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IN SHORT

COVID-19 HANDOUTS FOR PET OWNERS COVER SOCIALIZING DOGS, RETURNING TO WORK

The AVMA has developed information for pet owners that covers how to socialize dogs during the COVID-19 pandemic and 10 ways to get pets ready for when owners return to work.

“Even while observing social distancing, it's important to prepare dogs to enjoy new and different experiences, people, and other animals,” according to the handout titled “How can I socialize my dog during COVID-19?”

The downloadable document provides tips for activities in the categories of going for a walk, going for a car ride, preparing for veterinary visits, letting dogs explore indoors, working with a crate, and maintaining a routine.

The handout “Return to work: 10 ways to get your pet ready” states: “Dogs and cats are creatures of routine. If you've been at home with them for weeks or months, they've gotten used to having you around all day. Before you go back to work, it's important to prepare them. A gentle transition will help make this change in routine as stress-free as possible.”

This document provides tips in areas such as slowly introducing workday routines, taking anxiety out of the owner's departure, exercise for pets, keeping pets occupied through the day, creating a safe space, and turning on background noise.

The handouts are available at jav.ma/socialpet.

STUDY DEBUNKS DOG YEARS

University of California-San Diego researchers have created a genetic formula for comparing human age to dog age that researchers claim is more accurate than the traditional ratio of 1-to-7.

The new methylation-based formula, published July 2 in the online journal Cell Systems, is a kind of epigenetic clock that helps determine the age of a cell, tissue, or organism based on a readout of its epigenetics. These chemical modifications are akin to methylation, which influences which genes are off or on without altering the inherited genetic sequence itself.

What emerged from the study is a graph that can be used to match up the age of a dog with the comparable human age.

Compared with humans, dogs age rapidly, especially when they are young, according to the study. A 1-year-old dog is similar to a 30-year-old human. A 4-year-old dog is similar to a 52-year-old human. Then by age 7, dog aging slows.

“This makes sense when you think about it. After all, a nine-month-old dog can have puppies, so we already knew that the 1:7 ratio wasn't an accurate measure of age,” said senior author Trey Ideker, PhD, professor at UC-San Diego School of Medicine and Moores Cancer Center, in a statement.

BLOOD TEST CREATED FOR CANINE IBD

A Mars subsidiary created a blood test for canine inflammatory bowel disease, also known as canine chronic enteropathy.

In an announcement published July 15, officials with Antech Diagnostics said the assay can tell veterinarians whether measurements of three biomarkers are consistent with IBD, giving them a chance to rule it out as a cause of chronic vomiting, diarrhea, or both. Veterinarians can use the results to justify imaging, endoscopy, or other diagnostics, as well as develop treatment plans, the announcement states. Repeated tests could help veterinarians monitor response to treatment.

The assay detects signs of bacterial proliferation, intestinal inflammation, and sensitivity to gliandins, which are components of gluten.

An article published in April in the Journal of Veterinary Internal Medicine describes the enzyme-linked immunosorbent assay-based method as promising for detecting and differentiating IBD versus other acute gastrointestinal conditions. That study involved 70 dogs with biopsy-confirmed IBD, 23 with non-IBD gastrointestinal disease, and 58 healthy dogs.

Details are available at antechdiagnostics.com.

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

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The AVMA House of Delegates held its regular annual session virtually July 30-31, with some AVMA leaders and staff members working behind the scenes in person at AVMA headquarters in Schaumburg, Illinois. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Diversity, equity, inclusion efforts approved by Board, House

AVMA seeks external expertise, explores professionwide entity to examine this issue

By Malinda Larkin

The AVMA Board of Directors at its July 29 virtual meeting committed to retaining an outside diversity, equity, and inclusion consultant to help identify areas of greatest need, set priorities, and use resources most effectively. The Board of Directors also approved in concept the establishment of a profession- and industrywide commission to examine DEI issues affecting veterinary medicine.

Two days later, the AVMA House of Delegates approved a recommendation to the Board in support of the Board's commitments to make veterinary medicine more diverse, equitable, and inclusive. The move, during the regular annual session of the HOD held virtually July 30-31, caps off months of increasing interest and discussion in the veterinary profession on how to address systemic racism in light of the killings of George Floyd and other Black individuals earlier this year and the resulting protests and movement for social justice.

The recommendation asks the Board to implement the following actions:

  • Establish diversity, equity, and inclusion as the Association's own strategic focus.

  • Retain outside DEI expertise to help identify areas of greatest need, set priorities, and use Association resources most effectively.

  • Collaborate with key stakeholders, including DEI affinity groups, among others, to establish a professionwide entity to examine and take action on DEI issues affecting the veterinary profession.

  • Provide timely and regular communications to update the HOD and members of the AVMA and Student AVMA on progress addressing DEI within the Association and in the profession.

  • Promote the AVMA's DEI resources to AVMA and SAVMA members.

The resolution passed with 92.3% support.

Earlier, the Board had approved hiring a DEI consultant. The goal was to define the consultant's scope of work and identify candidates by Sept. 15. The Board also approved exploring the establishment of a professionwide commission to examine DEI issues affecting the profession. A consensus on the concept is expected by Oct. 1.

The outside expert will advise the AVMA on several suggested initiatives and projects, including many raised by the DEI affinity groups, led by the Multicultural VMA. These include areas of self-assessment, accessibility for all AVMA members to join and grow within AVMA leadership, accountability and transparency, gathering and analyzing member data, expanding membership and organizational commitments, and considering additional financial and structural commitments to improve DEI in veterinary medicine.

CONGRESSIONAL ENCOUNTER

Dr. Janet Donlin, AVMA CEO, addressed the HOD at the beginning of the session.

“This is your association, and we are committed to making sure everyone feels welcome, included, and an important part of this great profession,” she said. “Recent events have given us an opportunity to pause and reflect, to listen and to learn, and to consider what more we can do. We are committed to ensuring our profession is infused with an inclusive and diverse culture so everyone feels welcome, respected, and valued so we can best serve members, teams, communities, and clients.”

Dr. Rena Carlson, outgoing AVMA Board chair, addressed the encounter on the Capitol steps between U.S. Reps. Alexandria Ocasio-Cortez, D-N.Y., and Ted Yoho, R-Fla., a veterinarian, during which Rep. Yoho reportedly directed a sexist remark toward Rep. Ocasio-Cortez (see letters to the editor, page 590).

“We've heard from many AVMA members, both women and men alike, about this matter. We hear you, and we are listening.

“On Friday, July 24, the AVMA posted a statement on Facebook clearly reaffirming our values and what we stand for: that such behavior, whenever it happens, is inappropriate and unacceptable. We stressed our expectation that our members—whatever their current role may be—should demonstrate professionalism to others at all times and uphold the dignity and respect of the veterinary profession. I understand that some are not satisfied with our statement because it doesn't directly condemn Rep. Yoho. However, we need to be clear on this as well: None of us were on those steps when this encounter occurred.

“So we're faced with two members of Congress offering very different characterizations of what happened on the Capitol steps. In the interest of fairness and without that firm knowledge of how the interaction transpired, we find it challenging to make a specific statement about Rep. Yoho's behavior or words.”

Dr. Carlson continued: “For many of us, this type of language is far from new. We vividly remember our own personal experiences, from small sexist comments to those that hurt us to abuses that left us harmed and forever changed. When these encounters are reported, that memory and pain returns. The language reported in the news does not reflect what we stand for. Abusive language and misogynistic behavior have no place in veterinary medicine or society as a whole. The AVMA will continue to stand by our values and reiterate that derogatory and abusive language, when it happens, undermines our progress toward gender equity.

“We must move forward together. Our profession is strong because it's unified. What we can do together as a unified veterinary community … is to learn from this and reflect on ways we should conduct ourselves and show respect to one another. And I firmly believe this lesson applies to all of us—myself, all of you, Representative Yoho, and everyone else who represents this great profession.”

TESTIMONIAL VIDEO

Also at the HOD meeting, Dr. Douglas Kratt, incoming AVMA president, made remarks on and introduced a video put together by 10 affinity organizations with a focus on diversity, equity, and inclusion: the Association of Asian Veterinary Medical Professionals, BlackDVM Network, Latinx VMA, Multicultural VMA, National Association for Black Veterinarians, Native American Veterinary Association, Pride Veterinary Medical Community, Pride Student VMC, Veterinarians as One for an Inclusive Community for Empowerment, and Women's Veterinary Leadership Development Initiative.

The video included testimonials from some of the hundreds who had submitted experiences of discrimination in the profession. Examples include a white professor at a veterinary college showing pictures of himself posing as a Mexican and another in blackface during a lecture. The person who recounted the latter incident reported it, but nothing happened. Another example was witnessing a veterinarian in the clinic telling a difficult pet, “Don't make me George Floyd you.”

Dr. Carol G. Ryan, Missouri delegate, said, “I think a lot of times when we hear problems like this, if we're not involved, we think they go away, but the other option is to face it head on, and that's what we need to do. If I don't hear things like that, I don't know they're going on.”

