Jan/Feb24 CV_2 by californiaveterinarian

California

VETERINARIAN THE PUBLICATION OF THE CALIFORNIA VETERINARY MEDICAL ASSOCIATION

VOLUME 78 NUMBER 01 | JANUARY–FEBRUARY 2024

Veterinary Telemedicine Expansion in California page 12

RVT Appointments: New California Law page 16

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CA LIC # 0F64180

CONTENTS

NEW MEMBER BENEFIT!

Features

Departments

7 Member Profile: Marie Ussery, RVT, BS

4 CE Calendar

8 CVMA Member Benefits 9 New Member Benefit: The ULTI™ Travel Bag by CONMIGO® 10 New Laws for 2024

5 Director’s Corner 6 News & Now 16 RVT News: RVT Appointments—New California Law

12 Veterinary Telemedicine Expansion in California

33 Compliance Corner: California Canine Rabies Vaccination Exemption Law

14 CVMA Policy on Telemedicine

35 CVMA Remembers

20 Introducing CVMA Watchdog—the CVMA’s Rebranded Practice Safety and Regulatory Compliance Website! 21 Start the New Year Right with a CVMA Guide to Cal/OSHA Compliance Subscription—Special Discount Offer 28 Document, Document, Document: The Importance of Documenting Employee Performance 32 CDFA News: 2023 Regulatory Animal Health Round-Up 36 Workplace Safety: Preparing for Power Loss in an Emergency 37 Unique Insights: When Opportunity Knocks 38 Veterinarian Beginnings: Where Has the Time Gone? 39 Something to Wag About

41 Student News 42 University News 45 Classifieds 46 Ad Index

Upcoming CE 22 CVMA Pacific Veterinary Conference in San Francisco 30 CVMA Spring Seminar in Yosemite 31 CVMA Food Animal Medicine Seminar in Yosemite 34 Online Seminars

40 CVMA Board of Governors Openings cvma.net/publications

UPCOMING CE

Employment Law Changes for 2024

January 23, 2024 | 12:30–1:45 PM (1.5 CEUs) January 25, 2024 | 5:30–6:45 PM (1.5 CEUs) For more information, see page 34.

Volume 78 Number 01 Janurary–February 2024 The Publication of the California Veterinary Medical Association Publisher Dan Baxter Managing Editor Kristen Calderon Editor Taryn DeOilers Publication Designer Marissa Collier

Navigating Nutritional Conversations

February 13, 2024 | 12:30–1:45 PM (1.5 CEUs) February 15, 2024 | 5:30–6:45 PM (1.5 CEUs) For more information, see page 34.

CVMA Spring Seminar in Yosemite March 8–10, 2024 (12 CEUs)

For more information, see page 30.

CVMA Food Animal Medicine Seminar in Yosemite March 9–10, 2024 (9 CEUs)

For more information, see page 31.

Classified Advertising Laura Phillips BOARD OF GOVERNORS President Dr. Michael Karle President-Elect Dr. Jennifer Hawkins Member-at-Large Dr. Peter Bowie Members Dr. Kelly Byam Dr. Patrick Connolly Dr. Inez del Pino Nicole Dickerson, RVT Dr. Misty Hirschbein Dr. Adam Lauppe Dr. Peter Mangold Dr. Diane McClure Dr. Teresa Morishita Dr. Shari O'Neill Dr. Kevin Terra Dr. Brent Wooden Dr. Jodi Woods Treasurer Dr. Ron Kelpe Chair, House of Delegates Dr. Laura Weatherford

Pathways to Payments: Leveraging Options to Help Clients Pay for Services March 26, 2024 | 12:30 PM–1:45 PM (1.5 CEUs) March 28, 2024 | 5:30–6:45 PM (1.5 CEUs) For more information, see page 34.

CVMA Pacific Veterinary Conference in San Francisco July 11–14, 2024 (28.5 CEUs)

For more information, see page 22.

STUDENT REPRESENTATIVES University of California, Davis Sarah Meil Western University Nicole Lent CVMA STAFF Executive Director Dan Baxter Director of Communications Kristen Calderon Director of Finance Kathy Van Booven Director of Conferences and Events Sarah Erck, CMP Director of Regulatory Affairs Grant Miller, DVM Membership and Student Services Manager Laura Phillips Publications Manager Taryn DeOilers Communications and CE Coordinator Nicole Campos Finance Coordinator Sharmele Browne

Registration for all CVMA events can be made online by logging onto cvma.net. If you have any trouble registering online, please call 800.655.2862 for staff assistance.

Graphic Designer Marissa Collier Conference Speaker Coordinator Lily Briggs Conference Expo Coordinator Erica Ferrier Membership Coordinator Jennifer Smith

CVMA-AFFILIATED PROGRAMS

Receptionist Mary Young DISPLAY ADVERTISING Please contact Taryn DeOilers at 916.649.0599 ext. 16 or email tdeoilers@cvma.net.

California Veterinarian (ISSN 00081612) is published bi-monthly by the California Veterinary Medical Association, e-mail: staff@cvma.net. California Veterinarian is an official publication of the California Veterinary Medical Association. Annual subscription rates to non-members: $50 U.S., $60 Canada/Mexico, $70 overseas. Price per single copy: $10 current year, $12 back issues. Periodicals postage paid at Sacramento, CA and at additional mailing offices. POSTMASTER: Send address changes to California Veterinarian, 1400 River Park Dr., Suite 100, Sacramento, CA 95815-4505. Phone: 800.655.2862 The CVMA and California Veterinarian assume no responsibility for material contained in articles and advertisements published, nor does publication necessarily constitute endorsement by them. ©2024 CVMA

California Veterinarian | January–February 2024

Tell us what you think! Want to comment on what the CVMA is doing or writing about? Send an email to comments@cvma.net or call 800.655.2862. Your thoughts and opinions matter to us. The CVMA is YOUR association—let us hear your voice!

DIRECTOR'S CORNER

had originally intended this piece to be included in the November/December issue of California Veterinarian but life— and legislation—got in the way, prompting me to alter course to meet the exigencies of AB 1399 (see page 12 if you are not yet acquainted with this legislation). In that regard, we anticipate another turbulent legislative year in 2024 and will likely have more to report in our next magazine. In the meantime, the CVMA will continue to represent and protect this truly exceptional profession. My personal ask of you is that when the CVMA issues alerts this year seeking membership action on legislative items, you take heed of such requests. Now, more than ever, your voice is needed. And now, without further ado, allow me to offer the veterinary profession a belated expression of thanks that was supposed to be published two months ago, next to a picture of a turkey and some stuffing. In doing so, I am writing not as a member of the CVMA’s staff, but instead as a longtime consumer of veterinary services. During my childhood and adolescence, my parents and I raised and loved our Labrador Retriever Colette and Ragdoll-looking cat Mittens, and after I left the house to go to college and beyond, my parents were the doting owners of cats Callie and Misty (they never did get another dog, convinced that none that could ever take Colette’s place). They faithfully took their animals to the veterinarian for both annual checkups and more acute treatment, and thus—likely without ever intending to do so—instilled in me the importance of veterinary care. So, over the course of my adult life and accompanying pet ownership, I have regularly brought—in chronological order—Spreckels, Nermal, Kubla, Pali, Benbow, Lompez, Tiki, Nala, and Gnocchi for every type of veterinary care…from spay/neuter surgeries to annual check-ups to end-of-life treatment, and everything in between. Over the course of various moves and dozens of appointments at several different veterinary practices, I have come to know a range of clinicians, including wizened practitioners who have seen everything and brand-new practitioners still developing their bedside manner. A couple of them have even become friends with whom I have frequently spent social time.

These combined personal experiences—first as an adolescent observer and later as the “C” in the VCPR— offered me a small window into veterinary practice and what it entails. However, it was just that…a small window. Indeed, since taking my position with the CVMA back in late 2020, not only have I become more aware of the vicissitudes of veterinary practice through my own day-to-day duties, but I have been fortunate to shadow several veterinarians in their daily appointments, truly seeing what goes into “a day in the life” of a real-world practitioner. First, I spent a day with equine veterinarian (and the CVMA’s director of regulatory affairs) Grant Miller, riding shotgun to his various horse appointments in the Sonoma/Marin area. Later, I passed a morning with the CVMA’s 2022–2023 president Keith Rode, a small animal practice owner in Woodland. And shortly after that, I accompanied the CVMA’s current president and food animal practitioner Mike Karle to two dairy checks, and toured his mixed-animal facility in Orland. These “ride-along” experiences shone a bright light on the intense nature of veterinary practice, including the extensive behind-the-scenes work that occurs before the first hand is ever laid on the animal. These visits also collectively demonstrated how unpredictable veterinary work can be. Indeed, Dr. Rode’s very first appointment during my day at his clinic was an unanticipatedly complicated spay, which neatly encapsulated how even a purportedly “basic” surgery can be fraught with difficulty (California legislators, if you are reading this, take note!). All of this is a prelude to what I really want to say, which is simply: thank you. On behalf of myself, my family, and those thirteen animals listed above, I want to thank veterinarians and veterinary staff for your hard work, your dedication, your patience, your grace under pressure, your intestinal fortitude, your kindness, and all that you do for animals and those who care for them. I wish you and yours a happy, healthy, and prosperous New Year!

Dan Baxter Executive Director

cvma.net/publications

UPCOMING MEETINGS

NEWS & NOW

JANUARY 17–18, 2024

CVMA

Veterinary Medical Board Meeting

News & Now

JANUARY 19–21, 2024 CVMA Leadership Forum and Joint Board and House Meeting in Costa Mesa

FEBRUARY 14, 2024 Investment Committee Meeting

FEBRUARY 22, 2024 Finance Committee Meeting

Call for Early-Career Veterinarians to Write About Their Experience!

The California Veterinarian is looking for veterinary professionals who are just starting their careers to write a short article (500-600 words) about their experience so far in practice! Contributors must practice in California and be a CVMA member. Interested writers can email Taryn DeOilers, the CVMA’s publications manager, at tdeoilers@cvma.net for more information.

Cal/OSHA Form 300A Posting Requirement

Cal/OSHA Form 300A is a summary of specific job-related illnesses and injuries that have been reported by businesses in 2023. Businesses must post this form for employee review between February 1, 2024 and April 30, 2024. Visit dir.ca.gov/dosh/doshreg/apndxb300afinal.pdf to access this form.

Complete a Quick CDPH Survey on Your Antimicrobial Prescribing Practices FEBRUARY 25, 2024 RVT Committee Meeting

MARCH 23, 2024 CVMA Board of Governors Meeting

APRIL 17–18, 2024 Veterinary Medical Board Meeting

= HYBRID OR VIRTUAL EVENT

The California Department of Public Health’s (CDPH) Center for Environmental Health’s One Health Program is requesting your help to understand the factors that impact your antimicrobial prescribing practices when treating companion animals. Please consider taking an anonymous, 10-15 minute survey to help the CDPH understand this complex challenge. Your participation will contribute to research efforts aimed at combating antimicrobial resistance and will aid in the development of materials that may benefit you and your patients. The survey will be open through February 29, 2024 and can be accessed by scanning the QR code to the right. Questions about the survey can be directed to Jason Tin, MPH at jason.tin@cdph.ca.gov or Kim Conway, DVM, MPVM at kim.conway@cdph.ca.gov. For more information, visit the CDPH One Health homepage at go.cdph.ca.gov/onehealth.

Start the Year Off Right with All the Necessary Compliance Products!

The CVMA offers members discounts on required compliance products, including required postings, new hire packets, and the below plaques: • Abandoned Animal Act Plaque (Veterinary Medical Board [VMB] required) • Continuous Presence Not Provided Plaque (VMB required) • Financial Interest Disclosure Plaque (required, if applicable) • Prescription Drug Dispensing Plaque • Prop 65 Warning for Employees Plaque • Written Prescription Upon Request Plaque (VMB required) Visit the CVMA store at cvma.net to purchase these products and to stay compliant in 2024!

California Veterinarian | January–February 2024

MEMBER PROFILE

I AM THE

Members are the heart of the CVMA

Marie Ussery, RVT, BS c

Large Animal Technician; Laboratory and Purchasing Manager

CSU, Chico; Veterinary Allied Staff Education

Mixed (Small Animal and Food Animal) Practice

The best advice I have ever received was: "You only

live once, but if you do it right, once is enough." (originally a Mae West quote)

When I was little, I wanted to be a paleontologist. If I won the lottery, I would build a new veterinary hospital to better serve our local community; we have outgrown the space we are currently in.

What was your best professional moment so far? Teaching students about laparoscopic AI in sheep at CSU, Chico.

Where would you go if you could go anywhere? Why? Ireland. The landscape looks absolutely beautiful,

and I would love to sit in a pub in Dublin and drink a pint of Guinness.

Do you have any morning rituals? Coffee...I have perfected my pour-over.

What five adjectives best describe you? Active, confident, determined, hard-working, and reliable.

