JAVMA News

IN SHORT

USDA OFFERS REIMBURSEMENT FOR DEPOPULATION LOSSES

Companies that depopulated agricultural animals during the pandemic will receive financial assistance to cover some of those losses.

U.S. Department of Agriculture officials announced in July that the Pandemic Livestock Indemnity Program would reimburse producers for losses incurred March 1-Dec. 26, 2020, because slaughter plants were closed or running at reduced capacity. The reimbursement will be given at rates intended to cover 80% of estimated losses in three areas: the market value of animals depopulated, costs to depopulate, and costs of carcass disposal.

“Eligible livestock and poultry include swine, chickens and turkeys, but pork producers are expected to be the primary recipients of the assistance,” a USDA announcement states.

Applications to the USDA Farm Service Agency are due Sept. 17, and more information is available at farmers.gov/pandemic-assistance. USDA officials also indicated they planned to later offer additional targeted assistance to small hog producers that endured disproportionate losses during a drop in prices in April through September 2020.

VETERINARY RESEARCH LOOKS AT POSITIVE SIDE OF VETERINARY MEDICINE

What brings veterinarians happiness in their jobs is the focus of a recently published study out of the University of Adelaide School of Psychology in Australia.

Australian veterinarians completed a questionnaire that asked respondents to provide 10 responses to the prompt, “I derive pleasure in my work as a veterinarian when ….” Some of the most frequent responses were related to positive relationships with clients and colleagues, more than positive relationships with animals.

Madeleine Clise, the lead author and a psychologist, said the results highlight an abundance of factors related to pleasure at work for veterinarians.

“Vets, just like all of us, feel good when they are shown trust and respect,” Clise said. “And a simple ‘thank you’ goes a long way.”

The responses from 273 veterinarians were categorized into themes. Other positive responses related to having opportunities to use and develop skills, a positive workplace culture, successful outcomes with patients, and opportunities to collaborate with other veterinarians.

The study is available at jav.ma/jobjoy.

FDA GIVES UPDATES ON SAFETY-RELATED DRUG LABELING CHANGES

Veterinarians can find safety-related drug labeling changes on a new webpage from the Food and Drug Administration, available at jav.ma/safetylabels.

Agency officials announced July 15 that the page would be updated monthly with approved safety-related changes to labels for animal drugs. Information about changes for each drug will remain on the site for two years.

“When adverse events are reported or safety concerns are identified for an animal drug, the FDA may work with the sponsor to revise the labeling to reflect this information,” agency information states. “Awareness of these safety-related labeling changes is essential for the safe use and administration of FDA-approved animal products.”

The page notes that the printed labels for approved drugs may not reflect the changes for more than a year as the drug company distributes existing inventory.

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

Are we in a veterinary workforce crisis?

Understanding our reality can guide us to a solution

Commentary by Matthew Salois, PhD, AVMA's Chief Economist, and Gail Golab, PhD, DVM, MANZCVS, DACAW, AVMA's Chief Veterinary Officer

While the delta and lambda variants of SARS-CoV-2 continue to challenge us, we also see hints of post-pandemic normalcy with the return of some in-person meetings, reopened retail establishments, and get-togethers with extended family and friends. Despite these positive signs of recovery, many of us in the veterinary profession are still reeling, professionally and personally, from the pandemic's effects on our practices, patients, and clients. Stress continues to run high, and our teams are feeling overworked and overwhelmed.

Our practices aren't running in quite the same way as before the pandemic. New workflows, operating procedures, and safety protocols have been implemented. Many hospitals are operating with fewer team members and dealing with higher turnover. Emergency clinics appear to be having an especially difficult time remaining fully staffed as they are inundated with a continuous stream of patients—both urgent and nonurgent cases. Pet owners, too, are feeling the crunch. They're having to wait longer to get appointments and to be seen for emergencies.

To determine where we go from here, it's crucial to let the data inform us. Where is this busyness coming from? Is it an aftereflect of the pet adoption boom suggested to have occurred during the pandemic? Are our teams truly seeing more patients than ever before? Or are other things happening that make it feel this way?

WAS THERE REALLY A ‘PANDEMIC PET’ ADOPTION BOOM?

One prevailing view is that veterinary practices are particularly busy because they're managing an influx of new patients stemming from the pet adoptions that “skyrocketed” during the pandemic. The belief that pet adoptions soared in 2020 needs to be further explored.

What the data show

While shelters aren't the only source of new pet adoptions, they're the primary source, according to the 2017-2018 AVMA Pet Ownership and Demographics Sourcebook.1 Second is receiving a pet from a friend or relative, followed by a breeder (dogs) or taking in a stray (cats). With this in mind—and recognizing that data on pet acquisition from nonshelter sources are difficult to obtain and in some cases are nonexistent—it makes sense to consider shelter data as a harbinger for what may have happened to the pet population during the pandemic.

When we look at transactional data from animal shelters, pandemic pet adoptions may not have been as dramatic as the media portrayed. The number of pets adopted from shelters in 2020 was the lowest in five years, based on data from over 4,000 shelters across the country. According to 24PetWatch2 and Best Friends Animal Society,3 there were an estimated 2.3 million adoptions (46% dogs and 54% cats) in 2020, compared with approximately 2.8 million (49.5% dogs and 50.5% cats) in 2019. That's nearly 450,000 fewer animals adopted in 2020 than in 2019.

The reason for this decrease is simply there was a smaller pool of animals available. Shelters saw 32% fewer dog intakes and 23% fewer cat intakes. Fewer people were relinquishing their pets, and animal control was less active in picking up strays. Finally, spay-neuter programs have been effective in keeping populations down.

It also took longer to adopt a pet during the pandemic. Shifting adoption visits to virtual appointments and later only allowing a limited number of physical visits meant that fewer potential pet adopters could be accommodated.

The result: The adoption rate—or percentage of available pets that were adopted—was up, but the actual number of pets adopted was down substantially.

According to early 2020 Packaged Facts data, from before COVID-19 restrictions, most dogs were acquired from a shelter or welfare organization (32% of respondents), followed closely by obtaining dogs from a family member or friend (31%) and then from a breeder (19%).4 In 2021, these numbers have shifted to 26%, 23%, and 23%, respectively. While new dog owners obtained more of their pets from breeders in 2021 than in prior years, given the time it takes to breed new litters, it is unlikely that breeders were able to increase the supply of new puppies substantively during the peak demand period of March through July 2020. Importantly, this is national-level data, and local experiences may vary.

The data from Packaged Facts are also consistent with information presented during the Animalytix 2021 Mid-Year Market Update.5 A market research survey conducted by M/A/R/C Research indicated that 32% of pet owners welcomed a new pet during the pandemic. The top three sources of new pets were shelters or rescues (29%), family or friends (24%), and pet stores (22%). The experts at Animalytix also noted that pets obtained from family or friends are generally not new pets but are re-homed pets. Many (perhaps most) pets adopted from shelters are re-homed pets as well. All of this is consistent with the general idea that there was not an epic rise in the total population of dogs and cats in 2020 in the U.S.

VETERINARY DEMAND: IS IT SKYROCKETING?

Various media outlets have reported a substantial increase in demand for veterinary services, hypothesizing that it is because of the suggested adoption boom of pandemic pets. This has led to concerns voiced about a shortage of veterinary personnel and a workforce crisis. While it's true that demand for veterinary services has increased since the pandemic, transactional data, once again, show a more balanced picture.

What the data show

According to national data on 4,000-plus veterinary practices from analytics company VetSuccess,6 the average number of appointments booked increased 4.5% from 2019 to 2020. Appointments increased 6.5% between January and June 2021, compared with the same period in 2020.

These numbers demonstrate healthy and encouraging growth but aren't consistent with what is being reported in the media. Recognizing that emergency and urgent care clinics appear to have taken on substantial additional demands from clients and patients, the AVMA is conducting a deeper analysis of the data for this practice segment. However, looking at the summary data currently available, which includes emergency and urgent care clinics, it's difficult to conclude that an increase in visits—albeit strong—is the only reason for the stress the veterinary workforce is currently experiencing.

Data from VetSuccess also demonstrate that the majority of revenue growth is coming from existing clients, not new clients or new pets. Specifically, clients are spending more per veterinary visit in 2020 than in prior years, with three key factors behind this trend.7 The first is that the number of line items per visit has expanded, indicating that clients are asking for more veterinary products and services. The second is that clients are opting for higher-value products and services. And lastly, average prices have continued to increase as well. While new clients are certainly a factor— and there has been a notable increase in the volume of new patients compared with last year or even the year prior—the data clearly show that existing clients contribute the bulk of practice revenue growth. This is also consistent with data presented in the Animalytix 2021 Mid-Year Market Update, which showed that the impact of new pets on revenue growth has been declining over time since the summer of 2020.5

PRACTICE PRODUCTIVITY AND STAFF ATTRITION

The uptick in veterinary appointments described above is just one factor contributing to veterinary teams' increased busyness. Taken alone, it doesn't seem to be enough to explain why practices are facing such difficulty serving clients and meeting demand for services. While more business does create more busyness, there are other factors related to the pandemic and the economy that appear to be contributing to our current reality.

What the data show

According to data from the AVMA Census of Veterinarians and Veterinary Practice Owners, veterinarians saw fewer patients per hour and average productivity declined by almost 25% in 2020, compared with 2019.8 While there are many ways to define productivity, a commonly used metric is total output per hour of work. Within the context of veterinary care, the average number of patients per veterinarian per hour is a good indicator of productivity within the practice.

That means, if a typical veterinarian saw four patients per hour before COVID-19, that same veterinarian could only see three patients per hour during the pandemic. When we look at this decrease in productivity, combined with the increase in appointments discussed above, we can better understand the source and scope of our workforce challenges. They aren't just the result of an uptick in business. What the data suggest is that the apparent increased work effort experienced in our practices is also largely tied to productivity gaps.

Here's an illustration: Let's say a practice typically sees 100 patients a week. If the practice sees a 5% increase in business, it's now seeing 105 patients per week. However, concurrent with business demand, efficiency has dropped by 25%, so the practice can only effectively see about 78 patients a week. Healthy growth coupled with substantial declines in productivity can generate client backlogs.

A decrease in productivity can also mean that more resources are needed to effectively see the same number of patients per hour. For example, by extending the number of working hours by staff members or leveraging more staff members to meet demand for veterinary care by clients.

COVID-19 has created a challenging 18-plus months for our practices, and many are still wrestling with the tangible changes it triggered. During the pandemic's earliest months, veterinary practices operated as essential businesses, seeing only urgent cases. This created a substantial backlog in wellness visits. As restrictions loosened, patients started returning for routine examinations and preventive care. Meanwhile, clients were spending more time at home with their pets, which gave them the opportunity to spot health issues more readily and to think about veterinary care more generally. Many also had more disposable income—from stimulus payments and reduced spending in other areas— that they could now allocate to pet care.

All the while, practices quickly adapted with new COVID-19 safety protocols to ensure the continued provision of quality patient care. But these same changes also limited team efficiency and productivity. Transitioning to curbside care, splitting staff members into rotating teams, and sanitizing examination rooms and other surfaces throughout the clinic between visits are just a few of the changes that impacted how practices delivered veterinary services.

