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IN SHORT

SCIENTISTS FIND DOG AGGRESSION-GUT MICROBE LINK

Researchers at Oregon State University have identified a link between gut microbes and aggressive behavior in dogs.

Their study, published Jan. 9 online in PeerJ at jav.ma/microbesbehavior, stops short of saying the composition of a dog's gut microbiome causes aggressiveness or vice versa, only that statistical associations exist between a dog's behavior and the microbes it hosts.

Researchers looked at 31 pit bull-type dogs, 14 male and 17 female, rescued from a dogfighting operation. Each animal was screened by an animal welfare agency and categorized as aggressive or nonaggressive. Fecal samples were collected and analyzed.

Firmicutes, Fusobacteria, Bacteroidetes, and Proteobacteria were the dominant phyla among all stool samples, but their abundance differed between aggressive and nonaggressive animals. Proteobacteria and Fusobacteria were more abundant in relative terms in nonaggressive dogs, whereas Firmicutes was relatively more abundant in dogs showing aggression, according to an OSU press release.

Other microbiome differences between aggressive and nonaggressive dogs were observed at the operational taxonomic unit.

AIRVET, VSG PARTNER ON TELEMEDICINE

Airvet announced a new partnership in mid-January to be the telemedicine platform of choice for the 1,400-plus member practices of Veterinary Study Groups Inc.

Based in Los Angeles, Airvet uses cloud-based technology to offer an app that enables veterinarians to connect with their clients via live video, audio, and chat. Airvet also includes a built-in triage service available 24/7 to pet owners.

VSG consists of veterinary management groups. Each group is made up of 16-22 individuals and meets biannually to share information, data, and management experiences.

“We are excited about this strategic partnership as we look to help our independent veterinary practices further leverage new technologies and implement telemedicine to prepare to meet the ever-changing expectations of their clients,” said Steve Curvey, VSG chief operating officer, in an announcement about the partnership.

Brandon Werber, Airvet CEO, said, “Our focus is and will continue to be on leveraging technology to create new efficiencies in a practice's daily workflow, and provide a seamless continuity of care for clients, all without taxing an already busy practice.”

STUDY LINKS ORDER OF TREATMENTS, DRUG RESISTANCE

When treating recurring bovine respiratory disease, the order of antimicrobials used may influence the likelihood of drug resistance.

Treating BRD with bacteriostatic antibiotics, which inhibit bacterial growth, followed by bactericidal ones, which kill bacteria during a growth phase, may increase the risk of selecting for drug-resistant bacteria, according to study results published in December through PLOS One.

The article, citing a 2011 feedlot study, indicates about 15% of feedlot cattle receive multiple treatments for BRD, and more than 90% of those subsequent treatments involve a different class of antimicrobial. The authors of the 2019 article examined connections between drug class selection and antimicrobial susceptibility among Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni isolates.

Their examination used isolates that were sent to the Iowa State University Veterinary Diagnostic Laboratory over three years along with case histories with documented treatments.

The authors found associations between increasing numbers of treatments and increasing antimicrobial resistance. They also found more frequent resistance when cattle received subsequent treatments with antimicrobials that had different mechanisms.

Treating an M haemolytica infection with tulathromycin, which is bacteriostatic, followed by ceftiofur, which is bactericidal, was associated with the highest probability of drug resistance.

The research team is associated with Iowa State University, Kansas State University, and Drake University. The article is available at jav.ma/abxstudy.

Please send comments and story ideas to JAVMANews@avma.org.

AVMA revises declawing policy

Policy discourages procedure but defers to veterinarians on each case

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Dr. Catherine Lund, delegate for Rhode Island, spoke in favor of the revision to the AVMA policy on cat declawing. She said during the AVMA House of Delegates’ January meeting in Chicago that the changes would provide a powerful positive statement, bring the AVMA policy closer in alignment with public opinion, and potentially help demonstrate to legislators that the AVMA evolves with client expectations. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

By Greg Cima

The AVMA discourages declawing of domestic cats as an elective procedure. The Association encourages the use of alternatives but says professional judgment is key when making a decision as to whether to declaw a cat.

On Jan. 11, leaders in the AVMA House of Delegates updated the Association's policy on declawing, or onychectomy, to emphasize that the AVMA defers to veterinarians to decide what's best for each patient and client.

The resolution passed with 84% of the vote during the HOD regular winter session in Chicago.

The prior policy, last updated in 2014, indicated the procedure should be a last resort but focused on encouraging client education. The new policy still encourages education on cat behavior, the surgery, and its risks but also clearly calls out the importance of professional judgment when making the decision to declaw or not.

Both versions of the policy state that cats undergoing the surgery must receive pain management.

The House, which represents state and allied associations, is the Association's main policy-setting body.

STANDARDS AND PROFESSIONAL JUDGMENT

Discouraging elective declawing is consistent with positions from the American Association of Feline Practitioners and American Animal Hospital Association, which also discourage declawing and encourage veterinarians to educate clients about alternatives. The AVMA policy was revised partly in response to states and cities adding or considering measures to ban elective declawing.

AAFP leaders state in their policy that feline declawing is ethically controversial, unnecessary in most instances, and a response to behaviors cats inherit and learn. The AAHA position statement indicates a few circumstances—such as tumors or chronic infections—for which claw removal may be required, but it notes that the Centers for Disease Control and Prevention does not list declawing among potential means of preventing disease in humans.

Ahead of voting to enact the new AVMA policy, delegates debated whether the proposal as a whole or select statements within it would limit veterinary practice, set rigid pain management standards, or bolster arguments in favor of state or city bans on declawing. They also discussed the potential for the AVMA to lead on animal welfare concerns important to the public and speak on behalf of animals.

In July 2019, New York Gov. Andrew Cuomo signed legislation that instituted the first statewide ban on elective declawing in cats. Echoing the sentiments of proponents of the bill, he issued a statement that described the practice as archaic and cruel and causing pain.

Cities including Los Angeles, San Francisco, Denver, and St. Louis have added bans since 2003, when West Hollywood, California, became the first in the nation to prohibit onychectomy except for medical reasons. Banfield Pet Hospital adopted a policy in January that its veterinarians would perform surgical claw removal only out of medical necessity, and the policy will extend to all Mars Veterinary Health hospitals—including VCA and BluePearl—in the first quarter of 2020, according to a company spokesperson.

The Banfield policy states that “Current evidence does not support the use of elective declawing surgery as an alternative to relinquishment, abandonment, or euthanasia.”

Dr. Apryl Steele, alternate delegate for the AAFP, said during discussion of the House resolution that the AVMA should lead by discouraging elective declawing and, if the delegates voted down the proposed change, risked being remembered for failing to do so.

Dr. Neil Moss, delegate for Utah, said he thinks most veterinarians would be relieved if declawing were banned. He said that since a series of laws banned cosmetic tail docking of dogs throughout the United Kingdom, those limits have become noncontroversial.

These bans are region based and include some exceptions for working dogs and medical needs, according to breeding and sporting organizations.

Dr. Sam Miller, alternate delegate for Texas, said that his state's delegation would have difficulty supporting the change in AVMA policy despite reading in House email discussions that veterinarians perform few onychectomies anymore.

The revised AVMA policy on “Declawing of Domestic Cats” reads as follows:

The AVMA discourages the declawing (onychectomy) of cats as an elective procedure and supports non-surgical alternatives to the procedure. The AVMA respects the veterinarian's right to use professional judgment when deciding how to best protect their individual patients’ health and welfare. Therefore, it is incumbent upon the veterinarian to counsel the owner about the natural scratching behavior of cats, the alternatives to surgery, as well as the details of the procedure itself and subsequent potential complications. Onychectomy is a surgical amputation and if performed, multimodal perioperative pain management must be utilized.

“The concern that a lot of the veterinarians had is that AVMA was going to dictate policy on how practitioners were supposed to practice and starting to restrict some of the things that we can do,” he said.

Dr. Miller cited statements in the proposed policy that it was incumbent on veterinarians to counsel owners and that veterinarians performing the surgery must provide multimodal perioperative pain management. He recommended referring the proposal back to the AVMA Animal Welfare Committee, via the AVMA Board of Directors, for reconsideration. Delegates voted down his proposal.

Delegates also debated whether the statement on professional judgment should lead off the policy, whether the policy would assure lawmakers the procedure would be performed in humane ways, whether the changes could encourage those who want to ban the procedure, whether stating veterinarians must administer multimodal pain management was too prescriptive to accommodate special cases of ill cats, and whether veterinarians should perform elective procedures on cats too ill to receive multimodal pain management.

Dr. K. Fred Gingrich II, alternate delegate for the American Association of Bovine Practitioners, said veterinary organizations should be comfortable with advocating for standards of care. He noted that the AABP enacted new dehorning guidelines in late 2019 that said pain management is part of the standard of care.

If veterinarians are unable to think of a situation where pain management would be inappropriate, the word “must” is appropriate in the policy.

“We should speak for the cat here, and it must be provided,” he said.

ETHICAL DILEMMA

Before voting on resolutions, the House divides into groups known as reference committees that deliberate on resolutions or issues and report to the House. The committees may recommend that the House pass, defeat, or modify a resolution, but their advice is nonbinding.

Dr. Enid Stiles, president-elect of the Canadian VMA, told delegates during one reference committee meeting that the CVMA encourages the AVMA to pass the resolution and strengthen its statement. In 2017, her organization published a policy of opposition to elective and nontherapeutic onychectomy.

Dr. Stiles said the CVMA policy has helped advance regulations and end the procedure, which is now allowed in only three of Canada's 10 provinces. She said members are happy with the change.

“There's no competition with their neighbor declawing,” she said. “They don't need to worry about that anymore. They can just do what they've been told to do, which is provide excellent medical care for their patients and not worry about medically unnecessary procedures.”

Dr. Stiles said in an interview outside the meeting she has heard that, across Canada, fewer people ask for declawing, and she believes the same is true in the U.S. She also thinks the procedure can contribute to compassion fatigue and burnout among veterinarians who are uncomfortable with declawing but work at clinics where they need to perform it.

Dr. Steele, who was in the same reference committee meeting, said afterward that veterinarians, especially newer associates, are struggling with having to perform onychectomies. Results of an AAFP survey of 1,200 feline practitioners indicated 51% do not declaw cats and slightly more support legislative bans on the procedure, she said.

“What that tells us is they're ethically opposed to declawing and they're having to do it anyway,” Dr. Steele said. “Of the ones who do declaw, 75% do it less than once a month.”

The AAFP includes members who work in Canadian provinces with onychectomy bans. Dr. Steele said she has heard only praise from those members.

“You would think that there would be a mix or there would be a loss of revenue, but it has been a relief that they don't even have to have the conversation anymore,” Dr. Steele said. “I don't know a single veterinarian that enjoys declawing a cat.”

Dr. Steele later would praise the delegates’ vote to enact the new policy.

“It does take a much stronger stance from the AVMA, and it does require that pain medication be used for cats,” she said. “It was a little bit of a fight, but we're happy.”

HOD ADOPTS POLICIES ON CRIBBING, MICROCHIPPING ANIMALS

Story and photo by R. Scott Nolen

The AVMA House of Delegates on Jan. 11 overwhelmingly voted to adopt a new policy on humanely managing horse cribbing and a revised policy concerning microchip identification of animals.

Additionally, delegates approved recommendations relating to two topics discussed during the Veterinary Information Forum held the previous day (see story, page 508).

The first recommendation concerns potential liability issues related to student externs and practice volunteers. The House voted for a recommendation that the AVMA Board of Directors consider developing a toolkit, including potential forms, and an awareness campaign to protect practitioners, students, and other members of the veterinary health care team.

The second recommendation relates to online veterinary care and telehealth. Delegates voted for a recommendation that the AVMA continue developing guidelines for this quickly emerging area and that AVMA members contact telehealth@avma.org with further questions about the issue.

The HOD agenda also included two additional policy proposals, one dealing with cat declawing (see story, page 502) and the other on using technology in veterinary medicine.

Delegates adopted a new policy on technology that combines related policies into a single statement, giving the AVMA latitude to advocate for the use of technology in veterinary medicine.

CRIBBING

Cribbing is a common equine stereotypy during which a horse grasps a solid object, such as a stall door or fence rail, with its incisor teeth. In 2019, the AVMA Animal Welfare Committee learned that injurious devices are being used to curb the behavior, the committee explained in the policy backgrounder.

Metal hog rings are one such device cited by the AWC. Placed through the incisors and around the teeth of a horses, the hog ring causes gingival damage, periodontal disease, and abrasive wear to the teeth.