I am a CVMA member because I believe that organized veterinary medicine is essential to the

advancement of the profession. CVMA advocates for veterinary professionals so that we can continue to do the job that we love.

cvma.net/publications

CVMA MEMBER BENEFITS

CVMA Member Benefits Continuing Education High-quality CE offered in person and online at special member rates – cvma.net/continuing-education/ Continuing education record maintenance on the CVMA website with licensure renewal reminders – cvma.net/continuing-education/ CVMA’s Certified Veterinary Assistant Program – cvma.net/resources/

Business Free legal and regulatory consultation for member veterinarians

Savings on Products and Services Wellness TELUS Health (formerly LifeWorks) is the CVMA’s full-service member assistance program LetsGetChecked provides discounts on over 30 home health tests Active&Fit gives discounts to over 11,600 national fitness centers

Insurance Coverage Veterinary Insurance Services Company (VISC) insurance specialized for the needs of veterinary professionals – visc-ins.com Delta Dental Insurance Vision Service Plan

CVMA InLine program to assist with workplace safety, legal issues, and laws and regulations – cvma-inline.net Relief Veterinarian Directory Find-a-Veterinarian online listing

Advocacy CVMA legislative advocacy – cvma.net/advocacy/ Continual monitoring and reporting of unlicensed veterinary activity

Career The CVMA Career Center post and view classified employment and practice sales ads CVMA members-only online directory MentorVet discounted fee for peer support coaching for new veterinary graduates

Student Information Immediate critical access to information through California Veterinarian magazine, CVMA’s Weekly e-newsletter, the CVMA website, press releases, and action alerts The CVMA Member App puts the power of the CVMA in the palm of your hand

Summer Work Experience Program (SWEP) connecting veterinary students with veterinary practices for summer employment – cvma.net/resources/ VISC UC Davis and WesternU veterinary student members receive complementary professional liability insurance

CareCredit healthcare financing The Castle Press discounts on printing services and products CheckmarcUSA free check recovery services RECENTLY ADDED! Clean Harbors discounts on medical waste services packages, including biohazard, sharps, and pathology waste Epicur Pharma discounts on its 503B product line for in-house use and administration as well as secondary dispensation to clients GlobalVetLink discounts on electronic prescriptions, health certificates, feed directives, and other products HireRight discounted employee background screening i3 Merchant Solutions lowering credit card processing rates National Pharmaceutical Returns discounts on mail back disposal services for unwanted prescription and over-thecounter drugs, and reverse distribution of unwanted controlled substances RECENTLY ADDED! PetFundr provides pet owners access to create crowdfunding campaigns which sends funds directly to your account for their pet's care RECENTLY ADDED! The OnHold Experience discount on professionally produced "on hold" message campaigns to inform your clients of your practice's services, pet health tips, and more JUST ADDED! The ULTI Travel Bag by CONMIGO see the next page for full description

Entertainment California Academy of Sciences discounted admittance Car Rental Savings

For more information on CVMA member benefits, visit cvma.net/membership/. 8

California Veterinarian | January–February 2024

TicketsAtWork discounts for theme parks and more

NEW MEMBER BENEFIT

NEW CVMA MEMBER BENEFIT:

The ‘ULTI’™ Travel Bag by CONMIGO®

he CVMA is proud to introduce a new member benefit created by one of the CVMA’s very own members and a practicing veterinarian, Dr. Bernadine Cruz: the ‘ULTI’™ travel bag by CONMIGO®. “Like many of my veterinary colleagues, I am an organizational freak,” Dr. Cruz explained about the creation of the travel bag and her company, CONMIGO®. “If I don’t have everything in its own spot, my already-crazy days as a companion animal

clinician can easily go off the rails. That same need for order and calm spilled over into my life on the road, traveling for work as a multimedia veterinary medical consultant and leisure adventurer. For years I looked for the perfect carry-on bag—one that would keep me comfortable, organized, and ‘solo woman traveler’ safe. I could never find one that fit the bill, so after years of research and development, I designed it myself.” Whether embarking on a cross-country adventure or simply commuting to work, the 'ULTI'™ travel bag by CONMIGO® promises the ultimate fusion of luxury, organization, and safety. Packed with an array of innovative features, this versatile bag serves as a testimony to the brand's commitment to delivering premium quality at affordable prices. Weighing a mere 3.7 pounds and available in

sleek obsidian black or vibrant cobalt blue, the 'ULTI'™ redefines travel convenience. Its ergonomic crossbody design offers both comfort and practicality, ensuring your essentials remain secure in its plethora of wellorganized compartments. Notably, the bag's unique built-in TSA-compliant padded sleeve guarantees that you will never forget your devices at a security checkpoint. The reinforced handle and weather-resistant materials provide the peace of mind every traveler craves. CONMIGO® pledges a 5% donation from every bag purchased by a CVMA member to the California Veterinary Medical Foundation, making the 'ULTI'™ not just a travel essential, but a symbol of purposeful, conscientious living. With an enticing price tag of $83.30 (15% discount from the MSRP) available exclusively online to CVMA members, the 'ULTI'™ is poised to become the go-to travel accessory for those seeking a seamless blend of functionality and style.

cvma.net/publications

NEW LAWS FOR 2024

New Laws for 2024

s the CVMA has widely reported in prior publications, 2023 was a significant legislative year for the veterinary profession, with big changes in the offing due to the passage of Assembly Bill (AB) 1399 (see pages 12-15) and Senate Bill (SB) 669 (see pages 16-19). Beyond those veterinary-specific bills, other new laws of general application should be noted by veterinary practitioners. A few of those are discussed below.

SB 616 (Gonzalez) Sick days: paid sick days accrual and use.

This new law expands California’s Paid Sick Leave (PSL) statutory provisions from three days or 24 hours to five days or 40 hours, with other components of existing sick leave law remaining the same. The bill also raises the cap employers can place on PSL and the number of sick days an employee can roll over to the next year. For purposes of sick leave compliance under the modified law, employers may generally choose from the following three options: 10

California Veterinarian | January–February 2024

• As before, the employee can accrue one hour of sick leave for every 30 hours worked; or • The employee can receive an upfront grant of 40 hours or five days of paid sick leave (whichever is greater) at the beginning of employment and each 12-month period thereafter (“frontloading,” such that no carryover or accrual of sick leave is required); or • As before, the employee can accrue sick leave at a rate other than one hour of sick leave for every 30 hours worked, provided the accrual is regular and results in the accrual of no less than 24 hours or three days of sick leave by the 120th day of employment and no less than 40 hours or five days of sick leave by the 200th day of employment. When sick leave is accrued (i.e., not frontloaded), SB 616 allows employers to impose a maximum accrual cap of 80 hours or 10 days and a use limit of 40 hours or five days per 12-month period. This is a significant expansion since, under prior law, the allowable maximum accrual cap was 48 hours or six days and the allowable use limit was 24 hours or three days per 12-month period.

SB 848 (Rubio) Employment: leave for reproductive loss.

This law requires employers with five or more employees to provide up to five days of work leave for specified reproductive losses, including miscarriage, failed adoption, failed surrogacy, stillbirth, or an unsuccessful assisted reproduction, as defined. The leave days must be offered either as consecutive or non-consecutive but must be taken within three months of the event. If an employee experiences more than one defined reproductive loss within a 12-month period, an employer shall not be obligated to grant a total amount of reproductive loss leave time in excess of 20 days within a 12-month period. If there is no existing applicable leave policy, reproductive loss leave may be unpaid, except that an employee may use vacation, personal leave, accrued and available sick leave, or compensatory time off that is otherwise available to the employee. The law specifically prohibits retaliation against an employee taking reproductive loss leave.

SB 553 (Cortese) Occupational safety: workplace violence: restraining orders and workplace violence prevention plan. This law implements workplace violence safety requirements applicable to nearly all California employers, including veterinary practices, under the jurisdiction of Cal/OSHA. New requirements include: • A written workplace violence prevention plan to be incorporated as part of the existing Injury and Illness Prevention Plan with information specified in law. (Labor Code 6401.9(c).) • An incident investigation form containing requisite information specified by law. (Labor Code 6401.9(d).) • Worker training when the plan is first established, for new hires, during changes in job positions, and annually on a general basis. (Labor Code 6401.9(e).) • Maintenance of relevant records for up to five years. These requirements have a delayed implementation, taking effect on July 1, 2024.

contact with a COVID-19 case, as well as any employer with an employee who had a close contact, as soon as possible. Second, California’s 2020 COVID-19 workers’ compensation presumptions for workers, first responders, and healthcare personnel, as well as the workers’ compensation notice requirements, have also ended.

Minimum Wage Increase

Regarding California’s new minimum wage requirements, it is first and foremost important to note that SB 525—which raises minimum wage for “health care workers” to $25 per hour—does not apply to the veterinary profession. In that regard, SB 525 defines “covered health care employees” as individuals working for human health care facilities and other defined locations that do not include veterinary practices. However, the veterinary profession and other California employment sectors will be required to make another incremental minimum wage increase triggered by SB 3, which was signed by Governor Jerry Brown in 2016. Accordingly, all veterinary and other employees must be paid a wage of at least $16.00 per hour beginning on January 1, 2024. In addition, specific municipalities throughout the state are independently imposing even higher minimum wage requirements for employees within their respective jurisdictions; most of those requirements took effect on January 1, while a few jurisdictions are waiting until later in the year to implement their new wage standards. Therefore, it is important for all employers to be aware of any requirements operative within their respective cities and counties to ensure full compliance with both state and local laws.

CVMA Legislative Action Center

For specific information on bills or to track CVMA-monitored bills through the legislative process, visit the CVMA’s online Legislative Action Center in the Advocacy section of cvma.net.

COVID Laws

Two COVID-19 laws that have been on the books since 2020 sunsetted at the end of 2023. The first rollback concerns the notice provisions found in Labor Code section 6409.6, which required employers to provide notice of COVID-19 exposures in the workplace. While those statutory requirements are expiring, employers should remember that even after that expiration, Cal/OSHA’s COVID-19 non-emergency regulations still require employers to notify employees and independent contractors who had a close

cvma.net/publications

TELEMEDICINE

California Veterinarian | January–February 2024

Veterinary Telemedicine Expansion in California The enactment of AB 1399 makes California the sixth state in the nation to permit the Veterinarian-Client-Patient Relationship (VCPR) to be established virtually. The CVMA has updated its telemedicine policy providing guidance to the profession.

B 1399 changes the California Business and Professions Code to permit a VCPR to be established by electronic means, thus discarding the current requirement for a veterinarian to physically examine an animal patient or make medically appropriate and timely visits to the premises where the animals are kept in order to prescribe medication and treat patients. Additional parameters of the new law are as follows: • A virtual VCPR may only be established by using synchronous electronic audio-visual communication and may only be offered by a California-licensed veterinarian to animal patients located in California. • Numerous client disclosures must be made at the outset of a telemedicine appointment, including providing the client with one or more local practices where in-person veterinary services are available, if requested. • A veterinarian utilizing synchronous electronic audio-visual communication to establish a VCPR must have historical knowledge of the animal patient by obtaining and reviewing the animal patient’s relevant medical history, and, if available, medical records. If medical records exist from a previous in-person visit and are available to the client, the client may transmit those records, including any diagnostic data contained therein, to the veterinarian electronically. • There is a 14-day limit on the amount of antimicrobial drugs that may be prescribed when telemedicine is used to diagnose and treat an animal patient for the first time. Should a patient require antibiotics beyond the initial 14-day supply, an in-person examination by a veterinarian will be required. Prescription of scheduled drugs (controlled substances) is prohibited when a VCPR is established via telemedicine. • Telemedicine may not be used to prescribe medication to a horse engaged in racing or training at a facility under the jurisdiction of the California Horse Racing Board. The CVMA convened a task force—comprised of CVMA member veterinarians and registered veterinary technicians—to analyze the law and develop an updated telemedicine policy and guidance document for dissemination to the profession. Those materials have been approved by the CVMA’s Board of Governors and can be reviewed on the following two pages. They are also available in the Policies section under the About Us tab on cvma.net. Veterinarians who utilize telemedicine to establish a VCPR should be aware of potential legal risks that are not addressed specifically in AB 1399. These risks—further addressed in the CVMA's guidance document—arise from inconsistencies between state and federal law, additional required client disclosures not specifically included in AB 1399 (but still required under other provisions), and other legal considerations. In addition, the CVMA’s guidance document includes recommendations to minimize risk to the veterinarian, client, and patient when telemedicine is utilized. cvma.net/publications

TELEMEDICINE

CVMA Policy on Telemedicine

he CVMA supports the use of telemedicine for cases in which it can be used safely, appropriately, and at a standard consistent with current veterinary medical practice in this state. In accordance with California’s telemedicine law, veterinarians who use telemedicine are held to the same standard of care that is expected of them when seeing patients in person. California Business and Professions Code section 4826.6(c)(1) states: “The same standards of care apply to veterinary medicine services via telehealth and in-person veterinary medical services.” Without physically examining animal patients, this legal requirement makes the use of telemedicine legally risky from both general liability and administrative law standpoints. When investigating and enforcing telemedicine-related complaints, the state Veterinary Medical Board (VMB) will not consider a separate (lower) standard of care for these cases, but rather will expect veterinarians to practice at the same level as if patients were seen in person. In consideration of the statement above, the CVMA recommends that: • Telemedicine only be used to diagnose new conditions in patients when a previous in-person physical examination or medically appropriate and timely visit to the premises where the animals are kept has occurred in such time as good standards of medical practice dictate. • Telemedicine only be offered if the veterinarian providing the service is associated with a California-registered veterinary premises that is capable of seeing the animal patient in person if the need arises. • All prescriptions issued via telemedicine be limited to 14 days and refills only be given following an in-person examination of the animal patient. (California Business and Professions Code section 4826.6(g)(5) is explicit in this limitation for antibiotic prescriptions.) • Veterinarians who utilize telemedicine to establish a VCPR should check with their insurance provider to ensure that adequate liability coverage is included in their policy. • The quality of the synchronous audio-video communication should be adequate, and both the veterinarian and client should have sufficient proficiency in using technology to conduct an appointment. • The animal patient and client should be visible to the veterinarian in the synchronous audio-video appointment. • If possible, record the synchronous audio-video appointment and retain it as part of the patient's medical record.