Many practices also have struggled with losses of staff members. Whether a team member became sick, had to quarantine, or needed to stay home for child care or other personal reasons, operating with a suboptimal number of employees only made a challenging situation worse.

Although data show that veterinary appointments are growing in 2021, it's important to remember that many practices are still playing catch-up with patients that haven't been seen in over a year, and teams still aren't working at peak productivity because of lingering effects of COVID-19.

It's well known that high turnover also hurts productivity and efficiency. Employee turnover and attrition remain high in veterinary medicine, especially when compared with other health care professions. The average turnover for veterinarians is twice as high as it is for physicians in medical practice.9,10 And veterinary technicians have one of the highest turnovers of all health care positions compared. 9,11

HOW TO SOLVE TEAM BURNOUT: ADDRESSING THE ROOT CAUSE

The irregular flow of patients and clients from the height of the pandemic to now, combined with the disruption of COVID-19 to practice operations, declining productivity, and higher turnover, are causing many team members to feel overworked and overstretched. Veterinary health care teams are burnt out—and understandably so.

If we want a successful remedy, we need to address root causes. A knee-jerk reaction to today's busyness might be to hire more people. In reality, improving team productivity, employee engagement, opportunities for professional development, and employee longevity are far more effective approaches. A study of human medical practices demonstrated that when efficiency is enhanced through improved work processes and engaged employees, burnout is reduced and job satisfaction improves.12

If we don't address the primary sources of burnout, we'll never fix the problem itself—no matter how many new veterinarians or veterinary technicians we add to the workforce. Instead, we need to implement innovative and lasting approaches that harness technology, better utilize staff members, and engage our teams.

One way to do this is to make sure we're using our existing employees—especially veterinary technicians— to full capacity and paying them accordingly. This means familiarizing ourselves with the duties veterinary technicians are legally allowed to perform in each state and identifying opportunities to use more of our veterinary technicians' considerable skills. This can help us free up veterinarians for more of the work that fully uses their advanced veterinary medical education. The whole practice operates more efficiently.

Inefficient staff utilization hurts our practices in other ways, too. It's well known that when credentialed veterinary technicians are not efficiently utilized, they're likely to feel less engaged. And while productivity certainly plays a role in employee burnout, the environment in which we work is just as—if not more—important. Devoting more attention to engaging employees, building teams, honing leadership skills, and paying staff members appropriately for the services they deliver have proven to be effective at reducing job dissatisfaction and lowering staff turnover.

AVOIDING KNEE-JERK REACTIONS

Some approaches have been proposed that may seem to make sense, especially in the short term, but the reality is that we still don't have a complete picture of what is happening in our economy and how that influences our labor force needs. We know, for example, that lingering concerns from COVID-19 continue to influence decisions to return to work—putting pressure on the labor supply—and we don't know how long that will last. Moreover, positive upward momentum in demand may be temporary, which could also impact our future labor force needs. Lastly, none of the proposed approaches is likely to address the root causes of our challenges around productivity and turnover. Let's take a deeper dive.

Adding more veterinarians

It's important to be clear: There is a need for more food animal and public health veterinarians, especially in underserved rural areas. This very real problem requires its own set of solutions, including expanding the Veterinary Medicine Loan Repayment Program to remove the federal withholding tax on service awards and to make more funds available to recruit veterinarians to states experiencing shortages.

However, adding veterinarians to the companion animal sector is unlikely to address the profession's current workforce issues for a variety of reasons. First, while there were more veterinary visits in 2021, it's critical to note that we don't yet know if these increases are permanent. It's possible that temporary, cyclical economic factors are influencing demand—factors such as increased disposable income and owners spending more time at home with their pets. Additionally, the backlog caused by delayed veterinary services adds to the current demand for veterinary care. All of this takes time to work through.

The post-pandemic economic recovery is not going to be a smooth process. Markets and consumer reactions to business conditions are expected to remain volatile—at least for the next several months.13 This means we cannot expect business conditions today to be the same a year from now or even a few months from now.

Aside from the pandemic recovery, there are several other factors impacting the veterinary market. We know that some veterinarians want to reduce the number of hours they work each week. This could be contributing to increased feelings of effort and exertion at work. According to a 2020 AVMA survey,14 about 30% of companion animal veterinarians said they wanted to work fewer hours, compared with 23%-24% from 2017-19. The top two reasons were work-life balance and mental health, including stress, anxiety, and burnout.

Adding veterinarians to the market may seem like a logical way to address the challenges we're feeling right now, but such an approach is aimed more at symptoms than root causes. Becoming more efficient or reducing turnover won't be achieved simply by adding more people to the profession. Better work-life balance and improved mental health require a critical assessment of team engagement, work culture, and practice leadership.

The question of additional roles

Adding a new type of veterinary professional who operates between credentialed veterinary technicians and veterinarians has been suggested as a way to reduce workforce stress and improve efficiency. One version of this midlevel veterinary professional—described as a veterinary professional associate or advanced practice registered veterinary nurse15—would be able to diagnose, prognose, prescribe, and perform surgery at some limited level, all under the supervision of a veterinarian. A second version— described as a veterinary extender—would have duties that stop short of extending into the scope of practice for a licensed veterinarian. The scope of practice for this individual is not well defined, but appears to be related to management of the clinical aspects of the practice.

Unfortunately, no comprehensive, quantitative analysis has looked at the extent to which such professionals are needed and whether they would be utilized appropriately. Furthermore, it is unclear how their skills might differ from the competencies already provided by veterinarians and other team members, particularly credentialed veterinary technicians, veterinary technician specialists, and practice managers.

Despite these informational gaps, there are efforts to move ahead with this concept, with some in the industry crafting a curriculum for use in midlevel veterinary professional programs at AVMA Council on Education–accredited veterinary colleges that would lead to a master's degree. While the proposed roles differ, as currently shared, the curriculum includes coursework that would seem to support the graduate being able to diagnose, prescribe, and perform certain types of surgery, as well as limited management and leadership training. Some basic science and math prerequisites must be completed for matriculation, but it has been said that an associate's or bachelor's degree may not be required for the veterinary extender model. What would be required for the veterinary professional associate or advanced practice registered veterinary nurse model is not clear.

Beyond not having a firm indication that this additional professional is needed, other risks are the lack of programmatic accreditation pathways to evaluate such a degree (programmatic accreditation is different from institutional [regional] accreditation at the university level), and the absence of statutory or regulatory frameworks—at both the state and federal levels—that would allow this midlevel professional to legally practice and provide clear expectations for type and amount of oversight. Until these issues are addressed, veterinarians, practices, patients, and clients will face questions around quality of care and accountability, and graduates of midlevel professional educational programs will be faced with uncertain futures.

The AVMA is conducting research to determine whether there is a need for additional types of team members. This research entails economic modeling on the distribution of veterinarians by region to determine whether and where shortages may exist and what the impact of adding a midlevel professional might be. At the same time, the AVMA is conducting a study to better understand what approaches and actions are needed to improve the utilization of veterinary technicians, team engagement, and practice productivity. A thorough assessment of the overall market is necessary before making any efforts to develop any new position within the veterinary profession.

Instead of adding a new veterinary position, it makes sense and is a more efficient use of resources to first be sure all current veterinary positions are being used fully. Work by the AVMA Veterinary Economics Division has demonstrated that practices that are more efficient tend to use veterinary technicians' full skill sets more than practices that are less efficient. Unfortunately, many practices don't appropriately make use of the breadth of skill and education that credentialed veterinary technicians already bring to the table. Instead of creating a new type of staff member, we would serve our clients and patients more effectively and more efficiently by fully utilizing our credentialed veterinary technicians and veterinary technician specialists. At the same time, we would free up veterinarians for the work that uses more of their advanced veterinary and specialty education—things such as diagnosing, prognosing, prescribing medication, and performing surgery.

You can find tips for fully utilizing veterinary technicians at avma.org/TechnicianUtilization.

Solutions you can implement now

Clearly, there are questions that need to be answered before we can successfully understand our true veterinary workforce needs, such as the following:

  • Is the increase in demand for veterinary services we experienced between mid-2020 and now here to stay, or do we expect this to soften as we move through economic recovery?

  • What are the barriers to effective utilization of veterinary technicians, how do we ensure they are appropriately compensated, and how can we improve engagement of our veterinary health care teams to boost productivity and reduce turnover?

  • What would be the economic impact of introducing midlevel professionals, what is the right accreditation pathway to evaluate such a program, and what statutory and regulatory changes may be necessary to allow them to perform their role with the appropriate responsibility and oversight?

Work is ongoing to answer these questions. And yet we also recognize that veterinary practices need approaches they can implement today to address the challenges they face. There are solution-oriented strategies in the short term that can help our practices manage today's turbulence. It comes down to the following three things: technology, talent, and teams.

  • Technology: You can leverage technology to automate and streamline management and administrative processes within the practice, such as inventory control, vendor management and purchasing, accounting and financial standardization, and more. There are many digital solutions out there that can help make practice workflows more efficient (e.g., VetSuccess, AVMA Direct Connect, VitusVet). And don't forget tools of telehealth. They support workflow and practice efficiency and provide opportunities for better client communication and care continuity.

  • Talent: By focusing on fostering talent, you can empower employees to perform the full range of work they've been trained and are qualified to do. This means offloading nonmedical tasks—such as entering data, coordinating appointments, answering phones, and record keeping— from clinical staff to nonclinical staff. Credentialed veterinary technicians, for example, should be spending less time answering phones and cleaning examination rooms and more time administering vaccines and assisting with preoperative preparation and surgery. Look at the entire health care team to identify and tap the skills, strengths, capabilities, and passions of each team member.

  • Teams: We need to support our teams by creating inclusive, healthy workplaces that nurture individual and workplace wellbeing. We can start by honing our individual leadership abilities. A recent study of human medical practices showed a strong relationship between leadership quality and employee wellbeing.16 Medical practices with leadership that was described as seeking to inform, engage, inspire, develop, and recognize their staffs' efforts and accomplishments had more job satisfaction and less burnout.

Leveraging technology, nurturing talent, and supporting the team are all things we can do right now.

THE BOTTOM LINE: WHERE DO WE GO FROM HERE?

The stress and pressure veterinary professionals are dealing with today are both real and prevalent. While the increase in demand for veterinary care that many practices have experienced is a part of the challenge, impacts to productivity and issues of staff turnover make the situation even more difficult and complex. By taking a data-informed view that evaluates the national veterinary experience, we can be confident that the right steps are taken to successfully navigate the challenges confronting the veterinary profession. While you take steps to leverage technology, foster talent, and support your teams, the AVMA is committed to supporting you and your practice in the best ways possible.