“Unfortunately, this practice is not only prevalent in the lay industry but is also being performed by some veterinarians,” the AWC stated.

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Alabama Delegate Libby Todd, chair of a reference committee that discussed the proposed AVMA policy on cribbing in horses prior to the House of Delegates vote, explains the committee's support for adopting the policy.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

The American Association of Equine Practitioners adopted a similar policy against the use of hog rings placed around the maxillary incisors to prevent cribbing in horses.

The policy, approved unanimously by the HOD, reads as follows:

Management of Cribbing in Horses

Cribbing (also known as crib biting or windsucking) is one of many repetitive behaviors known as stereotypies, which are sometimes demonstrated by horses. A variety of devices have been utilized to prevent horses from cribbing, including hog rings. The AVMA condemns the use of hog rings or other devices placed around the teeth to prevent cribbing in horses. These devices are detrimental to the welfare and health of the horse due to the potential to cause persistent pain, damage to the gingiva, periodontal disease and abrasive wear to adjacent teeth. The AVMA encourages research to understand and address the underlying causes of cribbing.

Prior to the vote, when the policy's adoption seemed assured, Dr. Lauren Atkins, Massachusetts delegate, addressed her colleagues. “I'd like to say how proud I am of this organization. This is what it looks like to be a leader in animal welfare,” Dr. Atkins said.

MICROCHIPS

The revised AVMA policy on microchips is the work of the Council on Veterinary Service, State Advocacy Committee, and Animal Welfare Committee, which realized the previous AVMA policy had become cumbersome.

As the entities explained in the policy background, there are valid reasons to scan new patients and regularly scan existing patients for implanted microchips. However, dictating in the policy the precise situations, frequency, or procedure for such scanning may impinge on or conflict with state laws regarding property ownership.

For example, if a veterinarian has already established a veterinarian-client-patient relationship with a new client, then discovers that the client's animal has a microchip of which the owner was unaware, the requirements and ability of the veterinarian to attempt to notify anyone about this situation are likely limited owing to the existing VCPR.

In light of these real-world challenges, the AVMA entities proposed a scaled-down version of the current policy. Delegates voted in favor of the revised statement, which reads as follows:

Microchips: Identification of Companion Animals and Equids

The AVMA endorses the implantation of electronic identification in companion animals and equids and supports standardization in materials, procedures, equipment, and registries. Veterinary healthcare teams are thereby encouraged to recommend the implantation of electronic identification of animals to their clients.

The objectives of an effective system of electronic identification of animals are to:

The AVMA supports ISO (International Organization for Standardization) compliant RFID (Radio Frequency Identification) technology that adheres to and is based on ISO 11784/11785 standards.

AVMA DEVELOPS PLAN FOR COMBATING SEXUAL HARASSMENT IN PROFESSION

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AVMA Board of Directors Chair Rena Carlson and Montana Delegate Rex Anderson present the AVMA report on sexual harassment during the winter session of the House of Delegates, Jan. 10-11 in Chicago. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

AVMA leadership on Jan. 10 reviewed an Association-prepared report on sexual harassment in the workplace and a plan for how the AVMA will help the veterinary profession address the problem.

The report, developed by the AVMA Board of Directors, comes at the direction of an AVMA House of Delegates resolution from this past July. That resolution dealt with sexual harassment awareness and was submitted by 10 state and allied VMAs.

In addition to formally recognizing the seriousness of the issue, the resolution requested that the Board review existing AVMA sexual harassment policies and develop additional resources for members. Further, the House resolution recommended that the Board update delegates by the 2020 HOD regular winter session, being held Jan. 10-11.

The Board shared its report with the House in early December 2019. The report had the following four action steps for the AVMA:

  • • Update the AVMA website in 2020 to include additional resources on preventing sexual harassment in the workplace and provide assistance to both veterinary employers and employees.

  • • Include continuing education programs related to preventing sexual harassment on AVMA Axon, the Association's online CE platform, such as the Workplace Wellbeing Certificate Program.

  • • Identify specific workplace harassment training programs to recommend to veterinary practices.

  • • Request that the AVMA Council on Veterinary Service conduct a review this year of the AVMA policy on “Harassment and Discrimination-Free Veterinary Workplace,” in collaboration with the AVMA Department of Human Resources, for continued relevance and scope.

AVMA resources and programs need not be limited to sexual harassment, the report noted, but should address workplace harassment and discrimination broadly, also accounting for illegal workplace conduct based on race, ethnicity, and religion.

On Jan. 10, during the Veterinary Information Forum portion of the HOD's winter session in Chicago, Dr. Rena Carlson, chair of the AVMA Board of Directors, and Dr. Rex Anderson, Montana delegate and member of the House Advisory Committee, reviewed the report and plan for delegates.

“The Board did exactly what we asked them to do,” Dr. Anderson said. “What happens now is up to us.”

AVMA leaders discuss potential legal liability of student, volunteer work

House of Delegates also talks about cannabis, telehealth

By Greg Cima and Malinda Larkin

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Dr. James Brett, left, addresses the AVMA House of Delegates, Jan. 11 at its regular winter session. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Work on farms and in clinics provides future veterinarians valuable experience, but allowing students and other nonemployees to work or volunteer in a veterinary practice can raise concerns about potential liability.

AVMA leaders called for guidance and education during a discussion on the use of students, externs, and volunteers in veterinary practices. The discussion was part of the Veterinary Information Forum, a series of short discussions on priority topics for the AVMA House of Delegates.

Other topics included the current status of cannabidiol-containing products in veterinary medicine and ongoing AVMA efforts to encourage the use of telehealth services while maintaining standards of care. The delegates met Jan. 10-11 in Chicago as part of the AVMA Veterinary Leadership Conference, a combination of AVMA governance meetings and professional development sessions.

STUDENT LAWSUIT

In 2017, a Missouri jury found a veterinarian and a cattle owner each partly responsible for injuries suffered in 2009 by a then veterinary student who was vaccinating cattle on a farm when a calf crushed her hand against the wall of a cattle chute. The jury also found the veterinary student partially responsible. A state appellate court affirmed the decision in March 2019.

The appellate court ruling states that the student was working with a farm worker who was unauthorized to supervise her. That farm worker did not properly restrain the calves for vaccination and responded in anger to the student's safety concerns.

An unrestrained calf jumped and crushed the student's hand, the court file states. She suffered a carpal bone fracture and, according to the ruling, developed chronic conditions associated with arm and shoulder pain.

A jury decided the cattle operation was responsible for $3 million in damages and the supervising veterinarian for $1.2 million.

Dr. Jim Brett, a representative on the House Advisory Committee, said volunteer work and externships with private practitioners have great educational value, noting that veterinary colleges consider such work experience when evaluating admission applications and that some colleges with distributed education models rely on partnerships with private practices to teach clinical skills.

Dr. K. Fred Gingrich II, executive vice president of the American Association of Bovine Practitioners, said some veterinarians seem to be uncertain about whether their insurance covers injuries to volunteers and externs. He also said the potential legal liability risk may discourage cattle-owning clients from allowing student volunteers to work on their animals.

He wants education on what veterinarians should do when a student is injured, as well as what veterinarians can do to reduce their legal risk.

A GREY AREA

Dr. Andrew Maccabe, CEO of the Association of American Veterinary Medical Colleges, said in a reference committee meeting that while the Missouri student's lawsuit was a singular case, it was an important one that highlighted and caused veterinary leaders to pay attention to what has been a grey area for many practitioners or one that many may have been unaware of.

“The opportunity for (veterinary) students and prevet students to shadow is valuable and benefits the profession. But we need to ensure there is appropriate oversight and safety and personal injury and liability issues are covered, so that when accidents do happen, there isn't an uncovered liability people are responsible for,” he said.

He noted that, in general, if a student is injured while engaged in an activity overseen by a veterinary school through a formal relationship with a private practice, the student would generally be covered under the university's insurance policy.

This is the situation, for instance, for practices that participate with a veterinary school in a distributed education model. “Those are where employers are often paid to take students, and the employers may be considered adjunct faculty usually. That's a high order, and those are well regulated,” Dr. Maccabe said.

The situation may be less clear for practices that offer externships or clerkships as an elective or for no credit. At many schools, he said, the associate dean's office has a list of several practices with which the veterinary school has an agreement outlining how the practices will manage students, but these may not address potential legal liability issues.

However, grey areas can arise when students and practices engage in informal arrangements, even if it's with a student who previously worked at the practice through a school-sanctioned program. This is also true when preveterinary students seek out opportunities to shadow a veterinarian on their own and when individuals volunteer in clinics.

Marie Bucco, Student AVMA president, said this may be an opportunity for SAVMA to educate students, too, by working with the American Preveterinary Medical Association to develop an FAQ or checklist.

“Most students assume they'll be covered or things will get taken care of,” she said. As a former prevet student, she said, she would have just accepted it as her own fault if an accident occurred. “But it would be good to remind students to ask questions at a practice you're about to shadow.”

In an effort to better understand and address these issues, the HOD recommended that the AVMA Board of Directors consider the development of a toolkit, including potential forms, and an awareness campaign for the protection of practitioners, students, and other members of the veterinary health care team.

CANNABIS AND TELEHEALTH

Introducing the discussion on cannabis-derived products, Dr. William Flynn, deputy director for science policy in the Food and Drug Administration's Center for Veterinary Medicine, said the agency is deliberating how to manage or regulate such products, which have not been approved as food additives or for therapeutic uses in animals. CBD has some recognized clinical benefits in humans, but many unanswered questions and safety-related data gaps remain, he said.

Some data raise concerns about potential harm to animals, especially toxic effects on the liver and male reproductive organs, Dr. Flynn said.

FDA officials issued warning letters to 22 companies that sold illegal CBD products in 2019; 15 of those companies were selling such products for use in animals.

Delegates indicated they want guidance and leadership from AVMA on how to approach use of products.

Marijuana is legal in 11 states for recreational use among adults over the age of 21 and legal for medical use in 33 states. State veterinary medical boards have given varying direction to veterinarians regarding communication with their clients.

Dr. Mike Jones, delegate from Oklahoma, said in a reference committee meeting that since his state legalized medical cannabis in October 2018, pet intoxication is astronomical now.

“These dogs are stumbling in the exam room and peeing all over the place. I've been at it 29 years, and this is new. We're seeing one to two a week in practice,” he said. “The dogs don't eat just one, they eat the whole bag. … Back in the days when it was illegal, you used to hide it, but now it's out and legal to have,” and pets can get into it more easily.

Dr. Melanie Marsden, District IX AVMA Board of Directors representative, said practitioners in her state of Colorado also saw a spike in marijuana intoxication after the drug became legal recreationally in 2014. She said: “Now, I see (intoxication) maybe once every few months. I don't know if it will be similar, but that has been our experience.”

In telehealth, AVMA staff and volunteer leaders indicated many pet owners want more options for reaching veterinarians from a distance, and veterinarians are increasing their use of remote consultations with specialists. Whether veterinarians can establish a veterinarian-client-patient relationship without an in-person examination remains a source of debate.

VETERINARY STUDENTS FIND LEADERSHIP ROLES MATTER AT EVERY LEVEL

Story and photo by Malinda Larkin

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The crowd in Chicago watching “HOD 101,” a live stream of the AVMA House of Delegates winter session Jan. 10. Dr. Karen Bradley, District I AVMA Board of Directors representative, and Adrian Hochstadt, AVMA deputy CEO, provided commentary on the House's actions for AVMA Veterinary Leadership Conference attendees. (Photo by Malinda Larkin)

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

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Left to right: Kristina Williams, a second-year veterinary student at Colorado State University; Kayla Corey, a second-year veterinary student at Texas A&M University; Ava Mastrostefano, a second-year veterinary student at Tufts University; and Bryanna Andrews, a third-year veterinary student at the University of Edinburgh, speak during the session “Our Passion, Our Profession, Our Perspectives on the Future” Jan. 11 at the AVMA Veterinary Leadership Conference in Chicago.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

“Don't Be a Crab” was the slogan Kristina Williams used when running for class president at Colorado State University College of Veterinary Medicine & Biomedical Sciences, which refers to the crabs-in-a-bucket mentality. That is, when two crabs are in a bucket, as soon as one tries to climb out of the bucket, the other will grab the escaping crab by the legs and try to escape itself, with the result that neither crab ends up escaping.

“In veterinary school, there's lots of competition. People don't learn how to work together, and then they get in the real world, where it's collaboration heavy, and they get culture shock,” Williams said. “I think a lot of mental health problems take root in vet school—it's very high stress … and difficult enough without that cut-throat mentality.”