Dr. Christina V. Tran, president of the Multicultural VMA, told JAVMA News, “The results from the AVMA HOD July 2020 session represent a significant shift in AVMA's previous prioritization of issues involving diversity, equity, and inclusion. We hope that forward progress will continue in a timely fashion and that these sustained efforts will be appropriately supported by the AVMA and made transparent to its membership and all stakeholders. There is more work to be done, and we anticipate broad participation and active collaboration between the AVMA and the veterinary community.”

Busy times, stress for veterinarians during pandemic

Delegates talk about lessons learned so far from dealing with COVID-19

By Malinda Larkin

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Drs. Issac Bott, Society for Theriogenology delegate, and Diana Thomé, Washington state alternate delegate, talk about their experiences during the COVID-19 pandemic at the AVMA House of Delegates’ Veterinary Information Forum, held virtually at the regular annual session on July 30. (Photos by Malinda Larkin)

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

The AVMA House of Delegates Veterinary Information Forum focused on “Veterinary Medicine in the Aftermath of COVID-19: What Have We Learned That Will Guide Our Future.” The forum took place virtually July 30 during the HOD's regular annual session.

Delegates discussed how busy their practices are now, concerns they have for keeping themselves and their staff members healthy, how to balance work with having children who aren't going to school in person, and more. Federal agency representatives also gave an update on SARS-CoV-2 in animals, their efforts to communicate with those on the front lines, and preventing drug shortages and the sale of fraudulent products.

NO GOOD OPTIONS

Delegates took much of the time to express their concerns about and suggestions for how to work safely and effectively during a pandemic.

Dr. Diana Thomé, Washington state alternate delegate, said she was looking for strategies for parents dealing with returning to work while their kids are at home. “There are potential staffing shortages that might occur for working families and in particular working mothers as they have to educate their kids this fall,” she said.

Other well-being issues were brought up by Dr. Wendy Hauser, who is the American Animal Hospital Association delegate. She's been bringing her own pets in for care and having conversations with the staff members.

“From the outside, things are running efficiently, but from their perspective, they are stressed,” Dr. Hauser said. “One is a lack of efficiency, the additional time it's taking. I understand the flood gates are open now, but we can't ask people to work consistently these longer days to make up for a lack of efficiency.”

“The other pain point is the lack of patience on the part of clients. What communication tools could be enhanced for our veterinary hospitals to help them deal with unhappy clients rather than knee-jerk fire them?”

Dr. William Grant, California delegate, said his clinic is averaging 70-100 transactions a day. It also had two exposures to COVID-19 among staff members. The infections came from family members or other people outside the hospital.

“I think our focus, which was protecting staff from the general public, actually protected staff from each other. It worked out well,” he said. “We do have quite a bit of stress going on with the number of cases we're seeing, but if we really focus on taking care of our staff, it really protects them not just from people coming in, but from the people at home, which was the case for the two we saw. We were fortunate.”

Another practitioner wasn't so lucky. Dr. Issac Bott, Society for Theriogenology delegate, has a mixed animal practice in Springville, Utah. Despite his team being diligent about wearing masks and following guidelines, at the end of June, he and two other staff members contracted COVID-19, which forced him to close his practice for two weeks. He also applied for a Paycheck Protection Program loan and received one.

“If not for that, my clinic—which has been running since 1966—would have failed,” Dr. Bott said. “I wanted to thank the AVMA for their work on COVID.”

Dr. Kate Boatright, Pennsylvania alternate delegate, works with a lot of veterinary students and recent graduates. She thinks it will be important for practitioners to work on being mentors for recent graduates in the next few years because the pandemic has had a big impact on their education.

“We're going to be filling in gaps down the road,” she said. “We need to be patient. For the next several years, this will have a ripple effect on their education.”

Dr. Cheryl Greenacre, delegate for the Association of Avian Veterinarians, is a faculty member at the University of Tennessee College of Veterinary Medicine.

“We do need to make sure we teach fourth-year students and have hands-on instruction and put them in the clinic,” Dr. Greenacre said. However, she said, “You have to put yourself in my shoes and other faculty, technicians, and staff working at a university. We have no choice; we have to go in. We're considered essential workers, seeing students and patients.

“We have faculty out sick with COVID-19. How bad do you let it get, and where do you draw the line?

No one had a good answer for this. Me personally and others, we have moderate risk, and my husband has severe risk. I have no choice, I have to go into work.”

Dr. Greenacre suggested the AVMA form an advocacy group for veterinary academic faculty to give this group a collective voice.

COVID-19 VIRUS IN ANIMALS

Drs. Casey Barton Behravesh, director of the One Health Office for the Centers for Disease Control and Prevention's National Center for Emerging and Zoonotic Infectious Diseases, and Jane Rooney, assistant director of the One Health Coordination Center at the U.S. Department of Agriculture Animal and Plant Health Inspection Service's Veterinary Services, gave the presentation “Mobilizing a One-Health Approach to Understand the Role of Animals in COVID-19.”

“Since the emergence of SARS-CoV-2, much emphasis has been placed on the one-health aspects of the pandemic,” Dr. Barton Behravesh said. “This is critical to address the pandemic as well as future health threats. We've been coordinating, collaborating, and communicating across all relevant sectors, including the CDC, USDA, state partners, and Interior Department.”

She also noted that published and preprint research on experimental or natural infections with the COVID-19 virus in animals has found that cats, ferrets and minks, golden hamsters, nonhuman primates, and tree shrews are highly susceptible to SARS-CoV-2 infection. Dogs and Egyptian fruit bats are moderately susceptible. Mice, poultry, and pigs are not susceptible.

As of Aug. 5, animals positive for SARS-CoV-2 reported globally were 27 cats, 18 dogs, four tigers, three lions, and 31 affected mink farms, with most of the mink farms being in the Netherlands. In all, 1 million minks have been depopulated.

PREVENTING DRUG SHORTAGES, FRAUD

Dr. Steven Solomon, director of the Food and Drug Administration Center for Veterinary Medicine, said drug shortages, fraudulent products, and veterinary telemedicine have been the center's focus during the pandemic.

“When COVID-19 started affecting facilities, we proactively contacted animal health drug makers and set up a mechanism for them to forecast and report so they could keep animal drugs available,” Dr. Solomon said. “We've mitigated multiple drug shortages through working together.”

Examples of active pharmaceutical ingredients and finished products that were either at risk of going into shortage or were in actual shortage included sedative and anesthesia products, nonsteroidal anti-inflammatory drugs, cardiac drugs, and antimicrobials, according to the FDA CVM. Some of the root causes of manufacturing slowdowns were a lack of personal protective equipment for production, sudden closures because of COVID-19-related issues, decisions by foreign governments to shut down export of specific active pharmaceutical ingredients, and a decrease in air travel leading to shipping products by sea, resulting in shipment delays, the agency said.

The pandemic has also offered a tremendous opportunity to capitalize on fears by selling products that have false claims, Dr. Solomon said.

“We monitor for claims and hazardous products. When hydroxychloroquine popped up, we warned against that. We did the same for ivermectin and worked with online marketplaces to remove (these drugs) from websites,” he said. “Fraudulent products for COVID-19 have been plentiful, like claims that CBD could cure COVID-19.”

On July 21, the FDA CVM issued additional warning letters to Fishman Chemical of North Carolina and New Life International for marketing unapproved chloroquine products labeled for use in ornamental fish. An agency spokesperson said although neither product identified in these warning letters made claims about use in people, the agency is concerned that consumers may mistake unapproved chloroquine phosphate animal drugs for the human drug chloroquine phosphate.

Finally, Dr. Solomon said the FDA CVM recognized that many veterinarians wouldn't be able to see patients in person while states were under stay-at-home orders and even after reopening.

“Through guidance, we temporarily relaxed some in-person visit requirements of the veterinarian-client-patient relationship,” he said. “This allows vets to expand the use of telemedicine, instead of doing an in-person examination before prescribing extralabel drugs and veterinary feed directive drugs.”

DELEGATES REVISE POLICIES ON TRANSPORT OF RESEARCH ANIMALS, ANTIPARASITIC RESISTANCE

The AVMA House of Delegates approved revisions to AVMA policies on transportation of research animals and on antiparasitic resistance during the regular annual session of the HOD in late July.

The AVMA Animal Welfare Committee had reviewed the AVMA policy on “Transportation of Research Animals for the Purpose of Research, Testing, and Education” because of the directive that all policies be reviewed every five years.

The HOD approved changes that included adding language stating that veterinarians should be involved in the evaluation of transportation methods for research animals and that air and ground transportation should be available to allow for selection of the best method to provide for animal welfare.

“In recent years, there have been very severe restrictions put on the air transportation of certain species due to pressures from outside groups,” said Dr. William Stokes, delegate for the American Society of Laboratory Animal Practitioners, in an HOD reference committee. For instance, very few airlines worldwide will transport nonhuman primates for research. “When air transportation is advantageous to the welfare of the animal because you can get it to a place much faster than by ground transportation or even ship transportation, the biomedical research community and the veterinary laboratory animal community would really like to have better access to air transportation.”

