CV May/June 2024

Update

on

Antimicrobial Use and Stewardship Recommendations in Large and Companion Animals

August 13, 2024 | 12:30 PM–2:00 PM (1.5 CEUs) August 14, 2024 | 5:30 PM–7:00 PM (1.5 CEUs)

This course satisfies the one hour of California CE requirement on the judicious use of medically important antimicrobial drugs. For more information, see page 31.

CVMA Pacific Veterinary Conference in San Francisco

July 11–14, 2024 (28.5 CEUs)

For more information, see page 24.

CVMA Fall Seminar in San Diego

October 4–6, 2024 (12 CEUs)

For more information, see page 17.

Registration for all CVMA events can be made online by logging onto cvma.net or by calling 800.655.2862.

CVMA-AFFILIATED PROGRAMS

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

The Publication of the California Veterinary Medical Association

Publisher Dan Baxter

Managing Editor Taryn DeOilers

Editor Kristen Calderon

Publication Designer Marissa Collier

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

STUDENT REPRESENTATIVES

University of California, Davis Sarah Meil

Western University Nicole Lent

CVMA STAFF

Executive Director Dan Baxter

Director of Finance Kathy Van Booven

Director of Member Services Kristen Calderon

Director of Communications Taryn DeOilers

Director of Conferences and Events Sarah Erck, CMP

Director of Regulatory Affairs Grant Miller, DVM

Director of Finance Thomas F. Palmieri, CPA

Membership and Student Services Manager Laura Phillips

Communications and CE Coordinator Nicole Campos

Finance Coordinator Sharmele Browne

Graphic Designer Marissa Collier

Conference Speaker Coordinator Lily Briggs

Conference Expo Coordinator Erica Ferrier

Membership Coordinator Jennifer Smith

Receptionist Mary Young

DISPLAY ADVERTISING

Please contact Erica Ferrier at 916.649.0599 ext. 15 or email eferrier@cvma.net.

Tell us what you think!

Want

One of the CVMA’s calling cards for the veterinary community is our fleet of robust continuing education offerings, which range from our flagship Pacific Veterinary Conference (PacVet) with its four days of CE offered in multiple tracks, to one-off webinars like the annual new laws sessions that CVMA Director of Regulatory Affairs Dr. Grant Miller and I present each January.

Apropos of our CE calendar, the CVMA held its annual Spring Seminar at the Tenaya Lodge in Yosemite over the weekend of March 8–10. Speakers Drs. Kristin MacDonald and Jim Lavely presented 12 CEUs on the topics of cardiology and neurology to approximately 400 in-person and virtual veterinarian and veterinary technician attendees. While the Spring Seminar has been a reliable ship in the CVMA’s CE fleet for many years, this was the first time the seminar was held at the Tenaya Lodge. This new location supported a virtual component for those preferring to learn from the comfort of their homes and permitted a greater inperson attendance than our prior Spring Seminar venue, allowing RVTs to attend for the first time ever.

Because I joined the CVMA in September of 2020, this was my first opportunity to attend an in-person Spring Seminar (2021 and 2022 were virtual events due to COVID, and 2023’s event was snowed out at the last minute, forcing us to pivot to a virtual presentation on three days’ notice). The smaller scale of both this event and our Fall Seminar represents a nice complement to PacVet, which this year will take place in San Francisco from July 11–14.

Literally adjacent to the Spring Seminar (indeed, right across the hotel hallway), the CVMA held its first-ever Food Animal Medicine Seminar (FAMS). This seminar featured dedicated, food/large animalspecific continuing education from Drs. Andrea Mongini, Richard Pereira, and Meera Heller. In addition, attendees enjoyed a welcome reception, a presentation on animal disaster management from Dr. Miller (who also serves as the state coordinator for the California

Veterinary Medical Reserve Corps), and a reception and town hall, during which attendees discussed issues affecting food animal practice, including the acute workforce shortage the sector is currently experiencing.

All told, 40 food animal practitioners participated in FAMS. While this number might seem modest at first blush, it actually represents a significant percentage of such practitioners in the state. So, we are proud of the results and certainly intend to maintain FAMS as part of our CE stable going forward, possibly holding a food animal medicine seminar in even-numbered years and an equine medicine seminar (do I hear “EMS,” anyone”?) in odd-numbered years. In fact, as I write this column, we are currently in the process of applying for a federal grant for these seminars from the National Institute of Food and Agriculture (NIFA, a division of the United States Department of Agriculture), through its Veterinary Services Grant Program. Our hope is that NIFA will recognize the value of these subject matter-specific seminars to—among other things— strengthening rural and agriculturally focused veterinary programs, enhancement of food safety, and other items of importance to NIFA.

We are grateful for the support of Elanco, Covetrus, and Legally Mine, who sponsored the Spring Seminar. We are also thankful to the California Veterinary Medical Reserve Corps for supporting FAMS, as well as representatives from the American Association of Bovine Practitioners for their presence at FAMS.

The CVMA’s CE offerings have historically been a significant piece of what we bring to the table for the veterinary profession, and I would be remiss if I didn’t note that CVMA members receive discounts on every one of our CE seminars, webinars, and conferences (including several free webinars throughout the year!). Don’t miss out…join the CVMA and take advantage of all we have to offer!

Dan Baxter Executive Director

JUNE 5, 2024

Veterinary Insurance Services Company Board Meeting

News Now & CVMA UPCOMING MEETINGS

JULY 14, 2024

Joint CVMA Board of Governors/House of Delegates Meeting in San Francisco

JULY 23–25, 2024

Veterinary Medical Board Meeting

Thank You for Paying Your CVMA Membership Dues!

Membership dues are available to pay online starting May 15. The CVMA is grateful to all of our members who have renewed their memberships. If you have not renewed yet, you still have time! Please visit cvma.net, click on Pay Bill Online under the Membership tab, and take full advantage of your member benefits. If you have any questions or wish to renew by phone, call 800.655.2862 or email membership@cvma.net.

AUGUST 28–29, 2024

Veterinary Insurance Services Company Board Meeting

OCTOBER 4–6, 2024

CVMA Board of Governors Meetings in San Diego

OCTOBER 15–17, 2024

Veterinary Medical Board Meeting

UC Davis and WesternU Commencements

The commencement ceremony for WesternU’s College of Veterinary Medicine will take place on Friday, May 17, and the UC Davis School of Veterinary Medicine commencement is scheduled for Friday, May 24. The CVMA congratulates the graduating veterinary medicine students, and we wish you the best on your new journey!

This

Legislative

Season, Consider Giving to the CVMA PAC

With the generous contributions of CVMA members who give to the CVMA Political Action Committee (CVMA PAC), the CVMA can maintain its stature as the premier voice on important issues related to the veterinary profession and the health of animals in California. This year, we face several unprecedented bills that would significantly impact veterinary medicine. Please consider giving to the PAC to help protect your profession. Contribute online by scanning the QR code.

Happy Pride Month!

The CVMA wishes the LGBTQIA+ community a Happy Pride Month this June! We emphasize the importance of accepting, understanding, and respecting the wide-ranging spectrum of sexual orientations, gender identities, and gender expressions that make up the veterinary profession.

I AM THE

Evelyn Sagastume, DVM

c Owner of Petsadena Animal Hospital in Pasadena California

c UC Davis

c Small Animal Exclusive General Practice

My favorite quote is "You will face many defeats in life, but never let yourself be defeated." -Maya Angelou

I still want to learn how to perform laparoscopic surgical procedures, such as laparoscopic spays and arthroscopy.

If I could have dinner with any famous person in history, it would be Charles Darwin.

A movie that impacted my life is Stand by Me

The most adventurous thing I’ve done is swim in the ocean with giant manta rays while on a trip to the Galapagos Islands.

My first job was an office assistant at a local elementary school.

Something I do that my clients love is creating educational videos that I send to my clients to explain common conditions.

Members are the heart of the CVMA

I am a CVMA member because I wanted to create a network of colleagues who share a common interest in improving the veterinary medical profession. As a member of the CVMA House of Delegates, I have learned about the importance of organized veterinary medicine in influencing legislation that impacts our profession.

Together we are stronger!

Harnessing the power of veterinary professionals across the state, the CVMA provides advocacy, continuing education offerings, savings on products and services, leadership, and community. Your membership empowers your career and the veterinary profession!

JOIN OR RENEW NOW!

Scan to see what the CVMA has to offer. ®

SavingLife

We all know that microchips are a key factor in returning pets to their families, yet a very small percentage of dogs and cats have one. SavingLife Inc. has found that one of the top reported reasons for not getting a microchip is the cost of the procedure and accompanying registration. To address these issues, SavingLife wants to drive down the cost of microchips and registration so that more pets will get this important service.

To obtain a volume discount rate, SavingLife will aggregate all CVMA member orders. As CVMA members as a whole surpass price break points,

all members benefit. Additionally, to help increase the number of chips registered and accounts maintained, microchip registration and maintenance is FREE for pet owners. It is a win-win-win situation: your clinic can maintain its revenue stream from microchips, owners will save money, and more pets will be returned home.

Our microchips meet the highest standards of the industry and come in both regular and nano sizes. We also have QR collar tags and microchip scanners, which are included in the volume discount program.

When is a microchip more than just a microchip?

• When it is cost effective,

• Comes with additional life saving products and services,

• Includes Free for life registry

CVMA members can access the discount code by visiting the Membership tab at www.cvma.net and clicking on CVMA Member Benefits. info@saving-life.com

Workplace Violence Prevention Plans Required in California

By Grant Miller, DVM, CVMA Director of Regulatory Affairs

The passage of SB 553 (Cortese) in 2023 requires nearly all California employers to implement a Workplace Violence Prevention Plan (WVPP) either as part of their Cal/OSHA Injury and Illness Prevention Plan, or as a standalone policy. Unlike other Cal/OSHA requirements, which are found in Title 8 of the California Code of Regulations, the WVPP requirements are part of statute in Labor Code section 6401.9. The law was implemented on January 1, 2024, but has an implementation deadline for employers of July 1, 2024.

The WVPP statute defines several workplace violence terms, classifies workplace violence into different types, and requires employers to implement a written policy document, maintain a workplace violence investigation and correction procedure (which includes a specific violent incident log), train employees, and establish and retain specified records for set time periods.

WVPP Policy Document Requirements

Employers must establish, implement, and maintain an effective written WVPP that is specific to the potential/likely violence hazards which may occur in their workplace. The plan must be in effect at all times and be available and easily accessible to employees and/or their representatives.

The written plan must include:

• The names or job titles of the persons responsible for implementing the plan. If there are multiple persons responsible for the plan, their roles shall be clearly described.

• Effective procedures to obtain the active involvement of employees and authorized employee representatives in developing and implementing the plan, including, but not limited

to, through their participation in identifying, evaluating, and correcting workplace violence hazards, in designing and implementing training, and in reporting and investigating workplace violence incidents.

• Methods that the employer will use to coordinate implementation of the plan with other employers, when applicable, to ensure that those employers and employees understand their respective roles, as provided in the plan. These methods shall ensure that all employees are provided the training required by subdivision (e) and that workplace violence incidents involving any employee are reported, investigated, and recorded.

• Effective procedures for the employer to accept and respond to reports of workplace violence, and to prohibit retaliation against an employee who makes such a report.

• Effective procedures to ensure that supervisory and nonsupervisory employees comply with the plan in a manner consistent with paragraph (2) of subdivision (a) of Section 3203 of Title 8 of the California Code of Regulations.

• Effective procedures to communicate with employees regarding workplace violence matters, including, but not limited to, both of the following:

» How an employee can report a violent incident, threat, or other workplace violence concern to the employer or law enforcement without fear of reprisal.