California Veterinarian | January–February 2024

View California’s telemedicine law at leginfo.legislature.ca.gov/faces/billNavClient. xhtml?bill_id=202320240AB1399.

Veterinarians utilizing telemedicine should be aware that the California telemedicine law overlaps or, in other instances, does not account for pre-existing state and federal laws and requirements, which must still be followed, including as described below: 1. California law prevents corporations and non-veterinarian individuals from influencing the way veterinary medicine is practiced. The VMB has legal enforcement authority against non-licensed individuals or corporations that interfere in any way with the professional judgment of a veterinarian. This includes pressure to follow pre-written treatment protocols and pressure to prescribe and sell select drugs. The California Business and Professions Code explicitly addresses this in sections 4854.1, 4853(g), and 4883(t). 2. If a client requests a written prescription, veterinarians are now mandated to either give the prescription to the client, or submit the prescription directly to a pharmacy of the client’s choosing. California Business and Professions Code section 4826.6(i)(7) states: “The veterinarian shall notify the client that some prescription drugs or medications may be available at a pharmacy and, if requested, the veterinarian shall submit a prescription to a pharmacy that the client chooses.” California Business and Professions Code section 4170(a)(6), states: “The prescriber, prior to dispensing, [must] offer to give a written prescription to the patient that the patient may elect to have filled by the prescriber or by any pharmacy.” Therefore, veterinarians are now obligated to abide by both laws and act according to the client’s request, regardless of whether an appointment is conducted via telemedicine or in person. 3. If a veterinarian uses telemedicine to establish a VCPR, it may only be used on pets located in California. California Business and Professions Code section 4826.6(f) states: “Only a person who holds a current license to practice veterinary medicine in this state is authorized to practice veterinary medicine via telehealth on an animal patient located in this state.”

4. The Financial Interest Disclosure requirement still applies to telemedicine practice. While California’s telemedicine law does require veterinarians to provide several specific notices and disclosures to clients, it does not mention California Business and Professions Code section 654.2 (financial interest disclosure obligation), which is a requirement that preceded the telemedicine law but still applies. 5. California has a judicious use of antibiotics mandate and continuing education requirement for veterinarians. California veterinarians are mandated to complete one unit of continuing education every four years on the judicious use of antibiotics (California Business and Professions Code section 4846.5(k)(1)). This is part of California’s legislative effort to curb antibiotic resistance. For foodproducing animals, California Food and Agriculture Code section 14402 is explicit in stating limitations for antibiotic prescriptions. The VMB can and does pursue veterinarians for the non-judicious provision of antibiotics. Grounds for doing so may include over-prescription of antibiotics in amount, strength, and/or duration, choosing a sub-optimal type or class of antibiotics, providing antibiotics without justification through adequate physical exam findings or laboratory testing, and others. 6. California telemedicine law limits the prescription of antimicrobials to 14 days. This includes all types of antibiotics, including topical, parenteral, ophthalmic, and oral. 7. Any drug prescribed pursuant to federal Extra Label Drug Use (ELDU) regulations and the Animal Medicinal Drug Use Clarification Act (AMDUCA) requires an in-person examination of the patient. Federal law permits veterinarians, in accordance with their professional judgment and federal regulations, to prescribe drugs in an off-label manner. Offlabel drug use is any deviation from what is written on the label and includes use: in a different species (such as drugs labeled for human use, including generics), for a different medical indication, at a different dose, by a different route, or at a different frequency of administration. As the authority to prescribe drugs off-label is a federal (not state) prescribing authority, the federal definition of a VCPR must be followed when prescribing. The AMDUCA states: “Extralabel use of drugs may only take place within the scope of a valid VCPR.” ELDU regulations define a VCPR to include the requirement that “the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal(s) by

virtue of examination of the animal(s), and/or by medically appropriate and timely visits to the premises where the animal(s) are kept.” Furthermore, the Federal Food and Drug Administration (FDA) states that “a VCPR cannot be established solely through telemedicine (e.g., photos, videos, or other electronic means that do not involve examination of the animal(s) or timely visits to the premises).” See supporting documentation at cvma-inline.net/wp-content/ uploads/2023/08/FDA-VCPR-In-PersonExam-Requirement.pdf. Therefore, veterinarians who utilize telemedicine to establish a VCPR are restricted to only prescribing drugs according to their labeled instructions. No extra-label prescribing is permitted unless an animal patient has been seen in person or the veterinarian has made medically appropriate and timely visits to the premises where the animals are kept. 8. Telemedicine may not be used to establish a VCPR that involves the prescription of a Drug Enforcement Administration (DEA) Scheduled Drug (a.k.a.: “controlled substance”). California Business and Professions Code section 4826.6(i)(6) states: “The veterinarian shall not order, prescribe, or make available a controlled substance, as defined in section 4021, or xylazine, unless the veterinarian has performed an in-person physical examination of the animal patient or made medically appropriate and timely visits to the premises where the animal patient is kept.” 9. Veterinarians providing telemedicine services to equine clients must determine if the patient(s) are engaged in horse racing. California Business and Professions Code section 4826.6(i)(8) states: “A veterinarian shall not prescribe via telehealth any drug or medication for use on a horse engaged in racing or training at a facility under the jurisdiction of the California Horse Racing Board.” Therefore, any veterinarian establishing a VCPR for equine patients via telehealth must inquire about the racing status of the patient and avoid prescribing for racing patients. 10.Telemedicine may not be used to issue Certificates of Veterinary Inspection (“Health Certificates”) or any other duties performed as a USDA NVAP-accredited veterinarian. The United States Department of Agriculture National Veterinary Accreditation Program (USDA NVAP) requires that animals be examined in person to fulfill requirements that determine an animal’s fitness to travel.

cvma.net/publications

RVT NEWS

ISTOCK PHOTO

RVT Appointments: New California Law

he passage of SB 669 marks an unprecedented change for California veterinary practice. The new law, which took effect on January 1, 2024, permits veterinarians to utilize registered veterinary technicians (RVTs) as agents in establishing the veterinarian-clientpatient relationship (VCPR) for the specific purposes of administering prophylactic vaccinations and/or for controlling or eradicating apparent or anticipated internal or external parasites.

Before Proceeding: Remember that in California, the VCPR Is Condition-Specific

California is the only state in the country where the law is interpreted to require veterinarians to establish a separate VCPR for each and every medical condition that they treat in an animal patient. Many veterinarians have been under the misconception that a patient with a current annual exam has a valid VCPR.

California law provides no such leeway. In California, each time a veterinarian institutes a treatment plan of whatever nature for a previously untreated illness, injury, or condition in an animal patient, the veterinarian must first examine the patient either in person or virtually (the latter being newly permitted under AB 1399, also effective as of January 1, 2024), or make medically appropriate and timely visits to the premises where the animals are kept. Following their assessment, the veterinarian must communicate with the client to determine the course of action that will be taken to manage the case. This process must occur for each and every medical condition that the veterinarian has not previously diagnosed and treated—including for the purposes of giving vaccines and providing preventive procedures for parasite control. Instances in which “wellness and preventive care” are provided to animal patients via vaccination and parasite control

California Veterinarian | January–February 2024

still require a VCPR. Even though the diagnosis or assessment of the animal patient may be “clinically healthy”—the purpose of the VCPR is to determine if the animal is physiologically capable of receiving the treatment of vaccines and/or parasite control medication.

How SB 669 Changes the VCPR (with Limitations)

Until the passage of SB 669, veterinarians had to examine a patient and communicate with a client first-hand for a VCPR to be valid. But now, for the specific purposes of administering vaccinations and/or controlling or eradicating apparent or anticipated internal or external parasites, a veterinarian may elect to have an RVT act as their agent in establishing the VCPR. As a point of clarification—the VCPR and the patient are still the veterinarian’s, and treatments and medications are still being prescribed by the veterinarian; however, these tasks are being completed in a new

RVT appointments will improve access to veterinary care, better utilize RVTs in accordance with their standard education, help retain RVTs by allowing them to do more in practice, and free up veterinarians to see other patients and perform other services.

ISTOCK PHOTO

and different way. A veterinarian who opts to utilize an RVT as their agent for the specific purpose of administering vaccinations and eradicating apparent or anticipated internal or external parasites should note that the law does not permit RVTs to function as agents for any other purpose(s). Therefore, if an RVT encounters an abnormal physical finding during the course of an appointment, or is asked to do anything by the client other than what is permitted by law, they are not authorized to diagnose or treat, and doing so could result in disciplinary action by the Veterinary Medical Board (VMB).

Legal Requirements

Prior to an RVT acting as an agent on behalf of the veterinarian to establish a VCPR to administer vaccinations and/ or to control or eradicate apparent or anticipated internal or external parasites, several legal requirements must be met. The law mandates the following: 1. The veterinarian establishes protocols that include, at a minimum, the following: b. The requirement to obtain the animal patient’s history from the client in

order to reasonably ensure that the administration of preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites is appropriate. c. Performance of a physical examination of the animal patient and collecting data in order to reasonably ensure that the administration of preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites is appropriate. d. Directions to determine if information found in the patient history or physical examination would preclude the administration of preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites. e. Criteria that would disqualify the animal patient from receiving the preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites. f. Vaccination protocols for each animal species for which preventive or prophylactic vaccines are administered, that include, at a minimum, handling and administration of vaccines in accordance with manufacturer label recommendations and protocols in the event of an adverse reaction or other emergency.

g. Preventive procedures for parasite control for each animal species for which medications for the control or eradication of apparent or anticipated internal or external parasites are being administered, which shall include, at a minimum, handling and administration of medications in accordance with manufacturer label recommendations and protocols in the event of an adverse reaction or other emergency. h. Documentation requirements— medical records, signed assumption of risk agreement, and signed agent authorization agreement (read more below). 2. The veterinarian and the RVT sign and date a statement containing an assumption of risk by the veterinarian for all acts of the RVT related to examining the animal patient and administering preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites, except for willful acts of animal cruelty, gross negligence, or gross unprofessional conduct on behalf of the RVT. This is a document that applies generally to the allowed practices and would presumably be maintained apart from the patient medical record and part of the veterinarian’s general files. 3. The veterinarian and RVT sign and date a statement authorizing the RVT to act as the agent of the veterinarian only to establish the VCPR for purposes

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RVT NEWS

4. Before the RVT examines the animal patient or administers any preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites to the animal patient, the RVT informs the client orally or in writing that the RVT is acting as an agent of the veterinarian for purposes of administering to the animal patient preventive or prophylactic vaccines or medications, as applicable, and provides the veterinarian’s name and license number to the client. If the client authorizes the RVT to proceed, the RVT must notate this in the patient’s medical record.

breed, species, and color of the animal 5. Beginning and ending dates of custody of the animal, if applicable 6. A history or pertinent information as it pertains to each animal’s, herd’s, or flock’s medical status 7. Data, including that obtained by instrumentation, from the physical examination 8. Treatment and intended treatment plan, including medications, dosages, route of administration, and frequency of use 9. Diagnosis or assessment before performing a treatment or procedure 10. If relevant, a prognosis of the animal’s condition 11. All medications and treatments prescribed and dispensed, including strength, dosage, route of administration, quantity, and frequency of use Both the RVT and the veterinarian are responsible for ensuring that medical records are kept in accordance with law. While the RVT is primarily responsible for entering required information in the medical record, the supervising veterinarian is subject to disciplinary action if medical record requirements are not met.

Important Conditions Pertaining to RVT Appointments

Once all of the aforementioned requirements are met, the RVT may administer vaccinations and medications for the control or eradication of apparent or anticipated internal or external parasites.

Medical Record Requirements

The specific medical record requirements for RVT appointments are specified in law. Documentation of all of the following animal patient information is required: 1. Name or initials of the person responsible for entries 2. Name, address, and phone number of the client 3. Name or identity of the animal, herd, or flock 4. Except for herds or flocks, age, sex,

California Veterinarian | January–February 2024

• If the RVT is conducting vaccine and parasite control appointments as an agent of the veterinarian in a registered veterinary premises, the veterinarian must be physically present at the registered veterinary premises. • If the RVT is working at a location other than a registered veterinary premises, the veterinarian must be in the general vicinity or available by telephone and must be quickly and easily available. At this remote location, the RVT must have equipment and drugs necessary to provide immediate emergency care at a level commensurate with the provision of preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites.

ISTOCK PHOTO

of administering preventive or prophylactic vaccines or medications for the control or eradication of apparent or anticipated internal or external parasites when acting in compliance with the established protocols and procedures, and only until the date the veterinarian terminates authorization for the RVT to act as the agent of the veterinarian. Like the prior “assumption of risk” document, this document would presumably be maintained separate from the patient’s medical record as part of the veterinarian’s general files.