The AVMA is working on several fronts to ensure practices can make strategic and well-thought-out decisions that lead to great results. We are providing the following:

1. Data and transparency. We believe that finding the right solution is more important than adopting an oversimplified solution. That's why we seek to balance the dialogue on these topics by providing a data-informed approach to the challenges that the veterinary profession is facing. We tap the expertise of our Veterinary Economics Strategy Committee and have invested in a Veterinary Economics Division to help us make sure we are collecting the right data and generating the best actionable insights to support veterinary medicine.

2. Tools to help practices increase productivity. The AVMA has developed materials to help support practice management, leverage technology, and simplify workflow— all of which can lead to improved productivity and reduced turnover. Examples include the following:

  • Resources on how to improve utilization of veterinary technicians.

  • Continuing education on veterinary business issues.

  • Veterinary market reports on pet ownership and veterinary economics.

  • Financial tools to support practice management, including the market share calculator, profit-loss estimator, and the Veterinary Industry Tracker.

  • Guidelines and resources for the use of telehealth in veterinary practice.

3. Resources to support mental health and wellbeing. The wellbeing of veterinary professionals is one of the most important issues facing the profession, with practice teams, business owners, veterinary colleges, organizations, and individuals all having an important role to play. Wellbeing is a key focus of the AVMA, with great effort put into securing information and developing resources to support the veterinary community. These include the following:

  • The Workplace Wellbeing Certificate Program.

  • QPR suicide prevention training.

  • CE webinars and educational videos on workplace wellbeing.

  • A full-time AVMA employee, Jen Brandt, PhD, dedicated to supporting wellbeing initiatives in veterinary medicine.

By relying on a variety of sources of leading industry research and data, we can be sure our collective view of the current situation is grounded in facts. This also provides confidence that the recommendations we make are deliberative and comprehensive and will help us all alleviate the stress we and our clients are feeling, better support our teams, deliver great patient care, and return to feeling good about our work—now and well into the future.

References

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HOD passes resolution on workforce issues

AVMA also adjusts policies on residues, drugs, and research animals

By R. Scott Nolen and Greg Cima

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The AVMA House of Delegates met in Chicago for its regular annual session. Among other things, delegates passed a series of minor revisions to the AVMA's “Policy on Use of Random-Source Dogs and Cats for Research, Teaching, and Education.” (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Veterinary practitioners feeling like there aren't enough hours in the day may think their workload is a consequence of too many “pandemic pets” and too few veterinarians to meet the surge in demand. Yet, as Matthew Salois, PhD, the AVMA's chief veterinary economist, explained July 29 during the AVMA House of Delegates' Veterinary Information Forum, reality is often more complicated.

Productivity and efficiency in veterinary care has taken a significant hit as a result of COVID-19, Dr. Salois said. High staff attrition is also contributing to that sense of having too much work. He and Dr. Gail Golab, the AVMA's chief veterinary officer, elaborate more on the current landscape of the veterinary workforce in a commentary in this issue (see page 560).

MULTIFACETED PROBLEMS

During the comment period following Dr. Salois' presentation on the veterinary workforce, several VIF attendees spoke about how the professionwide underutilization of veterinary technicians has contributed to practice inefficiencies and high turnover.

Practice owners can't retain their veterinary technicians because the owners have failed at providing the veterinary technicians with a professional identity within the business, according to Dr. Wendy Hauser, the American Animal Hospital Association delegate to the HOD.

“We ask them to be janitors instead of aligning their talents and passions to the mission of the practice,” Dr. Hauser said.

Dr. Amanda Bisol, Maine's delegate in the HOD, suggested the AVMA could aid in elevating the professional status of veterinary technicians by advocating for uniform education standards nationwide and licensing requirements in every state.

On July 30, delegates voted during their regular annual session in Chicago to approve a resolution that calls for the AVMA Board of Directors to consider issuing the following statement to the profession:

“Your AVMA recognizes the economic, staffing, and morale challenges that currently exist in the U.S. veterinary workforce. Your AVMA is working on these complex problems and will be delivering information to aid in your understanding of these issues, including JAVMA articles going forward, as well as providing tools to assist you, such as convening the economic summit in the fall of 2021 with a focus on these issues.”

ACTIONS ON RESOLUTIONS

AVMA leaders also adjusted policies to add or expand statements about veterinarians' importance in animal health. And they amended a policy on how dogs and cats are acquired for research.

Members of the HOD also revised the “Policy on Veterinary Foresight and Expertise in Antimicrobial Discussions,” which now includes a statement that veterinarians are responsible for medical decisions, antimicrobial stewardship, and oversight of antimicrobial use in animals.

The delegates also agreed to edit the “Policy on Notification to the Veterinarian of Violative Residues in Foods of Animal Origin” to expand the scope of the policy beyond pharmaceuticals and into residues from pesticides and environmental contaminants. They also removed the previous policy's call for public notification about all residue violations and expanded on language calling for federal regulators and animal owners to work with veterinarians once violations are identified.

In another vote, the delegates passed a series of minor revisions to the AVMA's “Policy on Use of Random-Source Dogs and Cats for Research, Teaching, and Education.”

Some of those revisions are intended to reflect that the U.S. Department of Agriculture is phasing out licensing of Class B dealers that acquire and sell animals, often from multiple sources, as opposed to Class A dealers that sell animals bred and raised in their own facilities or in closed or stable colonies, according to information given to delegates. Other changes are intended for clarity and alignment with the principles of reduction, replacement, and refinement of use of animals in research.

Among the changes, the policy now includes explanations of why scientists might need dogs or cats beyond those purpose bred for research, and those dogs may include “random source” animals that are acquired from sources such as animal shelters, city animal control departments, and breeders. The new policy also notes that researchers justify such use before an institutional animal care and use committee.

The delegates considered amending and combining three AVMA policies on drug compounding, but the delegates decided against doing so over concerns that what constitutes sufficient evidence to demonstrate a compounded product's safety, efficacy, and stability is not consistently defined and rigorous evidence may not be readily available. Delegates noted that veterinarians use compounded drugs to treat myriad zoo animals, birds, reptiles, and wild mammals, and the House voted instead to refer the policy back to the AVMA Council on Biologic and Therapeutic Agents for revisions.

The delegates also considered combining three policies on prescriptions into a singular “Policy on Use of Prescription Drugs in Veterinary Medicine” but decided to also refer the policy back to the COBTA, this time to address concerns about language related to drug labeling.

GUIDELINES FOR CANDIDATES

Finally, the delegates also enacted new rules for candidates for AVMA president, president-elect, and vice president. Candidates can still seek endorsements prior to their official introductions to the House of Delegates as candidates, but they are now prohibited from announcing those endorsements or seeking voting commitments from delegates prior to that introduction.

Under the modified rules, the AVMA prohibits candidates from receiving campaign funding—for travel or other expenses—from employers or corporate sponsors.

The rules also now include a statement that candidates and their supporters should not give delegates anything valued at more than $10. And the update adds guidelines for candidates' use of social media.

The updated rules state that House Advisory Committee members should refrain from campaigning for candidates, other than themselves, and they note that the AVMA Board of Directors has adopted a policy that district directors and officers also should refrain from campaigning for candidates other than themselves.

HOD recommends depopulation policy sent to expert panel for further consideration

Methods for depopulating swine, poultry in the spotlight after being used last year

By Malinda Larkin

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The AVMA House of Delegates voted to refer a resolution on reclassifying ventilation shutdown methods as not recommended to the AVMA Board of Directors for consideration by the Panel on Depopulation. (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Two methods of depopulating chickens or pigs listed in AVMA guidelines have come under scrutiny in the past year.

During 2020, meat processing plants experienced substantial employee shortages because of COVID-19, with unprecedented declines in processing capacity nationwide. As a result, farmers were forced to hold animals longer than planned, leading to overcrowding and resulting in animals becoming too big for housing and processing facilities. After alternatives for marketing were exhausted, some meat processing companies used either ventilation shutdown or what is called VSD plus to quickly depopulate animals.

In reaction, a group of AVMA members submitted a late resolution by petition to the AVMA House of Delegates for the regular winter session in January. That resolution asked that the AVMA classify all forms of ventilation shutdown— VSD and VSD plus—as “not recommended” for poultry and pigs within the “AVMA Guidelines for the Depopulation of Animals: 2019 Edition.”

Delegates opted not to consider the resolution in January because it was submitted late, but took it under consideration during the regular annual session, held July 29-30 in Chicago. Ultimately, 99.1% of the HOD voted to refer the resolution to the AVMA Board of Directors with a recommendation to refer the proposal to the AVMA Panel on Depopulation for consideration.

The panel consists of more than 60 subject matter experts and continuously reviews new research on approaches to depopulation. If, based on its review of that research, the panel decides to make any updates, AVMA members are given a chance to review and comment on those changes before the document is finalized.

According to the depopulation guidelines, VSD is a method of depopulation that involves closing the facility, shutting inlets, and turning off the fans associated with the ventilation system. VSD is not listed in the AVMA guidelines as an option for pigs and is “not recommended” for poultry.

According to background materials for the resolution, VSD plus incorporates components such as heat, humidity, and carbon dioxide, in addition to shutting down the ventilation system, to cause the death of pigs or poultry. VSD plus is listed as a “permitted in constrained circumstances” method for depopulating swine and poultry and should only be used in emergencies after preferred methods have been contemplated and ruled out, according to the guidelines.

Last year, the COVID-19 pandemic caused disruptions in the food supply that affected swine and poultry markets.

“While alternate strategies were sought first, some producers and companies made the decision to depopulate animals in response to these market disruptions,” according to the background materials for the resolution.

The depopulation guidance is extremely important for veterinarians who provide input into these decisions, said Dr. Gail Golab, chief veterinary officer for the AVMA.

“The amount of deliberation and care taken in developing these guidance documents is what has provided their validity not only here, but internationally,” she said to a reference committee of the HOD.

At the same time, according to the background materials, the AVMA acknowledges that it is not a regulatory body and “has no authority over depopulation decisions made by producers, the companies with which they are affiliated, or by state or federal agencies. … Nor does the AVMA oversee depopulation when it is being conducted.”

Animals should not be depopulated unless required by a serious emergency—such as a zoonotic or pandemic disease like COVID-19—and all other reasonable alternatives to managing the affected animals have been explored and been found to not be viable, according to the background materials.

Specifically regarding VSD plus, the method should be applied with a scientifically validated protocol and with strict engineering process control that causes greater than 95% mortality in less than an hour.

Dr. Cia Johnson, who provides staff support to the Panel on Depopulation and is director of the AVMA Animal Welfare Division, said data in a manuscript that appears in the Aug. 15 issue of JAVMA suggest producers at a swine facility in Iowa were able to achieve that standard.

Dr. Bill Williams, Iowa alternate delegate, said to the HOD reference committee: “The veterinarians making these choices made no small effort to come to that conclusion that VSD plus was the last effective, available, and efficient type of option. I can tell you those people were permanently affected by that decision.”

Dr. Michael Zager, Georgia delegate, said to the committee that state veterinarians from Georgia and South Carolina told him they would prefer to have these depopulation methods as options when necessary.

“We have African swine fever in the Dominican Republic. There's avian influenza,” he said. “There are going to be times when this is needed, like it or not.”