» How employee concerns will be investigated and how employees will be informed of the results of the investigation and any corrective actions to be taken.

• Effective procedures to respond to actual or potential workplace violence emergencies, including, but not limited to, all of the following:

» Effective means to alert employees

of the presence, location, and nature of workplace violence emergencies.

» Evacuation or sheltering plans that are appropriate and feasible for the worksite.

» How to obtain help from staff assigned to respond to workplace violence emergencies (if any), security personnel (if any), and law enforcement.

• Procedures to develop and provide the training (see training section below).

• Procedures to identify and evaluate workplace violence hazards, including, but not limited to, scheduled periodic inspections to identify unsafe conditions and work practices and employee reports and concerns. Inspections shall be conducted when the plan is first established, after each workplace violence incident, and whenever the employer is made aware of a new or previously unrecognized hazard.

• Procedures to correct workplace violence hazards identified and evaluated in subparagraph (I) in a timely manner consistent with paragraph (6) of subdivision (a) of Section 3203 of Title 8 of the California Code of Regulations.

• Procedures for post-incident response and investigation.

• Procedures to review the effectiveness of the plan and revise the plan as needed, including, but not limited to, procedures to obtain the active involvement of employees and authorized employee representatives in reviewing the plan. The plan shall be reviewed at least annually, when a deficiency is observed or becomes apparent, and after a workplace violence incident.

• Procedures or other information required by the division and standards board as being necessary and appropriate to protect the health and safety of employees, pursuant to subdivision (h).

WVPP Training Requirements

Employers are required to provide effective training to employees, which must include training material appropriate in content and vocabulary to the educational level, literacy, and language of employees.

Employers must provide employees with initial training when the plan is first established, and annually thereafter, on all of the following:

• The employer’s plan, how to obtain a copy of the employer’s plan at no cost, and how to participate in development and implementation of the employer’s plan.

• Specified WVPP term definitions and requirements of the WVPP law.

• How to report workplace violence incidents or concerns to the employer or law enforcement without fear of reprisal.

• Workplace violence hazards specific to the employees’ jobs, the corrective measures the employer has implemented, how to seek assistance to prevent or respond to violence, and strategies to avoid physical harm.

• How to obtain copies of workplace violence incident reports, logs, and records.

• An opportunity for interactive questions and answers with a person knowledgeable about the employer’s plan.

Additional training must be provided when a new or previously unrecognized workplace violence hazard has been identified and when changes are made to the plan. The additional training may be limited to addressing the new workplace violence hazard or changes to the plan.

WVPP Recordkeeping Requirements

The employer is required to record information in a violent incident log for every workplace violence incident based on information solicited from the employees who experienced the workplace violence, on witness statements, and on investigation findings. The log must protect personal, identifying, and contact information of any person involved in the incident.

The information recorded in the log shall include all of the following:

• The date, time, and location of the incident.

• The workplace violence type or types, as specified in the law.

• A detailed description of the incident.

• A classification of who committed the violence, including whether the perpetrator was a client or customer, family or friend of a client or customer, stranger with criminal intent, coworker, supervisor or manager, partner or spouse, parent or relative, or other perpetrator.

• A classification of circumstances at the time of the incident, including, but not limited to, whether the employee was completing usual job duties, working in poorly lit areas, rushed, working during a low staffing level, isolated or alone, unable to get help or assistance, working in a community setting, or working in an unfamiliar or new location.

• A classification of where the incident occurred, such as in the workplace, parking lot or other area outside the workplace, or other area.

• The type of incident, including, but not limited to, whether it involved any of the following:

» Physical attack without a weapon, including, but not limited to, biting, choking, grabbing, hair pulling, kicking, punching, slapping, pushing, pulling, scratching, or spitting.

» Attack with a weapon or object, including but not limited to a firearm, knife, or other object.

» Threat of physical force or threat of the use of a weapon or other object.

» Sexual assault or threat, including but not limited to rape, attempted rape, physical display, or unwanted verbal or physical sexual contact.

» Animal attack.

» Other.

• Consequences of the incident, including but not limited to:

» Whether security or law enforcement was contacted and their response.

» Actions taken to protect employees from a continuing threat or from any other hazards identified as a result of the incident.

• Information about the person completing the log, including their name, job title, and the date completed.

Training records shall be created and maintained for a minimum of one year and include training dates, contents or a summary of the training sessions, names and qualifications of persons conducting the training, and names and job titles of all persons attending the training sessions.

All training, the violent incident log, and investigation documents shall be made available to employees and their representatives, upon request and without cost, for examination and copying within 15 calendar days of a request.

A Few Exceptions to the Rule

There are few exceptions to the WVPP requirement for California employers. Employer WVPP provisions do not apply to employers already covered by California’s existing workplace violence prevention standard for human healthcare, employees working outside the place of business from a location of their own choice (“teleworking”) that is not under the

employer’s control, places of employment where there are fewer than 10 employees working at the place at any given time and that are not accessible to the public, and a few other small exceptions (mostly in the public sector). This means that essentially all veterinary practices in California are subject to the WVPP legal mandate.

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.

Does your practice have a Written Safety Plan? The CVMA Online Guide to Cal/OSHA Compliance is only available to CVMA members and is specifically created for California veterinary practices.

• 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

• Important notifications and updates

• Online access to the guide

• Regulatory and tech support

• NEW FOR 2024! A Workplace Violence Prevention Plan (WVPP), which is required for all California employers and includes incident response logs and records, employee training, and other components

Welcome, New CVMA Members!

Veterinarian

Dr. Charley Abernathy

Dr. Kristen Anderson

Dr. Lucy Anthenill

Dr. John Araujo

Dr. Heather Aubrey

Dr. Baljinder Singh

Dr. Rachel Beck

Dr. Michelle Beehler

Dr. Sara Caraballo

Dr. Karyn Carlson

Dr. Damanjeet Chadha

Dr. Edward Cheng

Dr. Jinyeung Choi

Dr. Johnny Chretin

Dr. Nycole Cole

Dr. Shea Cox

Dr. Sameh Dawoud

Dr. Manjinder Dhaliwal

Dr. Ashvin Dhankhar

Dr. Kanwarbir Dhillon

Dr. Cheyenne Dingemans

Dr. Peter Dowell

Dr. Grant Dunbar

Dr. Cynthia Edelman

Dr. Elizabeth Engall

Dr. Lincoln Every

Dr. Scott Fetherston

Dr. Drew Fleischman

Dr. Christine Gerst

Dr. Dana Gilliam

Dr. Emmalena Gregory-Bryson

Dr. Vikas Godara

Dr. Cory Hanks

Dr. Stephen Hanson

Dr. Paul Heimlich

Dr. Lauren Heit

Dr. Suzanne Hennessy

Dr. Heidi Hilleary

Dr. Lauren Hobstetter

Dr. Jennifer Hu

Dr. Michael Hung

Dr. Victoria Impett

Dr. LeAnne Jain

Dr. Vikas Jaglan

Dr. Daman Jairath

Dr. Ambreen Jassal

Dr. Keith Jenne

Dr. Kevin Jepsen-Grant

Dr. Michelle Jobert

Dr. Holly Jordan

Dr. Heylim Kang

Dr. Alexander Kanholm

Dr. Aida Kasaei Roodsari

Dr. Subash Kethavath

Dr. Jennie Kim

Dr. Briana Konigsberg

Dr. Nilanthi Kulasekara

Dr. Ratul Kumar

Dr. Fred Li

Dr. Yin Yin Lo

Dr. Amy Lowe

Dr. Christine Lundy

Dr. Elizabeth MacDonald

Dr. Arlene McKinstry

Dr. Melody McLaughlin

Dr. Lindsey Meyer

Dr. Aleisha Michael

Dr. Kaitlin Mielnicki

Dr. Stephanie Morrow

Dr. Fernando Najera

Dr. Ashley Navarrette

Dr. Mark Nichols

Dr. Gabrielle Nosewicz

Dr. Rebecca Nostrand

Dr. Jennifer Osborne

Dr. Stephanie Paclot

Dr. Vidhya Pandi

Dr. Veda Penta

Dr. Cecile Ramsies

Dr. Morgan Renaud

Dr. Mehrdad Rezvan

Dr. Jennifer Riedel

Dr. Deborah Rivenburgh

Dr. Lillian Rizzo

Dr. Rachel Rowen

Dr. Harpreet Sekhon

Dr. Lauren Silverman

Dr. Megan Sisson

Dr. Kimberly Soderholm

Dr. Katy Sommers

Dr. Beth Sperka

Dr. Bonnie Stone

Dr. Ana Suarez Gonzalez

Dr. Luzette Suau

Dr. Katherine Sunderland

Dr. Katherine Tucker-Mohl

Dr. Justin Uhl

Dr. Gabriella Varcoe

Dr. Debra Voulgaris

Dr. Lynnette Waugh

Dr. Geoffrey Wisbrock

Dr. Matthew Wooddall

Dr. William Woodley

Dr. Audrey Yu-Speight

Dr. Alexandra Zierenberg Ripoll

Dr. Dawn Zimmerman

Veterinarian Faculty

Dr. Christopher Impinna

Dr. Jayne Sykes

Veterinarian Public Service

Dr. Eline Britz

Dr. Sarah Cadwell

JOIN YOUR COLLEAGUES AND BECOME A CVMA MEMBER TODAY!