• The two signed and dated documents between the veterinarian and RVT (mentioned previously) must be retained by the veterinarian for the duration of the RVT’s work as an agent of that veterinarian and until three years from the date of the termination of the veterinarian’s relationship with the RVT. • Medical records must be retained by the veterinarian for a minimum of three years after the animal patient’s last visit. While several steps must be taken to permit RVT vaccine and parasite control appointments, the benefit of permitting an RVT to function as an agent of the veterinarian to establish a VCPR for these specific purposes is potentially significant. RVT appointments will improve access to veterinary care, better utilize RVTs in accordance with their standard education, help retain RVTs by allowing them to do more in practice, and free up veterinarians to see other patients and perform other services. It is important for veterinarians and RVTs to remember that the VCPR is still between the veterinarian and the client, and that any prescribing must be performed by the veterinarian.

RVT Appointments: Step-by-Step Guide The enactment of SB 669 in 2024 permits veterinarians to utilize RVTs as agents in establishing the veterinarian-client-patient relationship (VCPR) for the specific purposes of administering prophylactic vaccinations and/or for controlling or eradicating apparent or anticipated internal or external parasites. To view the full law, scan the QR code.

01 PROCEDURES AND PROTOCOLS

Veterinarian establishes written protocols and procedures to be followed by the RVT. [California Business and Professions Code Section 4826.7 (b)(3)(A-G)]

02 SIGN AGREEMENTS

Veterinarian and RVT sign assumption of risk and agent authorization agreements.

RVT

[California Business and Professions Code Section 4826.7 (b)(4-5)]

03 CONDUCT APPOINTMENT

RVT provides client disclosures, assesses animal patient, and administers vaccines/parasite control.

RVT

[California Business and Professions Code Section 4826.7 (b)(5-6)]

04 WRITE MEDICAL RECORD RVT

RVT enters all required information into the medical record. Veterinarian shares responsibility to ensure medical record requirements are met. [California Business and Professions Code Sections 4826.6 and 4826.7 (b)(3)(G)]

cvma.net/publications

CVMA WATCHDOG

Introducing CVMA Watchdog—the CVMA’s Rebranded Practice Safety and Regulatory Compliance Website!

elcome to CVMA Watchdog, the new and improved version of the CVMA InLine Program! Why rebrand, you ask? We felt the name “InLine” did not accurately describe the essence of the site, and that our website needed an improved visual identity. "Watchdog" fulfills these needs. Just like the trusted family dog maintaining surveillance, CVMA Watchdog monitors and alerts you to laws, regulations, and legal and workplace safety issues that affect your veterinary practice. CVMA Watchdog is beneficial to every member of your practice team, as each team member plays a crucial role in fostering a safe, healthy, and legally compliant practice for staff, clients, and patients.

By logging into cvma-watchdog.net, you can access valuable information, educational resources, and practical solutions to prevent common workplace injuries, promote overall wellbeing in the work environment, and navigate the complex regulatory landscape of government agencies overseeing veterinary medicine.

cvma-watchdog.net In addition to articles relating to legal issues, practice safety, and regulatory compliance, the site provides essential resources including: • A list and contact information of state and federal agencies governing veterinary medicine, including summaries of each agency’s legal jurisdiction • The list of California reportable diseases • Extensive Veterinary Medical Board (VMB) resources • Cal/OSHA information and resources, including the CVMA Guide to Cal/OSHA Compliance for purchase and renewal • Licensing and continuing education requirement information • Regulatory compliance products available for purchase • And much more!

CVMA Watchdog’s resources are exclusive to CVMA members as a member benefit. We invite members to visit the site regularly for current news and updates and to find solutions to common regulatory, legal, and practice safety issues.

California Veterinarian | January–February 2024

CAL OSHA

SPECIAL Start the New OFFER! Year Right with a CVMA Guide to Cal/OSHA Compliance Subscription

New subscribers save $56 off the regular subscription! For subscription purchases made between January 15 and March 15, 2024.

Ring in the New Year by putting safety and compliance first and purchasing or renewing your CVMA Guide to Cal/OSHA Compliance subscription.

he CVMA Guide to Cal/OSHA Compliance is available only to CVMA members as a member benefit and is specially created to assist California veterinary practices with Cal/OSHA workplace health and safety compliance. It offers a customized written safety and health plan specific to your practice, required forms and checklists, helpful training resources, and more to help meet legal mandates. Your annual subscription includes yearly reminders, notifications and updates on new Cal/OSHA requirements, 24/7 online access to the guide that stores your entered information, and regulatory and tech support. The guide has been updated to meet the new 2024 legal requirement that California businesses incorporate a Workplace Violence Prevention Plan (WVPP) into their written Cal/OSHA workplace health and safety plan. The CVMA Guide to Cal/OSHA Compliance provides: • A template to guide you through formulating a legally compliant WVPP policy specific to your practice • A mandated incident investigation form • Training materials that contain subject matter required by law

This CVMA member benefit is made possible by a grant from

It’s EASY, EFFICIENT, AND ESSENTIAL for every California veterinary practice! EASY–An interactive, step-by-step process that creates a written plan customized for your veterinary practice and guidance on implementing your Cal/OSHA program. EFFICIENT–The guide includes everything you need to maintain Cal/OSHA compliance all in one place, including: • A customized written safety and health plan with policy statements • Training information for designated safety coordinator(s) • Workplace inspection checklists and report forms • Required posting information • Employee training resources • Recordkeeping assistance • COVID-19 Protection Program ESSENTIAL–Cal/OSHA requires a current written plan and active ongoing health and safety program in every workplace. A Cal/OSHA inspector will ask to see your plan—don’t leave yourself vulnerable to significant fines.

If you are currently subscribed, be sure to renew your yearly subscription to retain access to the guide, which includes storage of your recorded plan. To order your CVMA Guide to Cal/OSHA Compliance or to renew your subscription, visit cvma-watchdog.net, email staff@cvma.net, or contact the CVMA at 800.655.2862.

cvma.net/publications

PACVET PROMO

THE CVMA’S 2024 PACIFIC VETERINARY CONFERENCE

Plan your cation!

Vet

JULY 11–14 2024 HILTON SAN FRANCISCO UNION SQUARE

Hosted by the California Veterinary Medical Association 22

California Veterinarian | January–February 2024

Discover—or Rediscover

UNSPLASH PHOTOS

San Francisco

San Francisco’s mesmerizing beauty, history, architecture, entertainment, cultural diversity, and iconic landmarks will be sure to capture your heart. Whether you are a regular visitor or coming for the first time, there is always something new to discover! TOP 10 THINGS TO DO IN SAN FRANCISCO (with hundreds of things to do, it was hard to narrow down!)

Golden Gate Bridge—Walk, bike, or drive the world-famous crown of San Francisco

Chinatown—Cultural immersion and history

Alcatraz—Explore the corridors of history

Golden Gate Park—Enjoy museums, the tea garden, and peaceful lakes

Lombard Street—Drive or walk the windiest street in the world

Twin Peaks—For a sky-high view of the bay

Fisherman’s Wharf—Dining, shopping, galleries, street performances, and more

The Painted Ladies—Fancy Victorian homes known as the setting for Full House

Pier 39—San Francisco’s mini amusement park

10 Giants game (the Giants have home

Oracle Park—Catch a San Francisco games scheduled July 9–14)

cvma.net/publications

Choose Your PacVet Experience

PacVet offers in-person or virtual attendance. Hybrid tracks are available to both in-person and virtual attendees.

In-person attendees have access to: • Up to 28.5 CEUs • Keynote Presentation • Enjoyment of all that San Francisco has to offer • Labs, workshops, and symposia • The two-day Vet Expo • Complimentary breakfast (all four days) and complimentary lunches on Friday and Saturday

IN-PERSON ONLY TRACKS DIVERSITY, EQUITY, AND INCLUSION

• Allison Cardona • Cristie Kamiya, DVM, MBA, CAWA • Sheila Donya Kouhkan

ONE HEALTH

• Kim Conway, DVM, MPVM • Heather Oxford, DVM, MPH, CVA, CCRT, ABAAHP

PRACTICE MANAGEMENT

• Jason Eldred, Wilke Fleury • Jizell Lopez, Wilke Fleury • Stephen Marmaduke, Wilke Fleury • Heather Prendergast, RVT, CVPM, SPHR • Rebecca Rose, RVT • Peter Weinstein, DVM, MBA

SHELTER MEDICINE

• Erin Doyle, DVM, DABVP (Shelter Medicine Practice) • Jeanette O’Quinn, DVM, MPH, DACVPM, ABVP (Shelter Medicine)

SMALL ANIMAL SURGERY

• Stephen Birchard, DVM, MS, DACVS • Stephen Jones, MVB, DACVS-SA, DECVS

Scheduled speakers as of December 22, 2023. Additional speakers are being added. For the most up-to-date list of speakers, sessions, and schedule, visit PacVet.net. *Speakers subject to change. ‡Extra charge 24

California Veterinarian | January–February 2024

• Rabies Titer Testing • Fun events, including the Vet Expo Mixer, the Technician Fair, the President’s Reception, and Alumni Receptions • Lecture notes • Fun raffles prizes

USDA-NVAP: APHIS-APPROVED SUPPLEMENTAL TRAINING (AAST) Speakers To Be Announced

• Module 1–Introduction to the National Veterinary Accreditation Program • Module 9–Interstate and International Health Certificates for Category 1 Animals • Module 13–Aquatic Animal Health Regulation and Health Certification • Module 14–Evaluation of Aquatic Animals for Detection of Reportable Diseases and Pathogens • Module 18–Avian Influenza and Newcastle Disease • Module 19–Animal Health Emergency Response • Module 22–Animal Welfare: An Introduction • Module 23–Use of Antibiotics in Animals • Module 25–Using Behavior to Assess Animal Welfare • Module 29–Veterinary Feed Directive • Module 34–Veterinary Export Health Certification System (VEHCS)

WELLNESS

• Speakers To Be Announced

LECTURES, LABS, SYMPOSIA, AND WORKSHOP

• Tackling GI Disease in Small Animals: When, How, and Why to Implement Endoscopy into Your Practice‡ (Presented by Karl Storz) • Proper Use of Legal Entities for Lawsuit Protection and Tax Reduction (Presented by Legally Mine) • Basic and Intermediate Ultrasound Lectures and Labs‡ (Presented by Esaote) • Basic and Advanced Life Support Rescuer Certification Workshop‡ (Presented by RECOVER and sponsored by the California Veterinary Medical Reserve Corps)

HYBRID TRACKS

• Renée Al-Sarraf, DVM, DACVIM (Oncology) • Fredric Gaschen, Dr.med.vet, DACVIM (SAIM), DECVIM-CA DVM • Lorrie Gaschen, DVM, Dr.med.vet, Ph.D., DECVDI • Bruce Kornreich, DVM, Ph.D., DACVIM (Cardiology) • Gwendolyn Levine, DVM, DACVP (Clinical Pathology), DACVR-DI, DACVR-EDI • Jonathan Levine, DVM, DACVIM (Neurology) • Brennen McKenzie, MA, MSc, VMD • Tomo Wiggans, DVM, MEng, DACVO

TECHNICIAN

• Mary Berg, BS, RVT, LATG, VTS (Dentistry) • Walter Brown, RVTg, VTS (ECC) • Kristen Cooley, BA, CVT, VTS (Anesthesia/Analgesia), VCC • Courtney Waxman, MS, RVT, CVT, VTS (ECC)

KEY

E AK R

SMALL ANIMAL MEDICINE

TE NO

S PE

CONFERENCE WELCOME by CVMA President Dr. Michael Karle, Keynote Presentation by Dr. Renee Alsarraf, CVMA Awards Recognition Ceremony, and Induction of the 2024–2025 CVMA Board of Governors

KEYNOTE PRESENTATION Renée Al-Sarraf, DVM, DACVIM (Oncology)

Treating Yourself Through a Dog's Eyes

VIRTUAL-ONLY TRACKS Virtual attendees have access to: • Up to 28.5 CEUs • Live and interactive instruction, including live Q&A • Lecture notes • Raffle prizes

AVIAN/EXOTICS

• Stephen Divers, BVetMed, DZooMed, DACZM, DECZM, FRCVS • Michael Garner, DVM, DACVP • David Sanchez-Migallon Guzman, LV, MS, DECZM (Avian, Small Mammal), DACZM • Laila Proença, MV, MSc., Ph.D., DVM, DACZM

EQUINE

• Erin Groover, DVM, DACVIM-LA • John Peroni, DVM, MS, DACVS • Mark Silverman, DVM, MS • Alina Vale, DVM, MS

Scheduled speakers as of December 22, 2023. Additional speakers are being added. For the most up-to-date list of speakers, sessions, and schedule, visit PacVet.net. *Speakers subject to change.