The AVMA Council on Biologic and Therapeutic Agents reviewed the AVMA policy “Antiparasitic Resistance” also in accordance with the five-year review directive. The HOD approved changes to delete a list of parasites known to have developed resistance to common parasiticides because the list is not exhaustive and to recommend that veterinarians lead the decision-making process regarding use of parasiticides and that studies of antiparasitic drug susceptibility be considered in decision-making.

Women candidates mark historic first for AVMA

Bransford and Teller are part of the first women-only race for AVMA presidency

By R. Scott Nolen

Two veteran AVMA volunteers are running for the 2022-23 AVMA presidency and are making history while doing it.

Dr. Grace Bransford, immediate past vice president for the AVMA, and Dr. Lori Teller, newly elected chair of the AVMA Board of Directors, launched their candidacies during the AVMA House of Delegates’ virtual regular annual session on July 31.

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Dr. Grace Bransford

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Although the nomination period remains open until July 26, 2021, this is the first time in the AVMA's nearly 160-year history that two women are competing for the presidency. Voting will occur next summer during the regular annual session of the HOD, with the winner elected as 2021-22 AVMA president-elect and next in line for the presidency.

Only three women have ascended to the office of AVMA president. Dr. Mary Beth Leininger was the first, in 1996. Next was Dr. Bonnie Beaver in 2004, followed by Dr. René Carlson in 2011. Since then, two women have run unsuccessfully for the AVMA presidency: Drs. Jan Strother in 2015 and Angela Demaree in 2017.

As a sign that the profession has shifted in recent decades from mostly male to female, women currently hold several leadership positions within the AVMA, including Board chair and vice chair, vice president, and executive vice president.

Dr. Bransford of Mill Valley, California, is a 1998 graduate of the University of California-Davis School of Veterinary Medicine and a small animal practitioner in Marin County in the San Francisco Bay area.

The former AVMA vice president has been involved in AVMA volunteer leadership for the past 20 years, serving on numerous councils and committees, along with being a member of the AVMA's 20/20 Commission and the Task Force on Governance and Membership Participation.

Prior to veterinary medicine, Dr. Bransford had a 10-year career in advertising and marketing, where she worked with some of the top consumer businesses, including Anheuser-Busch and Pepsi-Cola.

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Dr. Lori Teller

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Speaking during the virtual HOD meeting, Dr. Bransford said, “We can work harder to make sure that our Association and our profession reflect the diversity of our country, and we can continually evaluate ourselves to see that we are considering the global collective and perspectives in our actions.”

The same day Dr. Teller announced her candidacy, the AVMA Board elected her as its chair. Dr. Teller is a clinical associate professor of telehealth at Texas A&M University College of Veterinary Medicine & Biomedical Sciences, from which she graduated in 1990.

A board-certified diplomate of the American Board of Veterinary Practitioners in canine and feline practice, Dr. Teller practiced for several years at Meyerland Animal Clinic in Houston until joining the faculty at TAMU in 2018.

Three years earlier, Dr. Teller was elected District VIII representative on the AVMA Board, representing AVMA members living in Arkansas, Louisiana, and Texas. She is a founding board member of the Women's Veterinary Leadership Development Initiative, which is dedicated to helping develop female leaders in veterinary medicine.

During the virtual meeting, Dr. Teller said, “As president-elect of the AVMA, I can continue to help guide the Association to meet the needs of the profession and help us become more proactive in addressing current issues and those just over the horizon.”

ADVOCATE FOR ANIMAL WELFARE WINS AVMA AWARD

By Katie Burns

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Dr. Bonnie V. Beaver

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Dr. Bonnie V. Beaver has been active with fully 30 veterinary organizations and related groups over the course of a busy career as a veterinarian in academia, with her special interests being the human-animal bond, animal behavior, and animal welfare.

During the AVMA Virtual Convention 2020, the longtime professor at Texas A&M University received The AVMA Award, which recognizes contributions to the advancement of veterinary medicine in its organizational aspects. Among her accomplishments, Dr. Beaver is a past president of the AVMA and a founder of the American College of Veterinary Behaviorists and the American College of Animal Welfare.

Dr. Debra L. Zoran, also a professor at Texas A&M, nominated Dr. Beaver for the award. In her nomination letter, Dr. Zoran wrote of Dr. Beaver, “Her contributions to veterinary medicine in general, behavioral science, and animal welfare in particular, and most specifically to organized veterinary medicine have been exceptional and have changed our profession for the better.”

A veterinarian was the only thing Dr. Beaver was ever going to be, according to her mother. Dr. Beaver said: “I do not remember making that choice, but there was never any doubt. This was at the time when ‘Women can't be veterinarians,’ but I had parents who encouraged me to become anything I wanted.”

Private practice was Dr. Beaver's first choice. After graduating in 1968 from the University of Minnesota College of Veterinary Medicine, she worked for her hometown practitioner. Then she filled in temporarily doing surgery at the veterinary college, and she discovered that she liked teaching and the academic atmosphere. Afterward, she joined the veterinary faculty at Texas A&M.

“The longer I have been in teaching, the more I enjoy working with students,” Dr. Beaver said. “They challenge us to dig deeper into subjects, brighten your day, and reinforce our love of the profession.”

Dr. Beaver said she got involved in many organizations because she learned long ago that if you want to make a difference, you need to be where the decisions are made. Every organization she has belonged to has taught her something, from scientific information to leadership skills. In each organization, she has found her colleagues interesting and engaging.

Dr. Beaver said: “A few years after coming to Texas, a kennel club asked if I would give a talk on conformation and one on dog behavior. Why not? From there, it became obvious that the public was starting to demand solutions for pet behavior problems.”

She went on to call the organizational meeting of what became the American Society of Veterinary Ethology, now the American Veterinary Society of Animal Behavior. Eventually, she chaired the organizing committee for the American College of Veterinary Behaviorists, which received provisional recognition from the AVMA American Board of Veterinary Specialties in 1993 and full recognition from the ABVS in 2001.

Animal welfare has been important to Dr. Beaver throughout her life. Issues regarding horse slaughter and the housing of farm animals surfaced during her run for AVMA president-elect, so she decided to focus on animal welfare as 2004-05 AVMA president. She helped create the AVMA Animal Welfare Division and reorganize the AVMA Animal Welfare Committee.

“The American College of Animal Welfare came out of the package of ideas associated with my AVMA presidency about keeping veterinarians positioned as the go-to people for animal welfare,” Dr. Beaver said. She chaired the organizing committee for the college, which received provisional recognition from the ABVS in 2012.

Dr. Beaver continues to teach animal behavior, animal welfare, and the human-animal bond to veterinary students at Texas A&M. She also gives lectures and writes books on those topics, does some private consulting, and always enjoys the opportunity to watch her horses show.

MERITORIOUS SERVICE AWARD GOES TO POPPE

The AVMA presented the AVMA Meritorious Service Award in August to Dr. John Poppe, who retired at the end of 2015 as a brigadier general and the 25th chief of the U.S. Army Veterinary Corps after serving 28 years as a veterinarian in the Army.

Dr. Poppe (Washington State ‘86), a diplomate of the American College of Veterinary Preventive Medicine, oversaw veterinary care for pets of military families, government-owned animals ranging from military working dogs to ceremonial horses, and even the Navy's marine mammals, as well as ensured food safety for all services within the Department of Defense and many other federal agencies around the world. He was stationed in Korea and Turkey and in the United States, including a tour in the Pentagon, where he served as the Army assistant surgeon general. He served on multiple operational assignments, including in Grenada, Botswana, Thailand, and Iraq.

He retired to San Antonio, where he serves as the director of parish operations at Crown of Life Lutheran Church and vice chairman of the Military Affairs Committee of the San Antonio Stockshow & Rodeo. He is president of the Uniformed Veterinary Medicine Association.

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Dr. John Poppe

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Association presents Excellence Awards for 2020

Individuals recognized for contributions in a wide variety of areas

During the AVMA Virtual Convention 2020 this August, the recipients of this year's AVMA Excellence Awards were recognized for their contributions in areas such as public service, international veterinary medicine, and research.

Dr. Bonnie V. Beaver received the AVMA Award (see previous page), and the AVMA Meritorious Service Award went to Dr. John Poppe (see above). The AVMA previously announced that Dr. Robin Downing is the recipient of the Bustad Companion Animal Veterinarian of the Year Award, Dr. Harry Werner is the recipient of the AVMA Animal Welfare Award, and Janice Siegford, PhD, is the recipient of the AVMA Humane Award (see JAVMA, July 1, 2020, page 13). In addition, Dr. John Howe, 2019-20 AVMA president, recognized two individuals and one group (see story coming up Oct. 1). Following are some key achievements of the other award recipients.