Williams was one of four Student AVMA members selected to share their perspectives on leadership as veterinary students during the session “Our Passion, Our Profession, Our Perspectives on the Future” Jan. 11 at the AVMA Veterinary Leadership Conference in Chicago. They also were among 30 students who received scholarships from SAVMA that covered travel, hotel, and registration expenses for them to attend the VLC.

Ava Mastrostefano, a second-year student at Cummings School of Veterinary Medicine at Tufts University, said she was inspired by the resources she learned about at the conference. As president of Tuft's SAVMA Wellness Committee, she's looking forward to sharing with fellow members the AVMA's “My Veterinary Life” podcast and resources from avma.org/wellbeing.

Mastrostefano said her positions in nonclinical leadership have proved just as valuable as the clinical experiences she'll receive because they will make her a better veterinarian overall.

Kayla Corey, a second-year veterinary student at Texas A&M University, admits she had burned herself out on leadership during her undergraduate years. Instead of taking roles she was passionate about, Corey says she took roles that she thought would look good on her resume. So far, she hasn't sought any positions at her veterinary college, but that will now change.

“You have to find your own ‘why,’ so when you start going into leadership, you know why you're doing it. That's more motivating. It's why I'm ready to get back into leadership roles in the veterinary community,” Corey said, adding that attending the VLC has increased her motivation.

During the session, Williams shared a story about when she ran into a woman on a bus who asked what she did for a living.

“I responded with ‘I'm just a vet tech,’ and the lady told me to never say you're ‘just’ anything because every time you do, your salary goes down,” she said. “This goes back to impostor syndrome and devaluing your accomplishments. You can be a leader in your field without holding some high-ranking position.”

Getting teams to talk

Practice owners, managers unite at the AVMA Veterinary Leadership Conference

Story and photo by Kaitlyn Mattson

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Practice owners and practice managers discuss challenges within their relationships at a session during the AVMA Veterinary Leadership Conference in Chicago.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Any and all problems people have are relationship problems, said Dr. Andrew Sloyer during a session at the AVMA Veterinary Leadership Conference in Chicago.

Practice owners, practice managers, and other professionals came together to discuss the challenges of running a practice as a team during the Jan. 9 session “Leadership Through Partnership: Owners and Managers Working Together.”

The session's goals included assessing the working relationships of the attendees to identify areas for improvement, understanding the roles and responsibilities within a practice to promote trust and autonomy, determining the decision-making process and areas of authority, and understanding strategic and operational planning as well as how improving work relationships can help achieve goals.

The AVMA and Veterinary Hospital Managers Association organized the session, which was led by Bethany Bankovich Mihalik, the hospital administrator at Neffsville Veterinary Clinic in Lancaster, Pennsylvania, and Dr. Sloyer, owner and managing partner at the clinic.

Mihalik, a certified practice manager and certified veterinary technician, said the veterinary industry and practices are very relationship centered but mostly focused on the relationship between the client and veterinarian, not among the team within the practice.

“We don't take the time to figure out what we are doing,” she said. “Today we are going to focus on us.”

During the session, about 35 attendees discussed the challenges they face within their practices and their teams, including the lack of time to have regular meetings together to discuss operations, difficulties communicating with each other, and obstacles to reinforcing the chain of command throughout the team.

Mihalik and Dr. Sloyer focused heavily on their own experiences as manager and owner. They also discussed the need to identify and understand the different communication styles within a team.

Communication styles that the session focused on included the following:

  • • Thinkers are people who function in a steady and tenacious manner. They rely on observations and rational principles.

  • • Feelers are people who are dynamic and stimulating. They are sensitive to the needs and wants of others.

  • • Sensors are doers. They tend to thrive with a wide variety of projects and tasks.

  • • Intuitors are fast and deep thinkers with excellent imaginations.

Mihalik and Dr. Sloyer suggested that a practice offer a communication self-assessment to staff members and discuss the positives, the drawbacks, and the stressors of each style and how staff members can then own that behavior and work better together as a team.

“It is not just enough to know the style; you have to know how to motivate and reward,” Mihalik said. “We also have to take responsibility and ownership for ourselves and our own actions (and style).”

The session also included information about autonomy, how to build trust within the manager-owner relationship, what a positive working relationship looks like, what some relationship red flags are, and using a strategic plan as a relationship-building opportunity.

Neffsville Veterinary Clinic first started doing strategic planning in 2004. Mihalik and Dr. Sloyer used that experience as an example of how the process can bring a team together. Strategic planning can allow for discussion of what is and isn't working within a practice and potential goals for the future, Mihalik said. Creating a mission and values for the practice, then assigning short- and long-term goals for team members to achieve related to the strategic plan allows for collaboration, growth, and accountability as a team.

Taking steps against educational debt

Session features new playbook of resources for veterinary associations

Story and photo by Kaitlyn Mattson

The educational debt crisis was a key topic of conversation among students, association leaders, and veterinary college representatives at the AVMA Veterinary Leadership Conference, Jan. 10 in Chicago.

The session “Beyond Dollars and Cents: Leadership in Student Debt Strategies” included discussion of what the overall educational debt in the profession looks like, types of support associations can provide, strategies for leadership, and what effective financial resources are being and should be offered.

Specifically, the Veterinary Medical Association Executives compiled a list of resources to assist state and other veterinary associations in creating educational debt strategies.

Ralph Johnson, CEO of VMAE, announced the Ready. Set. Go! Tackle Educational Debt Initiative, which includes a step-by-step guide providing a menu of options that VMAs can take.

“We all own this problem,” Johnson said. “As VMAs, we must act.”

The guide includes the following suggestions:

  • • Start a conversation by the board of directors about what role the VMA will take in the debt crisis, how to create action against the issue, how to engage volunteers, and resources the VMA can use for this issue.

  • • Speak with early-career veterinarians about educational debt and how it affects their lives.

  • • Commit to an action that reflects VMA strategies.

  • • Take action by, for example, creating an educational debt resource center, spreading the word, or creating a scholarship fund.

  • • Track and measure progress, and adjust actions based on best practices.

The guide is available courtesy of the Veterinary Debt Initiative, which is led by the AVMA, Association of American Veterinary Medical Colleges and VMAE, and is focused on helping veterinarians pursue financially sustainable careers. The guide is available at jav.ma/ReadySetGo.

“I'm so pleased VMAE has put together such a comprehensive playbook of resources that we can use to address veterinary educational debt,” said Candace Joy, executive director of the Washington State VMA, to JAVMA News. “I plan on incorporating many of the excellent tools and strategies provided so my organization can help our members tackle an issue that touches all areas of the profession.”

Joy offered several examples during the session of what the Washington State VMA currently does to help members with educational debt, such as offering the services of a financial consultant as well as offering new graduates the opportunity to review employee contracts with a lawyer.

Jack Advent, executive director of the Ohio VMA, told JAVMA News that educational debt can be an overwhelming topic for a state VMA to start working on because it is a complex and daunting issue.

“Having a broad list of possible ideas such as those in the playbook can be extremely helpful in creating a launch point or supplementing what you are already doing as an organization,” he said.

The VLC session also included information about the effectiveness of financial literacy programs.

Dr. Caroline Cantner, director for professional development at the AAVMC, said during the session that the profession needs to rethink how it teaches financial literacy.

“Lecture learning doesn't lead to change,” she said, adding that financial literacy resources need to include information about the emotional side of money.

“What is your emotional relationship with money?” Dr. Cantner asked.

What veterinary educational debt looks like when broken down by the numbers and a discussion on the overall educational debt load in society also came up during the session.

Dr. Andrew T. Maccabe, CEO of the AAVMC, spoke during the session about the cost of a veterinary education.

The cost of tuition is the biggest factor in educational debt, but tuition is set by the university, and the cost results from a “systematic disinvestment in higher education,” he said.

In the past 10 years, state funding for public colleges has been substantially reduced.

Public colleges received about $6.6 billion less in state funding in 2018 than in 2008, after adjusting for inflation, according to data from the Center on Budget and Policy Priorities, a progressive think tank. States have made efforts to reinvest in higher education, but tuition at public colleges remains high. The mean annual tuition at four-year public colleges has risen $2,708 nationally since 2008. More data and information on the price of higher education and reduced state funding can be found at jav.ma/funding.

Educational debt is a significant issue in veterinary medicine, but debt doesn't just affect veterinarians.

The overall outstanding U.S. educational debt is $1.50 trillion, according to the Household Debt and Credit Report for the third quarter of 2019 from the Federal Reserve Bank of New York.

The U.S. Department of Education recently released a new website for information on federal student aid that combines information from other federal sites for students at studentaid.gov.

Along with the resources from VMAE, the AVMA has tools to help veterinarians handle their educational debt at jav.ma/Repayment.

Clients driving you nuts? Retrain your brain

Speaker at VLC outlines steps on how to be more compassionate to the most difficult people

Story and photo by Malinda Larkin

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Bridgette Bain, PhD, associate director of analytics in the AVMA Veterinary Economics Division, talks about the latest educational debt figures during a session hosted by the Veterinary Debt Initiative at the AVMA Veterinary Leadership Conference.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

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Dr. Sarah J. Wooten, a former practicing veterinarian turned leadership and personal development speaker, notes that it's easier said than done to hit the pause button before reacting to an unruly client, especially in the heat of the moment. Doing so takes intention as well as patience with yourself and others.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Clients who say they're listening but don't follow any of the instructions you gave. Clients who manhandle their cat to get it out of the cage instead of letting you try to help. Clients who yell at the front desk staff about the cost of a nail trim.

Some clients may seem as though they can't be controlled without sedation. But Dr. Sarah J. Wooten, a former practicing veterinarian turned leadership and personal development speaker, says with the proper tools, even the most unruly ones can be tamed. It just takes some understanding and a different mindset for veterinarians and staff to take back their practices.

The first thing to remember is what it's like to be on the other side of the examination table. Clients have no control over what is happening. Often they feel afraid that their pet is in pain and worry that their pet will be taken from the room.

Underlying all of that are other ongoing fears. How much is this going to cost? Am I going to be able to afford this?

“So they project on the nearest, nicest unsuspecting person, which is you. We are worldwide receptacles of everyone's bad behaviors,” Dr. Wooten said. “We need to remember we serve people in crisis. We don't go into veterinary medicine for this, but it is what it is.”

The trick is understanding fear behaviors—in yourself or others—and consciously overriding them, Dr. Wooten said. These fight-or-flight responses can involve some of the following:

  • • Getting defensive.

  • • Ignoring or avoiding issues.

  • • Disengaging.

  • • Using humor or jokes to deflect.

  • • Pretending to agree to avoid conflict.

  • • Aggressively arguing.

  • • Interrupting.

  • • Bullying others into submission.

  • • Behaving condescendingly.

Awareness, or mentally noting what is happening, helps to de-escalate the situation.

“When you're removed a little from drama, it gives you enough space from the stimulus to consciously choose your response in that situation,” Dr. Wooten said. “You can take control of your reaction and the situation by observing the client, silently labeling the client's fear reaction, and responding without judgment.”

Another tool is empathetic statements, which can reduce unproductive reactions during a difficult or triggering situation. A few examples include the following:

  • • “Hi there. I'm Dr. Doe. How are you doing?

  • • “I'm sure this isn't what you planned to do today, right?”

  • • “This is hard. I'm sorry.”

  • • “I understand you are worried. We are going to do everything we can.”

Coupling these statements with eye contact, smiling, and listening reflectively can also help, she said.

Finally, meeting the client's need for certainty and autonomy can go a long way. That means being upfront and transparent about how you will proceed with the examination, the options the client has, and what each option would mean as far as price and possible health outcomes.

Doing all these things will not only increase a person's emotional intelligence but also help decrease compassion fatigue and increase productivity.

She notes that it's easier said than done to hit the pause button before reacting, especially in the heat of the moment. Doing so takes intention as well as patience with yourself and others.

“This is all about practice. You won't get it right the first time, but eventually you'll hit the target, and you'll be able to choose your responses in any situation,” Dr. Wooten said.

Dr. Jennifer Schurrer, practice manager and veterinarian at East Central Veterinarians in Minnesota, said the workshop was good for refining her skill set. She has applied similar teachings in her practice to create more cohesion between the two clinics she helps run. Now she hopes to train the staff on how to react more empathetically to clients.

HOUSE ELECTS TWO TO COUNCIL ON RESEARCH

In January, the AVMA House of Delegates filled two vacancies on the AVMA Council on Research. The HOD elected Dr. Miles Theurer of Cimarron, Kansas, to represent private clinical practice and Dr. Mila Kundu of Morrisville, Pennsylvania, to represent veterinary medical research.