They say that a dog is man’s best friend, but perhaps dogs are actually incredible guides for us humans. In this session, Dr. Renée Al-Sarraf— veterinary oncologist and cancer survivor—will highlight life lessons from our four-legged companions. Using heartwarming stories from her veterinary cancer patients and her own journey with having cancer, Dr. Al-Sarraf will provide wonderful insight into how to live better, how to better take care of ourselves and each other, and ultimately how to be happier. cvma.net/publications

2024 Sponsors and Exhibitors

Thank you to our premier conference sponsors! DIAMOND

TOPAZ

EMERALD

Vet Expo 2024 Early Registered Exhibitors AS OF DECEMBER 21, 2023 Our exhibitors are trusted industry partners who generously support PacVet and the CVMA. Their participation helps keep conference costs down so we can pass those savings on to attendees. Be sure to visit their booths at the Vet Expo and check out their websites on PacVet.net! A&E Medical Systems Doctor Multimedia Advanced Monitors Corporation Dr. Treat American Regent Animal Health Dragon Veterinary Analgesic Services, Inc. Elanco Animal Health Antech/Heska Enova Illumination Avant Wellness Epicur Pharma Avid Identification Systems Esaote North America Banfield Pet Hospital ezyVet Bank of America Practice Solutions GerVetUSA Inc Bionote GlobalVetLink Blue Buffalo/BLUE Natural Veterinary Diet Golden Hour Blue River PetCare Hill's Pet Nutrition, Inc. Boehringer Ingelheim Animal Health USA Hidow International California Veterinary Emergency Team Horizon Veterinary Specialists California Veterinary Medical Reserve Corps IDEXX Capstone Financial Group Jorgensen Laboratories Cardiac Vet KARL STORZ Veterinary CareCredit Endoscopy-America, Inc. Christian Veterinary Mission Koefran Pet Memorial Services CNA Insurance Legally Mine Core Imaging Lenity Vet Specialists + Emergency Care CUBEX Medi Lazer Curo Pet Care Medical Pet Shirts International BV

California Veterinarian | January–February 2024

Merck Animal Health MiDOG Animal Diagnostics Mixlab MWI Animal Health Nationwide (Pet) NectarVet Nutramax Laboratories Veterinary Sciences, Inc. Nuvodia Omni Practice Group Pacific Professionals, Inc. Pawfect Notes Pet Emergency and Specialty Center of Marin PetDesk PetIQ PetSmart Veterinary Services PetVet Care Centers Preferred Employers Insurance Probo Veterinary Purina® Pro Plan® Veterinary Diets Roo Rose Micro Solutions LLC

Schultz Technology Shepherd Veterinary Software Southern Veterinary Partners Standard Process Inc. Talkatoo, Inc Tuttnauer USA UC Davis Veterinary Medical Teaching Hospital Universal Imaging, Inc. Vetamac VetBooks By Success Concepts VetCor Veterinary Emergency Group Veterinary Insurance Services Company VetnCare VetriScience Victor Medical Company Wedgewood Pharmacy YuMove ADVANCE 360 Zomedica

Conference Hotel and Venue PacVet 2024 will be held at the Hilton San Francisco Union Square in San Francisco, California. The Hilton is located in the heart of the city’s restaurant, theater, and shopping district.

HILTON SAN FRANCISCO UNION SQUARE 333 O’Farrell Street San Francisco, CA 94102

Just 14 miles from SFO, or 19 miles from Oakland International Airport! Secured self-parking available onsite for the discounted rate of $45/day. Valet parking $69 per night. EV charging stations available onsite.

DISCOUNTED ROOM RATE

Discounted rates available until June 19, 2024, or until the block fills up—whichever comes first.

Register for the 2024 Pacific Veterinary Conference To be environmentally friendly, we are eliminating paper registrations. Registration is available at pacvet.net. If you need help with registration, call 800.655.2862 for staff assistance. Register by March 29, 2024 to save up to $100!*

*Based on a full conference veterinarian registration.

cvma.net/publications

LEGAL

Document, Document, Document: The Importance of Documenting Employee Performance By Jizell Lopez, Wilke Fleury LLP 2024 Pacific Veterinary Conference Speaker

ost employers generally understand the importance of documenting employee performance. However, the challenge is to appropriately and effectively document employee performance to minimize risk for the employer and to effectively communicate perceived issues with the employee. This requires clear expectations and consistent communication from both the employer and the employee. In cases where an employee has a perceived shortcoming, the employer should provide notice, guidance, and time to correct the issue prior to it becoming a significant problem. There are far too many

California Veterinarian | January–February 2024

instances when an employer takes an informal approach with an employee and, as a result, fails to document performance or other issues. Now, the question employers may be asking is, “so what?” In response, the purpose of documenting employee performance is not just to protect the employer in the event of a lawsuit or to add additional duties to management. It also provides employers the opportunity to demonstrate the steps the employer has taken to help an employee’s success and to provide feedback when appropriate. As all employers know, there are times when employment relationships must end. Although California is an “at-will”

employment state, an employer is often at risk when it elects to take action to terminate or discipline an employee, even if the reasons seem justified. To reduce the risk of liability and to provide a justification for potential discipline or termination, employers should clearly communicate its employment-related expectations and policies. Additionally, if issues arise during the employment relationship, they should be documented and maintained for the duration of the employment relationship. Not only is documenting employee performance critical, but good documentation requires planning and may even begin before the employment relationship begins. For instance, written job descriptions and performance standards that reflect the employer's expectations are vital. These may be contained in an employee handbook or separate documents. These documents can be used hand-in-hand with training opportunities or to justify disciplinary action. Employers should maintain and follow a discipline policy, and that policy should in turn provide a balance of structure and flexibility. The importance of regular performance reviews and documentation of the reviews cannot be overemphasized. The documentation should make it clear that failures to meet job requirements and needed areas of improvement have been clearly and fairly explained. This is because there are many instances where there are obvious performance issues but the employer fails to bring it to the attention of the employee— this can result in frustration for both the employer and the employee. An employment relationship requires clear communication and trust. If an employee

is being provided consistent documented feedback and if the employee fails to meet performance standards, typically it will not be a shock if the employment relationship must end. By contrast, if performance issues are never discussed with the employee and the employment relationship ends, it may leave the employee to wonder or infer that there was a pretext for the termination. As performance issues arise, the employer should meet with the employee at issue, explain to the employee why their performance or misconduct fails to meet expectations and standards, give the employee an opportunity to explain their perspectives and raise grievances, and advise the employee that there could be discipline or termination if corrective action is not taken. The content of the meeting should be summarized in writing, with the summary placed in the employee’s personnel file and given to the employee. The employee should sign and return the copy acknowledging receipt. If the employee refuses to sign the copy, a note should be included in the written summary indicating that the employee refused to sign it. Practically, there are factors that employers should consider prior to taking an adverse employment action (i.e., discipline, termination, demotion, etc.). This includes, but is not limited to: whether there is credible evidence to support the disciplinary action; whether there is a need for further factual investigation; whether there is a clear notice of the policies and standards; whether the steps taken and the contemplated discipline are consistent with policies and treatment of other employees; whether there are

alternatives to discipline; whether the employee is a member of a protected class; or whether the employee has any claim of disability that was not reasonably accommodated. Employee discipline is not a step-bystep process and each situation must be evaluated carefully and independently prior to taking any adverse action. Clearly written policies, job descriptions, and documented reviews and write-ups can minimized an employer’s potential liability. The bottom line is that if the personnel file demonstrates: (1) the employer had clear employment policies and job expectations; (2) the employee was warned that they were failing to meet these expectations; (3) the employee was given an opportunity to improve; and (4) the employee failed to improve, then discipline—up to and including termination—will likely be appropriate and defensible.

Jizell Lopez is a civil litigation attorney who primarily represents clients in federal and state court litigation and before administrative agencies regarding all manner of employment claims, including single plaintiff lawsuits, class action lawsuits, and wage and hour representative lawsuits. Jizell’s practice includes allegations of harassment, discrimination, wrongful termination, retaliation, wage and hour non-compliance, and more.

cvma.net/publications

A World of Adventure and Illuminating CE in Yosemite

CVMA spring Seminar! March 8–10, 2024

he CVMA’s popular Spring Seminar returns to stunning Yosemite in just a few months! All members of the veterinary staff are invited to spend their mornings earning up to 12 CEUs on the topics of cardiology and neurology. Afternoons will be left open for attendees to explore all that Yosemite National Park has to offer!

LOCATION

SPEAKERS AND SESSIONS

Tenaya Lodge at Yosemite 1122 Hwy 41 Fish Camp, CA 93623

Rooms are available at discounted rates of $179-$219, depending on your room selection. Discounted rooms will be available until Monday, February 5, 2024, or until the block is sold out.

Cardiology

Neurology

Kristin MacDonald, DVM, Ph.D., DACVIM

Jim Lavely, DVM, DACVIM

• ECG Rescue: Diagnosis and Management of Arrhythmias • Is It Heart or Not? • A Dog’s Journey with Mitral Valve Disease • A Dobie’s Life with DCM: Navigation Through the Stages of Heart Disease • Incidental Murmurs in Cats: What Do I Do Now? • Kitty Crisis: Heart Failure and Arterial Thromboembolism Management

• Faint or Fit? Assessment of Seizure Versus Syncope • Need a Fix for that Fit? An Anticonvulsant Update • Insane in the Brain: Inflammatory Brain Disease • My Cat’s a Head Case: Feline Brain Disease • I’ll Take Neurology for 300! • I’ll Take Neurology for 500!

Full course descriptions are available at cvma.net.

Unable to join us in person? You may still attend via the Spring Seminar’s live and interactive online format! Secure your attendance now by visiting the Learning tab at cvma.net or calling 800.655.2862. 30

California Veterinarian | January–February 2024

CVMA Food Animal Medicine Seminar MARCH 9–10 2024 9 CEUs

eterinarians, RVTs, CVMA CVAs, and veterinary and RVT students are invited to attend the first-ever CVMA Food Animal Medicine Seminar in Yosemite on March 9–10! This seminar will be held alongside the CVMA Spring Seminar at the Tenaya Lodge in Yosemite but is a separate event specially tailored to practicing food animal and mixed animal veterinary professionals. The CVMA Food Animal Medicine Seminar is an in-person event only.

Location

Tenaya Lodge at Yosemite 1122 Hwy 41 Fish Camp, CA 93623

Rooms are available at discounted rates of $179-$219, depending on your room selection. Discounted rooms will be available until Monday, February 5, 2024, or until the block is sold out.

Ruminants Andrea Mongini, DVM, MS Dr. Andrea Mongini is a partner at M&M Veterinary Practice, which specializes in dairy cattle, dairy goats, and dairy sheep with an emphasis on herd health, nutrition, and production management. She has a master’s degree in nutrition and provides nutrition and management consultation to small ruminant dairy operations around the United States. Dr. Mongini manages the goat dairy owned by Cypress Grove Creamery in addition to owning and operating Ewetopia Dairy, an East Friesian sheep dairy. She was awarded the 2023 Dr. Don E. Bailey Practitioner of the Year Award by the American Association of Small Ruminant Practitioners.

The Veterinarian's Role in Disasters: Volunteering with the California Veterinary Medical Reserve Corps (CAVMRC) Grant Miller, DVM Dr. Grant Miller heads the California Veterinary Medical Reserve Corps (CAVMRC), a volunteer organization devoted to assisting animals with sheltering and veterinary care during disasters and emergencies. In addition, Dr. Grant Miller serves as the CVMA's Director of Regulatory Affairs assisting California veterinary professionals with compliance issues and regulatory matters involving various local, state, and federal agencies.

Judicious Use of Antibiotics Richard Van Vleck Pereira, DVM, Ph.D., DACVPM Dr. Richard Pereira earned his veterinary degree from the Federal University of Uberlandia, Brazil. Afterwards, he completed three years of clinical training in food animal health and reproduction at the University of Florida and Cornell University. He completed his Ph.D. degree at Cornell University with a focus on epidemiology and statistics. Since 2015, Dr. Pereira has served on the faculty at the University of California at Davis, where he is an associate professor and a clinician in the Livestock Herd Health and Reproduction Service. Dr. Pereira is board-certified by the American College of Veterinary Preventive Medicine.

Ruminants/Cattle Meera Heller, DVM, Ph.D., DACVIM-LA Dr. Meera Heller is a professor of clinical livestock medicine and surgery at UC Davis. She received her DVM degree from UC Davis and completed an internship in large animal medicine and surgery at the Atlantic Veterinary College at the University of Prince Edward Island in Canada. She returned to UC Davis for her residency in large animal internal medicine, followed by a Ph.D. in comparative pathology. She later returned to UC Davis to start her current position, where her interests are in medicine and surgery of ruminants and pigs, with a special focus on small ruminants. For full course descriptions and to register, visit the Continuing Education tab at cvma.net or call the CVMA at 800.655.2862. cvma.net/publications

CDFA

2023 Regulatory Animal Health Round-Up By Mandy Murray, DVM, MPVM, Ph.D. Branch Chief, Animal Health Branch, California Department of Food and Agriculture

hile the California Department of Food and Agriculture’s (CDFA) staff is busy working on a multitude of regulatory issues, here are a few highlights from 2023 and reminders as we settle into 2024.