HOUSE FILLS COUNCIL, HAC SEATS

At its regular annual session in July, the AVMA House of Delegates elected individuals to AVMA councils and the House Advisory Committee. The results are as follows.

Council on Biologic and Therapeutic Agents

Drs. Richard Hill, Ames, Iowa, and Stephanie Montgomery, Chapel Hill, North Carolina, at-large representatives; Michael Strobel, Northfield, Minnesota, representing clinical pharmacology; Marike Visser, Kalamazoo, Michigan, representing industry exclusive; Kenneth Pawlowski, Mather, California, representing private clinical practice, predominantly small animal

Council on Public Health

Drs. Douglas Meckes, Apex, North Carolina, and Sarah Babcock, Grosse Pointe Shores, Michigan, representing animal health

Council on Research

Dr. Kathryn Meurs, Raleigh, North Carolina, representing colleges of veterinary medicine

Council on Veterinary Service

Drs. Robin Tolmer Paterson, Pittsburgh, representing private mixed practice; Tiffany Collins, St. Petersburg, Florida, representing recent graduates or emerging leaders; and Kelly Cooper, Portland, Oregon, and Ronald Kelpe, Henderson, Nevada, representing private practice, exclusively small animal

House Advisory Committee

Dr. Rex Anderson, Absarokee, Montana

At the subsequent HAC meeting, members of the advisory committee elected Dr. Anderson as chair.

AVMA OFFERS WELL-BEING, SUICIDE PREVENTION RESOURCES

By Malinda Larkin

Mental health persists as an urgent topic among veterinary professionals—in particular, what is being done to promote well-being and prevent suicide in the profession.

The AVMA has been doing a lot of work with an emphasis on well-being—both public facing and behind the scenes—on behalf of veterinary professionals around the world. In particular, leaders have been looking at prevention and intervention in mental health crises through a systems lens, said Jen Brandt, PhD, AVMA director of member well-being and diversity initiatives.

She spoke about some of the highlights of AVMA efforts on July 29 during the informational session of the AVMA House of Delegates' regular annual session. They are as follows:

  • Participating in the first Mind Matters International roundtable, on the impact of the COVID-19 pandemic on mental health in the veterinary team, with delegates from regulatory agencies and member organizations from around the world.

  • The AVMA Workplace Wellbeing Certificate Program, which has five modules: “Creating a Culture of Wellbeing,” “How to Request, Receive, and Give Feedback Effectively,” “Transforming Conflict,” “QPR Assessment,” and “Diversity and Inclusion.”

  • The AVMA Brave Space Certificate Program, which has six modules— three on diversity, equity, and inclusion; two on interpersonal violence; and one on workplace harassment.

  • The My Veterinary Life website with resources for veterinary students, new veterinarians, and rising professionals.

  • The AVMA Wellbeing Educator Train-the-Trainer Program, funded by Merck Animal Health, which expands the pool of qualified individuals to meet the need for evidenced-based well-being programming nationally.

  • An upcoming suicide prevention roundtable in partnership with the American Foundation for Suicide Prevention that will focus on addressing safe communication practices related to suicide prevention.

In addition, the AVMA partnered with the American Association of Veterinary Medical Colleges on a webinar on suicide prevention and mental health. The webinar covered subjects such as the importance of addressing misinformation about suicide in the profession, evidence-based strategies for promoting mental health, and individual and community risk and protective factors.

The presentation, available at AVMA Axon, also reviewed toolkits that the AVMA, AAVMC, and AFSP created for veterinary workplaces and veterinary colleges to create a plan of action after a suicide.

“Why focus on post-vention resources?” Dr. Brant asked, referring to post-vention relative to prevention. “The reality is post-vention is prevention care. In the aftermath of a suicide, there is a window of time of much greater vulnerability. Good post-vention will help save the next life.”

Dr. Brandt pointed to six criteria that form the foundation for AVMA's well-being efforts. They are as follows:

  • Multilevel approaches: From individual to organizational to community.

  • Evidence based: Integrating the best-researched evidence and clinical expertise to maximize safety and efficacy, minimize risk of harm, be solution focused, and be trauma informed.

  • Cultural sensitivity: Having the understanding that this is an ongoing process that seeks to address power imbalances and empathize with others' experiences even if they are not shared.

  • Intersectionality: Understanding that discrimination is a social determinant of health and racism is a public health issue.

  • Interdisciplinary collaboration with other entities. This has included signing onto the National Academy of Medicine's Action Collaborative on Clinician Wellbeing and Resilience as well as advocating with the AFSP in Washington, D.C., to pass suicide prevention policies.

  • Relationship centered.

On the last criterion, Dr. Brandt said, “Regardless of the role we play on a team or in an organization, we are all communicators, so we all play a vital role. Effective communication is a key cornerstone of healthy relationships and workplaces. It involves establishing a foundation of trust and rapport. It's difficult for individuals and teams to be healthy without it.”

The AVMA strives to support the health and well-being of all its members in equitable and inclusive work environments. To learn more, visit avma.org/wellbeing or avma.org/diversity.

AVMA convention attendees stay plugged in

Special events, exhibit hall add to experience for thousands who registered

By Malinda Larkin and Greg Cima

Attendees at AVMA Virtual Convention 2021, held July 29-Aug. 1, didn't have to decide between two sessions happening at the same time—thanks to recorded lectures. Plus, special events and programs allowed attendees to connect with colleagues in a whole new way.

Michael Wilson, director of the AVMA Convention and Meeting Planning Division, said shortly after the convention: “The AVMA was able to transition the AVMA Convention into a successful virtual convention for a second straight year. Even with all of the virtual fatigue that attendees may have experienced over the past year and a half, we had over 3,600 registered attendees, thus far, and offered double the amount of continuing education. I am very pleased with the outcome, but look forward to being back in person in 2022.”

The exhibit hall's Digital District made professionals available to provide brand and resume reviews, and the tech hub showcased start-up and technology companies at the forefront of the veterinary industry.

A scavenger hunt, the Power Up Virtual 5K, and Virtual Zoo Yoga kept attendees' bodies and minds active. Kicking everything off was a concert by Prince tribute band Purple Xperience, whose performance was livestreamed from Minneapolis's famed First Avenue Club, a site featured in the film “Purple Rain.”

A mentorship program connected students with veterinary professionals prior to the convention and during Convention-al Conversations. The Meet-the-Experts Round Table allowed participants to connect with presenters and peers to discuss trends in the veterinary industry.

Also during the convention, hybrid in-person and virtual meetings of the AVMA Board of Directors, AVMA House of Delegates, and Student AVMA House of Delegates took place in Chicago. (See pages 567 and 569 for coverage of the AVMA HOD.)

ALL ABOUT FOLLOW-THROUGH

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Atul Gawande, MD, gave the keynote talk on July 30 at AVMA Virtual Convention 2021. He talked about the resistance he sometimes saw to changes despite benefits to patients.

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Atul Gawande, MD, delivered the keynote speech to kick off AVMA Virtual Convention 2021. He is an endocrine surgeon at Harvard Medical School, a professor of medicine and public health, a researcher, a book author, and an advocate for improving safety in surgery and other health care. He also co-founded an organization, CIC Health, a subsidiary of Cambridge Innovation Center, which has performed COVID-19 testing and vaccination in the U.S., and he advised the Biden transition team on COVID-19.

In his presentation, Dr. Gawande described how the numbers of complications and deaths plummet in hospitals that add checklists in surgeries. He partnered with the World Health Organization on a team that identified critical aspects of procedures that even experts could miss, places where surgical teams fall apart, and pause points to catch issues.

They identified three such pause points: before anesthesia, before a skin incision, and before a patient leaves the operating room.

Rather than provide a cookbook, the checklist helps ensure a team is ready for the unexpected. But it also is designed to change the values of how an operating room works and shift away from the “cowboy values” that prioritize the surgeon's autonomy.

“The decisions that the surgeon makes, what they think is most important, is what we have emphasized as the way we operate in operating rooms,” Dr. Gawande said. “And what we needed to do was instill the core values that are really team values—the values of a pit crew: humility, the recognition that no matter how pedigreed you are, no matter how experienced, you will make mistakes, dangerous ones.”

Dr. Gawande talked about the resistance he sometimes saw to changes despite benefits to patients. And he gave historical perspective by describing the rapid adoption of anesthesia, which had immediate and visible benefits to physicians and patients, in comparison with the slow adoption of antiseptics, which made life harder for physicians to provide a delayed and invisible effect.

“We are fantastic at breakthroughs in medicine,” he said. “We are all breakthrough, and we're not enough follow-through. We've had an unconscionable tolerance for terrible implementation.”

TAKE RISKS, TAKE ACTION

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Princess Sarah Culberson gave the general session talk on July 31.

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Princess Sarah Culberson spoke during the general session about her journey through life and lessons learned along the way. She was adopted by a West Virginian couple as a 1-year-old and raised with little knowledge of her ancestry. She also was one of only a few Black people in her community.

“I didn't realize I always tried to represent being the best and the person who represented my whole race,” Culberson said during her talk. “I was always operating as a kid like if I do something wrong, I don't want people to think all African Americans or biracial people are this way.”

She had spoken previously with Dr. Marci Kirk on the AVMA's “My Veterinary Life” podcast about this thought process. The episode is available at jav.ma/Culbersonpodcast. Dr. Kirk explained that sometimes veterinarians feel the same way, as though if they make a mistake or something goes wrong, they don't want the public to think it reflects on the veterinary community.

Culberson, in her talk, also discussed her journey to Sierra Leone to meet her birth father and family. There, she discovered that she was considered a mahaloi, the granddaughter of a paramount chief, with the status of a princess.

That wasn't all she discovered. The country was in the aftermath of an 11-year civil war. She was inspired to co-found Sierra Leone Rising, a nonprofit to support the community.

“One thing I've learned is you don't have to know how to do everything, you just have to know what you want to do and bring others together who can help,” she said.

Culberson also learned from her time in Sierra Leone to take risks as well as listen to others and then take action. She urged attendees do something as small as telling family members you love them or calling someone who can help you with your business.

“I don't know where you are in your journey, but take an action you've been wanting to take and move things forward in whatever area you've wanted to, and amazing things will happen,” Culberson said.

LOOKING TO NEXT YEAR

The AVMA intends to return to its in-person convention, planned for July 29-Aug. 2, 2022, in Philadelphia.

Dr. Douglas T. Ensley, AVMA Convention Education Program Committee chair, said: “One thing we're looking forward to next year in Philadelphia is being in person, but I think we will also have a hybrid option. That allows attendees' connection with each other and friends and networking that can happen face to face. Then you still have individuals who have enjoyed this online environment for meetings. Having both options allows you as an individual to choose what's best for you.”

SESSIONS WORTH PAYING ATTENTION TO

The Top 10 most popular continuing education sessions at AVMA Virtual Convention 2021 were as follows:

  • 1. “Chronic Vomiting in Cats–Reasons and Treatment”

  • 2. “It's Not Just Canned Food and Fluids: A Fresh Look on CKD in Cats!”