Veterinarian 1st Year

Graduate

Dr. Aryan Behzadi

Dr. Sophie Biencourt

Dr. Ashlyn Brewster

Dr. Sean Calalang

Dr. Jessica Callisher

Dr. Ashlyn Davis

Dr. Chloe Eaton

Dr. Theresa Frey

Dr. Xuke Ji

Dr. Suzanne Kraciuk

Dr. Teresa Le

Dr. Johana Maldonado-Ross

Dr. Audrey Marzan

Dr. Elisabeth Regusci

Dr. Maria Rodriguez

Dr. M. Lanae Rothe

Dr. Taylor Rudeen

Dr. Cody Sorce

Dr. Ashley Sujata

Dr. Ashley Turi

Dr. Myung-Won Seo

Dr. Daryon Smith

Dr. Brooke Weinstein

Veterinarian 2nd Year

Graduate

Dr. Claire Akashi

Dr. Maddisen Antes

Dr. Viviana Banuelos

Dr. Danielle Duron

Dr. Lisa Gale

Dr. Rachel Hanford

Dr. Nicolle Iacobacci

Dr. Dory Meraz

Dr. Lauren Nakonechny

Dr. Brooke Niederhauser

Dr. Anna Pheils

Dr. Jacqueline Sankisov

Dr. Audra Stepp

Veterinarian 3rd Year

Graduate

Dr. Marni Ackernecht

Dr. Marilyn Bane

Dr. Taurine Burger

Dr. Ericka Erickson

Dr. Han Goh

Dr. Emily Green

Dr. Stephanie Kuo

Dr. Emily Mocarski

Dr. Allan Pallarca

Veterinarian 4th Year

Graduate

Dr. Nathan Howlett

Dr. Hannah Ivers

Dr. Chloe Petauton

Dr. Amanda Thaler

Registered Veterinary Technician

Cassidy Abrahamson, RVT

Lynne Adelman, RVT

Catherine Allen, RVT

Mayra Amezquita, RVT

Ruby Arciga, RVT

Jessica Arndt, RVT

Carrie Atkinson, RVT

Erin Berringer, RVT

Katheryn Bessey, RVT

Shaina Black, RVT

Karen Bowman, RVT

Melissa Brown, RVT

Amber Buechle, RVT

Christopher Byrd, RVT

Kerin Calderon, RVT

Isabelle Campuzano, RVT

Angela Chan, RVT

Natasia Chica, RVT

Danielle Coutinho, RVT

Laura Craig, RVT

Lisa Darragh, RVT

Katelyn Davey, RVT

Luis De La Cruz Jr., RVT

Sonja Ebata, RVT

Amelia Eggers, RVT

Sarah Elias, RVT

Aletta Enge, RVT

Stephanie Fasone, RVT

Elizabeth Flores, RVT

Kayla Fok, RVT

Heather Frias, RVT

Santana Garcia, RVT

Brenda Gonzales, RVT

Jaime Goodpasture, RVT

Hailey Groover, RVT

Marybell Guzman, RVT

Jeanette Hanneman, RVT

Paige Hansen, RVT

Gabrielle Hernandez, RVT

Melissa Hulgreen, RVT

Cindy Jaime, RVT

Liliana Jimenez, RVT

Kimberly Jones, RVT

Laura Kenny, RVT

Brittany King, RVT

Sara King, RVT

Codey Kraft, RVT

Diana Lapop, RVT

Phoenix Liu, RVT

Bertha Machado, RVT

Leticia Malacara, RVT

Catharine Malone, RVT

Joline Manikowski, RVT

Maiya Manor, RVT

Madeline Marschak, RVT

Katerina Matias, RVT

Cody Matthes, RVT

Megan McLeod, RVT

Suzanne Mead, RVT

Andrea Morales, RVT

Ashlee Morgan, RVT

Danielle Munger, RVT

Summer Oliver, RVT

Tiphany Parker, RVT

Kristi Perales, RVT

Lisa Perry, RVT

Katherine Pope, RVT

Jay Porter Zucker, RVT

Mariah Raymundo, RVT

Jennifer Reed, RVT

Yessica Rios, RVT

Sarah Rodrick, RVT

Caroline Rose, RVT

Lacey Roy, RVT

Michael Ruggiero, RVT

Dominique Russo, RVT

Meredith Sachs, RVT

Briana Scocca, RVT

Jacqueline Simon, RVT

Melina Stambolis, RVT

Katherine Thierry, RVT

Victoria Udall, RVT

Alyssa Valderrama, RVT

Claudia Varguez, RVT

Juliette Veenstra, RVT

Alyssa Woodyard, RVT

Danae Yoshikawa, RVT

Kathleen Zerkle, RVT

CVMA Certified Veterinary Assistant

Molly Azevedo, CVMA CVA

Wendy Camargo, CVMA CVA

Evelyn Cantoran, CVMA CVA

Rachel Correa, CVMA CVA

Wendy Crews, CVMA CVA

Katrina Hall, CVMA CVA

Samantha Kerr, CVMA CVA

Kristine Schultz, CVMA CVA

Nicole Spragg, CVMA CVA

Jessie Talingo, CVMA CVA

Veterinary Hospital Staff

Carlos Echeagaray

Tania Hayes

Gregory Hughes

Rebekah Martinez

Tonya Tidwell

Jathniel Wright

2024 California Legislative Update

The CVMA legislative team is following approximately 40 bills that impact the veterinary profession, animal health and welfare, or general business practice in California during this year’s legislative session. In March, the CVMA Legislative Committee, co-chaired by Drs. Brent Wooden and Dayna Wiedenkeller, established recommended bill positions for consideration by the CVMA Board of Governors. As the ultimate deciding body in the CVMA, the Board of Governors took official positions on bills in late March, which are reflected in the bill chart on page 16.

Currently, both Assembly and Senate bills are making their way through policy and appropriations committees in their respective houses of origin. The CVMA’s lobbyist and leaders are attending bill hearings and testifying at the Capitol, writing position letters, and meeting with legislators, legislative staff, and committee consultants to effectively represent the veterinary profession on a number of critical bills.

High-priority bills this year are:

SB 1233 (Wilk) University of California: veterinary medicine: spay and neuter techniques.

CVMA-Sponsored Bill

CVMA Position: SUPPORT

Current Bill Status: Awaiting Review in Senate Appropriations

To help address pet overpopulation issues, the CVMA is sponsoring SB 1233 (Wilk) to create High-Quality, HighVolume Spay-Neuter (HQHVSN) certification programs at both of California’s veterinary schools: the Western University of Health Sciences in Pomona, and the University of California, Davis. The bill seeks to provide HQHVSN elective certification courses for qualified California veterinary students, as well as for veterinarians and registered veterinary technicians (RVTs) in private practice. The certification programs will teach respective roles, tasks, and techniques in an HQHVSN environment.

Students enrolled in the certification course will learn HQHVSN surgical techniques in addition to the assembly-line/team approach principles of HQHVSN. Students and veterinarians will be required to successfully complete a set number of surgeries using HQHVSN techniques to earn their certificate. Licensed veterinarians and RVTs who complete the program will earn continuing education credit in addition to their certificate. RVTs will not be authorized to perform surgery under the terms of this bill, but will instead be trained in surgical preparation, assisting, and recovery skills. Veterinary students will be able to take the certification courses for free, while licensees will pay a nominal fee. The spay and neuter surgeries will be provided at either no cost or at a low cost to qualified dog and cat owners, based on financial need. Each school will have the ability to structure its own program in accordance with HQHVSN best practices, available facilities, resources, and staff.

The CVMA recognizes the need to sponsor legislation to alleviate California’s pet overpopulation epidemic. Accordingly, this bill provides short-term and long-term solutions to the issue of dog and cat sterilization by not only creating two large HQHVSN centers in Northern and Southern California, but also by better equipping the veterinary workforce with the knowledge, skill, and ability to safely and efficiently perform HQHVSN surgeries.

AB 3029 (Bains) Controlled substances.

SB 1502 (Ashby) Controlled substances: xylazine.

CVMA Position: SUPPORT

Current Bill Status: Awaiting Review in respective Appropriations Committees

Both of these bills aim to add xylazine to the Schedule III category of the State of California controlled substances list to help reduce the illicit use of xylazine among human substance abusers. Xylazine, also known as “tranq” in the illicit drug trade, is commonly combined with fentanyl and taken by drug abusers. The physiologic ramifications of these drugs in humans can be lethal, and thus California is taking steps to limit the availability of xylazine to anyone other than a licensed

veterinarian who is using it for legitimate veterinary medical practices. Xylazine is a commonly used sedative among livestock, equine, and wildlife veterinarians and is also utilized by animal control officers in the field who administer it under veterinarian direction. The CVMA is working closely with both authors to help ensure that veterinarian access to xylazine is maintained following the transition of xylazine becoming a scheduled drug.

AB 2954 (Carrillo) Cats: declawing procedures: prohibition.

CVMA Position: OPPOSE

Current Bill Status: Withdrawn by Author, Potentially Awaiting Review

This bill will be the seventh attempt by animal rights activists to ban cat declawing in the California state legislature. Currently, California law prohibits the declawing of exotic large-breed cats, but this bill will expand the prohibition to include domestic cats. The CVMA has historically opposed legislation banning cat declawing on the grounds that veterinarians should have the freedom to choose, on a caseby-case basis and in conjunction with client discussion, whether or not a declaw surgical procedure is warranted. In addition, the veterinary profession has done an outstanding job of regulating itself regarding the performance of this surgical procedure. It is performed rarely and with far less frequency than in past decades. It is not taught in either of California’s veterinary schools, and several large corporate veterinary hospital groups have policies that eliminate declawing as an option for clients. In addition, veterinarians routinely counsel clients on alternatives to declawing, and work to educate clients on cat behavior and environmental and management needs. Consequently, the CVMA does not see the need for legislation that will criminalize licensed veterinarians who may seldom perform the procedure based on situations that arise with clients. As of this writing, the author has withdrawn this bill from committee hearing and presently it is unclear if the bill will be continuing in this year’s legislative session.

AB 2133 (Kalra) Veterinary medicine: registered veterinary technicians.

CVMA Position: OPPOSE

Current Bill Status: Awaiting review in Assembly Appropriations

This bill seeks to permit registered veterinary technicians (RVTs) to perform surgery specifically to neuter cats. While the CVMA appreciates the valuable service that RVTs contribute to the veterinary profession, there is significant concern that the RVT licensing curriculum does not include subject material that qualifies them to perform surgery. In addition, veterinarians are not reporting that they have difficulty in meeting the demand for cats to be neutered in their practices. The CVMA supports current California law, which specifically restricts diagnosing, prognosing, prescribing, and surgery to licensed veterinarians. The CVMA Board of Governors took an early

opposition position to this measure, joined in that position by the American Veterinary Medical Association (AVMA).

SB 1478 (Nguyen) Veterinary medicine: registered veterinary technicians.

CVMA Position: WATCH

Current Bill Status: Awaiting review in Senate Appropriations

This bill will add specific language to existing law that better defines the written protocols which must be established by shelter veterinarians for RVTs to follow when managing animals in shelters. The protocols include time periods by which an impounded animal must be assessed at intake and monitored while in the custody of the agency; protocols to address the treatment of common medical conditions that are encountered in animals and for controlling infectious and zoonotic diseases, controlling acute pain, and preventing environmental contamination; communication requirements between the registered veterinary technician and the supervising veterinarian; and euthanasia criteria for medically related cases. The CVMA has been in communication with the author as well as with several shelter veterinarians and other stakeholders and will continue to closely monitor this bill as it makes its way through the legislative process.

2024 Legislative Calendar

May 24

June 15

July 3

August 23

August 31

September 30

Last day for bills to pass out of the house of origin

Budget bill must be passed by midnight

Last day for policy committees to meet and hear bills

Last day to amend bills on the Floor (general session)

Last day for each house to pass bills

Last day for governor to sign or veto legislation

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.

Priority Bills

Bill # Author Title CVMA Position

SB 1233 Wilk

AB 2133 Kalra

University of California: veterinary medicine: spay and neuter techniques. Sponsor/Support

Veterinary medicine: registered veterinary technicians. Oppose

AB 2954 Carrillo Cats: declawing procedures: prohibition. Oppose

AB 3029 Bains

Controlled substances. Support

SB 1502 Ashby Controlled substances: xylazine. Support

SB 1478 Nguyen Veterinary medicine: registered veterinary technicians. Watch

Other Bills

AB 1902 Alanis Prescription drug labels: accessibility. Watch

AB 1983 Maienschein Income taxes: voluntary contributions: Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund. Watch

AB 1988 Muratsuchi Stray animals: availability for adoption or release. Watch

AB 2006 Mathis Sales and Use Tax Law: exemption: over-the-counter medication. Watch

AB 2012 Lee Rabies control data. Watch

AB 2216 Haney Tenancy: common household pets.

Watch

AB 2248 Maienschein Contracts: sales of dogs and cats. Watch

AB 2265 McCarty Animals: spaying, neutering, and euthanasia. Watch

AB 2269 Flora Board membership qualifications: public members. Disapprove, Seek Infomation

AB 2425 Essayli Bowie’s Law: animals: adoption, shelter overcrowding, and breeding. Watch

AB 2445 Wallis Prescriptions: personal use pharmaceutical disposal system. Oppose Unless Amended

AB 2481 Lowenthal Social media-related threats: reporting. Watch

AB 2640 Kalra Pupil instruction: animal dissection. Watch

AB 2761 Hart/Lowenthal Product safety: plastic packaging: Reducing Toxics in Packaging Act. Watch

UNBACKED NO AUTHOR Budget Trailer Bill: CURES fee increase. Watch

AB 2964 Hart Crimes: animal cruelty. Watch

AB 3053 Kalra State-supported fairs: exhibits: regulations. Disapprove Unless Amended

AB 3063 McKinnor Pharmacies: compounding. Support

SB 902 Roth/Portantino Firearms: public safety. Watch

SB 921 Roth Animal welfare. Approve

SB 922 Roth Animal cruelty. Approve

SB 1067 Smallwood-Cuevas Healing arts: expedited licensure process: medically underserved area or population. Watch

SB 1093 Padilla Vehicle equipment: tires. Watch

SB 1217 Glazer Pet insurance. Watch

SB 1345 Smallwood-Cuevas Employment discrimination: criminal history information. Disapprove

SB 1358 Nguyen Rabies control data. Watch

SB 1459 Nguyen Animal shelters: veterinarians. Watch

CVMA Fall Seminar

Calling all veterinarians, RVTs, and CVMA CVAs: Come explore world-class CE and the gorgeous coastline of San Diego at the CVMA’s Fall Seminar!