FELINE FOAMY VIRUS IS EVERYWHERE

By Katie Burns

Exposure to or infection with feline foamy virus is common in pumas and domestic cats in Colorado, Southern California, and Florida, according to two recent studies. Another recent study found frequent cross-species transmission of FFV between domestic cats and pumas.

The overall seroprevalence of antibodies against FFV was 78.6% across subpopulations of pumas from those three states, according to a study published April 19 in the online journal Viruses. The FFV seroprevalence was 64.0% among domestic cats at eight animal shelters in those same states, according to a study published Sept. 16 in the online Journal of Feline Medicine and Surgery Open Reports.

“Despite FFV having been associated with increased viral loads in retroviral co-infections and with histological changes in lung and kidney tissue, the virus is still poorly understood and not well documented in most countries, especially the United States,” said Sarah Kechejian, the first author on the prevalence studies and a fourth-year veterinary student at Colorado State University.

A third study from the research collaborators found that FFV variants from domestic cats and pumas were not distinguishable at the host level. Analyses supported frequent cross-species spillover from domestic cats to pumas during the last century as well as frequent puma-to-puma transmission in Colorado, according to the study published in January in the journal Virus Evolution.

“The high FFV seroprevalence in U.S. domestic and wild cats exposes how connected these individuals are to each other—and shows how vulnerable the populations are to infectious disease transmission,” Kechejian said. “The data also spark discussion on the potential risks associated with a poorly understood retrovirus almost reaching ubiquity in domestic and wild cats.”

The research collaborators are not pursuing further FFV prevalence studies at this time, Kechejian said, but owned cats could have a lower seroprevalence when compared with the study populations.

Among domestic cats admitted to shelters because of nonowner surrender or that were involved in trap-neuter-return programs, the FFV seroprevalence was 75.0% in Southern California, 52.4% in Colorado, and 41.9% in Florida. Among pumas, the FFV seroprevalence was 69.1% in Southern California, 77.3% in Colorado, and 83.5% in Florida.

The study on FFV seroprevalence in domestic cats is available at jav.ma/FFVcats, and the study on FFV seroprevalence in pumas is available at jav.ma/FFVpumas. The study on cross-species transmission is available at jav.ma/FFVcross.

AUXILIARY CELEBRATES NATIONAL PET WEEK 2020

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Sophie Casey's artwork won the AVMA Auxiliary's poster contest for National Pet Week 2020.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

The Auxiliary to the AVMA will be celebrating National Pet Week 2020, May 3-9, with the theme “Pets & Vets the Perfect Duet.”

The AVMA and the AVMA Auxiliary, a century-old association primarily made up of the spouses of AVMA members, created National Pet Week in 1981 to foster responsible pet ownership, recognize the human-animal bond, and increase public awareness of veterinary medicine.

Last year, the Auxiliary held its annual poster and writing contests to generate promotional materials for National Pet Week 2020. Sophie Casey of Westport, Connecticut, was in 11th grade when she submitted the accompanying artwork that won the poster contest. Madeleine McConnell of Venice, Florida, was in sixth grade when she submitted the following poem that won the writing contest.

Pets and Vets the Perfect Duet

There are so many places to go—

And sometimes there isn't much time

Your pet is starting to show

A sickness or an illness kind-of sign.

It is important for pets and vets

To have the best relationship needed.

In order to give a medicine or shot,

There has to be a friendship that is undefeated.

The duet is filling the air with joy.

As a veterinarian watches the dog wiggle.

He or she gives the pet a toy,

And everyone in the room giggles.

Everyday a new vet is blessed

With a pet that was the very best

They have to come home with the joy all confessed;

And that's why pets and vets make the perfect duet.

The Auxiliary is selling the winning poster for National Pet Week as well as pencils, bookmarks, balloons, and a children's book. The order form is at avmaaux.org/national-pet-week/shop.

Details about the poster and writing contests for National Pet Week 2021 are available at avmaaux.org/national-pet-week/contests. The theme will be “Love is a 4-Legged Word.” June 14 is the postmark deadline. The contests are open to students in kindergarten through 12th grade.

VETERINARY STUDENTS CAN APPLY FOR AVMF SCHOLARSHIPS

The application period is now open for a number of scholarships for students attending AVMA Council on Education-accredited veterinary colleges.

Students can submit applications for the following scholarships from March 1-May 15:

  • • AVMA/AVMF Scholarship for Veterans: In honor of the 100th anniversary of President Woodrow Wilson's signing of the National Defense Act of 1916 and the creation of a Veterinary Corps within the U.S. Army, the AVMA and AVMF established a special scholarship for military veterans pursuing an education in veterinary medicine. Scholarships in the amount of $1,000 are available to veterans of the U.S. Air Force, Army, Coast Guard, Marines, and Navy currently in their first three years of veterinary school at any COE-accredited school.

  • • AVMF/Arizona VMA Scholarship: Five $1,000 scholarships are available to third-year veterinary students with a connection to the state of Arizona. Applicants must be attending a COE-accredited program in North America, be a member of the Student AVMA and a student member of the AzVMA, and have been born, lived in, employed, or educated in the state, among other requirements.

  • • AVMF/Winn Feline Foundation Scholarship: A $2,500 scholarship is available to a second- or third-year student in the U.S. who demonstrates an interest in feline veterinary medicine. The recipient of this award must be able to document a history of participation in activities that benefit the health and welfare of cats, including research, shelter work, cat clubs, and other community service programs. A strong GPA and financial need are also considered for this scholarship.

  • • Mildred Sylvester Scholarship: This $1,000 scholarship, established by the estate of Mildred Sylvester, is available to an outstanding first-, second-, or third-year U.S. veterinary student with a connection to the state of New Jersey—whether a current or past resident or a graduate of a New Jersey high school or college.

  • • Dr. Elinor McGrath Scholarship: Juliette Fassett, founder of Dr. McGrath's, partners with the AVMF in offering a $500 scholarship to a first-, second-, or third-year student at a U.S. veterinary college. Dr. McGrath is recognized as America's first female member of the AVMA. The recipient of this award will be selected on the basis of his or her story of achieving veterinary goals with the strength and determination of Dr. McGrath.

For the 2018-19 year, the AVMF awarded $552,000 in the form of 254 scholarships.

VETERINARY TECHNOLOGY ACCREDITATION DECISIONS ANNOUNCED

By Kaitlyn Mattson

The AVMA Committee on Veterinary Technician Education and Activities granted initial accreditation to five new veterinary technology programs and continued the terminal accreditation of four programs at its Nov. 7-10 meeting in Schaumburg, Illinois.

There are currently 208 CVTEA-accredited programs in veterinary technology, including 11 distance learning programs.

The CVTEA visited 45 sites in 2019, including eight new programs. The committee has 25 site visits scheduled for 2020, including visits to five new programs. There are currently 17 programs applying for accreditation.

The CVTEA uses 11 standards to accredit veterinary technology programs, including standards related to finances, admissions, students, and resources for clinical instruction.

The following schools received initial accreditation during its meeting:

  • • Apex College of Veterinary Technology, Colorado Springs, Colorado.

  • • Institute of Medical and Business Careers, Erie, Pennsylvania.

  • • Mount Wachusett Community College, Gardner, Massachusetts.

  • • Pima Medical Institute, San Marcos, California.

  • • Vermillion Community College, Ely, Minnesota.

The initial accreditation terminology is used for newly accredited programs for their first five years. Graduates of an initially accredited program are considered graduates of a CVTEA-accredited program and are eligible in nearly all states to take the Veterinary Technician National Exam.

The CVTEA continued the terminal accreditation of Baker College in Clinton Township, Michigan, and Baker College of Flint in Flint, Michigan, which are both expected to close in May. The Vet Tech Institute of International Business College in Fort Wayne, Indiana, and the Vet Tech Institute at Bradford School in Columbus, Ohio, were expected to close in February.

In other news, the CVTEA elevated the following programs to full accreditation status:

  • • Colby Community College, distance learning, Colby, Kansas.

  • • Midwest Institute, Fenton, Missouri.

  • • Northeast Iowa Community College, Calmar, Iowa.

  • • Platt College, Riverside, California.

  • • Sinclair Community College, Dayton, Ohio.

  • • YTI Career Institute, York, Pennsylvania.

The CVTEA is seeking feedback on certain Standards of Accreditation and essential skills including Outcomes Assessment (Standard 11), Nursing (Appendix I, Section 3), Avian, Exotic & Small Mammals Procedures (Appendix I, Section 9), and restraint, laboratory, and radiographic imaging equipment (Appendix H).

The committee has two open positions for 2020 and is seeking a veterinary technician and a small animal veterinarian to fill those positions.

The CVTEA's next meeting is scheduled for April 23-26.

Australian bushfires a ‘monstrous’ event wreaking havoc on wildlife

Country reels from devastation of unprecedented fire season

By R. Scott Nolen

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A snapshot of the destruction in Batemans Bay, New South Wales, Australia, where bushfires destroyed hundreds of homes (Photo by Dr. Kate Toyer)

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

On New Year's Eve 2019, Drs. Kate Toyer and Tara Cashman sat down with their three kids and reviewed their escape plan.

The bushfires that had been burning for weeks were now threatening to overtake Batemans Bay, a coastal town in New South Wales, Australia, where the family lives and the veterinarians run a small animal clinic.

They had packed the car a month ago with food, water, and a few other essential items—enough for the family members and their cat to live a short time away from home.

The calls came at 6 the next morning: Evacuate now.

“We weren't even asked to go to the evacuation center in town but to go straight to the beach,” said Dr. Cashman, explaining they did, in fact, drive 6 miles to an evacuation center because of the better facilities. “Thankfully, that was the right decision because the fires were so bad that those who evacuated to the beach actually had to stand in the water.”

FIRE SEASON

Fire season in Australia typically begins late in the year during the hot, dry summer when a lightning strike or human negligence sets a tree or patch of grass alight.

BUSHFIRES CLAIM VETERINARIAN'S SON

Ian McBeth, son of Dr. William McBeth, a member of the AVMA Food Safety Advisory Committee, was killed with two other Americans in a plane crash during a firebombing mission on Jan. 23 in Australia.

McBeth, 44, was piloting a C-130 Hercules loaded with flame retardant when the airtanker crashed around 1:30 p.m. in the Snowy Monaro area of southern New South Wales.

McBeth was working for Coulson Aviation, which provides aerial firefighting services worldwide. In a statement, Coulson said the accident was reported to be extensive.

Dr. McBeth told JAVMA News his son deployed to Australia on Dec. 28. 2019, for a tour that was scheduled to end Jan. 24.

McBeth was an experienced aerial firefighter with years of experience flying C-130s for the military and Coulson Aviation. He served with the Wyoming Air National Guard and Montana Air National Guard.

“Ian was deployed to Iraq and Afghanistan multiple times, but firefighting was what he was good at and enjoyed doing. It's a complex task. You have to be an expert pilot and navigate difficult terrain and weather,” Dr. McBeth said.

“I practice in a small town in northeastern Colorado, and Ian grew up in that practice,” he added. “Ian loved working horses and cattle and dogs and cats. Veterinary medicine was a part of his life.”

McBeth is survived by his wife, Bowdie, and their three children, his parents, William and Anneliese; and his siblings, Rick, Eleanor, and Aislinn.

Bushfires are destructive and often deadly. In the southeast state of Victoria, 173 people died during the Black Saturday bushfires of 2009 that scorched more than a million acres of land and destroyed over 4,000 homes and other buildings.

The tragedy, one of the worst in Australia's history, led to the creation of a task force to study all aspects of the government's bushfire strategy. That investigation resulted in several reforms, including early warning alerts similar to the kind Drs. Toyer and Cashman received.

The changes are widely credited with the relatively low number of human fatalities despite the unprecedented severity of the 2019-20 fire season. At press time in late January, the government reported the fires had killed more than 30 people, burned over 25 million acres, and destroyed roughly 3,000 houses.

Most of the fatalities and property loss occurred in New South Wales, where three American firefighters were killed in a plane crash on Jan. 23, one of whom was Ian McBeth, son of Dr. William McBeth, a member of the AVMA Food Safety Advisory Committee (see sidebar, this page).

“Batemans Bay was hit really hard early on,” said Dr. Toyer, adding that 350 homes were destroyed. “Most of the pictures you see in Western media, of the massive flames and burned-out landscapes, were taken in this area.”

The clinic Dr. Toyer runs with her partner, Dr. Cashman, was, like their home, damaged but not destroyed. The practice operated off a generator for more than a month.