  • 3. “Cytology for the Practitioner”

  • 4. “Cytopoint Essential Facts and New Information You Need to Know!”

  • 5. “Top 10 Toxins Affecting Dogs & Cats”

  • 6. “New Advances in Chronic Pain Management in Cats”

  • 7. “Keynote: Cowboys and Pit Crews With Atul Gawande, M.D.”

  • 8. “Apoquel (Oclacitinib Tablet) Essential Facts and New Information You Need to Know!”

  • 9. “The Most Appropriate Age for Spaying or Neutering to Avoid Increasing the Risk of a Joint Disorder or Cancer: A New Spay/ Neuter Paradigm”

  • 10. “A Practical Guide to Managing Osteoarthritis: Making Sense of Current Therapies”

Registered attendees can view all 300 hours of CE on demand through the end of October. Those who missed the live event can still register to get access to CE sessions, visit exhibitor booths, and view special events and activities. Visit the AVMA Virtual Convention website at avma.org/convention for more information.

When adopting a dog, staying within US a safer option, expert says

Rabies not the only concern when it comes to international travel for rescue dogs

By Malinda Larkin

The Centers for Disease Control and Prevention made news earlier this summer when the agency announced a temporary ban on the import of dogs from countries at high risk for the canine variant of the rabies virus.

The CDC estimates nearly 1 million dogs enter the country annually, with 700,000 arriving via land borders and 300,000 by air. Approximately 100,000 of those dogs come from high-risk countries.

While the primary focus of the CDC's ban is to prevent introduction of the canine variant of the rabies virus, multiple factors impact the health and well-being of a dog during travel, said Dr. Emily G. Pieracci, a veterinary epidemiologist with the CDC, during her presentation “International Pet Travel and Animal Importation: The Usual and Unusual Suspects in International Dog Movements” on Aug. 1 at AVMA Virtual Convention 2021.

“Young puppies are cute, and clients will often be asked to pay more for a younger dog, but it may not be safe for puppies to travel, especially over eight hours, until they're older,” Dr. Pieracci said. “Helping clients understand what the travel process may be like for a young puppy can help clients make an informed decision. The same goes for educating them on the risks for brachycephalic breeds, mode of transport, and importance of routine vet care prior to travel.”

OTHER ZOONOTIC, INFECTIOUS DISEASES

When pets travel by air, they can come in cargo, as checked baggage, or as hand-carried baggage, meaning they are in the cabin with passengers. If they arrive in cargo, they must be listed on the plane's manifest, which is checked by customs. But animals that come as checked or hand-carried baggage are not on the manifest.

“Many organizations and importers will fly dogs as checked baggage because it's less expensive than flying as cargo,” Dr. Pieracci said. “Also, entries may not be filed with Customs and Border Protection, meaning they don't know how many dogs enter the U.S. or where they are coming from.”

This is why she recommends veterinarians be vigilant.

“As a practicing U.S. veterinarian, it's important to understand that when you see imported dogs in your clinic, they may need additional care and treatment to ensure they remain healthy,” she said. “Many rescued dogs from high-risk countries, especially rescued street dogs, may have an increased prevalence of certain diseases, including rabies and parasitism, perhaps due to free-roaming behavior combined with lack of access to routine veterinary care and routine vaccination.”

In January 2019, a dog from Egypt arrived in Canada and then crossed over into the U.S. Three weeks later, it developed polydipsia, polyphagia, and diarrhea. Eventually it was euthanized and confirmed to have rabies. This past June, a rescue dog imported from Azerbaijan was confirmed to have rabies. It was the fourth imported case of a rabid dog since 2015.

Two other recent incidents also underscore the need for vigilance by veterinarians when clients bring in dogs adopted from abroad. This past May, a dog from China that had been imported by one rescue group was then given to another. The dog was healthy when it arrived but later tested positive for Brucella canis.

Also in May, another dog arrived from China as well and developed a cough four days after arrival. It presented to a local veterinarian as lateral recumbent but able to rise, afebrile, and with bilaterally increased lung sounds. The dog had influenza A. Two other dogs in the shipment had also developed respiratory signs but were not tested.

DATA ANALYSIS

When a sick or dead dog arrives at a port of entry, customs will notify the CDC to see whether additional testing is needed. The CDC is limited in what it can require testing for as a regulatory authority really focused on rabies.

“There's no standard operating procedure that outlines which dogs should be tested for what. Everything is done on a case-by-case basis,” Dr. Pieracci said. “This can lead to missed opportunities to detecting diseases of concern.”

To try to get a better handle on causes of death and illness for imported dogs, the CDC did a data analysis, which is currently under review for publication.

From 2010-18, 92 dog deaths were reported to the CDC. Necropsies were performed on 37 of the dogs, and 13 were tested for rabies. Brachycephalic syndrome accounted for most deaths, at 17; followed by undetermined, at 12; ill thrift or dehydration, malnutrition, or poor body condition, at five; and infectious disease, at three, along with one each of rabies, distemper, and parvovirus.

Some of the dogs noted as dying of ill thrift or undetermined had limited diagnostics performed, so they may have had underlying infectious etiologies that were not identified.

Also from 2010-18, 84 dogs were reported to the CDC as sick on arrival. Among the 60 dogs for which medical records were available, diagnoses included the following:

  • Infectious disease (15)—H3N2 influenza (1), distemper (2), parvovirus (2), gastrointestinal parasites (5), mange (2), mycoplasma (1), and leishmaniasis (2).

  • Ill thrift (31).

  • Unresponsive or in critical condition (14) from heat stroke, severe vomiting, pneumonia, or gastrointestinal bleeding.

Further, the CDC analyzed 14,000 case reports from imported dogs during 2010-18 to assess the risk of illness or death, which the agency calls adverse events, during travel. Officials examined brachycephalic breeds versus nonbrachycephalic breeds, mode of transportation, country of origin, and size. Age was not assessed because of data limitations.

The results indicated the following:

  • Brachycephalic breeds were 3.88 times as likely to have an adverse event as nonbrachycephalic breeds.

  • Compared with dogs that were hand-carried baggage, dogs in checked baggage were 5.75 times as likely to have an adverse event and dogs in cargo 2.41 times as likely.

  • Dogs from countries where the canine variant of the rabies virus is endemic were 1.54 times as likely to have an adverse event as dogs from countries free of the variant.

TIPS FOR VETERINARIANS

With a new dog, Dr. Pieracci said, it's important to take a thorough history, to find out how the client obtained the dog, and to ask about the international travel history of the pet. Did the client buy online? Did the client visit the breeder to see where the dog was born and raised? If the dog is from abroad, she suggested verifying that all vaccinations the dog received meet the standards of the U.S. Department of Agriculture's Center for Veterinary Biologics and state requirements.

“Many clients are unaware their dogs were imported from overseas,” she added. “Ask to see all medical records and documentation that accompanied the dog. Make note of any documents that are not in English or contain addresses in foreign countries.”

Veterinarians should consider reporting to their state veterinarian if they notice any sick dog with a history of international travel in the previous six months or international vaccination records that don't match the age and appearance of the dog. In fact, practitioners should consider revaccinating dogs with any discrepant medical records as the dog may not be adequately protected against diseases such as parvovirus, distemper, and rabies, she said.

To help prevent the importation of zoonotic diseases of concern, veterinarians should do the following:

  • Recommend clients adopt or purchase pets from reputable local shelters and breeders.

  • Recommend clients visit the animal before adoption or purchase.

  • Recommend that new pets have a veterinary examination within 10 days of purchase or adoption.

  • Caution clients about online puppy scams from foreign suppliers.

African swine fever reaches the Caribbean

Infections in the region a source of caution, concern in U.S.

By Greg Cima

African swine fever killed 2,200 pigs in at least 24 outbreaks in the Dominican Republic this summer.

Another 200 pigs were culled in response to the outbreaks.

The infections are the first identified in the Western Hemisphere since 1984, according to the World Organisation for Animal Health (OIE). The first outbreak began around July 1 and killed almost 800 pigs in the country's northwest, and an OIE update published Aug. 8 indicates subsequent testing found infections back to April 10.

“While further investigations are ongoing to determine how the virus entered the country, several measures are already in place to halt its further spread,” an OIE announcement states.

The U.S. Department of Agriculture Foreign Animal Disease Diagnostic Laboratory confirmed the presence of ASF virus in the Dominican Republic on July 27, and Dominican Republic authorities reported the results to the OIE on July 29, according to OIE and USDA information.

ASF can wipe out entire herds of domestic swine. The virus is highly contagious, and study results suggest the virus is hardy enough to remain viable for months in common feed ingredients, including those shipped across oceans.

U.S. REINFORCES DEFENSES

U.S. veterinarians have warned for years that the virus could be devastating if it were to reach herds in the United States. The American Association of Swine Veterinarians, for example, has hosted lectures for years on ways veterinarians can identify and close any biosecurity gaps and lessons they can apply from ASF outbreaks in China.

ASF is found particularly in sub-Saharan Africa, according to the USDA. It emerged in the Caucasus in 2007, spread in subsequent years to countries in the European Union, and, starting in 2018, spread through China, Mongolia, Vietnam, and other countries in the region.

In response to ASF incursion in the Dominican Republic, OIE officials called for countries to strengthen their surveillance efforts. The OIE and Food and Agriculture Organization of the United Nations also are providing regional support through a joint project to control transboundary animal diseases, and experts within that project called for countries to reinforce their border controls and implement the OIE's international standards on ASF risk mitigation, according to the OIE announcement.

The USDA Animal and Plant Health Inspection Service has “numerous interlocking safeguards” to keep ASF from entering the U.S., which already prohibits importation of swine products from the Dominican Republic over concerns about classical swine fever, an agency announcement states. But U.S. Customs and Border Protection is increasing inspections of travelers arriving from the Dominican Republic and will work to safely dispose of garbage from airplanes arriving from the country, the APHIS announcement states.

“USDA is committed to assisting the Dominican Republic in dealing with ASF, is offering continued testing support, and will consult with them on additional steps or actions to support response and mitigation measures,” the APHIS announcement states. “We will also offer similar help to Haiti, which borders the Dominican Republic and is at high risk for ASF detections.”

Dr. Chris Rademacher, a clinical professor of veterinary diagnostic and production animal medicine at Iowa State University College of Veterinary Medicine and a member of the AASV board of directors, said that, if ASF reaches the U.S., including its territories, the loss of trade markets alone could cost pork producers at least $14 billion in the first two years. He noted that the virus is hardy and resilient, and it can remain viable in meat products that are cured but not fully cooked, in garbage arriving from airplanes or cruise ships, or on the clothing or shoes of people visiting countries with infections.

There is no vaccine against the virus nor effective treatment for infected pigs, Dr. Rademacher said. The risks in the U.S. include not only spread into domestic herds but also sustained spread of the virus among feral swine populations, and he noted the ongoing outbreaks of the disease among wild boar populations in Europe.

Dr. Rademacher said he is also concerned more countries in the Caribbean could have ASF infections that remain undiagnosed without adequate surveillance. He said the Dominican Republic alone had taken up APHIS officials on a 2019 offer to provide Caribbean countries with diagnostic testing for ASF, classical swine fever, and foot-and-mouth disease.