Spend your mornings earning up to 12 CEUs and attending illuminating lectures presented by two of the brightest minds in veterinary medicine. Spend your afternoons unearthing the beauty of San Diego. Take your pick between dozens of nearby beaches, tour the Craft Beer Capital of America, and enjoy the vibrant, relaxing San Diego culture. Whether you’re up for an adventure or seeking out a refuge to relax and recharge, there’s no better place for CE than the CVMA Fall Seminar! Beautiful Beaches, Sunshine, and High-Quality

Topic: Dermatology (6 CEUs)

Valerie Fadok, DVM, Ph.D., DACVD

Sponsored by:

Registration for the CVMA Fall Seminar opens soon. Watch for email notifications or visit the Continuing Education tab at cvma.net for the latest updates.

Your Veterinary Premises Has Water Damage: How

Would You Respond?

By Adam DeCarolis, PharmD Life Science Risk Control Consulting Director; John Mizurak, RRE, CRIS, Small Business Risk Control Consulting Director; Bret Martin, PE, CSP, CFPS, CHFM, CHE, CLSS-HC, Assistant Vice President, Property Risk Control, CNA Insurance

Water can destroy medical equipment, computer/phone systems, records, and supplies, and may cause significant damage to the walls and floors of your clinic. According to CNA Insurance claims data for veterinary clinics from 2017 to 2022, 21% of all claims have been related to water damage.

Many policyholders feel hesitant to file an insurance claim because they believe their premiums for coverage may increase. Some business owners would rather pay the claim themselves, but there are many questions to consider. Do you have that money readily available, or would you have to wait a few weeks to build up the cash reserves to pay? What are you going to do to make up for the loss of income because of the claim? What proportion of the operation’s output was impacted? What if seemingly innocuous water damage is more serious than you thought and leads to latent damage? All these variables and more must be carefully considered before you make this allimportant business decision.

Actions to consider when filing a claim:

a. File your claim so your carrier can complete your damage assessment as soon as possible.

b. Protect the property to prevent further damage.

c. Document the damage and provide complete and accurate information to the adjuster.

d. Secure accurate repair and replacement estimates from a

reputable contractor, and be sure to verify the contractor’s insurance.

e. Expediting repairs will enable you to resume operations in a timely manner.

Once you have all the facts and figures, filing a claim with your carrier and having the adjuster determine the cost of the claim and the possibility of latent damage (e.g., mold damage) will give you a better idea of how to proceed with getting your damages repaired and your business back up and running.

A solution for preventing, mitigating, and responding to water-related events involves leveraging internet-enabled sensing devices, commonly known as Internet of Things (IoT) devices. These devices possess the capability to detect causes of potential water claims such as freezing, leaks, flow irregularities as well as high/low temperatures, humidity, and power interruption. Upon detecting any irregularity, these devices send alerts to your phone or email, enabling you to respond promptly. Furthermore, some devices are equipped to take automated actions on your behalf. Early action usually reduces the size of a potential claim. They also can monitor refrigerator and freezer temperatures for medication storage. For more information about CNA’s allied vendor, please visit https://www.alertlabs.com/ pages/cna or the Alert Labs FAQ.

Additionally, it is important to consider the potential impact of a water release in your clinic and develop continuity plans in advance. Identify critical equipment (e.g., servers, computers, and X-ray equipment) that may be impacted and understand the time and cost to repair/replace water-damaged items. This will enable you to develop equipment recovery plans with the information needed (e.g., vendor/ contractor information, cost, and lead time estimates) to quickly restart your clinic’s operations.

CNA offers risk control solutions that can help businesses manage property-related exposures and minimize business interruptions. CNA’s dedicated website for Water Damage Mitigation (https://www.cna.com/web/guest/ cna/risk-control/prepwise/water-damage) includes reference documents for Water Damage Preparation, Water Damage Incident Response, and Water Damage Technology Solutions. There are also resources for Business Resiliency Planning, Winter Weather Preparation, and Hurricane Preparation, all of which can help prepare your veterinary clinic for water damage events.

The information, examples and suggestions presented in this material have been developed from sources believed to be reliable, but they should not be construed as legal or other professional advice. CNA accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situations. This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. “CNA” is a registered trademark of CNA Financial Corporation. Certain CNA Financial Corporation subsidiaries use the “CNA” trademark in connection with insurance underwriting and claims activities. Copyright © 2024 CNA. All rights reserved.

Counseling? Health Coaching? Life Coaching? What’s Best for Me?

By Anne Massey, MS Nutrition Health Coach

Various life situations call for distinct solutions. Mental health counseling, health and wellness coaching, and life coaching may share similarities; however, they each cater to distinct needs. Determining what's best for you depends on your specific needs and goals.

The distinction between coach and counselor

A coach is a collaborator and accountability partner working with clients to develop and follow a roadmap toward positive change. While health and wellness coaching and life coaching are similar in style, the primary differences are their backgrounds and the topics covered.

You’re likely familiar with mental health counseling services that you can access independently, through your organization’s member assistance program (MAP), or by referral. Mental health counseling sessions focus on improving emotional functioning in present-day life with the counselor as an expert who provides direction, guidance, and professional clinical recommendations. Counselors help clients feel better; coaches help clients do better.

Health and wellness coaching

Health and wellness coaches focus on helping individuals make lifestyle changes to improve their physical health and wellbeing. They can assist with weight management, nutrition, exercise, stress or sleep management, and other healthrelated goals. Health coaching is suitable if you have health and wellness goals and need guidance and accountability to achieve them. Some examples of situations that are appropriate for health and wellness coaching include:

• Guidance for those who desire to reach healthy weight goals without the use of traditional or restrictive diets

• Direction for those who desire to improve eating or exercise habits

• Support for people with concerns about diabetes because of family history or other reasons

• Strategies for those who want to quit the use of tobacco and/or nicotine products

• Help with developing healthy stress coping skills and implementing proven techniques

• Tips on improving sleep quality

• Self-care practices to achieve personal wellbeing

Life coaching

Life coaches work with individuals to help them set and achieve personal and professional goals. They can provide support, motivation, and strategies for improving various aspects of life, such as career, relationships, and personal development. Life coaching is ideal if you're looking to make positive changes, set and achieve goals, and enhance your overall life satisfaction.

What types of situations are appropriate for life coaching?

• Developing industry relevant skills

• Planning for a career change

• Adapting to a new life (a new normal) after a loss

• Starting or finishing a project at work or a personal project at home

• Creating greater balance by learning how to manage competing life priorities

Mental health counseling

Mental health counselors can provide guidance and support for immediate concerns, but the scope may be limited compared to long-term therapy.

What types of situations are appropriate for mental health counseling?

• Emotional distress, pain, or a history of trauma that is affecting daily life functioning

• A mental health diagnosis requiring treatment, or if already in treatment, an unmanaged mental health disorder

• Unmanaged depression, anxiety or grief

• Suicidal or homicidal ideation

• Violence or abuse

• Work with couples or families

Note that counseling delivered to you through your organization, such as MAP counseling, is typically a short-term, solutionfocused therapy to help employees or members address personal or work-related issues. It is ideal if you are facing specific challenges like anxiety, relationship issues, or workplace difficulties.

To decide what's best for you, consider your current situation and objectives. If you're dealing with specific emotional or work-related issues, mental health counseling may be the right choice. If you have health-related goals, a health and wellness coach could help you. If you're seeking to make broader life improvements to achieve personal and professional goals, a life coach might be the best fit.

Keep in mind that health and wellness coaching and life coaching are not counseling or therapy; it is not a substitute for mental health counseling or treatment. If you are coping with mental health issues, call your organization’s assistance program to speak to a counselor who can offer you support.

SPONSORED BY: © TELUS Health 2024

TELUS Health (formerly LifeWorks) is the CVMA’s Member Assistance Program. This complimentary member benefit offers confidential consultations, information and resources about work-life/wellbeing, connections to community agencies and supports, and referrals to counseling. If you are a CVMA member, you should have received an email invitation to join TELUS Health (or LifeWorks). If you have not received the email, please contact Jennifer Smith at jsmith@cvma.net.

Now You ‘C’ It, Now You Don’t: Defining the Client in the VCPR

By Stephen Marmaduke, Wilke Fleury LLP, 2024 Pacific Veterinary Conference Speaker

The Veterinarian-Client-Patient Relationship, or “VCPR,” is the Holy Grail of the practice of veterinary medicine. Business and Professions Code section 4826.6(a) definitively states that a “veterinarian shall not prescribe, dispense, or administer a drug, medicine, application, or treatment of whatever nature for the prevention, cure or relief of a wound, fracture, bodily injury, or disease of animals unless a veterinarian-client-patient relationship exists.” Simply put, with limited exceptions, a veterinarian cannot practice veterinary medicine without a VCPR. Although the “P” and the “V” of this relationship are clear, the “C” was not previously defined by statute or regulation. Effective January 1, 2024, Section 4826(a) provides some clarity as it defines the “Owner” as the “Client,” but it also creates ambiguous situations.

Prior to the passage of AB 1399 in 2024, California Code of Regulations Title 16, section 2032.1 was California’s VCPR law. It enumerated the requirements to establish a VCPR and provided that the client was the person (a) who authorized the veterinarian to make medical judgments regarding the care of the animal, and (b) with whom the veterinarian communicated about the condition being diagnosed and treated. Since the regulation did not mention ownership of the animal as a factor in determining “Client” status, it was implied that the individual who presented the animal for care and asserted that they had the responsibility for the animal was, in fact, the “Client.” This loosely defined process provided the practitioner flexibility to exercise judgment. Unless the veterinarian had reason to question the ostensible authority of the person presenting the animal for care, they could be relatively comfortable that the “C” component was satisfied.

Assume a breeder, who is not a dog’s owner, rushes the dog to the breeder’s veterinarian, who recommends and performs an emergency cesarian section. The dog’s owner calls the veterinarian for a status report and is advised by the veterinarian’s office that they will not speak to her despite her accurate claim of ownership of the animal. The breeder had asserted herself as the person in charge of the dog’s health and, prior to January 1, 2024, was the “Client.” Arguably, the disclosure of information to the owner would have been a violation of the privacy rules of Business and Professions Code section 4857, which provides that the veterinarian shall not disclose any information concerning the animal patient without the

written or witnessed consent of the “Client,” who in this case is the breeder. Effective January 1, 2024, Business and Professions Code section 4825.1 defines the “Client” as the “individual or individuals who represent that they are the owner or owners of the animal patient at the time that the services are provided” (emphasis added). This places an affirmative burden on the treating veterinarian to determine that the “Client” is the “Owner” of the animal.

How far does the veterinarian have to go to confirm ownership?

Animal ownership is rarely documented. In many instances, ownership of an animal is not transferred by a bill of sale, an ownership certificate, or a title document. Even an American Kennel Club registration, although indicative of ownership, is not proof of ownership. Unless there are facts that raise suspicion, a veterinarian should be able to accept an affirmative representation of ownership. If the veterinarian has information to the contrary, however, the veterinarian has a duty to perform a reasonable follow-up to better determine who the client actually is. It is most important that the medical records supporting the establishment of the VCPR also support the basis for determining the identity of the Client.