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Dr. Mo Salman

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA PUBLIC SERVICE AWARD

Dr. Mo Salman

A 1973 graduate of the University of Baghdad College of Veterinary Medicine, Dr. Salman has spent the past 36 years as a professor in the Department of Clinical Sciences at Colorado State University College of Veterinary Medicine & Biomedical Sciences and is founder and director of the Animal Population Health Institute at the veterinary college. His research interests focus on surveillance and survey methodologies for animal diseases with emphasis on infectious diseases and zoonoses. For more than 30 years, Dr. Salman has been involved in training nationally and internationally in the field of epidemiology, surveillance, disease management, and risk assessment. Many of his research activities are engaged in stabilization and reconstruction of national animal health and public health programs in places such as Bosnia, Afghanistan, Iraq, the Middle East, East Africa, Georgia, and Armenia, among others. Dr. Salman has been editor in chief of the journal Preventive Veterinary Medicine.

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Dr. David Castellan

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA GLOBAL VETERINARY SERVICE AWARD

Dr. David Castellan

Dr. Castellan (Guelph ‘87) is a veterinary epidemiologist with the Texas A&M University Institute for Infectious Animal Diseases. He was previously senior veterinary epidemiologist for Asia and the Pacific with the Food and Agriculture Organization's Emergency Center for Transboundary Animal Diseases, leading development of the Field Epidemiology Training Program for Veterinarians centers in three countries and delivering FETPV training in other countries. He has worked in more than 25 countries in North America, Asia, Africa, and the Caribbean to develop and implement intervention and mitigation efforts for Newcastle disease and avian influenza; contingency planning for avian influenza; tools for vaccination planning and epidemiology capacity development for avian influenza; methods for joint risk assessment by the FAO, World Organisation for Animal Health (OIE), and World Health Organization; and outbreak investigations, surveillance, and studies. During the past two years, Dr. Castellan led the FAO's Frontline In-Service Applied Veterinary Epidemiology Training for 14 African countries.

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Dr. Timothy M. Fan

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA CAREER ACHIEVEMENT AWARD IN CANINE RESEARCH

Dr. Timothy M. Fan

Dr. Fan (Virginia-Maryland ‘95) is a professor and serves as the principal investigator of the Comparative Oncology Research Laboratory within the Department of Veterinary Clinical Medicine at the University of Illinois College of Veterinary Medicine. He is a core member of the Anticancer Discovery from Pets to People theme at the Carl Woese Institute for Genomic Biology at the university. Most recently, he has been appointed co-leader of Cancer Discovery Platforms Across the Engineering-Biology Continuum at the Cancer Center at Illinois. Dr. Fan's laboratory works closely with other scientists to evaluate novel drugs or drug delivery strategies for the treatment of cancer. Dr. Fan investigates treatment strategies in dogs with spontaneously arising cancers and conducts comparative oncology research to aid in treating cancer in not only companion animals but also human beings.

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Dr. Anthony Blikslager

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA CLINICAL RESEARCH AWARD

Dr. Anthony Blikslager

Dr. Blikslager (Virginia-Maryland ‘89) is a professor of equine surgery and gastroenterology and head of the Department of Clinical Sciences at North Carolina State University College of Veterinary Medicine. His research is focused on equine colic, recognition and treatment of pain, and mechanisms of intestinal repair. He has in excess of 180 peer-reviewed publications. At the veterinary college, Dr. Blikslager is also the head of the Comparative Gastroenterology Lab, which studies the roles of nutritional inputs in the development of a healthy and disease-resistant intestinal microbiome, enteric nervous system, and epithelial barrier. He is assistant director of the Center for Gastrointestinal Biology and Disease at the University of North Carolina School of Medicine. Dr. Blikslager serves as vice chair of the Foundation Advisory Council for The Foundation of the Horse of the American Association of Equine Practitioners.

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Dr. John Kruger

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMF/WINN FELINE FOUNDATION RESEARCH AWARD

Dr. John Kruger

Dr. Kruger (Minnesota ‘81) is a professor of internal medicine and chair in feline health in the Department of Small Animal Clinical Sciences at Michigan State University College of Veterinary Medicine. He joined the faculty at the veterinary college in 1989. For the Department of Small Animal Clinical Sciences, he has served as assistant chair for research and graduate studies, associate chair, and interim chair. He was co-founder of MSU veterinary college's Center for Feline Health and Wellbeing and has served as its director since 1998. Dr. Kruger's research interests have focused on urinary disorders and infectious diseases of cats with special interests in feline idiopathic cystitis, nutritional management of urolithiasis, evaluation of renal function, feline viral uropathogens, and development of feline herpesvirus vaccines. He has authored or co-authored more than 93 peer-reviewed articles, 62 refereed research abstracts, and 78 book chapters largely dedicated to feline health issues.

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Dr. Richard Bowen

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA LIFETIME EXCELLENCE IN RESEARCH AWARD

Dr. Richard Bowen

Dr. Bowen (Colorado ‘73) is a professor in the Department of Biomedical Sciences at Colorado State University College of Veterinary Medicine & Biomedical Sciences. He began his career at the university as a clinician working on bovine embryo transfer and bull reproduction. He always had an interest in infectious diseases and gradually transitioned his research to that area. Dr. Bowen works with a broad range of pathogens to study disease pathogenesis and evaluate countermeasures for mitigating infections with viral and bacterial agents. His projects include working to understand the pathogenesis of infection with West Nile virus in domestic animals, birds, and reptiles and develop vaccines to protect against that virus; determining the competency of vertebrates and mosquitos as hosts for the Japanese encephalitis virus and elucidating the pathogenesis of infection; evaluating the role of bats in transmission of viruses; and understanding the human-animal interface in the transmission of avian influenza.

AVMA ECONOMIST ADVISES CAUTION DURING ECONOMIC UNCERTAINTY

By Greg Cima

Veterinarians should prepare for the current national economic downturn to continue this fall, said the AVMA's chief economist.

Matthew J. Salois, PhD, director of the AVMA Veterinary Economics Division, stresses that he doesn't know what economic changes will come, but he urges caution. He sees signs of a continuing recession and recommends that veterinarians maintain savings, delay unnecessary large expenses, and improve efficiency.

He also recommends they stock additional personal protective equipment in case of a rise in COVID-19 infections.

Warning signs emerged during a busy summer for private practitioners, who reported solid income numbers, Dr. Salois said in an interview with JAVMA News. He cited encouraging practice revenue data published this spring from analytics company VetSuccess.

“As of early May, we were pushing toward recovery, in that moving out of negative territory of revenue, back into positive year-over-year gains,” Dr. Salois said. “There have been some valleys and some peaks, but we've remained comfortably—nationally—10% ahead of revenue last year.”

But revenue at veterinary practices had started falling again in U.S. states with high numbers of COVID-19 cases, including California, Florida, and Texas, Dr. Salois said.

He also delivered those messages in late July to members of the AVMA House of Delegates.

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Matthew J. Salois, PhD

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

During that presentation, Dr. Salois said many clinics likely saw short-term increases in business this summer from pet owners who delayed veterinary appointments in the spring as well as from owners who, when they started working from home, had more opportunities to see potential health concerns in their pets. Veterinary medicine fared better in those months than some other health professions, such as optometry and dentistry.

In the interview and his presentation, Dr. Salois described signs of struggle in global economies, worrying signs among U.S. companies, and the risk to clinics’ clientele if the federal government reduces or ends unemployment relief enacted early in the pandemic.

He noted that, in July, American Airlines warned that the company could furlough 25,000 employees, and Bank of America announced its second-quarter profits were down 52% from a year before. He also noted the uncertain future of the unemployment safety net.

At press time, Congress and President Trump had yet to agree on terms for extending payments to millions of people laid off during the pandemic.

Federal data back Dr. Salois’ observations. In the second quarter of 2020, the U.S. gross domestic product fell at an annual rate of 32.9% from a year earlier, according to a July 30 announcement from the Bureau of Economic Analysis.

In addition to saving money, Dr. Salois recommends that practice owners explore ways to make curbside care more efficient, integrate telemedicine into their business strategy, and increase income through telemedicine.

“The need for these types of approaches isn't going away,” he said.

If anything, they will become more important at least into early 2021 but likely beyond, he said.

Potentially tens of millions of pet owners are already unemployed, and many may think they need to choose whether veterinary care is a priority. Dr. Salois recommends having conversations with pet owners about payment plans, credit financing options, and pet insurance.

This summer, the AVMA had several surveys out to recent graduates of veterinary colleges, practice owners, and veterinarians in general. Dr. Salois plans to share insights once his team has time to analyze the survey results, including through the AVMA Economic Summit, which will be presented online Oct. 26-28.

State, local public health veterinarians work long hours to protect the public

Public health agencies, often unrecognized, lead efforts to help vulnerable people, educate all

By Greg Cima

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Iowa State University Health Services tested returning students for SARS-CoV-2 infection ahead of classes this August. (Photos by Matt Van Winkle/ISU Alumni Association)

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Dr. Betsy Schroeder, Pennsylvania state public health veterinarian, feels like she's sprinting a marathon.

She and the members of her public health teams are trying to find a sustainable pace in their work to protect people from COVID-19.

“We've all already put in at least a year's worth of what would be regular working hours in a little over six months,” Dr. Schroeder said.