Highly Pathogenic Avian Influenza

Highly Pathogenic Avian Influenza (HPAI) continues to be a concern for the poultry industry and poultry owners across the country. Since the beginning of the outbreak in early 2022, there have been over 900 confirmed positive flocks in 47 states. Here in California, we had a reprieve in domestic poultry detections over the summer months but saw positive detections in both wild birds and domestic poultry operations in the fall. 2023 also saw the successful utilization of a limited-use vaccine to save the endangered California Condor population from HPAI. Consistently following biosecurity practices remains the most effective tool in preventing infections. Stay vigilant; report sick birds to the CDFA’s sick bird hotline at 866.922.2473. Check the CDFA Avian Health Program website for up-to-date disease status: cdfa.ca.gov/AHFSS/Animal_Health/Avian_ Health_Program.html

Vesicular Stomatitis

CDFA staff have been working with veterinary practitioners, horse and livestock owners, and other industry partners on the Vesicular Stomatitis (VSV) outbreak. The outbreak began on May 17, 2023 in San Diego County and slowly worked its way north through the summer and fall months. Most cases have been in equine species with a small fraction of the reported cases being in other livestock species. It is important to note that all livestock species are considered susceptible; however, any NON-equine livestock species being reported for VSV rule-out must be

investigated by CDFA veterinarians. It is not uncommon for VSV outbreaks to have a two-year cycle. As such, it is likely that while we may see decreasing cases over the winter, we will also see an additional wave of detections in 2024. Please check the CDFA website for the most updated situation reports as well as useful outreach material that includes animal event biosecurity, vector control, and other useful information pertaining to VSV and the ongoing outbreak in California: cdfa.ca.gov/AHFSS/Animal_Health/VS.html

African Swine Fever

The United States Department of Agriculture (USDA) and U.S. pork producers have been on high alert in preparedness for a potential incursion of African Swine Fever (ASF) into the continental U.S. following ongoing outbreaks in Haiti and the Dominican Republic that began in 2021. ASF is a deadly pig disease that spreads rapidly with death rates approaching 100%. While people cannot contract this disease and it is not a food safety issue, ASF is an incredibly difficult disease to eliminate once it becomes endemic. If even a single case enters the U.S., it could devastate America’s pig population and pork industry with estimated industry losses exceeding $8 billion dollars per year. During 2023, CDFA and USDA staff have been working on our collaborative state emergency response plans in the event ASF were to be detected in California or within the continental U.S. These response plans will provide guidance to responders and regulatory agencies with respect to all aspects of surveillance, movement control, and disease eradication following both a domestic or wildlife detection.

Barbiturate Marking Reminder

Effective July 30, 2020, animals (not including domestic dogs, cats, and pet birds) euthanized with barbiturates must be marked with an orange B on the forehead, at least four inches in height, at the time

California Veterinarian | January–February 2024

of euthanasia. The marking of animals is critical so that animals euthanized with barbiturates do not get rendered into animal feed. Rendering of dead animals is an important method of carcass management, preventing animal carcasses from being sent to a landfill. For additional information please contact the CDFA’s Meat, Poultry, and Egg Safety Branch at 916.900.5004.

Animal Care Program and Proposition 12 Implementation

The CDFA Animal Care Program is responsible for the implementation of Proposition 12 (Health and Safety Code Sections 25990-25994), which sets minimum confinement standards for egglaying hens, veal calves, and breeding pigs that are raised in California as well as for the covered products that are sold in California. Egg, veal, and pork producers in California are currently required to keep their egg-laying hens, veal calves, and breeding pigs in enclosures that meet certain defined minimum requirements. As of January 1, 2024, egg, veal, and pork producers in California must be third-party certified as meeting these standards. This third-party certification can be issued by an accredited certifying agent, CDFA, or another recognized government entity and includes an on-site inspection to verify compliance. For a current list of certifying agents, please visit the Animal Care Program’s website: cdfa.ca.gov/AHFSS/ AnimalCare/AccreditedCertifyingAgents. html. The Animal Care Program’s website has more information including guidance documents for producers, distributors, products covered under Prop 12, and links to our recent educational webinar series.

COMPLIANCE CORNER

California Canine Rabies Vaccination Exemption Law California Health and Safety Code Section 121690(b)(2)

By Grant Miller, DVM, CVMA Director of Regulatory Affairs

xisting law requires that a dog three months of age or older must be vaccinated against rabies (California Health and Safety Code section 121690 (b)). The rabies vaccination is a prerequisite to licensing, which is required under subdivison (a) of the same section. In 2012, the California legislature passed “Molly’s Law,” which was an amendment to the Health and Safety Code declaring that the vaccination requirement is exempted in a dog whose life would be endangered due to disease and other considerations that a veterinarian can verify and document as a result of receiving the rabies vaccine. Local animal health authorities are vested with the jurisdictional authority to either grant or deny an exemption request. The following is a summary of the requirements outlined in the law in order for a dog to be considered for exemption: • A veterinarian must examine the dog on an annual basis to confirm that the dog should or should not receive the rabies vaccine. • At the discretion of the local public health officer, exempt dogs shall be confined to the premises of the owner, keeper, or harborer and when off the premises, shall be in the control of an adult by way of a leash no more than six feet long. • This law also prohibits the license period for an unvaccinated dog from extending beyond one year, implying that owners will have to reapply for the exemption on an annual basis. • Dogs that are granted a rabies vaccination exemption will be considered unvaccinated by health officials and thus, if they are involved in

a bite incident, the procedures followed for them will differ from those of a vaccinated dog. • Any dog in violation of these legal requirements shall be impounded by the local animal health authority. The law mandates that local health authorities create a rabies vaccine exemption request form that an owner must obtain and submit to authorities. The form must include a signed statement from a veterinarian explaining the inadvisability of the vaccination and a signed statement by the dog owner affirming that the owner understands the consequences and accepts all liability associated with owning an unvaccinated dog.

to confirm that the dog should or should not receive the rabies vaccine and to then issue a signed statement explaining the inadvisability of the vaccination. Note that submitting rabies antibody titers to local animal health authorities is insufficient for a vaccination exemption to be granted in accordance with the law. This article is for informational and general educational purposes only. It is not intended to take the place of legal advice nor should it be considered as a legal interpretation. Although significant effort has been made to ensure the accuracy and completeness of the information at the time of publication, the CVMA shall not be responsible for any errors or omissions, or any agency’s interpretation, application, or enforcement of the information presented herein.

It is incumbent upon owners to obtain forms from the county and apply for exemption on an annual basis. Veterinarians are not required to perform this function on behalf of owners. The only obligations of the veterinarian are to examine the dog on an annual basis

cvma.net/publications

ONLINE SEMINARS

Online Seminars Employment Law Changes for 2024

Jizell Lopez, Wilke Fleury January 23, 2024 | 12:30–1:45 PM (1.5 CEUs) January 25, 2024 | 5:30–6:45 PM (1.5 CEUs) This comprehensive course is designed to provide employers and employees in California with a detailed understanding of the latest employment laws shaping the workplace landscape in 2024. Delve into critical updates, legislative changes, and emerging trends that impact both employers and employees. Whether you're an employer seeking to align policies with the latest regulations or an employee aiming to understand your rights, this course equips you with the knowledge essential for success in California's dynamic employment environment. This course is complimentary to all CVMA members.

TELUS Health Wellness Webinars

Telus Health, the CVMA’s Member Assistance Program, is offering free webinars each month of 2024 addressing various wellness topics. Please note: TELUS Health webinars do not offer CE credit. SPONSORED BY:

Navigating Nutritional Conversations

Vicky Ograin, RVT February 13, 2024 | 12:30–1:45 PM (1.5 CEUs) February 15, 2024 | 5:30–6:45 PM (1.5 CEUs) Veterinarians and technicians should be discussing nutrition with pet owners; this session will help start the conversation. Learn how to structure and perform a nutritional consultation and how to address common questions owners may ask. We will work through a feline renal case, demonstrating how to do a nutritional consultation and discuss the importance of the consultation, especially when switching to a new food.

Pathways to Payments: Leveraging Options to Help Clients Pay for Services Peter Bowie, DVM March 26, 2024 | 12:30 PM–1:45 PM (1.5 CEUs) March 28, 2024 | 5:30 PM–6:45 PM (1.5 CEUs)

This online seminar will be an open discussion and tour through the methods at a hospital's disposal to help clients pay for large or unexpected veterinary costs. Traditional means for client assistance are discounts, "phoning a friend," and hospital billing, all of which have significant downsides. Thankfully, now there are more options. We will discuss the basics of pet insurance and then examine third-party payment companies, third-party billing, crowdfunding, and angel funds. By the end, we hope that you will have additional resources benefitting your practices and your clients. Register online by visiting the Continuing Education tab at cvma.net or by phone at 800.655.2862.

California Veterinarian | January–February 2024

Financial Fitness

February 9, 2024 | 11:00–11:30 AM Even smart people with good jobs and high-paying compensation can find themselves in financial problems. This includes cash flow and debt issues that can be a daily distraction and make for 'bad' corporate and personal behavior. This course will address the personal impact of financial inaction, the effect on family, and some simple and small steps necessary to initiate significant change.

Compassion Fatigue

February 23, 2024 | 11:00–11:30 AM For many of us, our day-to-day jobs are not only physically exhausting, but also mentally exhausting. This class will guide you through what compassion fatigue is, its symptoms, and real-life strategies to combat the exhaustion in our everyday lives.

Mindful Meditation

March 8, 2024 | 11:00–11:30 AM In our busy lives, we may find that we crave opportunities to be mindful. In this program, participants will examine the focus of mindful meditation, define it, explore what it is and isn’t, identify its benefits, discuss data that supports mindful meditation, and have an opportunity to practice it. For more information and to register for Telus Health webinars, visit go.telushealth.com/en-us/wellbeing-calendar-2024.

CVMA REMEMBERS

The CVMA extends our sympathy to the friends and family of those remembered. Dr. Neil Boodman, a CVMA Life Member, passed away on October 28, 2023. Dr. Boodman earned his DVM degree from Kansas State University in 1961.

Dr. Thomas Mack, a CVMA Life Member, passed away recently. Dr. Mack graduated from the

Ohio State University College of Veterinary Medicine in 1961. He founded and operated Bayshore Animal Hospital in San Mateo, California for over 35 years. In 1998, he was honored with the Western Region Practitioner of the Year Award by the American Animal Hospital Association. Dr. Mack was heavily involved in the CVMA, serving on its Board of Governors, as director and vice president of the California Veterinary Medical Foundation, and on numerous CVMA committees and task forces, including the Public Relations, Political Action, Legislative, and Disaster Preparedness Committees.

Dr. JoAn Marshall, a CVMA Life Member, passed away on April 3, 2023. Dr. Marshall received

her veterinary degree from Washington State University in 1958, where she was the only woman in her graduating class. She went on to own West Valley Veterinary Clinic in Lompoc, California with her husband, Wes, which they operated for 40 years. Dr. Marshall served as the regional California director for the American Animal Hospital Association and, after moving to Montana during retirement, served on the Montana Board of Veterinary Medicine.

Dr. John Weinmann, a CVMA Life Member, passed away on October 12, 2023. After his

undergraduate studies, Dr. Weinmann enlisted in the United States Air Guard and there served in the U.S. and Korea as a veterinary technician until 1955. He received a master’s degree in animal physiology at Oregon State University and went on to earn his DVM degree at Colorado State University in 1961. He practiced small animal medicine for 31 years on the San Francisco Peninsula until his retirement in 1992.

Dr. John Woodward, a CVMA Life Member, passed away on March 19, 2023. Dr. Woodward graduated with his DVM degree from the University of Missouri in 1965.

In memory of deceased members, the CVMA makes a donation to the California Veterinary Medical Foundation, whose mission statement reads: “Nurturing kindness, education, and well-being for all animals, people, and the environment.”

cvma.net/publications

CVMA INSURANCE SERVICES

running on natural gas or propane were able to continue servicing customers. By contrast, many portable generators cannot handle the load of refrigeration and AC compressors and fans. Power loads for a clinic will oftentimes be too much for the typical portable generator.

Preparing for Power Loss in an Emergency By Vince Scarcella, Risk Control Director, CNA

eather events, wildfires, and power grid problems can leave your veterinary hospital or clinic without power. This can affect critical operations like diagnostics/lab procedures, surgeries, and life support systems, including heat, air conditioning, refrigeration, security systems, computers, and the internet. Eleven years after Superstorm Sandy hit the East Coast, it still remains the largest Atlantic tropical cyclone on record. Sandy was not just large in size; it delivered a storm surge, strong winds, rain, and even mountain snow.1 During Superstorm Sandy, my family’s New York State home and community lost power for several days. On the second day of the storm aftermath, our dog Patches was attacked by several dogs roaming the neighborhood. My son Matthew raced into the brawl attempting to break it up. Unfortunately, both my son and dog came out battered. The hours following involved two visits for medical intervention. Matthew was brought to the local hospital ER for stitches and Patches had a trip to the veterinary clinic for antibiotics and mending. With the storm disrupting daily routines and wreaking havoc in so many areas, quality medical care was available

An additional advantage of installed standby generators (versus their portable counterparts) is that you don’t have to be present to start them. Many standby generators come with a notification option through a management app on your mobile device. Standby generators also have the advantage of not requiring on-site fuel storage, which poses a significant risk.

for our personal needs because the local hospital and our veterinarian invested in emergency generators.

Talk to a licensed electrician; many are authorized dealers trained to install standby generators.

All businesses rely on multiple systems for normal day-to-day operations. There are many reasons to invest in an emergency generator. Depending on the services provided, you may experience the following when there is a loss of power: 1. Practice closure Having your practice closed poses a reputational risk that can be hard to quantify. 2. Loss of air conditioning and dehumidification Loss of these functions can mean mold growth, contaminated operating theaters, and extreme discomfort for any patients sheltered at your location. Additionally, computing or data storage equipment can be damaged by high temperatures and humidity. 3. Loss of water and sanitary services If you are on well water, you won’t be able to do the cleaning necessary to recover. 4. Loss of refrigeration and consequent spoilage of any pharmaceuticals stored in a controlled environment

An Additional Word of Caution

What Type of Generator Is Recommended?

