperative Extension Service, serving as extension veterinarian at Auburn University until retirement in 1986.

A member of the Alabama VMA, Dr. Kjar was named Veterinarian of the Year in 1983. His three daughters, six grandchildren, four great-grandchildren, and two sisters survive him.

HANS D. REHE

Dr. Rehe, 86, Loma Linda, California, died Sept. 10, 2019. After graduating in 1962 from the University of Veterinary Medicine Hanover in Germany, he moved to the United States. Dr. Rehe subsequently established Highland Avenue Veterinary Clinic in San Bernardino, California, where he practiced small animal medicine until retirement in 1990. He is survived by a son and a daughter.

AVERY L. SMITH

Dr. Smith (Cornell ‘64), 80, Kingston, New York, died Oct. 16, 2019. In 1980, he established Hurley Veterinary Hospital in Hurley, New York, where he practiced small animal medicine until retirement in 2000. He then worked part time for local animal welfare organizations until 2016. Early in his career, Dr. Smith served as an associate with Hoppenstedt Animal Hospital in Rosendale, New York.

He was a member of the New York State VMS and Hudson Valley VMS. Active in his community, Dr. Smith was a past president of Friends of Historic Kingston and a member of the Kingston Academy Board of Trustees. His wife, Marystephanie; two sons; a grandchild; and two brothers survive him. Memorials may be made to Friends of Historic Kingston, P.O. Box 3763, Kingston, NY 12402.

CYRUS J. STARCH

Dr. Starch (Iowa State ‘53), 89, Wild Rose, Wisconsin, died Oct. 10, 2019. Following graduation, he established Starch Pet Hospital, a small animal practice in Des Moines, Iowa. Dr. Starch founded a second practice in 1976 in Clive, Iowa. In the 1970s, he also began a career directing animal laboratory facilities, first for the veterans hospital in Des Moines and later for what is now known as Des Moines University. Dr. Starch served as veterinarian for the zoo in Des Moines for several years.

He is survived by his wife, Mary; a daughter, two sons, and a stepson; four grandchildren and two stepgrandchildren; three great-grandchildren; and a sister. Memorials may be made to the Wisconsin Alzheimer's Disease Research Center Fund, UW Foundation, U.S. Bank Lockbox 78807, Milwaukee, WI 53278, adrc.wisc.edu/give, or Humane Society of Portage County, 3200 Iber Lane, Plover, WI 54467, hspcwi.org.

LARRY P. THORNBURG

Dr. Thornburg (Texas A&M ‘70), 72, Columbia, Missouri, died Sept. 29, 2019. Following graduation and after earning a doctorate in 1974 in histochemistry from the University of North Carolina, he joined the faculty of the University of Missouri College of Veterinary Medicine. During his tenure and until retirement, Dr. Thornburg served as a veterinary pathologist and was an associate professor of veterinary pathology. He was a diplomate of the American College of Veterinary Pathologists.

Dr. Thornburg's wife, Frances; three daughters and a son; seven grandchildren; and a brother and a sister survive him.

JAMES C. WILSON

Dr. Wilson (Texas A&M ‘64), 79, Cleburne, Texas, died Sept. 14, 2019. Following graduation, he served in the Army, attaining the rank of major. Dr. Wilson then established Rhema Veterinary Service in Arlington, Texas. He later founded Alamo Pet Clinic in Arlington, where he practiced until retirement.

He is survived by his wife, Vesta; five children; 12 grandchildren; and four great-grandchildren. Memorials may be made to Addy's Hope Adoption Agency, 1101 W. Illinois Ave., Midland, TX 79701.

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