She is the operations section chief for Pennsylvania's pandemic response, supervising epidemiology, laboratory, and community nurse teams. They interact with health care providers and people exposed or potentially exposed to the COVID-19 virus.

Dr. Schroeder said Pennsylvania has a smart, dedicated corps of health officials but not the deep bench of the federal workforce. Friends at the Centers for Disease Control and Prevention told her about times rotating on and off pandemic-related duties.

She's working to add staff members, though, using funding from the CDC.

Public health veterinarians describe shifting this year from protecting against familiar local threats to managing broad health care and education efforts during a pandemic that, at press time, was killing about 1,000 Americans each day. Some in state government have been aiding national control efforts since the start of the year.

For example, veterinarians in the California Department of Public Health Veterinary Public Health Section began work in January to screen and monitor people arriving in their state from other countries, according to a CDC Morbidity and Mortality Weekly Report published May 15. Their duties since have included analyzing demographic data of people infected, collaborating with other agencies on testing in animals, and educating people who work with animals, according to CDPH officials.

In February, CDC officials created the 17-agency One Health Federal Interagency COVID-19 Coordination

Group to share information and coordinate messages to the public. The agency also leads weekly federal and state one-health calls among about 165 partners, including state public health veterinarians, wildlife officials, animal health officials, and local partners.

OTHER OUTBREAKS CONTINUE

Dr. Joann Lindenmayer is an elected volunteer on the Board of Health for Uxbridge, Massachusetts, a 14,000-person town on the state's southern edge. Early in the pandemic, she, a fellow board member, and the town health director worked 60-hour weeks for two months.

She is a public health expert, epidemiologist, and former professor who has worked for a variety of institutions, including the CDC, Tufts University, Brown University, and health departments in three states.

Dr. Lindenmayer led a coalition of community service organizations that bought and delivered food, cleaning products, baby diapers, and masks to unemployed people as well as offered to call people who needed daily check-ins, give rides to and from health care providers, and walk dogs. She and colleagues also put up signs encouraging practices such as washing hands and keeping safe distances and distributed information on COVID-19 through the town's website, the town's cable TV station, newsletters, and educational materials left on doorknobs of homes for people who are elderly or who have disabilities. And she supervised nine master's-level Harvard University School of Public Health students who were participating in the COVID-19 Academic Public Health Volunteer Corps.

Pennsylvania and Massachusetts both endured spikes in COVID-19-related deaths in April and drop-offs through summer, although confirmed infections rose in Pennsylvania in mid-to-late July, according to data from both states. As of Aug. 3, Pennsylvania had more than 7,000 deaths from 114,000 infections and Massachusetts had almost 9,000 deaths from 118,000 infections, according to the CDC.

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An Iowa State employee checks a student's temperature.

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Dr. Schroeder said her office is still investigating animal bites, and her enteric disease experts split their time among diseases.

At one time, they could be working on Salmonella outbreaks and trying to coordinate an investigation on COVID-19 exposures in a restaurant, she said.

Dr. Schroeder enjoys the familiarity of rabies consultations; she's good at them and able to give people definitive answers. Salmonella has a playbook, and the work is routine yet important, she said.

But public health authorities are still learning about COVID-19, including whether people can become reinfected.

Dr. Catherine Brown is Massachusetts's public health veterinarian and state epidemiologist.

Much of her work involves capturing and analyzing data to find the people vulnerable to SARS-CoV-2, the virus that causes COVID-19; finding patterns among clinical outcomes; and using those results to shape policy.

“It's fine for the Department of Public Health—at the state level—to collect information,” she said. “But if we're not turning that around and making actionable items out of it, and then helping people understand what those action items are that they should be involved in, then what's the point?”

With COVID-19, Dr. Brown is dealing with the unusual task of analyzing tens of thousands of negative laboratory results daily, in addition to looking at emergency departments’ data streams on COVID-19-like symptoms. She also is working with other agencies to coordinate information on infections in pets, whether pets should be tested, and how often human-to-pet transmission occurs.

URGING COMMUNITY RESPONSIBILITY

This spring, Dr. Kristen Obbink helped plan how to test Iowa State University students for COVID-19 when they returned this fall. In July, she became the university's COVID-19 public health coordinator.

Normally, she's a veterinary specialist at the Center for Food Security and Public Health at Iowa State. “In this new role, I'll be full-time serving as the public health coordinator for COVID-19 response through the end of the fall semester,” Dr. Obbink said.

She is coordinating efforts to mitigate risk of COVID-19 among 35,000 students and university employees. She is part of a university team using contact tracing, quarantine, isolation, and symptom tracking as well as working with ISU statisticians and the university's communications team. On campus and in the surrounding community, the university's Cyclones Care campaign encourages physical distancing, masks, hand washing, and—when people get sick—isolation in their apartments or in residence halls set aside for them.

About 9,000 of ISU's students will live on campus this fall. On Aug. 3, Iowa State officials announced they had started testing all students as they moved into residence halls and on-campus apartments ahead of classes that started Aug. 17.

ISU was processing those samples through the university's Veterinary Diagnostic Laboratory. Dr. Obbink said the laboratory intended to deliver test results within 24 hours—a goal she acknowledges is unmet in much of the country.

The school planned to offer a mix of classes in person and at a distance. For those that require in-person attendance, the university cut attendance by half and rearranged seating.

“We all have the same goal, although we have a different part to play in it,” Dr. Obbink said. “We want our students and our faculty and our staff to have the best experience possible. We'd prefer that to be as it used to be, and, of course, that's not possible right now.”

SAVING LIVES, OFTEN UNNOTICED

Dr. Lindenmayer said signs in her town thank first responders and essential workers but not public health workers. She said the public, historically, knows little about public health work and why it should be funded.

“The real dilemma with public health is that we don't have a constituency,” she said. “When public health succeeds, that means that nothing happens.”

Data published March 23 by the Association of State and Territorial Health Officials indicate that, from 2010-19, employment at state health agencies dropped by about 15% and spending by those agencies was almost the same in fiscal years 2010 and 2018—equal to a 13% budget cut after adjusting for inflation.

The ASTHO also warned in February against the Trump administration's fiscal year 2021 proposal to cut funding for public health agencies and consolidate public health programs.

“Now more than ever, Congress and the Administration must prioritize funding for the entire public health system,” the announcement states.

Public health veterinarians described boom-and-bust cycles tied to disease events, citing crises involving West Nile virus, anthrax, Zika, and Ebola.

Dr. Schroeder said public health agencies go unnoticed when they do their jobs well, and few people get into public health work for personal glory. It's hard to take credit for someone not developing polio, she said.

Dr. Brown likewise said, “One of the things we say in public health is, ‘It's very difficult to measure the diseases you prevent.'”

“What I hope COVID is teaching all of us is that there's always going to be the next thing,” she said. “And so, we need to not just invest in disease-specific public health responses; we need to invest in public health infrastructure.”

Dr. Lindenmayer also wants to see more veterinarians apply their population health training in local government. They can make life better for people and animals, and many communities are desperate for volunteers, she said.

Dr. Brown also thinks veterinarians can impact public health by, say, building relationships with local human health care providers and offering expertise in case of disease outbreaks.

Dr. Schroeder said everyone can help during this pandemic by wearing masks and washing their hands.

“Those really are the best things we can do to help take care of all of us, together,” Dr. Schroeder said. “The only way we're going to get through this is by looking out for each other.”

Q&A: LMU VET STUDENT TALKS ABOUT NATIONAL GUARD DEPLOYMENT DURING COVID-19

By Kaitlyn Mattson

Victoria Orlando is a third-year veterinary student at Lincoln Memorial University in Harrogate, Tennessee. In her limited free time, she is also a member of the Pennsylvania National Guard, which deployed this spring as part of a Joint Force Medical Strike Team to assist with COVID-19-related shortages at a nursing facility. Orlando served as a certified nursing assistant helping care for residents, many of whom had tested positive for the COVID-19 virus.

JAVMA News spoke with Orlando about her experience and what the transition back to veterinary college was like. The responses have been lightly edited for clarity.

Q. WHAT MADE YOU WANT TO GO TO VETERINARY COLLEGE?

A. From a young age, I knew I wanted to be a veterinarian. For me, I wanted to be one because I love people. I love helping people, and to me, the best way to help people is through the care of their animals. But I also knew I wanted to be in the military, so I became a member of the National Guard after I graduated high school.

I went to Pennsylvania State University for my undergraduate degree, and I was on the fence about going to veterinary school because of the student debt load. I figured I would go into pet nutrition, but I applied to LMU, and I got in on my first application cycle.

Q. WHAT WAS YOUR EXPERIENCE BEING DEPLOYED AT A NURSING FACILITY?

A. I got the phone call to be ready to be deployed in April.

We were told we were going to help in a nursing facility where a lot of staff had tested positive for COVID-19 or weren't comfortable going to work.

I think there were about 12 of us there. We were split up, and my partner and I were in a rehabilitation wing. We checked vitals, provided patients with showers, and helped staff catch up.