As of January 1, 2024, there is the additional question of agency. Business and Professions Code section 4826.6 expressly provides that the “Client,” who by definition is the “Owner,” may authorize an agent to act on their behalf for purposes of authorizing the veterinarian to assume responsibility for medical judgments and communicate with the veterinarian to establish a VCPR and approve a medical plan. While not expressly required by law, it is best that this agency appointment be in writing. An agency relationship, however, may be established orally or may be implied in fact. Thus, the establishment of the “C” in the VCPR may return to the reasonable judgment of the veterinarian regarding the nature of the agency relationship. Again, it is of paramount importance that the basis for this determination be included in the medical records.

The owner does not have to be physically present to establish a VCPR, authorize care, or appoint an agent. These acts can be taken telephonically or electronically and should be documented in the records.

Defining the owner and the “C” creates some practical issues. Consider:

• Neighbor/pet sitter – A neighbor or pet sitter presents the animal for care for a new condition that you have not treated before in this patient. You have a long-time relationship with the owner and are confident that you know what action the owner would instruct you to take. The owner is out of the country and cannot be reached. Can you treat the animal? Following the letter of the law, no. The VCPR cannot be established. If the neighbor or pet sitter claims they were provided authority to care for the pet, that may be enough to imply that they were appointed as the owner’s agent. It is not clear and becomes a judgment call.

• Unknown owner – The person presenting the pet claims that they do not know the identity of the owner of the animal, and you have never treated this animal. Business and Professions Code section 4826.6(a) excepts the “C” from the VCPR if the owner is unknown and you may treat the animal. The irony is that you can treat the animal if the owner is unknown, yet you may not be able to treat the animal if you know the owner and have previously treated the animal, but have not established contact with the owner or an agency relationship for purposes of the VCPR for the new condition being treated.

• Breeder/owner – In the breeder/owner scenario referenced on the prior page, the roles are now switched. The breeder could not authorize the cesarian section without an appointment as the owner’s agent. What if the owner could not be reached?

• Minor – The 17-year-old daughter of the owner presents the animal for care. You know the family well. Nevertheless, as she is a minor and does not have the power to contract, she cannot be an agent and cannot authorize treatment even with a note from her parents.

It should be noted that the establishment of a “Client” is not necessary to establish a VCPR for a wild animal. Further, a veterinarian is not required to treat an animal, whether wild or a stray pet, and may send these animals to municipal animal service authorities. And of course, emergency treatment can also be rendered in absence of a “Client.”

The new definition of a “Client” limits but does not eliminate the due diligence of the veterinarian or the exercise of reasonable judgment. The focus should now be on establishing a reasonable understanding of the ownership of the animal and any appointment of an agent to act on the owner’s behalf. Steps to consider implementing include:

• Incorporating affirmative representations of ownership on intake and authorization forms;

• Encouraging the owner to appoint agents to act on their behalf in advance by providing spaces to do so on intake or information forms;

• Offering an agency appointment and authorization form to owners;

• Including in authorization forms that agents may both authorize treatment and commit the owner to pay the charges associated with that treatment;

• Contacting the owner whenever an animal is presented for care by someone other than the owner;

• When not reasonably assured that the individual presenting the animal is the owner or an authorized agent, declining to treat the animal; and

• Routinely documenting in the medical record the establishment of the “C” in the VCPR by specifying the name of the person who presents the animal for care, and retaining additional documentation if the person is a client (owner) agent.

In summary, defining the “Client” to be the “Owner or Owners” of the animal focuses the scope of the inquiry to determine if the individual requesting medical services has standing to establish a VCPR. The veterinarian must continue to use reasonable diligence in determining this status. Further, and perhaps most importantly, the veterinarian must continue to document the medical files to support that the VCPR was reasonably established.

Stephen Marmaduke is of counsel at the Sacramento law firm of Wilke Fleury, LLP. His experience includes legal issues related to veterinary practices, employment law, and general business matters. Steve Marmaduke will be presenting on Laws and Regulations in the Workplace at the Pacific Veterinary Conference on Sunday, July 14.

Inn ovation . I n p ract ic e.

Surgical Removal of Linear Foreign Bodies in Dogs and Cats

By Stephen Birchard, DVM, MS, DACVS 2024 Pacific Veterinary Conference Speaker

Linear intestinal foreign bodies are common in dogs and cats and can be life-threatening. Besides causing intestinal inflammation and obstruction, they can also cause multiple perforations at the mesenteric aspect of the bowel. Linear foreign bodies, such as string, fabric, and towels, can involve only a few bowel loops or extend from the stomach to the colon. If perforation has occurred, the animal will develop septic peritonitis and rapidly deteriorate. Therefore, surgery to remove linear intestinal foreign bodies should be considered urgent.

Diagnosis

Animals with this type of foreign body usually present with acute vomiting and, in some cases, diarrhea. Lethargy and dehydration are common. Clinical signs are much more severe if septic peritonitis is present and can include abdominal pain, fever, and evidence of septic shock. Examination of the mouth in cats and, less commonly, dogs may reveal a string wrapped around the base of the tongue. Strings or other linear material may be seen protruding from the rectum. If a string is found around the tongue and coming out of the rectum, do not attempt to pull the string from either end.

Plain film abdominal radiographs show varying degrees of dilation and plication of the small intestine and, in some cases, bunching of the bowel in the abdomen. Ultrasound can confirm the presence of the foreign body and plicated bowel and may also reveal peritoneal fluid that can be sampled and analyzed cytologically. Ultrasound is superior to plain film radiography in diagnosing small intestine obstruction.1 Only 50% of dogs with linear foreign bodies showed intestinal dilation in that study.1

Treatment

Preoperative management of animals with intestinal foreign bodies involves intravenous fluid and electrolyte therapy, antibiotics, and other supportive care measures as needed. A string around the tongue should be cut and released to allow it to move into the stomach. Do not try to pull a string out of the mouth unless abdominal radiographs are normal, a very short amount of string is suspected, and a needle or other solid object is not attached to the string. A string can rarely be removed by pulling from the mouth.

Surgery

Induce and maintain general anesthesia and approach the abdomen via a ventral midline incision. After a thorough abdominal exploratory, identify the affected areas of the GI tract (Fig. 1). Strings in cats are usually present in the stomach and intestine. If so, begin with a gastrotomy to remove that portion of the string. Gently pull the foreign body through the gastrotomy to remove the intestinal portion. If that is not possible, remove as much as possible, cut the string, and close the gastrotomy. Remove the

remainder of the string through one or more enterotomy incisions.

After removal of the gastric portion of the foreign body, perform enterotomy in the middle of the plicated bowel. The entire linear foreign body can often be removed through one enterotomy if you patiently apply gentle traction while gradually releasing the plications of the intestine with your other hand or with the assistant’s help (Fig. 2). Also, before performing the enterotomy, if possible, milk the foreign material into one segment of the intestine to make it easier to remove via a single enterotomy. In an extensive study of dogs and cats with intestinal foreign bodies, multiple incisions in the gastrointestinal tract were one risk factor for higher mortality.2 Use suction and abdominal sponges to prevent peritoneal contamination. Close the enterotomy incision routinely (Fig. 3).

Perform resection and anastomosis of bowel that has been perforated. Do not try to close the perforations; the tissue is not healthy, and normal healing is unlikely. Avoid multiple anastomoses of the bowel. If possible, include all the

Fig. 1: Linear foreign body in the jejunum of a dog exposed via a ventral abdominal approach.

perforations in one resected segment so that only one anastomosis results.

If bowel perforation is present, obtain samples of peritoneal fluid for culture, flush the abdomen with copious amounts of sterile saline, and place a closed suction drain (e.g., Jackson-Pratt drain).

Postoperative Care

After gastrointestinal surgery, continue intravenous fluids until the dog or cat eats and drinks without vomiting. Offer bland flood and water 12-24 hours postoperatively. Although prophylactic antibiotics are indicated before and during surgery, continuing the antibiotic is unnecessary unless there is evidence of incisional infection or peritonitis.

Closely monitor the animal’s temperature and, if elevated, perform abdominal ultrasound to assess for abdominal fluid. If present, obtain a fluid sample and perform cytology. Bacteria in the sample, especially if seen intracellularly in white blood cells and macrophages, indicates septic

peritonitis. Unless peritonitis was already present preoperatively, immediate reexploration of the abdomen should be performed to identify the source of the contamination.

Because of the damage they cause to the intestine, linear foreign-body animals have a guarded prognosis compared to those with non-linear foreign bodies.

The topic of Dr. Stephen Birchard's presentations at the 2024 Pacific Veterinary Conference will be soft tissue surgery in dogs and cats. Attend his sessions in the Small Animal Surgery track in person in San Francisco on Friday, July 12.

References

1. Sharma A, Thompson MS, Scrivani PV, et al. Comparison of radiography and ultrasonography for diagnosing small-intestinal mechanical obstruction in vomiting dogs. Vet Radiol Ultrasound. 2011 May-Jun;52(3):248-55

2. Hayes G. Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases. J Small Anim Pract. 2009 Nov;50(11):576-83.

Dr. Stephen Birchard received his DVM degree from the University of Missouri and completed a surgical residency program at Purdue University. After working in private practice, he taught at Ohio State University for 27 years. Dr. Birchard is the chief editor of the Saunders Manual of Small Animal Practice and is board-certified with the American College of Veterinary Surgeons.

Fig. 2: Removal of the foreign body by an enterotomy in the middle of the affected bowel.

Fig. 3: Enterotomy closure with 4-0 PDS simple continuous pattern.

Your PacVet 2024 Checklist

Register to attend in person OR virtually by July 5.

Reserve your hotel room at the Hilton San Francisco Union Square with a discounted rate before June 19, or until the block fills up—whichever comes first.*

Plot out your CE schedule. You can view the full conference schedule at PacVet.net.

Register for a sponsored lab and/or symposia.*

Plan your visit to the two-day Vet Expo to view the hottest products and services.*

Bring Lady Luck—PacVet offers multiple raffles with valuable prizes!

Download the PacVet app to access conference information from the palm of your hand.

Register to get your rabies titer tested.*

Get ready for fun and CE!

*Applies to in-person attendees only.

PacVet 2024 Schedule at a Glance

THURSDAY, JULY 11, 2024

FRIDAY, JULY 12, 2024

8:00–9:30 AM

7:00–8:00 AM 9:30–9:50 AM

9:50 AM–12:00 PM

12:00 PM–1:30 PM

1:30–3:40 PM

3:40–4:00 PM

4:00–5:15 PM

5:15–7:15 PM

Conference Welcome, Annual Awards, Board of Governors Induction, and Keynote Presentation

Breakfast Break

CE Sessions

Lunch on Your Own OR Sponsored Symposia

CE Sessions

Break

CE Sessions

President’s Reception

SATURDAY, JULY 13, 2024

7:00–8:00 AM

8:00–10:25 AM

10:25–11:00 AM

11:00 AM– 12:00 PM

12:00–1:50 PM

1:50–4:00 PM

4:00–4:30 PM

4:30–5:30 PM

5:30–7:00 PM

5:30–7:00 PM

Breakfast

CE Sessions Break CE Sessions

Lunch and Raffles in the Expo Hall

CE Sessions Break

CE Sessions

Technician Fair

7:00–8:00 AM

8:00–10:25 AM 10:25–11:00 AM 11:00 AM–12:00 PM

12:00–1:50 PM

1:50–4:00 PM

4:00–4:30 PM

4:30–5:30 PM

5:30–7:00 PM

Breakfast CE Sessions

Break/Expo Hall Opens CE Sessions

Lunch and Raffles in the Expo Hall

CE Sessions Break CE Sessions Vet Expo Mixer

SUNDAY, JULY 14, 2024

7:00–8:00 AM

Alumni Receptions Breakfast CE Sessions Break CE Sessions

8:00–10:10 AM 10:10–10:25 AM 10:25–11:25 AM 11:25 AM–12:25 PM 12:25–3:45 PM

Lunch on Your Own CE Sessions

Thank you to our premier sponsors!