USDA RESTRICTS DOG IMPORTATION

On Aug. 6, APHIS officials also announced immediate restrictions on importing dogs from countries with African swine fever. Importers now need to affirm dogs and shipping containers are free of dirt or other organic bedding; all bedding traveling with the dogs must be thrown away at certain post-entry concentration points; dogs must have International Organization for Standardization-compliant microchips, and those chips must be verified; and dogs must be bathed at the post-entry concentration points within two days of arrival in the U.S.

“The number of dogs being imported for resale from ASF-affected countries is growing, and APHIS is taking this action to continue its efforts to protect the United States' swine industry against this devastating disease,” the announcement states.

ASF had been considered absent from the Caribbean since 1984, when the last infections were discovered in Haiti, OIE information states. The Dominican Republic had been free of the disease since 1981. Cuba is the only other Caribbean country with a history of ASF, and the disease has been absent there since 1980.

In the Americas, Brazil also once dealt with ASF among the country's domestic pigs, but the country has been free of the disease since 1981.

Drug-resistant hookworms spreading in dogs, parasitologists warn

Some isolates seem resistant to all anthelmintic drug classes approved to treat hookworm infections

By Greg Cima

Veterinary parasitologists warn that multidrug-resistant hookworms are spreading in the U.S. and that veterinarians should watch for persistent infections.

The Ancylostoma caninum bearing those genetic resistances likely emerged from retired racing Greyhounds and now appear to be spreading within the broader pet dog population, according to parasite researchers and representatives from the American Association of Veterinary Parasitologists. A rise in hookworm shedding also threatens human health because the larvae can infect people through skin contact, causing cutaneous larva migrans.

Some hookworm isolates collected from dogs appear to be resistant to all three anthelmintic drug classes approved in the U.S. for treating hookworm infections. Researchers have found efficacy with emodepside, an anthelmintic approved in Europe for use in dogs, but administering it requires administering a product that is unapproved in the U.S. for use in dogs and that can be dangerous if a dog is coinfected with hookworms and heartworm microfilariae.

Another, Food and Drug Administration–approved drug contains emodepside and praziquantel but is labeled only for use in cats, and administering this product to dogs would constitute extralabel use and carry the same heartworm-related concerns.

Antoinette Marsh, PhD, is an associate professor at The Ohio State University College of Veterinary Medicine, president-elect of the AAVP, and chair of the AAVP task force formed, in part, to teach veterinarians that hookworms in the U.S. can be resistant to common treatments and they should follow up on patients to verify the dewormers they prescribe are effective. She said that, until recently, veterinarians who encountered infections that persisted after courses of benzimidazole or pyrantel pamoate could usually rely on a combination course containing moxidectin to treat persistent hookworm shedding in dogs.

“In the last year or so, we're starting to see slippage—or dogs that are not responding to the moxidectin—and they're continuing to shed hookworm eggs into the environment, which means that now we have multiple drug-resistant hookworms out there,” Dr. Marsh said. “And we believe that it started in the Greyhound racing population because of the way that drugs were used in the racing Greyhound—maybe misdosing, inappropriate dosing—and just the genetics of the parasites themselves and their reproductive capacity.”

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Veterinary parasitologists suspect multidrug-resistant Ancylostoma caninum emerged among Greyhounds, but the parasites are now also spreading among other dog breeds. (Photo by Greg Cima)

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Hookworms can release hundreds of eggs per gram of feces and hundreds of thousands of eggs in a single kennel, Dr. Marsh said. That abundance of genetic material under selective pressure from anthelmintics provides opportunities for strains to emerge with genetic changes that give them the advantage to become the dominant strains in a population.

“If you deworm the dogs and one or two of the strains have had a genetic change which allows them to be drug resistant, they can actually then take over the whole population,” she said.

Dr. Marsh cited study results that indicate dogs with suspected or confirmed drug-resistant hookworms are becoming widespread in the Southeast, and she said they have been documented in the Northeast and California, although the prevalence is unknown as are the genetic markers for resistance. Not all of the isolates are multidrug resistant, she said.

Members of the AAVP task force have been among the authors of scientific articles on the rising threat of multidrug-resistant A caninum. Examples include a December 2019 article in the journal Parasites and Vectors that describes a dramatic increase in recurrent or persistent A caninum infections and tests that demonstrated resistances among independent isolates to anthelmintics from multiple drug classes; an August 2020 Clinician's Brief article that states that “most, if not all” racing or recently retired racing Greyhounds appear to be infected with multidrug-resistant hookworms; and a 2019 scientific article in the Journal of the American Animal Hospital Association on the use of pyrantel, febantel, and moxidectin in combination to treat nonresponsive or persistent A caninum ova shedding in eight former racing Greyhounds.

RESISTANCE SPREADING BEYOND GREYHOUNDS

Dr. Cassan Pulaski is acting director of the Parasitology Diagnostic Laboratory at the University of Georgia College of Veterinary Medicine. She is also a member of the AAVP task force and of the Companion Animal Parasite Council's board of directors. She said in late July that the volume of laboratory submissions for suspected drug-resistant hookworm infections had multiplied in the prior six months from about one submission every two weeks to one per day.

Dr. Pulaski also noted that the known infections, found through fecal samples submitted to the laboratory, include two hot spots for suspected drug-resistant hookworms in Georgia. One involved at least five dogs at a pet day care near Savannah, and the other involved at least two dogs brought to a dog park near the Georgia-Florida border. The cases near Savannah included at least one Greyhound, and the dog park further south was frequented by Greyhounds.

While she said Greyhounds likely were the initial sources of infection, “it is not a Greyhound-only issue anymore.” Among suspected drug-resistant hookworm submissions received at the UGA laboratory, about half to two-thirds are from Greyhounds, and the rest are largely from dogs with no known contact with Greyhounds.

Dr. Marsh said drug resistance in hookworms likely developed through misuse of anthelmintics that are approved for administration to livestock. Some of those products contain the same active ingredients as prescription anthelmintics intended for dogs but in different formulations and sometimes different routes of administration.

Nonveterinarians who care for dogs in racing kennels are able to buy such products without prescriptions, she said.

Such misuse can give Greyhounds doses that are ineffective at controlling their infections but sufficient to give resistant worms an advantage over susceptible worms. She said Greyhounds also may metabolize anthelmintics differently than other breeds.

Ohio-based consulting veterinarian Dr. Guillermo Couto, who specializes in Greyhound care and is another task force member, said A caninum had proliferated among racing dogs in the years before all of Florida's tracks shut down. Most kennels would let dozens of dogs out together for exercise, and hookworms readily spread through feces.

Florida had the majority of the nation's Greyhound racetracks a few years ago, with 11 tracks as of 2018. In November 2018, about 70% of voters favored amending the state constitution to ban dog racing after December 2020.

The National Greyhound Association now lists five active tracks remaining in the U.S.: two in West Virginia and one each in Arkansas, Iowa, and Texas. But the tracks in Arkansas and Iowa are also scheduled to phase out live racing by the end of 2022.

Dr. Jennifer Ng, who is a companion animal practitioner in Columbia, South Carolina, and a member of the task force, has seen hookworms become more common overall among Greyhounds she fosters and sees through her practice. She performs a mix of paid and volunteer work, including foster care, for the South Carolina–based organization Greyhound Crossroads.

Starting in 2016, Dr. Ng noticed that almost every Greyhound arriving from a track was positive for hookworms upon or soon after arrival, up from an estimated 10%-20% in prior years.

Dr. Ng also saw a rising proportion of those A caninum infections persist after standard treatments, and she has switched her standard protocol to involve one or two combination drugs, depending on the worm burden. But Dr. Ng said some arrivals in the past year have had lower worm burdens, suggesting to her that caregivers on farms and tracks may be improving treatments.

DRUGS UNAPPROVED IN U.S. FOR USE IN DOGS MAY HELP

Dr. Pulaski has consulted about a half dozen veterinarians on the use of anthelmintics approved in Europe for treatment of nematode parasite infections in dogs, especially emodepside. She had yet to see safety or efficacy problems, but she also warned that such use must be the last resort.

If veterinarians prescribe emodepside for dogs, she recommends they first run blood tests for heartworm microfilariae. Those microfiliariae are also vulnerable to emodepside, and their rapid death can cause a fatal anaphylactic reaction in a dog.

In the 2020 Clinician's Brief article, the authors state that they do not recommend emodepside treatment because they saw limited available data on such use. But the drug is the only potentially effective treatment if a triple combination of approved drugs is ineffective.

The article notes that emodepside with praziquantel is approved by the FDA as a topical solution for cats, but topical administration is ineffective in dogs, and the drug must be administered orally.

In a scientific article published in April 2020 by the International Journal for Parasitology: Drugs and Drug Resistance, researchers describe an A caninum isolate that was resistant to pyrantel pamoate, fenbendazole, and milbemycin oxime but susceptible to an emodepside and praziquantel combination. The study involved tests in Beagles experimentally infected with the isolate, known as Worthy 4.1F3P.

“Based on work in our laboratory, both published and unpublished, as well as frequent communications with veterinarians dealing with cases of persistent hookworm infections, Worthy 4.1F3P appears to be representative of the worms currently circulating in greyhounds,” the article states. “The lack of efficacy demonstrated by the most commonly used products in the U.S. for the treatment of hookworms in dogs therefore portends a very serious situation, and threatens not just canine health, but also human health due to its zoonotic potential.”

Dr. Couto said Greyhounds can have unexpected reactions to drugs commonly prescribed for other breeds, and he recommends only prescribing a drug for use in Greyhounds when data show it's safe. He has seen, for example, Greyhounds sleep for days after receiving a standard narcotic dose. For that reason, he has not recommended that veterinarians prescribe emodepside.

FOLLOW-UP NEEDED

Dr. Marsh urged that veterinarians follow up with clients when they prescribe any dewormers for hookworm infections, and she hopes the AAVP canine hookworm task force will help veterinarians in practice and government learn about the issue. When veterinarians use a dewormer—particularly in a dog with documented infection—it's important to retest that dog 10-14 days later to ensure the dog is no longer shedding eggs or it has significant reduction in fecal egg counts following deworming. She recommends monitoring as long as shedding persists.

Dr. Pulaski also urged veterinarians to report treatment failures to drug manufacturers, which are obligated to collect data for the FDA on lack of efficacy. And she advocates client education about the risk hookworms present to people and animals and how clients can help prevent infections.

MERITORIOUS SERVICE AWARD GIVEN TO STUART BROWN

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Dr. Stuart E. Brown II

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Stuart E. Brown II accepted the AVMA Meritorious Service Award in July in person ahead of the regular annual session of the AVMA House of Delegates and in a prerecorded video that aired during the keynote for AVMA Virtual Convention 2021.

After earning his veterinary degree in 1991 from Tuskegee University, Dr. Brown worked at Hagyard Equine Medical Institute, first as an intern, then as an associate veterinarian, and later as a partner. With a primary focus on Thoroughbreds, his areas of concentration have included equine reproduction, foal and yearling evaluations, purchase evaluations, herd health and preventive medicine, federal import and export protocols, and issues affecting the welfare and safety of racehorses.