“The South Coast has just been devastated since New Year's Eve,” said Dr. Julia Crawford, president of the Australian Veterinary Association. She estimates over 200 veterinary practices have been affected, about 90 seriously.

Support from around the world has been pouring in, including from the AVMA and American Veterinary Medical Foundation as well as other organizations, to support veterinary-and animal-focused relief efforts. The Morris Animal Foundation has allocated $1 million for scientific research grants to fund studies on how the region's wildfires have affected its native animals.

'A MONSTROUS EVENT'

The most startling news about the bushfires has been the number of animals killed. Chris Dickman, PhD, a professor of ecology, conservation, and management of Australian mammals at the University of Sydney, estimates the fires will kill more than 800 million animals in New South Wales alone and impact a billion animals nationwide. By way of comparison, the Royal Society for the Prevention of Cruelty to Animals estimated up to 1 million wild and domesticated animals died during the 2009 Black Saturday brushfires.

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Source: Australian Department of Agriculture and local fire services, Jan. 21

As Dr. Dickman explained in a statement from the university, animals that survive the fires in the first instance by fleeing or going underground will return or reemerge into areas without the resources to support them. Others will fall victim to predators. Even for those birds or other animals able to flee to unaffected areas, they will rarely be able to successfully compete with animals already living there.

“I think there's nothing quite to compare with the devastation that's going on over such a large area so quickly,” Dr. Dickman said. “It's a monstrous event in terms of geography and the number of individual animals affected.

“We know that Australian biodiversity has been going down over the last several decades, and it's probably fairly well known that Australia's got the world's highest rate of extinction for mammals. It's events like this that may well hasten the extinction process for a range of other species. So, it's a very sad time.”

Dr. Crawford described Dr. Dickman's estimates as “a fair assessment.”

“I talked to veterinarians who assisted in the animal part of the response early on. They were waiting for injured wildlife to be brought in, but nothing came in,” Dr Crawford said. “We think these fires are so hot and burn so fast that probably 90% of these animals died immediately.

“The deaths are just far more than we ever thought.”

TINDERBOX

How to explain the catastrophic loss of animal life? How, even with advance warning, were the Australian government and people caught off guard by the severity of the fires?

In September, the same month the 2019-20 bushfire season started, the Australian Bureau of Meteorology issued a special climate statement warning of elevated fire dangers for New South Wales and the neighboring state of Queensland. Australia is three years into one of the worst droughts in decades. Then, in December, a heat wave broke the record for the highest nationwide average temperature, with some areas reaching up to 120 degrees Fahrenheit.

FUNDRAISING CONTINUES

The AVMA, American Veterinary Medical Foundation, and VCA Charities have joined forces on a second phase of fundraising to support those impacted by the bushfires ravaging Australia.

As of the end of January, the AVMA and the AVMF had raised over $125,000 for the Australian Veterinary Association's Benevolent Fund. The AVMF received over $50,000 in individual donations coupled with a $50,000 matching grant from the AVMF, plus an additional $25,000 AVMA donation. Those funds are being sent to the AVA's Benevolent Fund, which provides financial assistance to veterinarians who have lost their own property because of the fires or who have provided charitable care for impacted animals.

A second fundraising effort was announced Jan. 31, driven by a grant from VCA Charities that will match up to $50,000 in additional donations made to the AVMF on behalf of the AVA Benevolent Fund.

VCA Charities had held a fundraiser in January that also was meant to help veterinarians in Australia provide care to affected pets and wildlife. In total, VCA Charities has raised $150,000 and will provide three donations: one to support veterinarians, one to help wildlife, and one to help pets. VCA Charities will match every dollar contributed to the AVMF on behalf of the AVA Benevolent Fund, up to $50,000; 100% of the donations will be directed towards disaster relief efforts in Australia.

To make a donation, visit avmf.org and use the AVMF code “Disaster Relief—AVA Benevolent Fund.”

Together, these factors created an environmental tinderbox on a scale unlike anything the country had previously experienced.

“The bushfires this season are unique in that multiple fires are occurring simultaneously and joining up to form superfires,” explained Dr. Robert Johnson, director of Vets Beyond Borders, an Australian nonprofit that runs charitable veterinary programs in regions of Asia and the Pacific.

“We are in the middle of a serious drought in Eastern Australia that has created an extraordinary amount of fuel for the fires,” he said. “What also sets these fires apart from previous ones is the fact that they have affected such a large proportion of populated areas. The amount of acreage burned is about eight times larger than the 2018 Californian wildfires.”

With fire season expected to continue into the spring, the extent of the destruction is not yet fully understood.

“Everyone's still in response mode,” Dr. Crawford said. The government puts the number of cattle and sheep deaths at more than 23,000, but she expects the final tally will be much, much higher.

When the last fire is finally out, Dr. Crawford worries about the economic fallout veterinary practices are sure to experience after months of interrupted services. She explained that Australian veterinarians generally do not charge to treat injured wildlife brought by the public to their clinics. Some practices provide as much as $3,000 in pro bono services weekly.

“That's all fine and well in ordinary times; we enjoy it,” she said. “But after a crisis like this, when your practice is almost burnt down, you're working from a generator, and the only patients you're seeing are wildlife, it becomes problematic from a cost standpoint.”

“It's summer here,” Dr. Crawford added, “and holidaymakers who'd normally bring their pets to these coastal practices aren't coming. Those veterinarians have lost that revenue, and it's just devastating.”

The country may see relief only temporarily, as conditions that caused the bushfires are predicted to continue, if not worsen, thanks to climate change.

Australia's climate has warmed by just over 1 degree Celsius since 1910, leading to an increase in the frequency of extreme heat events, according to the Meteorology Bureau's State of the Climate 2018 report. At the same time, there has been a decline of around 11% in April-October rainfall in the southeast of Australia since the late 1990s. As a result, there has been a long-term increase in extreme fire weather and in the length of the fire season across large parts of Australia, according to the report, which can be found at jav.ma/ClimateReport.

Australia is projected to experience further increases in sea and air temperatures, with more hot days and marine heat waves and fewer cool extremes. Decreases in rainfall across southern Australia with more time in drought are also predicted.

SENATORS URGE NIH TO OBEY LAW AND RETIRE CHIMPS TO SANCTUARY

Three U.S. senators are urging the National Institutes of Health to reverse its decision not to retire nearly four dozen chimpanzees at a biomedical primate facility in New Mexico to a sanctuary as originally promised.

Sens. Tom Udall of New Mexico, Bill Cassidy of Louisiana, and Martin Heinrich of New Mexico submitted a letter to NIH Director Francis Collins this past December requesting that the agency transfer 43 chimpanzees from the Alamogordo Primate Facility on Holloman Air Force Base to Chimp Haven in Keithville, Louisiana.

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Three U.S. senators object to a National Institutes of Health decision not to retire nearly four dozen chimpanzees at a biomedical primate facility in New Mexico to a sanctuary as the agency originally promised. The NIH says the remaining chimps were too frail to transfer to the sanctuary in Louisiana.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Starting in 2013, the NIH began to significantly reduce the use of chimps in agency-supported biomedical research. Ongoing projects were phased out, while no new studies were approved. Two years later, the NIH announced it would no longer fund any chimp-related research and that the roughly 300 chimps the agency owned or supported would be retired to Chimp Haven.

But last October, the NIH said the remaining chimpanzees at the New Mexico facility were too frail to transfer to Louisiana. “As chimpanzees age, they can develop serious chronic conditions, such as heart disease and diabetes. In fact, about half of the NIH chimpanzees are considered geriatric,” Collins explained in an Oct. 24 statement.

The agency's decision was based on an evaluation of the chimps by a panel of NIH veterinarians that advised the agency that it would be a serious risk to the chimps’ health to move them, he said.

“Accordingly, NIH expects that these 44 chimpanzees (since down to 43) will live out the remainder of their lives at APF to ensure their safety and welfare,” Collins said. “Chimpanzees at APF have indoor/outdoor living conditions in structures called Primadomes that allow them to climb and swing. They have strong dependency on their social groups as well as close bonds with their caretakers, from whom they receive excellent care.”

Sens. Udall, Cassidy, and Heinrich view the decision as a violation of the Chimpanzee Health Improvement, Maintenance, and Protection Act mandating that chimpanzees live their remaining years in a chimp sanctuary.

“In addition to our general questions about the NIH's rationale for retaining these chimpanzees that are no longer needed for biomedical research, we are concerned that the NIH's decision may be contrary to Congress's intent in passing the Chimpanzee Health Improvement, Maintenance, and Protection Act (CHIMP Act),” they wrote.

The NIH, the senators continued, has a legal duty to fulfill its commitment to relocate the chimps to the national sanctuary system. “There, these chimpanzees may live out the remainder of their lives under the supervision of caretakers with expertise in maximizing their psychological and physical wellbeing—precisely as Congress envisioned,” they wrote.

The senators then requested the NIH answer a series of questions regarding such matters as the number of staff members caring for the chimps, the facility's ability to meet the chimps’ complex physical and psychological needs, and a description of any and all instances in which a chimp has died or has been injured during transport.

Q&A: Veterinarian works to reduce caregiver placebo effect

Dr. Brennen McKenzie, also known as the SkeptVet, discusses his new book

Interview by Greg Cima

People see the changes they expect in their pets, leading them to misattribute illness, good health, improvements, and declines.

Dr. Brennen McKenzie is a companion animal veterinarian working in California, the writer behind the SkeptVet blog, and the author of the recently published book, “Placebos for Pets? The Truth About Alternative Medicine in Animals.” He also is a columnist for Veterinary Practice News and past president of the Evidence-Based Veterinary Medicine Association. He wrote a 2014 JAVMA commentary on cognitive bias in clinical decisions (J Am Vet Med Assoc 2014:244;271-276).

In his book, Dr. McKenzie teaches how to evaluate the theories, methods, evidence, and safety records for myriad complementary or alternative therapies. The following interview has been edited for length and clarity.

Q. DID YOU WRITE YOUR BOOK WITH A PARTICULAR READER IN MIND?

A. I initially was thinking of it as a resource for pet owners, and I tried to write the book in language that is accessible to the general public. So, I'm hoping that it will be an introduction to the general ideas about how we evaluate medical therapies for pets, what's the appropriate way to do that, what's the role of science in helping us to evaluate these things—and also an appraisal of some of the more common alternative medical approaches that pet owners are likely to encounter. However, I also wanted it to be useful to veterinary professionals. All of the things that I talk about have extensive academic references available so that they can dig deeper if they want.

Q. WOULD YOU RECAP WHY WE'RE ALL SUSCEPTIBLE TO THE CAREGIVER PLACEBO EFFECT?

A. It's a fundamental feature of human cognition, and this is one thing I think all veterinarians should have some familiarity with—the history and philosophy of science and cognitive psychology. We all reason in ways that are kind of built into our brains.

I give a patient a medication, and a week later, that patient's clinical symptoms resolve. I see a causal connection there and assume that the medication is responsible for the change. What we know from science is that it's a lot more complicated than that. We're often doing multiple things at once. Diseases have a natural history where their symptoms wax and wane and can just resolve spontaneously. We may have the wrong diagnosis to begin with, and so when things don't go the way we expect, it's not always because of what we did but because we were wrong about our assumptions.

It's very difficult for any of us, whether we're veterinarians or not scientifically trained, to ignore our personal experience. And if a study comes out saying something that I've been doing for 10 years and been selling to clients doesn't work, it's difficult psychologically and cognitively for me to accept that my assessment is wrong and that I've been doing the wrong thing.

Q. HOW DO YOU CHALLENGE MISTAKEN BELIEFS AMONG YOUR CLIENTS?

A. It's complicated. One of the primary questions in science education today is, “How do you change people's minds about things?” And we're facing a crisis in terms of vaccine hesitancy (see story, page 530).

As a clinician seeing patients, I have a few key things that I try to focus on when I want to challenge somebody's perception. The first is I have to acknowledge that I understand their perception and validate their experiences and their reasoning.

If you begin by telling people that they're ignorant or stupid, they won't listen to you. They may have perfectly rational reasons for a mistaken belief. So you begin by saying, “I understand why you feel that this is a useful approach or why you feel that this therapy has been helpful to you.” And then you introduce some potential reasons to doubt that.

I often talk about other cases in science where we've given up on therapies that clearly don't work anymore. Bloodletting is a great example where we believed in things for long periods of time and found them not to be true.

I also try to say, “OK, let's look at this in terms of risk and benefit.” Glucosamine is a widespread therapy for which there's very little evidence of efficacy, and yet, everyone's using it. I say to people, “Here are the reasons why I don't think it probably works. I also think that the risks are quite low, so I don't feel like it's imperative that you give up that.”