Vet Expo 2024 Registered Exhibitors AS

OF APRIL 29, 2024

Make sure to visit our exhibitors’ booths at the Vet Expo from July 12–13!

A&E Medical Systems

Advanced Monitors Corp

American Regent Animal Health

AmeriVet

Analgesic Services, Inc.

Antech

Avant Wellness

Avid Identification Systems

Banfield Pet Hospital

Bank of America Practice Solutions

BCP Veterinary Pharmacy

Bionote

Bird Dog Recruiting & Consulting

Blue Buffalo/Blue Natural Vet

Blue River PetCare

BluePearl Specialty + Emergency Pet Hospital

Boehringer Ingelheim Animal Health USA

California Veterinary Emergency Team (CVET)

California Veterinary Medical Reserve Corps (CAVMRC)

Capstone Financial Group

Cardiac Vet

CareCredit

CaRVTA

Cat and Dog Modern

Christian Veterinary Mission

Clarius Mobile Health

CNA Insurance

Core Imaging

Cubex

Curo Pet Care

DEA Diversion San Diego Field Division

Doctor Multimedia

DragonVeterinary Canada Ltd.

EDGE Life Technologies

Elanco Animal Health

Elite Payment Group

ELvation Medical

Enova Illumination

Epicur Pharma

Esaote North America

Evette

ezyVet

GerVetUSA Inc

GlobalVetLink

Healgen Scientific LLC

Hidow International

Hill's Pet Nutrition, Inc.

Horizon Veterinary Specialists

HRtoGO

Huntington Bank Practice Finance

I3 Commerce Technology

IDEXX

Jorgensen Laboratories

KARL STORZ Veterinary Endoscopy

Koefran Pet Memorial Services

Legally Mine

Lenity Vet Specialists + Emergency Care

Medi Lazer

Medical Pet Shirts International BV

MediLoupes

Merck Animal Health

MiDOG Animal Diagnostics

Mixlab

MWI Animal Health

NectarVet

Newvetequipment.com / Usedvetequipment.com

Nutramax Laboratories Veterinary Sciences, Inc.

Nuvodia

OakVet Animal Specialty Hospital

Omni Practice Group

Otto Trading

Pacific Professionals, Inc.

PawfectNotes

Pawlicy Advisor

Pet Emergency and Specialty Center of Marin

Petco/Vetco

PetSmart Veterinary Services

PetIq

PetVet Care Centers

Preferred Employers Insurance

Probo Veterinary

PS Broker

Purina® Pro Plan® Veterinary Diets

Remedy Veterinary Specialists

Roo

Rose Micro Solutions LLC

Royal Canin

SAGE Veterinary Centers

Schultz Technology

Scratch

Shepherd Veterinary Software

Solutions by Design

Southern Veterinary Partners

Talkatoo.Inc

Tiki Cat Vet Solutions

Tuttnauer USA

U.S. Bank Healthcare Business Banking

UC Davis Veterinary Medical Teaching Hospital

United Veterinary Care

Universal Imaging, Inc.

VCA Animal Hospitals

VDI Laboratory

VDx Pathology

Vetamac

VetBooks By Success Concepts

Vetcor

Veterinary Emergency Group White Plains VQ

Veterinary Insurance Services Company (VISC)

VetnCare

VetriScience

VetRec

VetRoam

Victor Medical Company

Vivos Inc.

WEAVE

Wedgewood

YuMove ADVANCE 360

Zoetis

Zomedica

Give to the California Veterinary Medical Foundation and Support Disaster Response and Veterinary Students

Looking to make a difference? Look no further than the CVMA’s charitable arm, the California Veterinary Medical Foundation (CVMF)! The CVMF maintains a two-pronged mission of supporting the health of animals impacted by disasters and promoting veterinary education through scholarships. The CVMF is funded entirely by donations, so your help is both needed and appreciated! With your support, the CVMF can continue the following efforts:

Disaster Preparedness and Response

Each year, California faces the threat of increasingly intense and destructive wildfires. Due to fire, hazardous air, infrastructural damage, and lack of access to food and water, many animals require medical attention.

The CVMF supports the California Veterinary Medical Reserve Corps (CAVMRC), which provides medical care

to animals impacted by declared states of emergency. The CVMF also maintains a fund to reimburse private practitioners who provide subsidized or no-cost veterinary care to the public during a disaster.

Scholarships for Local Veterinary Students

The CVMF presents annual monetary awards to third and fourth-year students at UC Davis and WesternU’s veterinary schools for their role in leadership and dedication to the human-animal bond. These awards include the CVMF Scholarship Award, the Ron Faoro, DVM Student Scholarship, and the Veterinary Insurance Services Company Scholarship Fund.

Memorial Gift Program

The CVMF’s Memorial Gift Program provides an avenue for veterinarians, family, and friends to honor or memorialize an animal in a meaningful way. It is also a great way

to recognize and honor an outstanding client, friend, or colleague. As with the pet donations, the CVMF will send a personalized letter to the individual advising them of your generosity and thoughtfulness. Your tax-deductible donation to this gift program will help fund the CVMF’s efforts.

Laparoscopy & LOVEspays

1 Devitt C et al. Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. JAVMA. 2005;227:6.

2 Culp W et al. The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs. Vet Surg. 2009;38:811-817.

3 Wooten W. Journal Scan: Are rigid endoscopy and laparoscopy worth the investment? dvm360. July 4, 2017.

KARL STORZ Veterinary Endoscopy

1 S Los Carneros Rd, Goleta, CA 93117 www.karlstorz.com

Dr. LeRoy LeBeuf, a CVMA Life Member, passed away on January 27, 2024. Dr. LeBeuf received his DVM degree from UC Davis in 1958. In the 1970s he opened Kings Canyon Veterinary Hospital in Fresno, which he later transitioned into a non-profit foundation to serve his community. He and others also founded Veterinary Emergency Services, now named 24/7 PetVets.

Dr. Norman Smith, a longtime CVMA member, passed away on February 21, 2024. Dr. Smith graduated from UC Davis with his veterinary degree in 1987. After graduation, Dr. Smith returned to the Morongo Basin to open Companion Animal Clinic, an ambulatory care practice that serviced the High Desert region for nearly 34 years. The CVMA extends our sympathy to the friends and family of those remembered.

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.”

Online Seminars

Update on Antimicrobial Use and Stewardship

Recommendations in Large and Companion Animals

Silene St. Bernard, DVM, DACVPM and Marissa Silva, DVM, MVB, DACVPM

August 13, 2024 | 12:30 PM–2:00 PM (1.5 CEUs)

August 14, 2024 | 5:30 PM–7:00 PM (1.5 CEUs)

This online seminar will cover important updates on antimicrobial use in both large and companion animals, as well as recommendations for antimicrobial stewardship.

Topics that will be discussed include:

• Why antimicrobial stewardship is crucial in veterinary medicine

• Updates on culture and sensitivity reporting

• Updates on stewardship practices and recommendations in large and small animals

• Applying the data to practical use in clinics

This course satisfies the one hour of California CE requirement on the judicious use of medically important antimicrobial drugs.

Register online by visiting the Continuing Education tab at cvma.net or by phone at 800.655.2862.

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.

Perfectionism

June 28, 2024 | 11:00–11:30 AM

SPONSORED BY:

In this course, we will look at the complicated topic of "perfectionism" through a critical eye, discussing the dangers of “being perfect." This session will help participants walk away with real suggestions and strategies on overcoming perfectionism.

Motivate, Recognize, and Energize Employees

July 26, 2024 | 11:00–11:30 AM

This high-energy seminar will help participants create a tool bag of techniques to motivate employees and managers. We will cover self-care, positive psychology, resiliency, laughter and more! This workshop discusses how motivation and recognition leads to increased productivity.

The Art of Giving Feedback

August 23, 2024 | 11:00–11:30 AM

The objective of this course is to teach participants how to give constructive feedback. Topics to be reviewed include the reasons to give someone feedback and why we avoid it. Participants will also learn about an effective feedback model and how to avoid value judgments.

For more information and to register for Telus Health webinars, visit go.telushealth.com/en-us/wellbeing-calendar-2024#june.

Veterinary Medical Board/Multidisciplinary Advisory Committee Update

The California Veterinary Medical Board (VMB) and its Multidisciplinary Advisory Committee (MDC) met in Sacramento on April 16–19, 2024. CVMA Director of Regulatory Affairs Dr. Grant Miller attended the meetings to represent the veterinary profession. The MDC and VMB discussed and took action on several important issues. Below is a summary of the major decisions made.

Multidisciplinary Advisory Committee

The MDC Chair, Dr. Dick Sullivan, presented an extensive rulemaking package for discussion and approval to address minimum standards for veterinary premises. The proposed regulations both refine existing minimum standards for veterinary premises and create new minimum standards for premises types that have not been previously described in law. The package will move several facility standards into a different section of the California Code of Regulations as well as make changes to existing requirements. The package was approved by the MDC for review by the VMB.

The MDC also discussed hypothetical scenarios drafted for industry guidance relating to registered veterinary technicians as a result of the enactment of SB 669 in January of this year, which expanded the role of RVTs in California. The scenarios were extensively debated and ultimately held in the MDC for further work and potential revision.

Veterinary Medical Board

The VMB reappointed Marie Ussery, RVT to her second term on the MDC.

The VMB appointed Dr. Mark Nunez and Dr. Jeni Goedken to fill the two open veterinarian seats on the MDC.

The VMB approved a statutory proposal to remove the word “oral” from several veterinary laws and replace it with “verbal.”

The VMB approved the aforementioned veterinary premises minimum standards regulation package. The package will now advance to legal review in the Department of Consumer Affairs. In addition, the VMB approved a longstanding regulatory package regarding medication compounding in veterinary practices. The compounding regulations have been developed in response to CVMA-sponsored 2016 legislation that affirmatively secured the right for veterinarians to compound drugs (in compliance with regulations promulgated by the VMB).

Extensive debate ensued regarding a proposed regulatory package to rewrite California’s veterinary record-keeping laws. The proposal sought to move from regulations to statute the requirement that a veterinarian provide medical records to a client within five days of a request. But the legislative proposal also sought to require the veterinarian to provide either a copy or summary of the record immediately if the patient is in critical condition or if transfer to another veterinary premises for medical care is recommended. In addition, the regulatory proposal contains a new requirement that veterinarians include invoices and client payment records for services and treatments provided. The CVMA protested these proposed changes because it is in many instances impossible or highly infeasible for a veterinarian to provide a copy or summary of a medical record immediately in an emergency or referral situation. Veterinarians make a dedicated effort to communicate with one another when referring cases, and often the referring veterinarian has other

emergencies to manage on an immediate basis. To defer patient care in order to satisfy a new medical record requirement places veterinarian in an untenable situation.

In addition, the CVMA is also opposed to the proposal to require veterinarians to include invoicing and payment information in every medical record entry. Medical records are intended to facilitate continuity of care and help a client understand what is occurring with their patient. The added requirement of linking financial information to each medical record entry is excessively burdensome to an already stressed profession and is not mandated in other California health care professions nor by any other state in a veterinary context. In addition, the VMB has authority to request financial documents during an investigation, so requiring veterinarians to now include that information in an already extensive medical record requirement is redundant and unnecessary. After listening to extensive stakeholder comments and carefully debating the issue, the VMB did not approve this rulemaking package. Rather, the VMB directed the MDC to continue work on amending the language to address stakeholder concerns.