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Victoria Orlando (center), a third-year student at Lincoln Memorial University College of Veterinary Medicine and a member of the Pennsylvania National Guard (Photo by Master Sgt. George Roach/U.S. Air National Guard)

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

The nursing home was struggling. We were there for about two weeks, and then we were sent home, and we went into quarantine.

Q. WAS IT HARD TO TRANSITION BACK TO YOUR CLINICAL ROTATIONS?

A. It was difficult. I love my program because they teach us a lot about communication and empathy, but I made these very intense relationships with these residents. And our leaving was abrupt. I didn't get a chance to say goodbye. One minute, I was giving someone a shower, and then the next, I was talking about vaccine schedules at LMU.

Q. WHAT DID YOU LEARN FROM THIS EXPERIENCE?

A. It was an eye-opener. I am thankful for the experience. It makes me think of volunteering at nursing homes in the future.

This experience will make me better, more empathetic, and more willing to make connections with people. Talking to someone can change their whole day, and I want to take that into practice with me.

Q. WHAT DO YOU WANT PEOPLE TO KNOW?

A. My team was exposed to COVID-19-positive patients but had personal protective equipment, and still, about 70% of our team tested positive for the virus and are still recovering.

When people are talking about COVID-19, I want to shake them because they don't realize how difficult it is.

Try to do your part. Veterinarians are medical professionals. Speak up. This is not a time to be callous.

Wear a mask, people are suffering.

VETERINARY PRACTICES RECEIVE $2.1 BILLION IN FEDERAL RELIEF

More than half of U.S. veterinary practices received Paycheck Protection Program loans totaling an estimated $2.1 billion, according to U.S. Small Business Administration data analyzed by the AVMA.

At least 18,657 veterinary practices were helped by the federal program created by the Coronavirus Aid, Relief, and Economic Support Act to encourage small businesses to keep workers on the payroll.

The SBA, which oversees the loan program, has issued PPP loans totaling more than $519 billion since the program launched in April.

Loan proceeds may be used to cover payroll costs, rent, interest, and utilities. The loan may be partially or fully forgiven if the business keeps its employee count and employee wages stable.

At least 201,900 veterinary jobs were protected with PPP loans, according to SBA data, while over 80% of loans taken out by individual practices were for less than $150,000.

Unsurprisingly, the greatest amount of PPP loan money to veterinarians occurred in states with the most veterinarians: California, $200 million; Texas, $160 million; Florida, $141 million; New York, $109 million; and Illinois, $83 million.

Likewise, the least amount of loan money went to veterinarians in Guam, $345,000; the Virgin Islands, $482,000; Puerto Rico, $2.9 million; Washington, D.C., $3.2 million; and Alaska, $4 million.

The deadline to apply for a PPP loan has been extended twice so far. As of press time, the latest extension was to Aug. 8.

CLARIFICATION

The article “Students, recent grads from underrepresented backgrounds are building spaces for themselves” in the Sept. 1, 2020, issue of JAVMA News mischaracterized Dr. Evelyn Galban's background. She is of Washoe and Mono Lake Paiute ancestry, not a member of the Washoe and Paiute tribes.

WAKING UP TO FATIGUE IN THE VETERINARY CLINIC

The hidden costs of insufficient sleep

By R. Scott Nolen

Much is known about compassion fatigue and its emotional toll on veterinary professionals. Less understood is how fatigue caused by insufficient sleep harms veterinarians, veterinary technicians, and veterinary assistants. Veterinary staff members may be tired after a demanding shift in the clinic, especially now with the added rigors of managing the coronavirus pandemic. And yet there appears to be little acknowledgement within the profession that such conditions are as much a danger to workplace safety as any infectious disease.

Sleep is a function of age, according to the National Institutes of Health, so while teens need at least nine hours of sleep each night, adults require between seven and eight hours. Fatigue occurs when a person doesn't sleep enough hours appropriate to their age group.

Signs of fatigue are hard to ignore. Lethargy. Irritability. Difficulty focusing. Chronic fatigue is a far more serious condition, described by the Mayo Clinic as “unrelenting exhaustion” that rest doesn't remedy, and may be a symptom of an underlying medical condition, including cancer or anemia.

Even the regular, run-of-the-mill fatigue attributable to working long hours and inadequate sleep is a health threat. A study cited by the nonprofit National Safety Council, which advocates for occupational safety, found that workers who reported less than five hours of sleep were three times as likely to be injured on the job as workers who reported seven or more hours of sleep.

Jenny Burke, NSC senior director of impairment practice, likened sleep deficiency to alcohol consumption. The effects of losing just two hours from an eight-hour sleep schedule are similar to drinking three beers. “Most of us would not drink three beers and drive home, right? But we're essentially doing that same thing when we take two hours away from a normal night of sleep,” Burke said.

When NSC surveyed more than 500 human resource officers about recognizing signs of fatigue in staff members, approximately 50% reported employees had fallen asleep at work, 57% said employees missed work because they were tired, and a third reported workplace injuries and “near misses” caused by fatigued employees. “These are just the incidents employers are noticing,” said Burke, adding that fatigue costs the U.S. economy $400 billion annually.

So essential is sleep to physical and mental well-being that the Centers for Disease Control and Prevention classifies insomnia and other sleep disorders as a public health epidemic. “We know there's a significant amount of the population that suffers from sleep apnea and doesn't even know it,” Burke explained. “Only 11% of actual sleep disorders are diagnosed and treated, so that leaves 89%—roughly 70 million people—who have a sleep disorder and don't know it.”

TOO BUSY TO SLEEP

Little is known about fatigue and its impacts within the veterinary profession, which in recent years has turned its attention to improving the mental health and well-being of its members. It's worth noting that fatigue is linked to depression, diminished psychological and emotional health, and burnout. Human medicine's experience in this area may be instructive to veterinarians, veterinary technicians, and veterinary assistants.

For starters, human health care professionals have been arguing over the effects of fatigue on physician performance and decision-making for more than three decades. In 1984, 18-year-old Libby Zion died in a New York state hospital as a consequence of mistakes made by overworked physicians. Five years later, the state passed legislation mandating that residents could not work in excess of 80 hours a week or for more than 24 consecutive hours. In 2003, the Accreditation Council for Graduate Medical Education adopted similar standards for U.S. medical schools.

The debate reignited in 2017 when the ACGME lifted the 16-hour cap for first-year residents, allowing them to work a 28-hour shift.

This past April, as the COVID-19 virus swept across the nation, the CDC stated fatigued and overworked health care workers “can jeopardize their own health and safety, such as increasing their susceptibility to infectious diseases, needle sticks, work-related muscle injuries, and burnout, as well as committing patient care errors.”

Then in May, the American Academy of Sleep Medicine warned that physician burnout is a serious and growing threat to the medical profession. While the prevalence is unknown, the academy cited recent estimates of physician burnout approaching 50% or more, with midcareer physicians at highest risk. “Sleep deprivation due to shift-work schedules, high workload, long hours, sleep interruptions, and insufficient recovery sleep have been implicated in the genesis and perpetuation of burnout,” the AASM stated.

“It is the position of the American Academy of Sleep Medicine that a critical need exists to evaluate the roles of sleep disruption, sleep deprivation, and circadian misalignment in physician well-being and burnout. Such evaluation may pave the way for the development of effective countermeasures that promote healthy sleep, with the goal of reducing burnout and its negative impacts such as a shrinking physician workforce, poor physician health and functional outcomes, lower quality of care, and compromised patient safety.”

Long hours and little downtime are also a challenge for fourth-year veterinary students in the clinical training phase of their education. In 2019, the Student AVMA updated its duty-hour guidelines with proposals that students work no more than 80 hours a week, work no more than 24 consecutive hours in continuous on-site duty, and be provided with breaks when they are on call. SAVMA does not have the authority to enforce these guidelines but encourages all AVMA Council on Education-accredited institutions to consider following them.

UP ALL NIGHT

Emergency and critical care is one sector of veterinary medicine where the effects of fatigue are the most acute. Despite high demand for veterinarians and veterinary technicians to staff emergency rooms and intensive care units, veterinary practices are struggling to retain staff members and fill these high-paying positions, said Dr. Armelle de LaForcade, executive secretary for the American Academy of Veterinary Emergency and Critical Care.

Reasons for the shortage vary, explained Dr. de LaForcade, a faculty member at the Cummings School of Veterinary Medicine at Tufts University, and include job-related stress, dealing with difficult clients, and a lack of professional development in veterinary emergency and critical care that doesn't require a residency.

“Then you add to all of that having to work five overnights in a row. It takes you a day and a half to recover, but by then, you're back at work.”

Staffing adjustments that account for these stressors are not commonplace in veterinary medicine, Dr. de LaForcade noted. Yet such a model is needed, one that allows staff members time to recover from overnight work. “I don't think clinics know what to do when they hire ER veterinarians, so they give them these crazy schedules, like overnights Friday, Saturday, and Sunday,” she said. “Let's see how long you can do that. But clinics have nothing else to go by and believe that if you chose emergency medicine, then you must enjoy working nights.”