If you meet people halfway and work with their beliefs and their goals, I think they're more likely to listen to you. Over time, you build a relationship with clients, and they come to trust you, and I think that gives you more credibility to tackle larger and more challenging beliefs.

It also makes a difference where that belief fits in their life. I'm not going to talk to a client who's a chiropractor and try to convince them that chiropractic is not a valid therapy because that's embedded in their entire life, and that's not going to be a useful or successful interaction.

Q. DO YOU THINK THAT A TYPICAL PERSON WHO USES AN ALTERNATIVE MODALITY UNDERSTANDS THE THEORIES BEHIND THAT PRACTICE?

A. Almost certainly not, no. I think most people don't understand the theories behind the drugs that I give them, either. Most people are not interested in the deep background of medical therapies. What they hear are claims by practitioners of benefits, usually justified in terms of, “I've been doing this for 20 years, and it sure looks to me like it works.” Anecdotal claims tend to be the easiest to offer and the most psychologically compelling, even though they're the least reliable.

There are certainly some people who have a general worldview that is skeptical of science and technology and the pharmaceutical industry, which has certainly earned a great deal of skepticism. And I think that alternative medicine fits into that worldview. I think also that conventional medicine, particularly for humans, has a lot of serious problems in terms of how we communicate with people, how we manage their lives and their needs. We've become very siloed and segmented into subspecialties and very technologically focused. I think there are a lot of things wrong with how we offer health care to people, and the environments and conversations that alternative practitioners often have with people address a lot of those concerns and those problems. I do think that alternative medicine fits into people's lives in an ideological and philosophical way.

Q. HOW CAN A PET OWNER TELL WHICH STUDIES ARE GOOD, WHICH RESULTS ARE EVIDENCE THAT SOMETHING WORKS?

A. I do offer some fairly simple guidelines in the book. One is that no single study is ever definitive because it's impossible to completely eliminate bias. If there's only one study, you should still be a bit skeptical. Larger studies are better than smaller studies. Any study that does not effectively have a placebo arm and doesn't hide from both the owners of the pets and also the investigators or veterinarians which therapy each pet is getting is probably going to be biased and not reliable. So, there are some very simple rules that you can apply.

I think, honestly, the onus is on veterinarians to be better at understanding how to appraise a clinical trial and then to talk to owners. Even in the absence of large-scale, definitive, high-quality evidence, I do think we can look at these therapies and the reasoning behind them and the evidence for them and make sound, honest recommendations one way or another—that don't just rely on anecdotes.

There's a method that I try to teach in the book for approaching things, so even if there are things that I don't cover in the book, I hope that it'll be useful to people in terms of finding a structured, reliable way to approach new things.

As a veterinarian, I'm hearing about new supplements and new therapies all the time, and many of them don't have a lot of research evidence. But I don't think we have to say to our clients, “I don't know, there's nothing I can do, take your best guess.” I think we can use a systematic, science-based approach to help guide and counsel our patients.

AAFP UPDATES GUIDELINES ON FELINE RETROVIRUSES

By Katie Burns

Feline leukemia virus and feline immunodeficiency virus are found in cats worldwide, according to the American Association of Feline Practitioners, but the spread of these viruses can be minimized through education, testing, and vaccination.

In January, the AAFP released updated Feline Retrovirus Testing and Management Guidelines online and in the Journal of Feline Medicine and Surgery. The association aims to provide the most current information about feline retrovirus infections so veterinary practitioners may optimize the care and management of cats.

The guidelines represent a consensus of current information compiled by an international panel of researchers and practitioners. The document is an update of the 2008 AAFP Retrovirus Testing and Management Guidelines.

According to the guidelines: “Although vaccines are available for FeLV in many countries and for FIV in some countries, identification of infected cats remains an important factor for preventing new infections. The retrovirus status of every cat at risk of infection should be known. Cats should be tested as soon as possible after they are acquired, following exposure to an infected cat or a cat of unknown infection status, prior to vaccination against FeLV or FIV, and whenever clinical illness occurs. It might not be possible to determine a cat's infection status based on testing at a single point in time; repeat testing using different methods could be required. Although FeLV and FIV infections can be associated with clinical disease, some infected cats, especially those infected with FIV, can live for many years with good quality of life.”

The guidelines cover the pathogenesis and outcomes of infection, diagnosis and prevention of retrovirus infections, considerations for multicat environments, and management of retrovirus-infected cats. A brochure for cat owners describes FIV and FeLV, signs of infection, diagnosis, prevention, and management of infected cats.

“The newly updated guidelines for 2020 describe a two-tier testing system for FeLV and FIV,” said Dr. Julie Levy, co-chair of the guidelines and a professor of shelter medicine at the University of Florida, in comments to JAVMA News. “One approach is ‘one and done,’ in which a reliable point-of-care combination test is performed for FeLV antigen and FIV antibody in cats with relatively low risk. A cat with a negative result is likely to be uninfected. A cat with a positive result is likely to be infected, but it may also be a false positive.

“If resources permit, a second-stage confirmatory tier of testing can be performed.”

Dr. Levy's test of choice is a polymerase chain reaction-based test because it is highly sensitive and detects a different part of the virus than the point-of-care tests do. In the case of FeLV, she uses a newly offered laboratory test bundle that includes a highly sensitive microtiter plate test for FeLV p27 antigen and a newly developed quantitative PCR assay. Not only does this test combination confirm infection, Dr. Levy said, but it can also determine whether a cat has regressive or progressive infection, which provides information about prognosis, early death, and risk of shedding virus to other cats.

“Recent research has shown that cats with FIV infection can safely live with uninfected cats if they get along and do not fight, with very little chance of transmission,” Dr. Levy said. “Cats with FeLV, however, should live alone or with other infected cats since the risk of transmission of FeLV is higher. Cats with FeLV and FIV are increasingly managed by adoption, necessitating strong pet owner education and support from their new veterinarians.”

The guidelines provide the following summary points:

  • • Retrovirus infections remain common and important diseases of cats worldwide.

  • • Ongoing research into viral pathogenesis and improvements in diagnostic testing continue to refine the state of knowledge about these viruses.

  • • Practitioners are advised to take advantage of current peer-reviewed published reviews and recommendations for testing and management of cats in different populations.

BRAKKE STUDY: PET HEALTH PRODUCT SALES MIGRATE TO ONLINE SOURCES

About 31% of pet owners are sourcing at least some of their pet health products online, according to a new study from Brakke Consulting Inc.

On Jan. 13, Brakke Consulting released “Pet Health Products: Changing Channels.” Based on national surveys of pet owners and veterinarians, the study documents the rapid migration of pet health product sales to online sources.

“Nearly two thirds of veterinary practices (63%) offer online ordering and home delivery, up 16% in the last two years,” according to key findings from the study. “However, client awareness of that service lags. Still, this is a $550-$600 million market being serviced by veterinarians.

“Although 20% of pet owners have ordered products or received refills via home delivery from their vet, an additional 25% would order from the vet if their vet offered the service or they were aware that their vet does already offer the service.”

Online sales and home delivery for veterinary clinics are primarily handled by three companies: Covetrus, a public company; VetSource, a private firm; and MyVetStore, a service of Midwest Veterinary Supply.

Leading online retailers for pet health product sales include Chewy, Amazon, and 1-800-PetMeds. About 17% of pet owners purchase pet health products online from Chewy, 12% from Amazon, and 9% from 1-800-PetMeds. Online retailers are making their greatest inroads into flea and tick products, heartworm preventives, and therapeutic diets, according to the study.

Another factor at play in channel use is demographics. Among pet owners age 55 or older, 89% consider the veterinarian to be the most trusted source of information about pets, whereas only 5% say the same about online sources. For pet owners age 18-34, only about half consider the veterinarian to be the most trusted source of information, and 29% put more trust in online sources. Younger consumers also are the most oriented to online purchasing.

VACCINE HESITANCY

By Kaitlyn Mattson

Veterinary professionals face challenges surrounding vaccinations

Dr. Sarah J. Wooten, a small animal veterinarian from Greeley, Colorado, has had first-hand experience with clients who are concerned about vaccinations but says listening to their concerns without judgment may be beneficial.

“People are afraid of what the vaccines may do to their pets,” she said. “The intentions of people that don't want to vaccinate are pure. They just want their pets to be healthy and they're afraid.” Dr. Wooten retired from clinical practice and is now a public speaker and author.

In recent years, human medicine has faced a growing number of individuals who reject mainstream science regarding the safety and efficacy of vaccines. In the same vein, many veterinary professionals say that, increasingly, they are hearing concerns from pet owners regarding the safety or necessity of vaccines for their pets.

Many websites that identify as natural or holistic warn about the dangers of over-vaccination of dogs and cats, but none define what they mean by over-vaccination. All agree, for most vaccines, that annual revaccination is unnecessary, but that is generally consistent with recommendations from the AVMA and other major organizations.

A SCRIPT FOR DISCUSSING VACCINES WITH A CONCERNED CLIENT

Dr. Sarah J. Wooten, a small animal veterinarian from Greeley, Colorado, suggests the following script, first published in October 2017 in dvm360 magazine, for veterinarians discussing vaccines with a concerned client.

The veterinary professional: Bella is due for her vaccines.

Client: I don't want to have Bella vaccinated today.

The veterinary professional: Can you tell me your main concern with vaccination?

Client: I'm just not interested.

(This is when you need to finesse this conversation a little to get the client to open up.)

The veterinary professional: No pressure at all. I really just want to know what your concerns are so we can do the best thing for your pet.

(Client may get squirmy or evasive.)

Client: Well, I read that vaccines can cause autism.

The veterinary professional: Thanks for telling me, and that's a valid concern.

(Client usually appears surprised and relieved at this point.)

The veterinary professional: You aren't the only person who has heard that. When I heard about the study, I researched it myself, because I was worried about my pets. What I found is that the British study that linked autism to vaccines, the one that scared all the parents, was retracted about six years ago because the study was proven false. The Centers for Disease Control and Prevention has published a resource center that goes into great detail about the safety of vaccines if you'd like more information.

Infectious disease control represents a major part of our effort as your pet's health care providers. Vaccines are better studied than any other medicine we prescribe, and the manufacturers guarantee their safety and efficacy.

The vaccines we recommend are the vaccines we think your pet needs. I made sure my pet got these vaccines, and if Bella were my pet, I would be getting these vaccines for her to make sure she is as safe and healthy as she can be. Is that OK?

(Hopefully, at this point the client nods head and smiles. She might even say …)

Client: Thank you for explaining that. And not thinking I was crazy.

The veterinary professional: Of course. I know you want the best for your pet. You and I want the same thing. It's my job to help you with these concerns.

“In 16 years of practice, using this approach, I never had anybody say no to the core vaccines after that discussion because however emotionally attached they were to their position beforehand, when they actually saw all the pros and cons of it, they realized it's probably just better to get this thing done,” Dr. Wooten said.

Used with permission from dvm360.com

Some of these same sites warn about the potential long-term harms of over-vaccination, especially the potential for immune-mediated disease and cancer, but none provide any information on the specific types of diseases and cancers they associate with over-vaccination or the incidence. And none provide any data proving a cause-and-effect relationship between over-vaccination and these long-term concerns.

Still, in 2019, only 66% of dog, cat, and rabbit owners in the U.K. said their pet had its primary vaccinations when young, compared with 84% in 2016, according to the PDSA Animal Wellbeing Report, an annual analysis of overall pet well-being in the U.K.

However, despite this apparent increase in the reluctance to vaccinate their pets, most pet owners are willing to discuss the issue and just want their concerns to be heard and validated, according to veterinarians with whom JAVMA News spoke.

The trend has not gone unnoticed. The World Health Organization listed vaccine hesitancy as one of the top global threats in 2019, and the theme of the World Veterinary Association's 2019 World Veterinary Day was the “Value of Vaccination.”

CURRENT EFFORTS

The World Small Animal Veterinary Association has also observed the increase in hesitancy among clients and is surveying companion animal veterinarians about the issue to better understand the phenomenon. The association defines vaccine hesitancy as a “delay in acceptance or refusal of vaccines despite availability of vaccination services.”

Dr. Michael Day, chairman of the WSAVA Vaccination Guidelines Group, said lower herd immunity is one of the biggest concerns around this issue, as it means that well-controlled infectious diseases might become problematic again.

“As I travel the world speaking to veterinarians about vaccination, it is clear that vaccine hesitancy is of great concern to our colleagues in practice,” Dr. Day said. “Interestingly, the phenomenon appears to exist in both mature and developing veterinary markets.”