The VMB also discussed 2024 legislation and took positions on several bills. Most notably, the VMB voted to oppose AB 2133, a bill that would permit RVTs to perform cat neuter surgery, and to support SB 1233, a CVMA-sponsored bill to create high-quality high-volume spay-neuter programs at both of California’s veterinary schools.

The next MDC and VMB meetings will be held in Sacramento and online on July 23–25, 2024.

Tom McFerson is one of the few CPAs serving the veterinary community who is Accredited in Business Valuation ( ABV ), by the American Institute of Certified Public Accountants

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Regulatory Compliance Products

FOR VETERINARY PRACTICES

The CVMA can help you with all your regulatory compliance needs. Visit cvma.net/products.

REGULATORY PLAQUES

The CVMA offers a series of 8 ¾” x 11 ¾’’ laminated plaques, suitable for hanging in your practice and designed to meet a number of regulatory requirements!

Required Postings

• Proposition 65 Warning (for practices with more than 10 employees)

• Continuous Presence Not Provided (required if animals will be left on the premises for any period of time without someone present)

• California Abandoned Animal Act (if you hospitalize/board animals)

• Financial Interest Disclosure (if applicable)

• Written Prescriptions (gives clients written notification that they have the right to receive a written prescription)

Not Required but Recommended

• Prescription Drug Dispensing (helpful in explaining restrictions to clients)

RADIATION COMPLIANCE KIT

The Radiation Compliance Kit is custom-designed to fulfill all of the regulatory requirements for veterinary practices with radiationproducing machines. It includes required postings, the “Caution X-Ray” sign, radiation safety training materials, and detailed instructions on how to implement a radiation compliance program.

MANDATORY PAMPHLETS FOR EMPLOYEES

Various regulatory agencies require that every employee be given several pamphlets at the time of hire. Employers should provide the pamphlets to all current employees if they did not receive them at the time of hire. VISIT cvma-watchdog.net/regulatory-guide/my-guide/ CALL the CVMA at 800.655.2862 EMAIL staff@cvma.net

For more information about the CVMA's Guide to Cal/OSHA Compliance or to renew your subscription:

Purchase or renew

Your CVMA Guide to Cal/OSHA Compliance

Subscription Today!

The CVMA Guide to Cal/OSHA Compliance is available only to CVMA members and is designed to help veterinary practices comply with the Department of Industrial Relations Division of Occupational Safety and Health (Cal/OSHA) regulations. It includes educational materials, required forms, training templates, implementation and recordkeeping resources, and a step-by-step wizard that simplifies the process of creating a customized written health and safety plan for your practice that complies with California-specific requirements.

New for 2024: Cal/OSHA Requires Employers to Provide Workplace Violence Prevention Plan Cal/OSHA regulations require essentially all California employers to implement a Workplace Violence Prevention Plan (WVPP). The CVMA Guide of Cal/OSHA Compliance has recently been updated to include the WVPP, which employers must implement by July 1, 2024.

The online subscription-only guide can be accessed and updated at any time with a paid subscription.

CVMA Regulatory Compliance Products Order Form

Mail, fax, or scan to staff@cvma.net

& Shipping

CVMA Guide to Cal/OSHA Compliance — Everything you need to comply with Cal/OSHA requirements. Online subscription only. (NO TAX OR S&H FEES)

New Hire Packets: Mandatory Pamphlets for Employees

�

Regulatory Plaques (please specify)

� Abandoned Animal Act (VMB requirement)

� Prop 65 warning for employees (Required for practices with more than 10 employees)

� Continuous Presence Not Provided (VMB requirement)

� Written Prescription Upon Request (VMB requirement)

� Written Prescription Drug Dispensing — Prescription Required (Satisfies requirement for written notification)

� Financial Interest Disclosure Plaque (VMB requirement, if applicable)

Name(s) of Organization(s):

Full Name: Phone #:

Hospital Name:

Shipping Address (no PO Box #s): City, State, Zip: Check enclosed made payable to CVMA MasterCard

Please allow up to five business days for the CVMA Guide to Cal/OSHA Compliance order to be processed. You will then be able to view the guide online by clicking on the CVMA Guide to Cal/OSHA Compliance link at the bottom of the CVMA Watchdog website home page after you login. Please allow up to three weeks to receive the New Hire packets and the plaques. All returned items are subject to a 15% restocking fee; shipping charges on returns are the customer’s responsibility. Credits will be issued only for returned item in original condition within 30 days.

Fulfilling a Dream

By Nilanthi Vipuli Kulasekara, DVM

Igrew up in Sri Lanka, a tiny island country south of India. Often called the pearl of the Indian Ocean, Sri Lanka is a tropical paradise. Wild mammals, birds, and snakes live side by side with humans. My garden was a place where you could watch birds feeding their young, butterflies checking out the flowers, caterpillars falling off of trees to make their cocoons, and monkeys raiding mango trees. Sometimes cobras slithered along the wall or deadly vipers hid under flower pots. My whole family was into nature, and we would spend hours outside enjoying the plants and animals sharing the space. At night, a family of mongoose would play tag with their babies on our lawn. Our family dog often barked at the monkeys who came in groups around 2 PM, as they knew that the humans were having a siesta in the afternoon.

My mother and father were interested in science, and our dinner conversations revolved around physics, chemistry, astronomy, and biology. Because of my parents’ influence, I always knew I wanted to pursue science or medicine. In Sri Lanka, education is free—and, as a result, highly competitive. When I missed medical school by nine points, I was devastated. My brother, who was in medical school at the time, told me not to despair and to pursue veterinary medicine instead, as it has two elements that I love: animals and medicine. So, I went to veterinary school in a beautiful mountainous city in Sri Lanka and graduated in 1995. In my final year, I told my friends how I wanted to improve veterinary medicine for small animals by owning a hospital with similar standards as veterinary hospitals in the United States. Despite that desire, I never thought it would actually happen and instead planned to pursue a Ph.D. in biochemistry at Cornell University. Just as I was about to mail in my application, a colleague called to ask whether I wanted to fulfill my dream of starting the first multidoctor practice in Sri Lanka.

And so in 1996, we started the PetVet Clinic in Sri Lanka’s capital, Colombo, becoming the country’s first multi-doctor (and all female) practice. Soon the word of our practice spread, and the Indian High Commissioner brought in his dog, Tashi the Tibetan Terrier, who had severe anemia due to Babesiosis, a tick-borne disease. We gave Tashi the first animal blood transfusion in Colombo. She survived and our hospital became wellknown among all the embassies. A few months later, Sri Lankan President Madam Chandrika Bandaranayake’s Cocker Spaniel was brought to PetVet to be seen for the same disease, Babesia.

The team of PetVet Clinic in Colombo, 1998.

My advice to young veterinarians is to be brave and adventurous, pursue your career, and never settle for less but always get help from the experienced and the wise whenever you can.

After practicing for three years, I knew I wanted to study in the U.S. to improve and share my veterinary knowledge with my colleagues in Sri Lanka. In 2000, I received a scholarship from the president to attend North Carolina State University to complete a nine-month externship under the mentorship of Drs. Bernie Hanson and Bruce Keene. I had to work and study hard to fill the gaps in my veterinary education. I think I read both volumes of Ettinger from front to back. The externship further paved the way for me to do an internship in anesthesia and critical care at Tufts University in Massachusetts.

I returned to Sri Lanka in 2003 and set up a nonprofit organization to eradicate rabies on the island by means of spay/neuter and vaccinating our stray dog population. Today, the Global Alliance for Rabies Control uses some of our data from that time, as we were able to generate rabiesfree zones in Colombo.

I then completed the Educational Commission for Foreign Veterinary Graduates (ECVFG) certification and started working in 24-hour referral hospitals as an emergency veterinarian in Massachusetts, Maryland, and California. While I was practicing in the ER, I got the opportunity to closely look at the function of the ER. The triaging, long wait times, and frustrated clients resulted in over-worked employees. I realized that there was a desperate need for urgent care practices, separate from the ER, to better serve clients, patients, and veterinary staff.

To assist in meeting this need, I opened my own urgent care practice in 2022 to serve East Bay pet owners. Efficiency was my motto: save time where I could, and give closer attention to the medicine part so that I could provide better patient care. While my urgent care practice offers the same standard of care as at the ER, the cost of our care is generally less.

My next project is to invite smart and competent foreign veterinarians who are hungry for knowledge and to mentor them so that they can pass the ECVFG exam and be competent to practice in the U.S. Recently, I invited my first foreign veterinarian from Ecuador, who was thrilled to be in a U.S. veterinary hospital. I am in the process of making my own syllabus to prepare them for the exam.

While managing and working at my practice, I also teach the Sri Lankan veterinary community via Zoom and mentor newly graduated veterinarians who work at my Sri Lankan hospital.

Now that I am a practice owner, I face new challenges. Sometimes it's hard, but I always remind myself of all the positive experiences I've had in my professional life—opportunities that were given to me and people who helped me to get here. I want to thank everyone who helped me achieve my goals, with a special thanks to the CVMA. My advice to young veterinarians is to be brave and adventurous, pursue your career, and never settle for less but always get help from the experienced and the wise whenever you can.

Dr. Nilanthi Vipuli Kulasekara lives in Berkeley, California with her husband, 14-year-old son, and three cats: Major Tiger, Captain Leo, and Sergeant Pepper.

Dr. Nilanthi Kulasekara with Gabe Quinto, former mayor and current councilmember of El Cerrito, California.

Dr. Nilanthi Kulasekara as an intern at Tufts University.

African Swine Fever 2024

By Nicki Humphrey, DVM

African swine fever (ASF), caused by African swine fever virus, is a hemorrhagic disease in swine with potential for high mortality. In July 2021, African swine fever was detected in swine in the Dominican Republic and subsequently in Haiti, the closest detection to the United States to date. Since January 2022, ASF has been reported in 50 countries, and it is estimated that 1,373,693 domestic pigs1 have been lost. ASF detection in the United States would be devastating to the swine industry, with estimates of loses up to $15 billion2 in the first two years of an outbreak.

Clinical signs include mortality (may be up to 100% depending on strain of virus), fever, petechia, cyanosis, tachycardia, hyperventilation, lethargy, anorexia, recumbency, and/or bloody diarrhea. On necropsy you may see splenomegaly, friable spleen, hepatomegaly, renal petechia, and/or hemorrhagic/ enlarged lymph nodes. There is currently no available vaccine for use in the U.S. and there is no treatment for the virus. In the event of an ASF detection in California, the outbreak would be controlled with strict biosecurity, surveillance, and depopulation of infected farms.

The California Animal Health and Food Safety (CAHFS) Laboratory at UC Davis is one of twelve laboratories currently participating in the United States Department of Agriculture’s ASF/classic swine fever (CSF) active surveillance program. When veterinarians or producers submit routine sick pigs for diagnostics to CAHFS, laboratory staff may test an approved sample type for ASF and CSF. To be considered for sampling, the submission should include a premises identification number, clinical history, and an approved sample type. Approved sample types include: spleen, spleen swabs, whole blood, whole blood swabs, or tonsil. When high suspicion of ASF is suspected, contact the California Department of Food and Agriculture (CDFA) or United States Department of Agriculture (USDA), Animal and Plant Health Inspection Services (APHIS) at:

Redding: 530-225-2140

Modesto: 209-491-9350

Tulare: 559-685-3500

Ontario: 909-947-5932

CDFA Headquarters: 916-900-5002

USDA APHIS: 877-741-3690

For more information on ASF, visit:

1. African Swine Fever (ASF) – Situation Report 47. World Organization for Animal Health. Web. 19 Feb. 2024.

2. Carriquiry, M., Elobeid, A., Swenson, D., and Hayes, D. 2020. "Impacts of African Swine Fever in Iowa and the United States." Center for Agricultural and Rural Development, Iowa State University.