In 2020, Dr. Brown became equine safety director at Keeneland Association Inc., which offers Thoroughbred sales and racing.

Some of Dr. Brown's recent appointments include serving as chair of the Gluck Equine Research Foundation, a trustee for the AVMA Trust, delegate from the American Association of Equine Practitioners to the AVMA House of Delegates, a board member for the Thoroughbred Club of America, and board chair for the University of Kentucky Equine Analytical Chemistry Laboratory.

Among previous appointments, Dr. Brown served as a commissioner for the Kentucky Horse Racing Commission, president of the Kentucky VMA, and director of the Racing Medication and Testing Consortium.

Dr. Brown also owns and operates a Thoroughbred breeding, racing, and sport horse farm in Versailles, Kentucky.

AVMA Award presented to Gregory S. Hammer

2007-08 AVMA president supported bill to increase veterinarians in public health workforce

By Katie Burns

The Veterinary Public Health Workforce Expansion Act would have awarded grants to veterinary colleges offering training to increase the number of veterinarians in the public health workforce.

The legislation never passed Congress, but the bill was the top priority for Dr. Gregory S. Hammer as 2007-08 AVMA president. He thinks the need to expand the public health workforce is even greater today with the COVID-19 pandemic and more zoonotic diseases coming to the forefront. Currently, the AVMA is backing the Advancing Emergency Preparedness Through One Health Act (S 861/HR 2061), which includes workforce development.

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Dr. Gregory S. Hammer

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Hammer, a Delaware-based small animal practitioner, accepted The AVMA Award in July in person ahead of the regular annual session of the AVMA House of Delegates and in a prerecorded video that aired during the keynote for AVMA Virtual Convention 2021. The award recognizes contributions to the advancement of veterinary medicine in its organizational aspects.

Dr. Ronald E. Gill, who represents District VI on the AVMA Board of Directors, nominated Dr. Hammer for the award. Dr. Gill wrote to his fellow Board members: “I submit to each of you that as a private practitioner, there are certain words and actions that are of great importance to me. Words like Dedication, Honesty, Trustworthiness, Hard Work and Sincerity come to my mind. I could use each and every one of these words to describe my experience with Dr. Hammer.”

Dr. Hammer, originally from Kansas City, Kansas, knew from an early age that he wanted to pursue a medical career. He loved science and biology, and he started leaning toward veterinary medicine. From age 7 or 8, he shadowed his uncle, Dr. Jim Boyd, a small animal practitioner in Nebraska.

“I loved watching him and couldn't wait until I could do something like spaying grandma's cat on an ironing board in the basement,” Dr. Hammer said. “That was the first surgery I ever saw, and I got a little nauseous.”

Dr. Hammer earned his veterinary degree in 1973 from Kansas State University. His uncle had served in the Air Force for two years before entering private practice, and Dr. Hammer thought doing the same would be a good way to pay off his educational debt of $3,000. He was stationed in Dover, Delaware.

He and his wife, Karen, had planned to return to Kansas City, but the country was in a recession in the mid-1970s, and Dr. Hammer had been visiting and working with the veterinarians at Brenford Animal Hospital in Dover. He joined the practice in 1976 and has been there ever since. His two children and six grandchildren remain in the area.

Dr. Hammer first got involved with the Delaware VMA helping organize its meetings. Later, he jumped on an opportunity to become a delegate to the AVMA House of Delegates. He served a term on the AVMA Board before becoming 2007-08 AVMA president, which allowed him to take the AVMA's messages to 48 states and six countries.

Dr. Hammer believes all veterinarians should be involved in organized veterinary medicine so their combined voice is stronger to the public and the government. He thinks the legislative issues that the AVMA works on are the most important thing the AVMA does for members.

Nowadays, Dr. Hammer tells people that he is retired because he only works Tuesdays, Wednesdays, and Thursdays.

“I enjoy my colleagues. I enjoy my clients, and I love the animals,” he said. “I have no plans to stop right now, although the first three out of four clients I saw the other day asked me when I was going to retire. I don't know if they wanted me to retire—or not retire!”

Association recognizes recipients of AVMA Excellence Awards 2021

Individuals recognized for contributions related to veterinary medicine

During AVMA Virtual Convention 2021, July 29-Aug. 1, a number of individuals received AVMA Excellence Awards for their contributions in the areas of the human-animal bond, animal welfare, governmental advocacy, international veterinary medicine, and public service. Following are some key achievements of the award recipients.

BUSTAD COMPANION ANIMAL VETERINARIAN OF THE YEAR AWARD

Dr. Jason Coe

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Dr. Jason Coe

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Coe (Guelph '01) is a professor in the Department of Population Medicine at the University of Guelph Ontario Veterinary College. After earning his veterinary degree there, he went into mixed animal practice. He returned to the veterinary college to complete a doctorate in veterinary communications in 2008. That year, he joined the Department of Population Medicine, where he has established a research program examining the human-animal bond and the role of interpersonal communication in the outcomes of veterinary care. He has established an international reputation for his leadership in veterinary communications, education in veterinary primary care, and understanding the human-animal bond.

AVMA ANIMAL WELFARE AWARD

Dr. Jeff Boehm

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Dr. Jeff Boehm

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Boehm (California-Davis '90) traces his career path back to a volunteer position he held at The Marine Mammal Center based in Sausalito, California, as a young adult. The center is the world's largest hospital for marine mammals, rescuing animals in California and Hawaii. Dr. Boehm returned to the center as executive director in 2008 and has since expanded the organization's efforts to advance global ocean conservation. Previously, he served as senior vice president of animal health and conservation science at the John G. Shedd Aquarium in Chicago. He is a diplomate and founding member of the American College of Animal Welfare and served as its 2019-20 president.

AVMA HUMANE AWARD

Valerie Fenstermaker

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Valerie Fenstermaker

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Fenstermaker worked for the California VMA for more than 30 years. She served as the CVMA executive director for 16 years, until her retirement in late 2020. With the CVMA, she worked on more than 1,000 legislative bills affecting the veterinary profession and the well-being of animals, including legislation on scope of practice, judicious use of antimicrobials, and veterinary compounding. She worked to defeat a proposed sales tax on veterinary services. She oversaw the California Veterinary Medical Reserve Corps, which is the CVMA's disaster response program, and managed the California Veterinary Medical Foundation. She continues to work with the CVMA as a consultant for Veterinary Insurance Services Co.

AVMA ADVOCACY AWARD

Tina Smith

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Sen. Tina Smith

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Sen. Smith sits on two U.S. Senate committees that oversee many of the issues important to veterinary medicine: The Committee on Health, Education, Labor, and Pensions and the Committee on Agriculture. She has supported using a one-health approach to improve public health preparedness. She was one of two U.S. senators who introduced the Advancing Emergency Preparedness Through One Health Act (S 861/HR 2061). She has been a co-sponsor of the Prevent All Soring Tactics Act and the Preventing Animal Cruelty and Torture Act, and she is supportive of legislation addressing chronic wasting disease. She also is active on legislation important to animal agriculture.

AVMA GLOBAL VETERINARY SERVICE AWARD

Dr. Jonna Mazet

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Dr. Jonna Mazet

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Mazet (California-Davis '92) is vice provost for grand challenges at the University of California-Davis. She is a professor of epidemiology and disease ecology and founding executive director of the One Health Institute at the UC-Davis School of Veterinary Medicine, where she has focused on global health problem-solving, especially for emerging infectious diseases and conservation challenges. She is active in international one-health education, service, and research, notably in relation to disease transmission and ecological drivers of new diseases. Over the past decade, she was global director of Predict, a project to provide early warning of viral emergence, within the U.S. Agency for International Development's Emerging Pandemic Threats program.

AVMA PUBLIC SERVICE AWARD

Dr. Megin Nichols

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Dr. Megin Nichols

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Nichols (Colorado State '08) has served as the Enteric Zoonoses Activity lead at the Centers for Disease Control and Prevention since 2015. She works with state and federal partners on multistate outbreaks of Salmonella and Escherichia coli infections resulting from exposure to animals and pet products. In 2020, Dr. Nichols led a CDC working group to design and implement testing strategies during COVID-19 outbreaks among workers at meat processing plants. She leads organizing efforts for Veterinary Student Day at the CDC. Before joining the CDC, she worked at the New Mexico Department of Health. She is a diplomate of the American College of Veterinary Preventive Medicine.

VETERINARIAN COUPLE, AVMA STAFFER, PROFESSION HONORED WITH PRESIDENT'S AWARDS

Dr. Douglas Kratt, 2020-21 AVMA president, gave his three President's Awards during the President's Reception on July 29 during AVMA Virtual Convention 2021. The award recognizes individuals or groups for making a positive impact on health, veterinary organizations, or the profession.

This year's recipients are the late Dr. René Carlson and her husband, Dr. Mark Carlson, a veterinarian couple from Wisconsin; Carole Jordan, AVMA director of governance administration; and the full veterinary profession for its response to the COVID-19 pandemic. Dr. Kratt describes here why he chose the recipients.

DRS. MARK AND RENÉ CARLSON

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Drs. Mark and René Carlson

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

In recognition and appreciation for the inspiration and impact they provided to me throughout my leadership journey in organized veterinary medicine. We could have open and honest conversations, challenge conventional thinking, and be supportive of the decisions made. Their interactions and supportiveness for each other and those around them, inside and outside of the world of veterinary medicine, have been inspiring and have greatly contributed to my success in the veterinary profession.

CAROLE JORDAN

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Carole Jordan

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

In recognition and gratitude for her support and commitment during my leadership roles at the AVMA. She has helped challenge my growth as a leader, and her guidance, knowledge, and professionalism have been instrumental during my presidency journey and to the many leaders of this profession.

THE VETERINARY PROFESSION

In recognition and gratitude to the full veterinary profession that played an integral role in society during the worldwide pandemic of COVID-19. Everyone came together not only for the clients and patients but also for each other, while adapting to the ever-changing challenges of the pandemic. So many facets of the veterinary profession contributed to the successes made during this most challenging time: veterinarians and veterinary teams adjusting delivery of care to continue treating patients, credentialed veterinary technicians quickly adapting the way they work, practice managers adjusting protocols to stay open and serve patients, diagnostic sectors testing both human and animal samples, researchers helping to develop vaccines, those in regulatory medicine making sure the food supply is safe, veterinary colleges modifying their educational methods to a virtual setting, receptionists making accommodations to assist patients, and so much more. I am proud of all of the work that has and continues to be accomplished, and I am honored to be part of such a strong and resilient profession.

People: FLORIDA VMA

EVENT

Annual conference, July 8-11, Orlando

AWARDS

Veterinarian of the Year

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Dr. Philip Richmond

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Philip Richmond (Florida '06), New Port Richey. Dr. Richmond practices at Country Oaks Animal Hospital in New Port Richey. He has a special interest in anesthesia and pain management, dentistry, soft-tissue and orthopedic surgery, radiology, and cardiology. Dr. Richmond serves as chair of the FVMA Wellness and Well-being Committee and the FVMA Outreach Committee. He provides assistance to medical professionals in recovery from addiction.