Dr. Day is emeritus professor of veterinary pathology at the University of Bristol, U.K., and adjunct professor of veterinary pathology at Murdoch University in Western Australia.

“These are difficult discussions for any veterinarian to have with clients who may firmly believe that vaccines are a potential danger to their pets,” he said. “Veterinarians need to adopt a nonconfrontational but persuasive communication style to convey correct, science-based information in an understandable fashion.”

To facilitate that conversation, the AVMA has several vaccination-related resources available for pet owners at jav.ma/VxResources. AVMA members can also download a handout version of the materials at jav.ma/Vaccinations.

The WSAVA group also developed a resource document intended for owners and breeders. The document discusses infectious disease, the immune system, vaccination, and vaccination protocols and is available at jav.ma/WSAVAguidelines (PDF).

WSAVA created the vaccine hesitancy online survey for companion animal veterinarians to understand better why owners decline vaccination for their animals, even when vaccines are affordable and readily available. It closed at the end of January for analysis; the data will be released publicly in September.

THE CONVERSATION

Dr. Catherine M. Brown, Massachusetts state epidemiologist and public health veterinarian, has received calls about vaccine hesitancy from veterinarians as well as questions about it at veterinary conferences.

“I think it is something that everybody is struggling with, and they want to provide good guidance for their clients. They don't want to coerce them but they also want to make sure the animal gets everything that is appropriate,” Dr. Brown said.

d1279154e1634

A map depicting rabies laws for dogs by state. Sixteen states require rabies vaccination but allow for medical exemptions, one state does not have a statewide law requiring vaccination, nine states only discuss vaccination being required for dogs imported into the state, and 24 states have statewide laws requiring vaccination and do not allow exemptions.

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Source: Information compiled from the AVMA, state websites, and the Animal Legal and Historical Center at the Michigan State University College of Law

She said the exposure risk for rabies, specifically, varies across the United States and depends on what variant of the virus is circulating in the area. But there is always a chance that any individual animal could come into contact with an infected wild animal.

She added that it is important to note that the U.S. has eliminated the dog variant of the rabies virus from circulation.

“It (rabies) is not in your face as much and therefore people—all of us, veterinarians and the public—sometimes forget what a significant risk rabies still can be,” Dr. Brown said. “I think we're seeing the same thing in human medicine with measles, mumps, and rubella. We see them a lot less frequently so people feel like, ‘Why do I have to vaccinate?’ And to be fair, I think it's a reasonable question to ask.”

Dr. Brown said she usually speaks to people about the risk of rabies and other diseases, as well as shares data on the safety of vaccines. She noted that there are potential adverse effects for any vaccine but that the number of animals that react poorly to the vaccine is small.

Dr. Wooten agrees that sharing information while also trying to understand the client's perspective helps. For example, a pet owner may say they don't want autism in their dog or cat and that they're more afraid of autism than of distemper, parvovirus, or rabies.

“I think the main thing is accepting where the pet parent is at, even if they are on a different planet than you,” Dr. Wooten said.

She suggests asking a pet owner about why they have such beliefs and where they got the information.

“It can be something like: ‘You are as much a decision-maker about your pet's health as I am. Tell me more about why you think that. Tell me more about where you got that information.’ And then, just shut your mouth and listen. … I find when you give people a chance to share their piece, to share their knowledge— even if it's erroneous—they feel heard, they feel validated, they feel respected. And then, if you ask for permission to share what you know about vaccine safety, efficacy, and the diseases they protect against and you allow the pet parent to make the decision based on all of that information, then you've done your part.”

ON THE BOOKS

Legally, pet owners in some states are required to vaccinate their dogs and cats against rabies. Some states prescribe a specific interval, while others refer to the label of the vaccine used or the Compendium of Animal Rabies Prevention and Control. Some states do provide exemptions to their vaccination requirements if medically necessary as determined by a veterinarian.

The AVMA has compiled a summary of the various state laws on rabies vaccination, which is available at jav.ma/StateRabiesLaws (PDF).

Importantly, although owners may be legally required to vaccinate their animals against rabies, other vaccines may not be required by law.

The WSAVA global vaccination guidelines list core vaccines for dogs as those that protect against canine distemper virus, canine adenovirus, and the variants of canine parvovirus type 2. Core vaccines for cats include those that protect against feline parvovirus, feline calicivirus, and feline herpesvirus-1, according to the WSAVA global guidelines for the vaccination of dogs and cats, released in January 2016. The Vaccination Guidelines Group recognizes that particular countries will identify additional vaccines that they consider core.

The American Animal Hospital Association updated its canine vaccination guidelines in 2017 and 2018. The guidelines are developed by the AAHA Canine Vaccination Guidelines Task Force and are at jav.ma/aahavax. The American Association of Feline Practitioners also has cat-specific vaccination guidelines at jav.ma/AAFPvax.

CONTINUED CHALLENGES

As the industry continues to face challenges around this topic, veterinary students are learning about how to speak to clients about vaccination.

Dr. Christopher R. Lea, an assistant clinical professor at Auburn University College of Veterinary Medicine, tries to include communication skills in the curriculum, including how to discuss vaccines.

“Twenty years ago, people never asked me about that. Now, people are more educated about vaccines, and they will ask more about safety and about risk,” Dr. Lea said. “We are trying to train our veterinarians to be educated about that and be able to answer those questions.”

Dr. Lea is one of two faculty members who direct Auburn's Veterinary Clinic, designed to provide preventive and wellness care for animals while providing fourth-year veterinary students with the educational experience of running a community practice.

He said when people come into the veterinary clinic who are hesitant to vaccinate, the students and veterinarians do their best to communicate their expertise.

“Sometimes they take our recommendations, and sometimes they don't,” Dr. Lea said. “At the end of the day, they'll make the decision for their cat, and you know, at that point we tell students, ‘You make your recommendation, and if they choose not to do that, you make some sort of medical record that it was discussed and declined, and then you move on.'”

Dr. Wooten believes that education and an open dialogue are key to curbing vaccine hesitancy.

“I think the main thing that we need to address is a combination of misinformation, usually from the internet, and then fear,” Dr. Wooten said. “You have to be open and curious about where that person is coming from.”

People: AMERICAN ASSOCIATION OF FELINE PRACTITIONERS

EVENT

Annual conference, Oct. 31-Nov. 3, San Francisco

PROGRAM

The conference, held during the 5th World Feline Veterinary Conference, focused on complex disease management. Attendees included 1,171 veterinarians, 166 veterinary technicians, 42 practice managers and hospital team members, 58 students, and more than 250 exhibitors and guests. On offer were educational sessions, including scientific research posters and oral abstract presentations; a feline-friendly handling laboratory; and opportunities to network with colleagues on feline medicine.

AWARDS

Journal of Feline Medicine and Surgery 20th Anniversary Award

d1279154e1738

Dr. Sally Lester

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Dr. Sally Lester (Washington State ‘67), Lake Stevens, Washington, for exceptional contributions to the journal in advancement of veterinary health care for cats around the world during the last two decades. A member of the JFMS editorial board for several years, Dr. Lester has reviewed the greatest number of articles for the journal since the association began to keep track in 2012. She is the founder of Central Laboratory for Veterinarians in Langley, British Columbia, and has served as a contributor to the Veterinary Information Network. Dual-certified in anatomic and clinical pathology by the American College of Veterinary Pathologists, Dr. Lester advises practitioners on the pitfalls of sample collection and handling, laboratory equipment, and what should be taken into consideration when interpreting laboratory results that may impact management and outcome for patients. She has also developed diagnostic tests to help veterinarians care for their patients.

Student Feline Enrichment Contest, sponsored by Purina Pro Plan Veterinary Diets

Winners: Jennifer Nary, Texas A&M University; Kate Rowatt, Texas A&M University; Samia Shalabi, University of Missouri; and Roxana Chan, University of Missouri

In addition to the above awards, a student award program, sponsored by Kindred Bio, and a Young Veterinarian Scholarship, sponsored by Royal Canin, provided several students and veterinarians access to education and networking at the conference.

OFFICIALS

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Dr. Kelly St. Denis

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Drs. Kelly St. Denis, Brantford, Ontario, president; Michelle Meyer, Sterling Heights, Michigan, president-elect; Colleen Currigan, Chicago, treasurer; Apryl Steele, Denver, immediate pastpresident and AVMA alternate delegate; Marcus Brown, Arlington, Virginia, AVMA delegate and director; and directors—Drs. Lauren Demos, Waterford, Michigan; Diana Lafer, West Hartford, Connecticut; Ken Lambrecht, Madison, Wisconsin; Paula Monroe-Aldridge, Tulsa, Oklahoma; Kira Ramdas, The Woodlands, Texas; and Tammy Sadek, Grand Rapids, Michigan

AMERICAN BOARD OF VETERINARY PRACTITIONERS

The American Board of Veterinary Practitioners welcomed 30 new diplomates following the board certification examination it held Oct. 9, 2019, in Denver. New diplomates are as follows:

AVIAN PRACTICE

Richard Burdeaux,

Cowlesville, New York

Kristin Gill, Tampa, Florida

Bianca Murphy, Oakley, California

Michelle Sutherland,

Hampton, Australia

Lauren Thielen, Grapevine, Texas

CANINE AND FELINE PRACTICE

Ericka Carroll, Frankfurt, Germany

Stephen Delia, Niles, Illinois

Beth Galles, Lincoln, Nebraska

Irit Grader, Brookfield, Connecticut

Doron Harel, Haifa, Ohio

Rhonda Holt, Corvallis, Oregon

Kathy Jordan

Townville, South Carolina

Nicolle Kirkwood,

Dulwich Hill, Australia

Lyndsey Larson, Denver

Casey Lee, Houston

Elaine Ng, Hong Kong

Rossana Perez-Freytes, Davenport, Florida

Amelie Thibaudeau, Adel, Iowa

DAIRY PRACTICE

Pedro Melendez, Tifton, Georgia

Gabriel Middleton, Orrville, Ohio

EQUINE PRACTICE

Patricia Bailey, Columbia, Missouri

Kelli Beavers, Baton Rouge, Louisiana

Michelle Husulak, Saskatoon, Saskatchewan

Jessica Millwood,

College Station, Texas

Emily Sundman, Lipan, Texas

Tracy Walker, Elkins, West Virginia

EXOTIC COMPANION MAMMAL PRACTICE

Andrew Bean, St. Paul, Minnesota

Sara Dias, Derby, England

FELINE PRACTICE

Lauren Demos,

White Lake, Michigan

FOOD ANIMAL PRACTICE

Michael Pesato,

Cochranville, Pennsylvania

AMERICAN COLLEGE OF VETERINARY RADIOLOGY

The American College of Veterinary Radiology welcomed 56 new diplomates in 2019. New diplomates are as follows:

EQUINE DIAGNOSTIC IMAGING

Myra F. Barrett, Fort Collins, Colorado

Elizabeth Biscoe, Irving, Texas

Robert C. Cole, Auburn University, Alabama

John F. Griffin IV, College Station, Texas

Eric T. Hostnik, Columbus, Ohio

Julien Olive, Annecy, France

Dana A. Neelis, Irving, Texas

Nathan C. Nelson, Raleigh, North Carolina

Amy Norvall, Davis, California

Mathieu Spriet, Davis, California

RADIOLOGY

Michelle M. Acierno, College Station, Texas

Ryan B. Appleby, Raleigh, North Carolina

Mylene Auger, Knoxville, Tennessee

Keely S. Brewer, Cypress, Texas

Laura Chadwick, Ames, Iowa

Bennett L. Deddens, Raleigh, North Carolina

Walter R. Detwiler, Pittsburgh

Helen Dirrig, Hatfield, England

Lincoln J. Every, Columbus, Ohio

Julien Fages, North Grafton, Massachusetts

Jason A. Fuerst, Columbus, Ohio

Rebekah A. Gallaher, Baton Rouge, Louisiana

Michelle Greer, Blacksburg, Virginia

Philip E.S. Hamel, Gainesville, Florida

Elizabeth Huynh, Gainesville, Florida

Monica L. Jensen, Guelph, Ontario

Kelsey Johnson, North Grafton, Massachusetts

Darin R. Kepler, Metairie, Louisiana

Timothy B. Kloer, Fort Collins, Colorado

Carrie A. Kuzma, Stillwater, Oklahoma

Jody E. Lawver, Raleigh, North Carolina

Assaf Lerer, Ithaca, New York

Samantha J. Loeber, Madison, Wisconsin

Ehren McLarty, Davis, California

Trevor R. Morimoto, Philadelphia

Masahiro Murakami, West Lafayette, Indiana

Esther G. Nell, St. Paul, Minnesota

Britton K. Nixon, Davis, California

Jae Yoon Park, Vancouver, British Columbia

Jennifer L. Ruby, Athens, Georgia

Adam J. Schlax, Philadelphia

Kate L. Shumway, Columbia, Missouri

Carissa L. Southard, Auburn, Alabama

Elisa Spoldi, Gainesville, Florida

Mark B. Taylor, Cypress, Texas

Janvier S. Valentin, Ithaca, New York

Jessica Vallone, College Station, Texas

Federico R. Vilaplana Grosso, Gainesville, Florida

Mason W. Wanamaker, Davis, California

Wylen W. Won, Mississippi State, Mississippi

Seng Wai Yap, Fort Collins, Colorado

Amy R. Zalcman, Frederick, Maryland

RADIATION ONCOLOGY

Carolynne R. Kruckman-Gatesy, Fort Collins, Colorado

Beatrix Jenei, Fountain Valley, California

Melanie A. Moore, Cincinnati

Jillian Walz, Columbus, Ohio

WISCONSIN VMA

EVENT

Annual meeting, Oct. 24, online; awards ceremony, Nov. 3, Madison

AWARDS

Veterinarian of the Year

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Dr. Nigel Cook

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Dr. Nigel Cook, Madison. A 1992 veterinary graduate of the University of Bristol in England, Dr. Cook is head of the Department of Medical Sciences at the University of Wisconsin-Madison School of Veterinary Medicine. He also manages Dairyland Initiative, an online resource that aims to optimize dairy cow health, performance, and well-being in order to create an economically viable and competitive dairy industry for all members of a dairy team.