TIRED WORKERS ARE AT HIGHER RISK OF INJURY

HOURS OF SLEEPANNUAL INJURY INCIDENT RATE PER 100 WORKERS
Less than 5 hours7.89
5 to 5.99 hours5.21
6 to 6.99 hours3.62
7 to 7.99 hours2.27
8 to 8.99 hours2.50
9 to 9.99 hours2.22

Source: “Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008),” Chronobiology International

Dr. de LaForcade wonders about the health costs of working second or third shift in the veterinary emergency sector. “We don't know,” she said. “There are models in other professions that show the level of fatigue you get from working off-cycle from the rest of the world. There's studies that show you are more prone to illness and other health issues.”

Ideally, Dr. de LaForcade said, the ACVECC and Veterinary Emergency and Critical Care Society would partner with the AVMA or other veterinary organization on a study to identify a staffing plan that encourages longevity in veterinary emergency and critical care.

“We need to look at practices that are retaining people and figure out what they're doing differently,” she said. “I suspect they're doing something like three days on, four days off, which is crazy compared to other veterinary fields, but the ER has so many stressors that that might be what you need.”

SETTING BOUNDARIES

Like their colleagues in emergency and critical care, large animal veterinarians are well acquainted with fatigue. The on-call shifts, hours on the road, and handling patients weighing hundreds of pounds can easily wear a person down.

“Fatigue is a very real issue for equine practitioners because our clients’ appreciation is often measured by our availability to them,” said Dr. Cara Rosenbaum, who works at a four-doctor referral hospital and ambulatory center in Wauconda, Illinois.

“You may only be working 8 to 5, but then you're on the phone till 8 o'clock at night answering client questions,” she said.

Dr. Rosenbaum prepared herself as best she could for the demands of a career as an equine practitioner. As a student at Cornell University College of Veterinary Medicine, she was mindful of the importance of personal care and helped start a student wellness initiative at the veterinary college. After graduating in 2017, she interned at an equine hospital for a year before hiring on as an associate at the Wauconda practice the following year.

She quickly discovered there was more to learn, such as setting boundaries with clients and not being at their beck and call. Dr. Rosenbaum, who is a member of the American Association of Equine Practitioners’ Wellness Committee, says she's also “respecting” her sleep more.

“I can tell the difference between being burned out and when I'm fatigued,” Dr. Rosenbaum said. “When I'm a little bit burnt out, if I get away from work and get on my kayak for two hours or get the dog to the dog park, I feel better. But when I'm fatigued, I can do all the things I enjoy, and I still wake up the next morning not wanting to go back to work.”

“I think we forget that there is a physical part to being a large animal practitioner that contributes to fatigue,” she continued. “I've had one shoulder surgery already, and if it starts hurting after having to haul a hundred pounds of equipment out of the truck each time for six appointments, it just exhausts you in a whole different way.”

People: FLORIDA VMA

EVENT

Annual meeting, March 12-15, Orlando

AWARDS

Veterinarian of the Year

Dr. Gerardo J. Diaz (Florida ‘90), Miami. Dr. Diaz owns Briarwood Animal Hospital in Miami. He is a past president of the Florida VMA and a member of the South Florida VMA. Dr. Diaz is known for mentoring young veterinarians and lobbying for the veterinary profession at the local and state levels.

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Dr. Gerardo J. Diaz

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Distinguished Service Award

Dr. Jeffrey S. Godwin (Florida ‘80), Melbourne. Dr. Godwin practices at Animal Medical Clinic in Indialantic. He is a past president of the Veterinary Orthopedic Society and of the Florida and Brevard County VMAs. Dr. Godwin has a special interest in legislative issues and is active with advocacy on the local and state levels.

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Dr. Jeffrey S. Godwin

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Lifetime Achievement Award

Drs. Julio A. Ibañez (Florida ‘80), Palmetto Bay, and David T. Wise Jr. (Georgia ‘72), Miami. Dr. Ibañez recently retired from Quail Roost Animal Hospital in Cutler Bay. A past president of the Miami Veterinary Foundation, he served on the executive board of the South Florida VMA for 13 years. Dr. Ibañez coordinated relief efforts for pets following Hurricane Andrew in 1992. Dr. Wise owns VCA Knowles Central Animal Hospital in Miami, incorporating both a regular practice and a 24-hour emergency and critical care facility. He is known for his expertise in neurosurgery and orthopedic surgery. Dr. Wise is a member of the South Florida VMA.

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Dr. Julio A. Ibañez

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

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Dr. David T. Wise Jr.

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

President's Award

Ann Wade, Sanford. Wade has served as deputy executive director of the Florida VMA for the past two years. She previously served as the association's communications director. Wade is known for her professionalism, work ethic, passion, and delivery.

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Ann Wade

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Gold Star Award

Drs. James H. Block, Miami; Cherie T. Buisson, Seminole; Jo Ann Daniels, Land O’ Lakes; James W. Fawcett, Palmetto Bay; Stephen D. Fish, Tallahassee; Wade Gingerich, Bonita Springs; Francesca C. Griffin, Gainesville; Dorsey G. Hightower, Lakeland; Rachel K. Klemawesch, Seminole; Robert B. Leonard Jr., New Smyrna Beach; Dawn Logas, Maitland; Leena Plavumkal, Fort Myers; Kelly Sloan-Wade, Merritt Island; Mary Smart, Bradenton; and Michele A. Tucker, West Palm Beach

OFFICIALS

Drs. Mary Smart, Bradenton, president; Marta P. Lista, West Miami, president-elect; Donald H. Morgan, Largo, treasurer; Michael Epperson, Destin, immediate past president; and AVMA delegate and alternate delegate—Drs. Ernest C. Godfrey, Pinellas Park, and Richard B. Williams, Jacksonville

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Dr. Mary Smart

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

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Dr. Marta P. Lista

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

Obituaries: GORDON THEILEN, PIONEER OF ONCOLOGY, DIES AT 92

Dr. Gordon Theilen, an emeritus professor at the University of California-Davis School of Veterinary Medicine, died June 30 at 92.

Dr. Theilen (UC-Davis ‘55) was a veterinary comparative scientist and a pioneer in veterinary clinical oncology. He worked at the veterinary school for 37 years and researched cancer-causing viruses in horses, cows, turkeys, cats, and primates. He identified several viruses, including simian sarcoma virus in 1971, and co-authored one of the first comprehensive reference books on veterinary oncology, “Veterinary Cancer Medicine.” His research helped advance cancer medicine and treatments for animals and humans in areas such as chemotherapy, radiotherapy, and immunotherapy.

Dr. Niels C. Pedersen, emeritus professor at UC-Davis, said Dr. Theilen was a man of great vision.

“Gordon was one of a handful of key academics in the U.S. who started to specialize in oncology,” said Dr. Pedersen, who earned his veterinary degree from UC-Davis in 1967 and was a former student of Dr. Theilen. “As a student, we tended to believe that cancer was not treatable by any means other than surgery, and even then, it was largely a disease to diagnose and euthanize. Gordan was questioned by many of his colleagues for his novel belief that cancer in animals was potentially treatable.”

During his career, Dr. Theilen served in several fellowships at the National Cancer Institute and the Chester Beatty Institute in London. He was the first president and a founding member of the Veterinary Cancer Society. The American Association for Precision Medicine awarded him with the Distinguished Emeritus Award for Excellence in Veterinary Oncology in 2019.

“Gordon achieved many awards and accolades during his career, evidencing his importance to comparative and veterinary oncology, and will be missed by those of us that had the pleasure of his friendship, mentoring, and collaborations,” Dr. Pedersen said.

Dr. Theilen also served in the Army shortly after World War II. He recently published two books documenting his journey in his early life and in veterinary oncology: “The Boy with the Wounded Thumb” and “One Medicine War on Cancer.” He was an honor roll member of the AVMA.

He is survived by his daughter, Ann Theilen Yeo; seven grandchildren; and four great-grandchildren.

UC-Davis has established the Dr. Gordon Theilen Endowed Fund, at jav.ma/Theilen, which will help train young veterinary oncologists.

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Dr. Gordon Theilen, an emeritus professor at University of California-Davis School of Veterinary Medicine and a pioneer in veterinary clinical oncology (Courtesy of UC-Davis)

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.563

AVMA MEMBER | AVMA HONOR ROLL MEMBER | NONMEMBER

EDWARD L. ANDERSON

Dr. Anderson (Iowa State ‘53), 94, Bonsall, California, died April 14, 2020. Following graduation, he worked at the Brookfield Zoo in Chicago, subsequently practicing in Joliet, Illinois. Dr. Anderson then moved to California, where he worked in Bellflower. He later became a partner at Bay Cities Pet Hospital in Torrance, California. In 1973, Dr. Anderson sold his partnership at Bay Cities and moved to Fallbrook, California, establishing Circle R Animal Clinic in Escondido, California, where he practiced until retirement at the age of 75.

In retirement, he became an avid woodturner, with his artwork displayed in several homes and businesses in the San Diego area. An Army veteran of World War II, Dr. Anderson served in the Battle of the Bulge and received the Bronze Star Medal and Distinguished Service Cross. He published two memoirs on his experiences during the war, copies of which now reside at the National WWII Museum in New Orleans.