Distinguished Service Award

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Dr. John Steven Woodby

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. John Steven Woodby (Tennessee '81), Miami. Dr. Woodby is the founder of Calusa Crossing Animal Hospital in Miami. He is a past president of the South Florida VMA and has served on the FVMA Outreach Committee for more than two decades, chairing it from 2010-18. Dr. Woodby provides peer assistance to members of the veterinary profession who are suffering from addiction and who are injured, impaired, or infirm.

Lifetime Achievement Award

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Dr. Janet Whitlock

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Dr. Janet Whitlock (Iowa State '76), Sarasota. Dr. Whitlock is the founder of Beneva Animal Hospital in Sarasota, which is accredited by the American Animal Hospital Association. She also helped establish an emergency clinic in Sarasota County. Dr. Whitlock is a past president of the FVMA and Southwest Florida VMA.

President's Award

This award was presented posthumously to Philip Hinkle (see obituary, Oct. 15, 2020, JAVMA, page 796). Hinkle began working for the FVMA as director of finance and membership in 1986. In 2007, he became the association's executive director, serving in that position until 2020. Hinkle was an advocate for veterinarians, veterinary technicians, practice managers, and veterinary assistants in Florida.

Gold Star Awards

Drs. Mario Cabrera, Margate; Melanie Donofro, Tallahassee; Robert Encinosa, Riverview; Robert B. Swinger, Fort Lauderdale; and Abigail Walls, Orange Park

OFFICIALS

Drs. Richard Sutliff, Bradenton, president; Marta P. Lista, West Miami, president-elect; Donald H. Morgan, Largo, treasurer; Mary Smart, Bradenton, 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. Richard Sutliff

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

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Dr. Marta P. Lista

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.559

Correction

The article “USDA expanding efforts to protect farmed aquatic animals” in the Sept. 1, 2021, issue of JAVMA News, page 449, stated that President Joe Biden signed an executive order authorizing the creation of a new national plan for aquaculture health. The order was signed by then-President Donald Trump.

Obituaries: AVMA MEMBER | AVMA HONOR ROLL MEMBER | NONMEMBER

RANDALL JAY BICKERS

Dr. Bickers (Texas A&M '90), 59, Weatherford, Texas, died June 20, 2021. A diplomate of the American College of Veterinary Surgeons, he owned Bickers Equine Surgery and Consulting in Weatherford and had a special interest in veterinary acupuncture and chiropractic. Earlier in his career, Dr. Bickers practiced at Brazos Valley Equine Hospital in Stephenville, Texas. He is survived by his wife, Rhonda; two sons; his father; and two brothers and a sister.

DAVID M. CARLSON

Dr. Carlson (Kansas State '60), 85, Greenfield, Indiana, died June 8, 2021. A mixed animal veterinarian, he began his career in Aurora, Illinois. In 1963, Dr. Carlson took ownership of Greenfield Veterinary Clinic, where he worked for 40 years until retirement in 2003. Active in his community, he was a member of the local school board, Lions Club, and Knights of Columbus. Dr. Carlson is survived by his wife, Joyce; two sons, two daughters, and two stepsons; seven grandchildren and four stepgrandchildren; and 10 great-grandchildren. Memorials to the Alzheimer's Association, alz.org; St. Louis Public Television, ninepbs.org; Greenfield Public Library, greenfieldpl.org; or the Greenfield Foundation for Educational Excellence may be sent c/o Shields-Bishop Funeral Home, 604 Walnut St., Greenfield, IL 62044.

ELMER G. DAVIS

Dr. Davis (Kansas State '64), 88, Great Falls, Montana, died Jan. 25, 2021. Following graduation, he owned Central West Animal Clinic in Great Falls, where he practiced small animal medicine for 40 years. Dr. Davis later worked at Skyline Veterinary Clinic in Great Falls for 14 years. He was a member of the Montana VMA. Active in his community, he served on the Great Falls Public Schools Board and was a member of the Westside Kiwanis Club. Dr. Davis served in the Air Force, attaining the rank of captain. His wife, Doris; a son and a daughter; four grandchildren; and a great-grandchild survive him. Memorials may be made to the Great Falls Rescue Mission, 408 2nd Ave. S., Great Falls, MT 59405, or Great Falls Animal Shelter, 1010 25th Ave. NE, Great Falls, MT 59404.

GERALD G. DREHMEL

Dr. Drehmel (Minnesota '55), 98, Eau Claire, Wisconsin, died April 1, 2021. Following graduation, he moved to Fall Creek, Wisconsin, where he established a mixed animal practice. Dr. Drehmel retired in 1994. Active in his community, he served on the Fall Creek School Board and was a member of the local Lions Club. Dr. Drehmel was an Army veteran of World War II. His three sons, a daughter, nine grandchildren, and seven great-grandchildren survive him. Memorials may be made to Community Driven, 64 Melbourne Ave. SE, Minneapolis, MN 55414; Feed My People Food Bank, 2610 Alpine Road, Eau Claire, WI 54703; The Salvation Army, 2211 South Hastings Way, Eau Claire, WI 54701; Hope Gospel Mission, 2650 Mercantile Drive, Eau Claire, WI 54703; or St. Paul's Lutheran Church, 721 S. State St., Fall Creek, WI 54742.

KEITH A. DRYBURGH

Dr. Dryburgh (Ohio State '07), 42, Hilliard, Ohio, died May 9, 2021. Following graduation, he worked at Annehurst Veterinary Hospital in Westerville, Ohio, for three years. Dr. Dryburgh subsequently served as an associate veterinarian at Dayton Animal Hospital in Dayton, Ohio. During that time, he earned certification in canine rehabilitation from the University of Tennessee.

From 2013-17, Dr. Dryburgh was a relief veterinarian with Lighthouse Veterinary Personnel Services in Westerville. He later served as an associate veterinarian at Cryan Veterinary Hospital in Westerville. At the time of his death, Dr. Dryburgh was associated with Peace of Mind Veterinary Relief Service in Dayton.

He is survived by his parents and a sister. Memorials may be made to Angels for Animals, 4750 S. Range Road, Canfield, OH 44406.

JOHN HAL HOPSON

Dr. Hopson (Colorado State '59), 87, Silver City, New Mexico, died April 8, 2021. Following graduation, he established Deming Animal Hospital in Deming, New Mexico, where he practiced mixed animal medicine for 12 years. During that time, Dr. Hopson also served for a while as state veterinarian. He subsequently moved to Silver City and established Arenas Valley Animal Clinic in Arenas Valley, New Mexico.

A past president of the New Mexico VMA, Dr. Hopson served on the New Mexico Board of Veterinary Medicine and was New Mexico's alternate delegate to the AVMA House of Delegates for several years. He also served on the board of directors of the High Desert Humane Society and the Gila Regional Medical Center. Dr. Hopson established the Dr. J. Hal and Florence Hopson Endowed Scholarship at New Mexico State University to benefit students furthering their studies in animal sciences who have aspirations to attend veterinary school.

In 1998, he was named Silver City Citizen of the Year. In 2015, New Mexico State University honored Dr. Hopson with the Spirit of Service Award. He is survived by two sons, two grandchildren, four great-grandchildren, and a sister. Memorials may be made to Cowboys for Cancer Research, P.O. Box 202, Dona Ana, NM 88032.

ERWIN M. KOHLER

Dr. Kohler (Ohio State '55), 90, Wooster, Ohio, died June 12, 2021. He was a professor emeritus in the Department of Veterinary Preventative Medicine and a past assistant dean at The Ohio State University College of Veterinary Medicine.

Following graduation, Dr. Kohler practiced in Winchester, Virginia. He subsequently returned to Ohio State, where he earned his doctorate in microbiology in 1965. Dr. Kohler then joined the Food Animal Health Research Program at Ohio State's Ohio Agricultural Research and Development Center, heading the program for 16 years. He also conducted research on porcine and bovine diseases and helped develop the center's gnotobiology laboratory. The new FAHRP building was built during Dr. Kohler's tenure. He retired in 1992.

Dr. Kohler was a life member and a past secretary-treasurer of the Conference of Research Workers in Animal Diseases, whose 1994 conference was dedicated to him. He received several other honors, including the American Association of Swine Veterinarians' Howard Dunne Memorial Award in 1978 and a Distinguished Alumnus Award from The Ohio State University College of Veterinary Medicine in 1992.

Active in his community, Dr. Kohler was a past president of the Wooster Noon Lions Club and was recently honored with a Melvin Jones Fellowship for his service. He also served as a volunteer with the medical alert program of the Wooster Community Hospital Auxiliary. Dr. Kohler is survived by a son, a daughter, four grandchildren, two great-grandchildren, and a sister.

WILLIAM M. MILLER

Dr. Miller (Ohio State '76), 70, Kenton, Ohio, died June 18, 2021. He owned Diamond-M Veterinary Clinic in Kenton for 25 years. Dr. Miller also served as an adjunct instructor of large animal medicine and pharmacology at Brown Mackie College in Findlay, Ohio. He retired from veterinary medicine in 2001. Dr. Miller later served as an independent contractor for IntraVet practice management software; owned Riverhill Management, guiding veterinary practice owners and managers in the principles of veterinary business management; and owned Arlington Hardware.

He was a life member of The Ohio State University Alumni Association and an honorary life member of the Ohio VMA. Dr. Miller's two sons, eight grandchildren, eight great-grandchildren, and a brother and a sister survive him.

JACK W. PETERSON

Dr. Peterson (Oklahoma State '58), 86, Bricelyn, Minnesota, died Feb. 7, 2021. A mixed animal veterinarian, he began his career in Kiron, Iowa. In 1960, Dr. Peterson moved to Bricelyn, where he practiced until retirement in 2018. A member of the Minnesota VMA, he was also a member of the Minnesota Quarter Horse Association, Professional Rodeo Cowboys Association, Midwest Fjord Horse Club, and Gideons International. Dr. Peterson is survived by his wife, Janet; two sons and two daughters; seven grandchildren; and a sister.

BILLY H. WINGFIELD

Dr. Wingfield (Georgia '58), 95, North Dinwiddie, Virginia, died May 19, 2021. Following graduation, he worked for the U.S. Department of Agriculture for two years. Dr. Wingfield then served 24 years as a partner at Petersburg Animal Hospital, a small animal practice in Petersburg, Virginia, retiring in 1984. He subsequently worked part time for six years at Banfield Pet Hospital in Virginia at Midlothian and Richmond.

Dr. Wingfield was a member of the Virginia VMA. He was also a more than 50-year member of the Masonic Lodge, was active with the Gerow Ruritan Club and the Chippoax Hunt Club, and was a charter member of the Wingfield Family Society. Dr. Wingfield served in the Army Air Force during World War II, attaining the rank of second lieutenant. His wife, Emma Wray; a son and two daughters; three grandchildren; and two great-grandchildren survive him.

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