Presidential Award

Dr. Douglas Kratt (Wisconsin ‘98), Onalaska. Dr. Kratt owns Central Animal Hospital, a small animal practice in Onalaska. He is president-elect of the AVMA and has served on the AVMA House Advisory Committee, Strategic Management Committee, and Task Force on Volunteer Engagement. Dr. Kratt is a past president of the WIVMA.

Meritorious Service Award

Dr. Eric Rooker (Wisconsin ‘13), Waldo. Dr. Rooker practices at Dairy Doctors Veterinary Services in Plymouth. He is working with the WIVMA to establish a leadership and business program.

Outstanding Service Award

Dr. Philip Johnson (Iowa State ‘81), Winneconne. Dr. Johnson practices at Omro Animal Hospital in Omro. He is a past chair of the Wisconsin Veterinary Examining Board and a past president of the WIVMA.

Outstanding Service Team

Country Hills Pet Hospital, Eden. The hospital serves as a resource for members of 4-H and scouts clubs, animal shelters, and schools. It also works with schools of technology to help students meet prerequisites for classes and fulfill externship requirements.

Veterinary Health Care Team Member of the Year

Jim Martin, Cedarburg. Martin is a customer service specialist at the Thiensville-Mequon Small Animal Clinic in Thiensville. He is known for his willingness to assist clients and fellow staff members.

Friend of Veterinary Medicine

Kristi Thorson, McFarland. Thorson is the associate dean for advancement and administration at the University of Wisconsin-Madison School of Veterinary Medicine. She was instrumental in helping get the veterinary school's expansion project approved.

BUSINESS

The financial report was presented.

OFFICIALS

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Dr. Ann Sherwood Zieser

Citation: Journal of the American Veterinary Medical Association 256, 5; 10.2460/javma.256.5.501

Drs. Ann Sherwood Zieser, Lodi, president; Thomas Bach, Madison, president-elect; David Jeans, Evansville, treasurer; and Alan Holter, Dodgeville, immediate past president

Obituaries: AVMA MEMBER | AVMA HONOR ROLL MEMBER | NONMEMBER

GERALD A. BEZNER

Dr. Bezner (Cornell ‘57), 86, Boxford, Massachusetts, died July 12, 2019. During his 58-year career, he owned small animal practices in Syracuse, New York, and Tequesta, Florida. Dr. Bezner's four daughters, a son, seven grandchildren, a great-grandchild, and a sister survive him.

GREGORY D. BOSSART

Dr. Bossart (Pennsylvania ‘78), 68, Milton, Georgia, died Nov. 19, 2019. He was senior vice president and chief veterinary officer at the Georgia Aquarium in Atlanta, overseeing animal care, research, and conservation programs. Dr. Bossart also served as an adjunct professor in the departments of pathology at the University of Georgia College of Veterinary Medicine and University of Miami School of Medicine, and he was a member of the graduate faculty at the Medical University of South Carolina. Earlier, he served as an affiliate professor at Florida Atlantic University's Harbor Branch Oceanographic Institute and was a research professor and director and head of pathology for the institute's Marine Mammal Research and Conservation Program.

Dr. Bossart led the Health and Environmental Risk Assessment Project for bottlenose dolphins, and with research partners, he identified resurgent and emerging diseases in dolphins, manatees, birds, and whales. He helped characterize the first viral diseases in manatees and developed the first immunohistochemical technique for diagnosing brevetoxicosis in both marine mammals and birds. Dr. Bossart had collaborative research projects with the National Marine Fisheries Service, National Ocean Service, National Institute of Environmental Health Sciences, and Office of Naval Research. He was a member of the board of directors of the One Health Commission and, along with a research team, studied the role of aquatic species as sentinels for the effects of environmental change on animals, the ecosystem, and human health.

Dr. Bossart had a doctorate in immunopathology from Florida International University and was a diplomate of the American College of Veterinary Pathologists and European College of Zoological Medicine. He received several honors, including an Alumni Award of Merit from the University of Pennsylvania School of Veterinary Medicine in 1993 and William Medway Award for Excellence in Teaching from the International Association for Aquatic Animal Medicine in 2019.

Dr. Bossart is survived by his wife, Jennifer; two daughters and a son; and a brother. Memorials may be made to the Georgia Aquarium, 225 Baker St. NW, Atlanta, GA 30313, georgiaaquarium.org; Christian Veterinary Mission, 19303 Fremont Ave. N., Seattle, WA 98133, cvm.org; or Medical Missions Ministries Guatemala, 11625 Rainwater Drive Suite 500, Alpharetta, GA 30009, mmm-guatemala.com.

WILLIAM W. BUISCH

Dr. Buisch (Kansas State ‘70), 75, Cary, North Carolina, died Aug. 17, 2019. He worked for the Department of Agriculture prior to retirement. Dr. Buisch authored the book “The Ark's Cargo: For the Love of Animals.” Memorials may be made to Trinity Park Church, 14001 Weston Parkway Suite, 122 Cary, NC 27513.

GWENDOLYN R. JANKOWSKI

Dr. Jankowski (Oklahoma State ‘08), 39, Denver, died Aug. 9, 2019. She was an associate veterinarian at the Denver Zoo. Dr. Jankowski participated in several research expeditions to Peru to study environmental impacts on seals and penguins. She was a diplomate of the American College of Zoological Medicine and a member of the American Association of Zoo Veterinarians.

Dr. Jankowski is survived by her husband, Ben; three children; her parents; and a sister.

GARY D. OSWEILER

Dr. Osweiler (Iowa State ‘66), 76, Ames, Iowa, died Aug. 13, 2019. A past president of the American Board of Veterinary Toxicology, he was a professor emeritus of veterinary toxicology at Iowa State University and a past director of the university's Veterinary Diagnostic Laboratory. Following graduation, Dr. Osweiler served as a clinician at the ISU VDL and ISU Veterinary Field Services unit. After obtaining his master's in pathology in 1968 and earning a doctorate in toxicology in 1973, both from Iowa State, he joined the veterinary faculty of the University of Missouri, where he taught, conducted research, and provided clinical and diagnostic toxicology services until 1982.

In 1983, Dr. Osweiler returned to ISU as a professor of veterinary toxicology and section leader of toxicology. He chaired the interdepartmental toxicology graduate program for several years and was named director of the VDL in 1994, serving in this capacity until 2004. Dr. Osweiler retired in 2010.

Known for his research on mycotoxins, he co-authored the textbook “Clinical and Diagnostic Veterinary Toxicology.” Dr. Osweiler was a past president of the American Association of Veterinary Laboratory Diagnosticians and American Academy of Veterinary and Comparative Toxicology, was a past chair of the Food and Drug Administration's Veterinary Medicine Advisory Committee, and served on the National Organics Standards Board.

His wife, Sue; two sons and two daughters; five grandchildren; and two brothers and a sister survive him. Memorials may be made to Heifer International, 1 World Ave., Little Rock, AR 72202.

KENNETH R. PADGETT

Dr. Padgett (Georgia ‘63), 82, Jacksonville, North Carolina, died July 14, 2019. He practiced small animal medicine at Jacksonville Veterinary Hospital, College View Veterinary Clinic, and Coastal Veterinary Emergency Clinic, all in Jacksonville. Dr. Padgett was a past president of the North Carolina Veterinary Medical Board and North Carolina VMA, and he was a past North Carolina delegate to the AVMA House of Delegates. In 1994, he was honored as NCVMA Distinguished Veterinarian of the Year. In 2004, he was named a Distinguished Alumnus by the University of Georgia.

Dr. Padgett served on the Onslow County Board of Health from 2007-12. His wife, Chase, and a daughter survive him. Memorials may be made to First Presbyterian Church, 400 N. Bayshore Blvd., Jacksonville, NC 28540.

DANIEL H. RICE III

Dr. Rice (Pennsylvania ‘63), 86, Hubbardston, Massachusetts, died Aug. 23, 2019. From 1969 until retirement in 2008, he owned a small animal practice in Holden, Massachusetts. Earlier, Dr. Rice worked at Shrewsbury Animal Hospital in Shrewsbury, Massachusetts. In retirement, he volunteered with NEADS, formerly National Education for Assistance Dog Services, in Princeton, Massachusetts.

Dr. Rice was a veteran of the Navy. His wife, Carol, and a sister survive him. Dr. Rice's nephew, Dr. Steven Atwood (Pennsylvania ‘80), is a veterinarian in West Tisbury, Massachusetts. Memorials may be made to NEADS, P.O. Box 1100, Princeton, MA 01541.

DAVID H. SPEARMAN

Dr. Spearman (Georgia ‘56), 86, Easley, South Carolina, died Aug. 15, 2019. In 1957, he established a practice in Easley, where he initially practiced mixed animal medicine, focusing later on small animals. Before that, Dr. Spearman worked at Cleveland Park Animal Hospital in Greenville, South Carolina. He retired after 48 years in practice.

Dr. Spearman served on the South Carolina Board of Veterinary Medical Examiners from 1981-88, chairing the board in 1987. He was a past president of the South Carolina Association of Veterinarians and was named Veterinarian of the Year in 1985. Dr. Spearman served as the alternate delegate from South Carolina to the AVMA House of Delegates from 1991-95 and was delegate from 1996-2000. He was also a past president of the Blue Ridge VMA, served on the advisory board of the veterinary technology program at Tri-County Technical College, and was a member of the admissions committee for the University of Georgia College of Veterinary Medicine and of the advisory committee for preveterinary students at Clemson University.

Active in his community, Dr. Spearman was a member of the Easley Chamber of Commerce, a past chair of the Easley Zoning Board, a past president of the Easley Lions Club, and a member of the Pendleton Farmers Society and Pickens County Historical Society. He was also a charter member and a past state director of Trout Unlimited and a life member of the World Wildlife Federation.

Dr. Spearman is survived by a daughter, a son, and two grandchildren. Memorials may be made to Christian Veterinary Mission, 19393 Fremont Ave. N., Seattle, WA 98133, cvm.org; Pickens County Historical Society/Hagood Mill Preservation, P.O. Box 775, Pickens, SC 29671; or Greenville Area Parkinson Society, 40 John McCarroll Way, Greenville, SC 29607, gapsonline.org.

JAMAL O. TOLER

Dr. Toler (Tuskegee ‘98), 47, Lithonia, Georgia, died July 3, 2019. A small animal veterinarian, he and his wife, Dr. Whitney R. Rose-Toler (Tuskegee ‘97), owned Deshon Animal Hospital in Lithonia since 2003. Dr. Toler had a special interest in orthopedic surgery. Earlier, he worked in Michigan and Ohio.

Dr. Toler was a member of the Ron Benders Fishing Club. He is survived by his wife, two daughters, his parents, and a brother.

Please report the death of a veterinarian promptly to the JAVMA News staff via a toll-free phone call at 800-248-2862, ext. 6754; email at news@avma.org; or fax at 847-925-9329. For an obituary to be published, JAVMA must be notified within six months of the date of death.

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