TRUSTED VETERINARY BROKERS-

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.

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 GROSS: ~$886,000 PRACTICE PRICE: $610,000

REAL ESTATE PRICE: $635,000

GREATER SACRAMENTO, FOOTHILLS:

Family-friendly oriented community. The surrounding area offers natural beauty and provides many opportunities for outdoor activities. Impressive, highly functional ~4,000 sq. ft. facility with favorable lease. Well equipped, general small animal practice. Growth potential. Ideal location for emergency hospital.

2023 GROSS: ~$1.39 Million CALL FOR DETAILS

SANTA CRUZ on Monterey Bay:

Vacant, built-out, free-standing veterinary facility consists of 3,200 sf. Landlord desires long term tenant& will cooperate with a new tenant. The facility, on the West side of Santa Cruz at 2301 Mission St. (AKA State HWY 1) located in a thriving commercial center. CALL FOR DETAILS

SONOMA COUNTY:

Less than 1 hour to Oakland & SF. Solo DVM PX has been experiencing health issues. 2023 Gross ~$565,000 produced with limited hours & surgeries. Wellmaintained, free-standing hospital. ~2,300 sq. ft. hospital. Excellent location on major, heavily trafficked road. PRACTICE PRICE ONLY: $380,000

REAL ESTATE PRICE: $810,000

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

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 Gross ~ $849,000.

PRACTICE PRICE ONLY: $699,000 REAL ESTATE FOR SALE. PRICED TO SELL!

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

SAN DIEGO COUNTY:

Rare high-grossing, multi DVM, turn-key practice. ~4,000+ sq. ft. facility with very favorable lease rate. Hospital boasts state-of-the-art equipment & highly trained staff. Seller is available to remain long-term. If you are a qualified buyer, why lose this one to the corporates?

2023 GROSS: ~$3.4+ Million

CALL FOR DETAILS

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

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. Free-standing facility ~2,000 sq. ft. Currently, PX is essentially closed.

TOTAL PRICE FOR BOTH PRACTICE & REAL ESTATE ONLY: $300,000

SOUTHERN RIVERSIDE COUNTY:

Multi-DVM, profitable practice about 1 ½ hours from LA & San Diego. Freestanding, well-maintained AAHAaccredited hospital consisting of 2,450 sq. ft. with three exam rooms. It is wellequipped & includes an outstanding 15-member staff. Room for growth.

2023 GROSS: ~$1,820,000 CALL FOR PRICING DETAILS

GREATER EAST BAY:

Thriving diverse suburban community with major development. Only open 4.5 days per week. Emergencies are referred elsewhere & surgeries are extremely limited. Additional income source accessible for the right buyer.

2023 GROSS: ~$730,000

PRACTICE PRICE: $535,000

REAL ESTATE PRICE: $530,000

Cell: (805) 794-1073 | Office: (805) 524-3195

Email: pacproinc@aol.com | Site: www.pacificproinc.com

Address: 545 Sespe Ave., Fillmore, CA 93015 | DRE 01140877

Something to About Wag

THE CVMA CONGRATULATES…

Insight Veterinary Wellness Center, for registering with California state authorities as a community blood bank. This is the third such registration in California, following the UC Davis Veterinary Medical Teaching Hospital. Located in Folsom, Insight Veterinary Wellness Center is owned by Dr. Ken Pawlowski, current member of the CVMA’s Legislative Committee and House of Delegates, and Kristi Pawlowski, RVT, the first voting RVT member of the CVMA’s Board of Governors. Dr. Pawlowski and Kristi, the CVMA is proud of your historic accomplishment!

JaCiara Johnson, DVM, for opening her new veterinary hospital in Folsom this past March. After three years of hard work, she is also celebrating the launch of her veterinary picture book series, BabyVet Books, which was created to celebrate diversity, promote child education, and encourage exposure to veterinary medicine at young ages. Dr. Johnson juggled these two major accomplishments all while enduring a highrisk pregnancy and the delivery of her baby girl at the end of 2023! Dr. Johnson, the CVMA congratulates you on these amazing new milestones, and we wish you the best during this exciting time!

Slaton Veterinary Hospital, for celebrating its one-year anniversary! Founded by Dr. Daniel Slaton, who—after selling his first practice to a corporation—followed his dream of returning to his hometown of Thousand Oaks and establishing a familyowned practice that embodies a commitment to delivering exceptional veterinary services. In just one year, the team at Slaton Veterinary Hospital has become one of the most reputable practices in the area, a testament to their unwavering dedication and collaborative spirit. While Dr. Slaton's leadership has been instrumental, they want to thank their entire team, whose invaluable contributions have ensured seamless operations and exceptional care. Congratulations to the team at Slaton Veterinary Hospital!

Tell Tail Moonlight Veterinary Urgent Care, for opening its doors to the Encinitas community in December of 2023 after almost a year of development. Independently owned by CVMA member Dr. Laura Halsey, Tell Tail Moonlight Veterinary Urgent Care’s main objective is to bridge the gap between emergency and general practice veterinary services while providing access to top-quality care when needed most. The veterinary team would like to give special shout-outs to their medical director Dr. Lindsey Hackett and hospital director Stephanie. Tell Tail team, we hope you have a prosperous first year of operation!

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 Director of Communications, at tdeoilers@cvma.net to be considered.

Team members at the Insight Veterinary Wellness Center draw a patient's blood.

Dr. JaCiara Johnson

Dr. Daniel Slaton, Carolyn Slaton, and their family

A patient at Tell Tail Moonlight Veterinary Urgent Care

2024 CVMA

Award Recipients

Every year, the CVMA honors individuals who have significantly contributed to organized veterinary medicine through their participation in CVMA activities and promoting the importance of the human-animal bond. These individuals embody the very best of the veterinary profession in California.

Congratulations to the recipients of this year’s CVMA awards! We will highlight each award recipient in upcoming issues of the California Veterinarian magazine.

Dr. George Bishop Lifetime Achievement Award

Jon Klingborg, DVM

This is the highest CVMA award to recognize a member of the Association who has contributed to the advancement of veterinary medicine and organized veterinary medicine.

Meritorious Service Award

Naomi Tobias

The Meritorious Service Award is designed to honor service on behalf of animals, the veterinary profession, or people who celebrate and promote the human-animal bond in California, including:

• Media members demonstrating a commitment to coverage of veterinary or human/animal bondrelated stories.

• A special program or service offered by a veterinary group or clinic that received media attention.

• A group, organization, or individual that led an activity to improve the bond between humans and animals in California.

Help Celebrate the Award Honorees at PacVet 2024 in San Francisco!

Thursday, July 11 | Hilton San Francisco Union Square

Join us as we recognize the achievements of these outstanding veterinary professionals and organizations.

Linda Markland Outstanding RVT of the Year Award (Non-Private Practice)

Melina Stambolis, RVT

The CVMA recognizes the significant role of Registered Veterinary Technicians in non-private practice in the veterinary profession through the presentation of this award. Recipients possess outstanding professional ability including educational achievements, individual contributions, professional affiliations, and special experience that sets them apart from others.

Animal Hall of Fame

Aloha, with Care Provider Laura Valdes

The CVMA Animal Hall of Fame celebrates the companion and working animals of California and the veterinarians who care for them. The winning animal is inducted into the Hall of Fame and the care provider receives a plaque. The nomination must be made with the owner’s permission by a Constituent VMA, a veterinary professional, a humane society, SPCA, or other animal care agency.

Another Fun, Educational Bandaging Lab at UC Davis!

The annual CVMA-coordinated bandaging lab for veterinary students at UC Davis took place on April 18, 2024, where 40 first- and second-year students honed their bandaging skills. Canine instruction was led by Dr. Chris Wong, a member of the CVMA House of Delegates and Medical Director of the VCA Sacramento Veterinary Referral Center who has taught at this event for several years. Lori Hohman, RVT of Jorgensen Laboratories assisted Dr. Wong in instruction.

The CVMA provided food and beverages for the event and the CVMA’s Membership and Student Services Manager Laura Phillips coordinated the event with Alexis McBride, the Class of 2026 UC Davis CVMA student representative. The event was a success thanks to Jorgensen Laboratories and 3M, our generous sponsors who donated the bandaging supplies.

The CVMA thanks Dr. Wong and Lori for giving their time and knowledge to help educate the students. The CVMA is grateful for all who made this valuable learning experience possible again this year!

Dr. Wong thanks CVMA Representative Alexis McBride for her work in planning the bandaging lab.

The veterinary students practice bandaging on the legs of a volunteer dog.

Lori Hohman of Jorgensen Laboratories helps instruct the UC Davis students.

Dr. Wong demonstrates proper bandaging techniques to the students

Access to Care Program at UC Davis Benefits Communities and Students

For many years, UC Davis has addressed the veterinary needs of underserved communities, shelters, and rescue groups through communitybased initiatives to provide animal care. Not only do these programs provide a much-needed service to our communities,

WESTERN

U NEWS

but they also supply DVM students with extracurricular hands-on experience that may ultimately enhance their careers. These activities include the Community Surgery Service, Covelo Clinic, Fracture Program for Rescue Animals, Knights Landing One Health Clinic, Orphan Kitten Project, and the treatment of animals burned in wildfires.

The Access to Care Program is structured to provide the framework for these programs, providing organizational leadership and connectivity. The mission of the program is to collaborate across these community outreach organizations, help elevate and unify that work, and broaden the base of access to veterinary

WesternU Student’s Podcast Provides Insight into Vet Med

Individuals interested in the fascinating field of veterinary medicine can listen to the thoughts of some of the most insightful minds in the field without ever leaving the comfort of their chair thanks to a new podcast called “Veterinary Vibes.” Launched by WesternU student Garth Robillard, DVM 2026 just as his second year was underway, the podcast features interviews with veterinary leaders and Garth’s fellow students. Guests have included WesternU’s Tracy McNamara, DVM, DACVP, Professor of Pathology, Wael Khamas, BVM&S, MS, Ph.D., and Ken Noriega, BS, MS, along with peers and preceptors.

“Every interview has been a rewarding experience,” Garth says. “Each participant has shared real, raw, and passionate insights. […] This venture has given me the

opportunity to connect with individuals across the field and has provided a unique perspective that goes beyond the classroom.”

Growing up, Garth didn’t seem destined to become a veterinarian. Rather, he came to the field gradually, mixing the love that he’s had for animals since growing up in Apple Valley with his interest in science. At this point, Garth is considering small animal emergency care with a focus on surgery, but specializing in a field such as orthopedics is another possibility.

“Every moment at WesternU has been cherished, from building strong connections with professors and colleagues to the unique approach of learning medicine through a problembased learning method,” he says.

care at UC Davis. Through this work, veterinary students develop cultural competencies while gaining additional training and learning compassionate care.

As a California public entity, it is the school’s responsibility to continue these important programs. Granting more access to care to underserved populations, based on the school’s mission to “address societal needs,” is a foundation of the school’s outreach. Teaching veterinary students about this important topic and supporting the health of animals and people in our community is key to the school’s land grant mission.

Veterinary Vibes completed its 14-episode first season in November. Despite the many challenges facing a secondyear veterinary student—including his upcoming clinical rotations—Garth intends to keep producing episodes. In the meantime, Garth is seeking sponsors for the podcast to offset production and promotion costs and increase its reach.

“It’s become more than just a project; it’s a community that fosters collaboration and stories that need to be heard,” he says.

The “Veterinary Vibes” podcast can be found on the Apple iTunes marketplace below and wherever you listen to podcasts.

Apple iTunes

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