Dr. Anderson's wife, Nancy; five daughters; 12 grandchildren; and nine great-grandchildren survive him.

SARAH A. BINGEL

Dr. Bingel (Pennsylvania ‘67), 77, Hendersonville, North Carolina, died May 8, 2020. Following graduation, she practiced small animal medicine in New Jersey and Philadelphia and worked for Bideawee, a rescue organization in New York City. After earning a doctorate in veterinary pathology in 1981 from Washington State University, Dr. Bingel served as a research associate and assistant professor in the Department of Comparative Medicine at the University of Washington in Seattle.

From 1990 until retirement in 2008, she worked as a veterinary pathologist in the Department of Comparative Medicine and the Department of Pathology and Laboratory Medicine at the Medical University of South Carolina in Charleston.

Dr. Bingel competed in agility competitions with her Border Collies and volunteered at children's charities in Hendersonville with one of her certified therapy Collies. She also volunteered as a den leader with the Boy Scouts of America. Dr. Bingel is survived by two sons, two grandchildren, and a sister. Memorials may be made to the World Wildlife Fund, 1250 24th St. NW, P.O. Box 97180, Washington, DC 20090.

GARRY E. ERNST

Dr. Ernst (Illinois ‘73), 78, Charleston, Illinois, died May 1, 2020. A small animal practitioner, he owned Forest Park Animal Hospital in Panama City, Florida, for more than 30 years prior to retirement in 2004. Earlier, Dr. Ernst owned Ernst Animal Hospital in Panama City. In retirement, he continued to perform surgery when requested. Dr. Ernst was a past president of the Panama City Northside Rotary Club and was a Paul Harris Fellow. He was also a member of the Elks Lodge. Dr. Ernst received an honorary doctoral degree for his contributions to the Gulf Coast State College Foundation. He was a veteran of the Army and the Air Force. Dr. Ernst's wife, Janet; a stepdaughter; and a brother survive him.

SAMUEL M. FASSIG

Dr. Fassig (Ohio State ‘73), 72, Boise, Idaho, died Jan. 16, 2020. He was a supervisory public health veterinarian with the U.S. Department of Agriculture's Food Safety and Inspection Service prior to retirement.

Following graduation, Dr. Fassig served in the Army Veterinary Corps. While stationed at Fort Sam Houston in San Antonio, he assisted with the Army's Olympic equestrian pentathlon horse team, and when posted at Fort Wainwright in Fairbanks, Alaska, he became involved in sled dog racing and the Iditarod. Dr. Fassig eventually organized his own sled dog team and entered the Iditarod twice, finishing the race once. He retired from military service as a captain.

Dr. Fassig subsequently earned a master's in organizational development and whole systems design from Antioch University and founded PCMR Consulting/Fassig Farms, serving as a consultant in risk management assessments, analysis, and strategic planning and establishing multiple companion, equine, and mixed veterinary practices in Washington state and Colorado. During that time, he also worked for several pharmaceutical companies, including Merial Animal Health and Schering-Plough Animal Health. In 2009, Dr. Fassig joined the USDA FSIS.

Active in organized veterinary medicine, he was a past president of the American Association of Industry Veterinarians and served on the AVMA Council on Public Health from 2018-20. Dr. Fassig was a member of the Idaho Veterinary Response Team, Veterinary Emergency and Critical Care Society, and Academy of Veterinary Consultants. He was also a member of what is now known as the Association for Supply Chain Management and served as a training resource for the Center for Food Security and Public Health. Dr. Fassig was a benefactor of the Florida Poodle Rescue for more than 20 years and volunteered his time and services to elderly pet owners.

He authored the book “Associate's Survival Guide” and contributed to the book “Principles and Practice of Veterinary Technology.” Dr. Fassig served as a lieutenant in the Army during the Vietnam War and was a member of the American Legion and Veterans of Foreign Wars. He is survived by his wife, Elizabeth Fassig, PhD. Memorials may be made to the American Cancer Society, P.O. Box 22478, Oklahoma City, OK 73123, or Humane Society of the United States, 1255 23rd St., NW, Suite 450, Washington, DC 20037.

WILLIAM E. MCADA

Dr. McAda (Texas A&M ‘52), 95, Yorktown, Texas, died April 27, 2020. A mixed animal veterinarian, he owned Yorktown Veterinary Clinic for 65 years. Dr. McAda was a member of the Texas and Golden Crescent VMAs. In 2012, the GCVMA named him one of the top five veterinarians in the Golden Crescent region of Texas. A veteran of the Army, Dr. McAda served in the Pacific Theater during World War II.

He is survived by three sons, a daughter, ten grandchildren, five great-grandchildren, and a sister. Other veterinarians in his family are sons Drs. Hampton D. McAda (Texas A&M ‘81) and Wesley S. McAda (Texas A&M ‘86); son-in-law Dr. Michael Jacob (Texas A&M ‘77); nephews Drs. Travis L. Respondek (Texas A&M ‘94) and Warren W. Migura (Texas A&M ‘97); and grandson and granddaughter-in-law Drs. Reagan S. McAda (Texas A&M ‘20) and Leah R. McAda (Texas A&M ‘20). A brother, the late Dr. Acie C. McAda (Texas A&M ‘50), was also a veterinarian. Memorials may be made to First United Methodist Church, 222 N. Riedel, Yorktown, TX 78164.

DAVID E. MCMILLON

Dr. McMillon (Kansas State ‘80), 64, Great Bend, Kansas, died Jan. 23, 2020. Following graduation, he joined Hoisington Veterinary Hospital in Hoisington, Kansas. In 1989, Dr. McMillon bought the hospital, practicing there until retirement in 2015. He later worked part time for Downs Veterinary Clinic in Downs, Kansas. Dr. McMillon was a member of the Kansas VMA.

Active in his community, he served on the Clara Barton Hospital Foundation, chairing the board of directors for several years. Dr. McMillon's wife, Peggy; a son, a daughter, and two stepdaughters; six grandchildren; and two sisters survive him. Memorials toward the American Diabetes Association, Down Syndrome Guild of Greater Kansas City, or Clara Barton Hospital Foundation may be sent c/o Nicholson-Ricke Funeral Home, P.O. Box 146, Hoisington, KS 67544.

BOBBY F. SHERWOOD

Dr. Sherwood (Georgia ‘59), 90, Elizabethton, Tennessee, died May 8, 2020. Following graduation, he practiced mixed animal medicine in Boone, North Carolina. Dr. Sherwood later served as an assistant professor of veterinary medicine at the Duke University Medical Center in Durham, North Carolina. During that time, he also participated in the Duke University Physician Assistant Program and served as a consultant for the Research Triangle Park. From 1980 until retirement in 1989, Dr. Sherwood practiced in Durham.

A veteran of the Army Air Force, he served four years in Korea. Dr. Sherwood is survived by his wife, Frances, and a son.

EARL D. SMITH

Dr. Smith (Colorado State ‘44), 97, Grand Junction, Colorado, died Feb. 15, 2020. He practiced mixed animal medicine at Steamboat Springs Veterinary Hospital in Steamboat Springs, Colorado, for 45 years prior to retirement. Dr. Smith co-invented the Kamar Heatmount Detector, used for bovine heat detection prior to artificial insemination. A veteran of the Army, he attained the rank of captain. Dr. Smith is survived by his wife, Alex; a son and a daughter; nine grandchildren; and five great-grandchildren. His son, Dr. Kenneth L. Smith (Colorado State ‘78), is a small animal veterinarian in Pueblo, Colorado, and late brothers Drs. Kenneth W. Smith (Colorado State ‘32) and Edwin J. Smith (Colorado State ‘38) were also veterinarians.

ROBERT W. STANNARD

Dr. Stannard (California-Davis ‘73), 72, Danville, California, died Jan. 16, 2020. He owned Adobe Pet Hospital in Livermore, California, prior to retirement in 2014. Having completed an advanced laser surgery program at the University of California-Davis in 2002, Dr. Stannard performed referral laser surgery and video otoscopy procedures throughout the state. He also took care of the Livermore Police K-9 unit for 35 years and the K-9 units from San Leandro, Fremont, and Berkeley in California.

Dr. Stannard served as a consultant and a key opinion leader for Novartis Pharmaceuticals and was a member of the company's advisory council. He served on the board of directors of the American Heartworm Society for several years and was the society's secretary-treasurer from 2013-16. Dr. Stannard was a member of the American Animal Hospital Association, California VMA, and American Association of Feline Practitioners. In 2018, he was honored with AHS honorary membership for outstanding dedication and service to the society.

Dr. Stannard was a founding member and a past president of Montair Foundation, a nonprofit organization dedicated to raising money for public education. He is survived by his wife, Wendelyn, and a son and a daughter. Memorials may be made to Lustgarten Foundation for Pancreatic Cancer Research, 415 Crossways Park Drive, Suite D, Woodbury, NY 11797, lustgarten.org.

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