Simply using portable gas generators is not the best option. During Superstorm Sandy, gasoline was scarce. Businesses with installed standby generators

California Veterinarian | January–February 2024

When using portable generators, be extremely careful of placement. Each year, there is loss of life due to carbon monoxide poisoning from portable emergency generators. Placing a generator anywhere inside a building—even in a garage—is prohibited under any circumstance. Make sure you have carbon monoxide detectors and check them every time you check your smoke detectors. Even then, your typical carbon monoxide detector alarms at levels too high for small animals to tolerate. Purchase digital CO detectors that alarm at 35 PPM. One last item: Any generator you purchase needs to be a quiet (low decibel) generator; options as low as 60 dB are available. Vibration mounts are a must. As always, consult with your local building code department and always use a licensed electrician! Superstorm Sandy By The Numbers 10 Years Later | The Weather Channel 1

UNIQUE INSIGHTS

When Opportunity Knocks By Mark Starr, DVM, MPVM, DACVPM

retired at the end of 2022 after having been an appointed deputy director of the California Department of Public Health (CDPH) and leading the state’s environmental health programs for the last 10 years, as well as after 22 years in state and county public health and over 38 years as a veterinarian. With retirement comes reflection…How did this all come about? What opportunities did I seek out and/or maximize along the way? What were the greatest rewards? Are there things in my path that may resonate with other veterinarians? Like many of you, I desired a veterinary career because of the challenges and rewards, making a difference in animal and human well-being, and contributing to society. During my veterinary training at UC Davis, I became aware of the breadth of career opportunities available, including in public health. I also became familiar with and completed the Master of Preventive Veterinary Medicine (MPVM) program there, training with two key mentors: Drs. Calvin Schwabe and Dave Hird. After a few years in private practice and reaping the rewards of hands-on, front-line work with animals and their people, I made the jump to public health in 1990, when my wife spotted “Sacramento County Epidemiologist” in the classifieds. After increasing

their awareness of what a veterinary epidemiologist could bring to this role, I got the job. The engagement with the community, other counties, and the state to utilize epidemiology and surveillance in understanding and addressing many public health challenges—ranging from HIV/AIDS to foodborne disease outbreaks to maternal/infant health—was rewarding and opened more doors. I joined the state health department in 1995 as a public health veterinarian, focusing on zoonotic diseases, including an early investigation of Mycobacterium tuberculosis in zoo and circus elephants. I later led communicable disease surveillance and then spent four years as the communicable disease division chief, all under the guidance of Dr. Kevin Reilly. Proactive interactions with county health officers led to my 2007 appointment as director of public health for Placer County and, leveraging my veterinary hat, I was also able to lead animal services and reinvigorate the project to build a new shelter there. After five years, I pursued a new opportunity and returned to state public health, this time leading a variety of programs to address foods, drugs, cannabis/hemp, radiation, drinking water, medical waste, recreational water, toxins, and other environmental health concerns. I was able to serve on the governor’s Drought Task Force, representing the CDPH to help address the health impacts of the 2012–16 drought, answer questions, and connect resources. I also volunteered to assist leading health equity and climate change programs and, of course, we all worked on COVID-19. I can attest that the oft-maligned statement “we are with the government and we’re here to help” is frequently true, and a career in public practice can be hugely rewarding. Organized veterinary medicine also played an important role in my career, beginning with time spent as a CVMA student representative and continuing

“Having walked a non-traditional path involving multiple roles, it is clear that my veterinary training and skills served as a solid foundation throughout.”

with service in the CVMA’s House of Delegates. I further served as my local VMA’s president, on various American Veterinary Medical Association councils and committees, and as president of the epidemiology specialty with the American College of Veterinary Preventive Medicine. Each of these helped open more doors. I was also able to teach epidemiology and community health at three universities (most recently in the UC Davis Master of Public Health Program), to participate in research, and to deliver over 100 presentations on myriad public health topics. Having walked a non-traditional path involving multiple roles, it is clear that my veterinary training and skills served as a solid foundation throughout. Every step seemed perfectly natural for someone with my background. Veterinarians in particular have much to contribute, being welltrained for careers in agriculture, food and drug safety, wildlife health, environmental health, teaching and research, and public health. The rewards of this career path have been both personal (work-life balance) and professional, on a larger scale than clinical practice but also less immediate, and included the opportunities to work with teams of experts to address community and statewide public health challenges—leveraging the One Health approach.

cvma.net/publications

VETERINARIAN BEGINNINGS

Where Has the Time Gone? By Rachel Natsume, DVM

here has the time gone? One minute I was graduating with my DVM degree, and the next I’m already eight months into my first year of practice. It has been quite the rollercoaster, but I have no regrets in regards to the decisions I made—not even one. I am nearing the conclusion of my small animal rotating internship, but the ending is bittersweet. I went in with an open mind and the expectation to work more than a 40-hour workweek. It’s all about managing expectations and changing your attitude. Luckily, I enjoy my work, so it becomes a great learning opportunity with each procedure or interesting case that keeps me late. At this point, when I have a normal two-day weekend, I find that I want to go back to work. When I have a three-day weekend with no apparent plans, I actually find that I go mad and nearly end up at work’s doorstep. I really enjoy the hustle and bustle. I enjoy the pressure. But I also enjoy socializing with my coworkers—there’s nothing better than sharing good food and a good laugh. I’ve found that with the right support at work, I look forward to going in every week. I’ve learned to become efficient at work so that I can enjoy walks with my puppy, cuddles with my cat, and eight hours of sleep. Like most people attracted to the veterinary field, I am the typical type-A nerd who did everything in my power to hit the ground running on Day One of my veterinary career. Since my internship is meant to prepare me for my veterinary career, I now have a pharmacy chart prepared, a log of all the patients I’ve ever seen, a differential diagnosis list, a description of common procedures, and

helpful discharge templates. I realize it may be excessive and maybe unnecessary, but my templates help me sleep at night. I have learned valuable tidbits from casual conversations with colleagues. Two months into my internship, I did not have enough time to really appreciate the value of my license until one of my colleagues said, “If you lose your license, you lose your career.” That night, I signed up for the most extensive insurance coverage I could find and also started beefing up my communication logs in my medical records. I may write short essays for my comm-logs, but I can tell you that I won’t be the one with my license in question when I’ve written a lengthy description of the diagnostics and treatment plan I offered to a client that went home AMA (against medical advice). It is better to write more than regret writing dismal records when called to defend your license. I’ve worked so hard to get here that it doesn’t seem worth it to write a one-liner objective physical examination for my entire medical record. So, to hit it over the head, write a thorough record! You’ll sleep better at night. Of the handful of thank-you letters I have received from owners, 50% of them have been from clients who presented for euthanasia consults (I have received two such letters, thus far). It’s difficult to go from treating an eight-week-old puppy and bouncy-but-naughty foreign-body Golden Retriever to a 16-year-old Chihuahua presenting for euthanasia. I realize that. But your ten minutes spent with the clients are the last thing they will remember of their family member. If you take a minute to slow yourself down, it can mean the world to the owners as well as a good night’s sleep after a job well done. The other half of the letters I received were from owners who were grateful for my time. They were concerned with my medical plan because, honestly, the pathophysiology of acute-on-chronic pancreatitis doesn’t make much sense.

California Veterinarian | January–February 2024

The mainstay of treatment is pain control. But do we do anything about the inflammation itself? Nope, just a tincture of time and supportive care until the inflammation subsides. After five days of hospitalization and a great deal of conversations over the phone and in person, we finally got there. Their sweet kitty was feeling better at home and was eating like a champ. Through all of my experiences so far, I have found that as long as you have the patience and perseverance to explain your thought process and the reasons behind your proposal, most owners will actually agree to your plan. And if they end up leaving with nothing but a receipt of their exam fee with their pet under arm, then all you can do is write a thorough comm-log and get a good night’s sleep.

Dr. Rachel Natsume is a Los Angeles native currently working as a small animal rotating intern in Southern California. She graduated with a DVM degree from the University of Sydney and is interested in pursuing small animal surgery.

SOMETHING TO WAG ABOUT

Something to About

Wag

THE CVMA CONGRATULATES… Julie Dechant, DVM, for receiving the 2023 Zoetis Distinguished Veterinary Teacher Award for excellence in teaching in the classroom and the clinic. Dr. Dechant has been a member of the UC Davis School of Veterinary Medicine faculty since 2004, now serving as a professor of clinical equine surgical emergency and critical care in the Department of Surgical and Radiological Sciences and the assistant director of the Large Animal Clinic. Teaching in all four years of the DVM curriculum, Dr. Dechant has one of the highest teaching loads in the school. She is recognized for being not only a great instructor, but a supportive mentor for her students. Congratulations on this well-deserved honor, Dr. Dechant! Samantha O’Hagan, RVT, for passing the Veterinary Technician National Examination (VTNE) this past fall. Samantha has worked at VCA Veterinary Specialists of the Valley for a year and a half. She decided to pursue her RVT license while managing a horseback riding stable, where she realized how much medical care is involved in proper horse care. With her certification, she is excited to pursue more advanced skills and start laying the ground work for becoming a specialist in the future. Congratulations on this new chapter, Samantha!

Dr. Julie Dechant (left) receives her award from Dr. Joie Watson.

Samantha O’Hagan, RVT

Erica Johnson, DVM, and her husband Casey for welcoming their first daughter this December. Dr. Johnson, who currently works at ABC Veterinary Hospital Pacific Beach, is excited to be a mother and for her dog Kona to meet her baby girl! Dr. Johnson, the CVMA congratulates you and Casey on your beautiful bundle of joy! Kay Lubansky, DVM, for returning to biking after a year of recovering from multiple surgeries. Dr. Lubansky, who has been doing relief work with Purrfurably Cats in Monterey while recovering, has completed numerous century rides, ridden crosscountry, and biked across multiple countries. Dr. Lubansky, we are so happy that your recovery was smooth and that you are back doing what you love!

Erica Johnson, DVM

Let’s Celebrate Your Achievements! The CVMA likes to spotlight the many accomplishments of our members and their practices, whether a professional development or a personal milestone. Don’t be shy! Please send in your good news and a photo to Taryn DeOilers, the CVMA’s Publications Manager, at tdeoilers@cvma.net to be considered.

Kay Lubansky, DVM

cvma.net/publications

CVMA BOARD OPENINGS

CVMA Board of Governors Openings

District V—Counties of Fresno, Madera, Inyo, Mono, Mariposa, Merced, Calaveras, San Joaquin, Stanislaus, Tuolumne, Alpine, Amador, Kings, and Tulare • Dr. Adam Lauppe, not eligible for another term

he CVMA Board of Governors—the association’s governing body—is comprised of 16 governors consisting of 11 geographic representatives and five at-large members. The Board terms listed below expire on June 30, 2024.

Geographic District Representation

District VIII—Counties of Alameda, Contra Costa, Napa, and Solano • Dr. Peter Mangold, eligible for another term

Any eligible CVMA member may become a candidate for the Board by submitting a written petition of intent, signed by 10 CVMA members who reside in or maintain a principal office for the practice of veterinary medicine within the district to be represented.

Download the petition by visiting cvma.net and click on Get Involved under the About Us tab, or contact Dan Baxter at dbaxter@cvma.net. Completed candidate district petitions must be returned to the CVMA office by March 22, 2024.

District I—County of San Diego • Dr. Jodi Woods, eligible for another term gatto-half-080923.pdf

8/9/23

At-Large Board of Governors Applications

Applicants for at-large Board positions shall not simultaneously run for an elected district Board position. After receiving letters of interest and applications from qualified CVMA members, the CVMA’s Leadership Committee will evaluate candidates for open at-large positions. Existing at-large Governors must complete an application for a second term.

Governors-At-Large

• Dr. Michael Karle, not eligible for another term

To view the at-large position description and download an application, visit cvma.net or contact Dan Baxter at dbaxter@cvma.net. Completed at-large applications must be returned to the CVMA office by February 1, 2024.

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California Veterinarian | January–February 2024

STUDENT NEWS

STUDENT SCHOLARSHIP AWARDS

Applications Available February 1, 2024

ach year, the California Veterinary Medical Foundation (CVMF) offers two scholarships to veterinary students. Descriptions and criteria of both awards can be found below.

CVMF/VISC Student Scholarship Award

The CVMF/Veterinary Insurance Services Company (VISC) Student Scholarship Award is given each year by the CVMF in partnership with VISC. This scholarship is made possible with donations from VISC and the CVMF and is part of VISC’s ongoing commitment to support the veterinary profession in California. The CVMF will award $1,000 scholarships to third- and fourth-year veterinary students in good standing at the UC Davis School of Veterinary Medicine or the Western University College of Veterinary Medicine, or California residents attending outof-state American Veterinary Medical Association-accredited veterinary medical colleges.

Ron Faoro, DVM, Student Scholarship Award

The second student scholarship is the Ron Faoro, DVM Student Scholarship Award. Established in the memory of former CVMA president Dr. Ron Faoro and given by the CVMF, this award grants recipients with $2,500 scholarships for their role in leadership. Second-, third-, and fourth-year veterinary students in good standing at the UC Davis School of Veterinary Medicine and Western University College of Veterinary Medicine are eligible to apply.

 How to Apply

Recipients will be selected by the CVMF/VISC Student Scholarship Fund Subcommittee and the Ron Faoro, DVM Student Scholarship Fund Subcommittee based on their submitted application materials. Applications for both scholarships must be received by April 15, 2024 to be considered. For eligibility requirements and application information, please visit the CVMF website at cvmf.net, call Dan Baxter at 800.655.2862, or email staff@cvmf.net. Recipients will be notified of their award by June 2024.

cvma.net/publications

UNIVERSITY NEWS

UC DAVIS NEWS

in 2024. The popular summer online UC Davis Offers program runs from May 15 to August 10 combines self-paced online modules Veterinary Business and on general business principles with three live, interactive Saturday Zoom sessions Course covering practical, veterinary-specific Veterinary Business certificate program

business concepts. The program is designed for practice owners, prospective owners, practice leaders, and hospital administrators who want to take their understanding of business to the next level.

he UC Davis School of Veterinary Medicine and UC Davis Graduate School of Management (GSM) will once again offer the Foundations of

The program provides veterinary working professionals with a timeand cost-efficient way to further their understanding of business basics, including managerial accounting, finance, marketing, strategy, and more. Attendees work in small teams on an online Capstone Project analyzing actual veterinary practice data and present their findings in the final Zoom session.

The online modules are taught by GSM business experts, and the live Zoom sessions on June 15, July 13, and August 10 are taught by veterinary industry experts. Upon successful completion of the program, graduates receive a certificate from GSM as well as CE credit in the area of practice management. Registration is $2,599, with an early bird special of $2,449 if registered by February 15. Space is limited to 42 participants, and the event has sold out previously, so register early. Zoetis has generously supported this program since its inception in 2019, providing tuition support for up to twelve veterinary students with a strong interest in business. Registration and more information can be found at: gsm.ucdavis.edu/executiveeducation-programs/foundationsveterinary-business.

WESTERN U NEWS

WesternU Career Ladder Camp Targets Economically Disadvantaged Students

ore than a dozen students from nearby high schools traveled to WesternU this past summer for the 2023 Health Career Ladder Veterinary Medicine Summer Camp. This program was student-led and directed, with Kathryn Garcia (DVM 2025) and Miahuatl Kuauhtzin (DVM 2026) developing and implementing the program with coordination and oversight from College of Veterinary Medicine (CVM) instructor Ken Noriega. WesternU’s unique Career Ladder Program, now in its 10th year, is an alliance the university has forged with the Pomona Unified School District and the Sherman Indian High School and Anahuacalmecac International University Preparatory of North America. The program is designed to inspire students from economically disadvantaged backgrounds to consider careers in different medical fields.

The Veterinary Medicine Summer Camp took its cue from the CVM’s Problem Based Learning (PBL) format. The CVM students designed a week of activities in which campers experienced what it would be like to go through a PBL case. They worked through disclosures and engaged in hands-on activities to supplement their learning. The program also allows CVM students to develop and write PBL cases to deliver to camp participants. The result was a program that engaged both the high school students and the CVM student instructors. “I never really expected to have my summer […] filled with turtles, tortoises, chameleons, and a bearded dragon named Lars,” Garcia said. “I did have a lot of fun writing, learning, and teaching about these critters.”

California Veterinarian | January–February 2024

Kuauhtzin also found the summer camp experience to be rewarding, noting that the hands-on educational experiences sparked something extra in the camp attendees. “Working with live animals, even the quietest students came out of their shell,” Kuauhtzin said. “A majority of the students expressed interest in working with animals and the veterinary field from the beginning of the program, and I feel this experience only deepened their interest in the field. I had a handful of students express their deep interest in continuing with our programming during the school year with the Health Career Ladder.” Programs like Career Ladder are extremely important for students of color, Kuauhtzin added. “This sort of programming helps them feel welcomed and encouraged, so they are reminded they belong at institutions of higher learning such as WesternU and veterinary school,” she explained. “I hope to see the program continue to grow.”

Contact Simmons

today to get started on your valuation! Byron Farquer, DVM, CVA Dardalee Bussell, DVM

(209)-845-2088 pacific@simmonsinc.com

New USP guidelines are here

It’s Time to Switch!

Order from a 503B Facility like Epicur Pharma As of November 1, 2023, new USP guidelines are limiting beyonduse dates (BUDs) on drugs compounded at all 503A compounding pharmacies. Epicur Pharma’s manufactured 503B medications are NOT required to follow the requirements of USP <795> or <797>. Instead, they use longer/proven expiration dates validated by the current Good Manufacturing Practice (cGMP) regulations enforced by the FDA and will continue to have an expiration date of up to 365 days. Learn more about what these new guidelines mean for you and your practice

CVMA members receive 10% off all office orders with Epicur Pharma! cvma.net/publications

Ellie Wattles, DVM, President, Broker Beka Herrera, Vice President, Broker Serving CA Veterinarians for 30+ Years. With our proven track record, we can help you reach your goals. NEW! VENTURA COUNTY: Located in a thriving valley community. Solo DVM practice has limited competition for a growing population. Real estate includes a separate office & private parking. Friendly clients. Limited DVM hours (PX closes at 5 PM) & no weekend or emergency services provided. Spanish speaker ideal. 2023 PROJ GROSS: ~$956,000 PRACTICE PRICE: $610,000 REAL ESTATE PRICE: $635,000

NEW! SIERRA FOOTHILLS REGION: Only an hour to Sequoia National Park. Well-maintained, exceptional, ~7,100 sq. ft. free-standing facility includes three exam rooms, boarding wings, & much more. Well-equipped, busy solo DVM & quality staff. Both practice & real estate are priced below the appraised value. 2023 PROJ GROSS: ~$1,300,000 PRACTICE PRICE: $895,000 REAL ESTATE AVAILABLE FOR SALE

NEW! SAN DIEGO, EAST COUNTY: Within easy reach of nearby cities & attractions like great restaurants, Padre baseball, and SeaWorld. Wellestablished practice located in an active, popular shopping center. Practice needs a new energetic DVM. ~1,400 sq. ft. leased facility with 2 exam rooms, digital X-ray & new ultrasound. 2023 PROJ GROSS: ~$650,000 PRACTICE PRICE ONLY: $400,000

NEW! SAN FRANCISCO BAY AREA: Urban/Suburban mix with easy access to San Francisco, Napa Valley, Sonoma County & Sacramento. Conveniently, centrally located, leased facility of ~ 2,750 sq. ft. Well-equipped practice, with excellent client base, most being homeowners. Income produced with one DVM per day. 2023 PROJ GROSS: ~$1.1 Million CALL FOR PRICING DETAILS

NEW! SANTA CLARA COUNTY: A thriving community that boasts a great quality of life to its residents. Wellestablished PX is ready to welcome a new owner operator. 2,500+ sf building which sits on a quarter acre lot. Room for expansion within the footprint of the building. 2023 Projected Gross ~ $846,000. PRACTICE PRICE ONLY: $699,000 REAL ESTATE FOR SALE. PRICED TO SELL!

NEW! GREATER EAST BAY: Thriving diverse suburban community with a strong economic base and major development. Practice is only open 4.5 days per week. Emergencies are referred elsewhere & surgeries are extremely limited. Additional income source accessible for the right buyer. 2023 PROJ GROSS: ~$703,000 PRACTICE PRICE: $535,000 REAL ESTATE PRICE: $530,000

MENDOCINO COUNTY, COASTAL: Located in the scenic harbor town of Fort Bragg, just 3 hours North of SF. The superb quality of life offers exciting recreation. The practice draws from a large area with minimal competition & big demand for DVM services. Freestanding facility ~2,000 sq. ft. Currently, PX is essentially closed. PRACTICE PRICE ONLY: $125,000 REAL ESTATE PRICE ONLY: $300,000

NORTHERN CA: A quaint community located 30 minutes north of Chico, two hours from Davis. Well-maintained 3,000 sq. ft. freestanding facility built in 2005. Exceptional profitability & growth potential. Owner available post-sale. 2023 PROJ GROSS: ~$1,500,00 PRACTICE PRICE: ONLY $999,000 REAL ESTATE PRICE ONLY: $625,000

YOSEMITE COUNTRY: Situated in the foothills of the Sierra Nevada Mountains, near Yosemite National Park. Small animal hospital with a favorable lease rate in a freestanding ~1,680 sq ft. facility. The facility includes two exam rooms, 20 cages & IDEXX lab equipment. 2022 gross produced with solo DVM working PT. 2022 PRACTICE GROSS: ~$497,973 PRACTICE PRICE ONLY: $330,000

IN 2023, WE’VE SOLD PRACTICES & REAL ESTATE IN:

Veterinary lenders offering below-market interest rates! Visit us at the 2024 WVC- Booth #2128

Address: 545 Sespe Avenue Fillmore, CA 93015 | Phone: 805-524-3195 | Fax: 805-524-3192

Email: pacproinc@aol.com | Site: www.pacificproinc.com California Veterinarian | January–February 2024

CLASSIFIED ADVERTISING

POSITIONS OFFERED

Northern California Veterinarians

DVM/VMD full-time or part-time. Myrtle Avenue Veterinary Hospital is a privately owned five doctor small animal practice established in 1982 on the northern coast of California. We will have completed construction of a new hospital on January 1, 2024, and we are looking forward to an addition to our team. We are open to experienced veterinarians looking to relocate to a more peaceful existence as well as new graduates. Enjoy small town feel, farmer’s markets, redwood majesty, highly accessible beaches that are almost all dog friendly, affordable housing (at least for coastal CA!), hiking/biking/surfing/mycology! 21% production with a fallback base pay (no negative accrual); Relocation assistance; Simple IRA with 3% employer match; $2500 annual CE allowance; Group medical insurance; Yearly membership to AVMA/CVMA; Paid professional licensure renewal fees/membership

dues; Mentorship—you can meet our two doctors that were new graduate hires if you want to see if it is a good fit!; Paid time off; Pet discounts; Paid holidays. Practice features: Brand new construction. In house laboratory with IDEXX courier, digital radiography, ultrasound, digital records, two surgical suites, eight exam rooms, fish-bowl style doctor’s office overlooking the large treatment area. Myrtle Avenue Veterinary Hospital looks forward to hearing from you. Contact us at myrtleavevethospital@gmail.com. Looking for compassionate, enthusiastic small animal veterinarian to work at our 2-doctor practice in beautiful South Lake Tahoe. General surgery, medicine, ultrasound, digital radiology, dentistry, and more. No after-hours emergency. Commitment to our clients and patients an absolute must. Flexible hours, pay based on production, retirement, paid holidays, and more. Valid CA veterinary license. At least 6 months practice experience preferred. npowell@bluelakevet.com.

cvma.net/publications

CLASSIFIED ADVERTISING

Central California Veterinarians

Do you remember why you went to vet school? Are you tired of practicing sales rather than veterinary medicine? Well – here is your chance! Happy Tails Animal Hospital in West Garden Grove, CA is looking for a new associate vet (full-time or part-time) to join our family and help our community! In February, we moved into our new, state of the art facility and are looking to expand. Happy Tails is ENTIRELY privately owned and operated since 2014. We believe in compensating our team generously. In addition to a competitive wage, 401k, etc. we offer perks (such as team trips to the French Caribbean just to relax – no CE, no work, just fun!). New grads and “old salties” feel free to apply. Please send your CV to k2berka@gmail.com. And check out our website: htanimalhospital@gmail.com. Thanks!

SOCIAL MEDIA! facebook.com/TheCVMA

instagram.com/california_vma

twitter.com/TheCVMA

HOSPITALS—SALES/LEASE/BUY Long established successful, Northern California veterinary practice, located in a highly visible shopping area with room to expand. Annual collections over 900K with single DVM working a 4-½ day work week. Established in 1997, designed and built by DVM retiring/selling the practice. Newly negotiated lease. Located in an upper-middle-class area within walking distance to churches, schools, parks, and community center. Email bclaycamp@earthlink.net.

ADVERTISING INDEX CONMIGO ..…................................................................. 9

Pacific Professionals Inc. …........................................ 44

Dunbar Academy…...................................................... 35

Preferred Employers Insurance .…................................ 2

Epicur Pharma ….......................................................... 43

Simmons Inc. .............................................................. 43

Gatto McFerson …........................................................ 40

Veterinary Insurance Services Company .................... 48

Omni Practice Group ................................................... 47

California Veterinarian | January–February 2024

Thinking about an Exit Plan?

We can help. We've sold over 300 practices in the past 25 years.

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License #2205339

CURRENT LISTINGS Popular Veterinary Clinic in an Excellent Location (CAV3029) Northern California Small Animal Clinic (CAV3016) Sonoma County Veterinary Hospital for Sale (CAV3020) Well Established Practice in Sacramento County (CAV3021) El Dorado County Veterinary Hospital for Sale (CAV3018) Long-Established Successful Southern California Veterinary Practice (CAV3017) Southern California Animal Clinic (CAV3024)

Scan for our upcoming practice transition seminar in Palm Springs, February 2024.

Prime Location, Los Angeles County Veterinary Hospital (CAV3030) Extremely Desirable Los Angeles County Location. Long Established Practice Located in One of the Best Parts of Los Angeles (CAV3026) Modern Veterinary Hospital in Los Angeles County (CAV3022) Southern Los Angeles County Small Animal Practice and Pet Hotel (CAV3015)

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Call VISC at 888.762.3143 or email info@visc-ins.com for solutions to all your insurance needs. visc-ins.com VISC is a wholly owned subsidiary of the California Veterinary Medical Association | CA Lic. #0F64180