CV M A VO ICE
Today’s Voice, Tomorrow’s Vision
• Cat Health and Welfare • CVMA Governance Model Update • CVMA Convention 2017
2017, ISSUE #2
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CV M A VO ICE
TABLE OF CONTENTS Inside President’s Post . . . . . . . . . . . 4 Briefings . . . . . . . . . . . . . . . . . 5 Of Note . . . . . . . . . . . . . . . . . . 6
6 PetCheck 2017
Pets Receive Complimentary Exams and Vaccinations through PetCheck 2017 . . . . . . 6 Updates from the CSU DVM Program . . . . . . . 8 What’s New and Exciting at CVMA Convention 2017! . . . . . . . . . . . . . . . . . . . . . . . 10 The Biggest Lie We Tell Ourselves . . . . . . . . 12 CVMA BIG Ideas Forum | Spring 2017 . . . . . . 13
Focus on the Feline . . . . . . .
14 A “Tail” of TNR in Pueblo, Colorado
20 DFL Solutions— Cat Spay and Neuter Clinic Opens
The Challenges and Opportunities with Cats in Our Communities . . . . . . . . . . . 14 Metro Denver C.A.T. . . . . . . . . . . . . . . . . . . . . . . 15 A “Tail” of TNR in Pueblo, Colorado . . . . . . . . 16 Making Every Pet Healthy and Wanted . . . . 17 Advancing Cat Health and Welfare . . . . . . . . 18 Colorado is Connecting Cats to Care . . . . . . 19 Pioneering Solutions in Cat Welfare . . . . . . 20 Community Cats: CVMA Members Speak . . . 21 DFL Solutions—Cat Spay/Neuter Clinic Opens at 191 Yuma Street . . . . . . . . . . 22 DFL Solutions—Cat Spay/Neuter Clinic FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 An Evaluation of Visual and Permanent Identification in Pet Cats . . . . . . . . . . . . . . . 24 Cats I Have Known . . . . . . . . . . . . . . . . . . . . . . 26 Confessions of a Not-so-crazy Cat Lady . . . 28
CVMA Events and Deadlines July 20 Managing Bad Clients Webinar August 1 End of Life Communication Principles Webinar August 4/5 Introduction to External Skeletal Fixation Denver August 17 Golden Rules to Impress Callers Webinar September 6 PDS: Neurological Conditions in Small Animal Patients Denver September 21 10 Ways to Educate Clients about Dentistry Webinar September 21–24 CVMA Convention 2017 Loveland October 6–8 Power of Ten 2017 Initial Gathering Breckenridge October 14–15 CVMA CE Southwest Durango October 18 PDS: What’s New in Veterinary Oncology Denver October 19 Own the Phone: How to Lead Conversations Webinar October 20-21 CVMA BIG Ideas Forum | Fall 2017 Beaver Creek
Government Affairs . . . . . . . 30 2017 Legislative Session . . . . . . . . . . . . . . . . . 30
Science Update . . . . . . . . . . 32 Canine Distemper a Growing Threat to Animals in the Front Range . . . . . . . . . . . 32 Rats and Seoul Virus . . . . . . . . . . . . . . . . . . . 34
34 Rats and Seoul Virus
In Practice . . . . . . . . . . . . . . . . 36 Helping Cats Live Happier Lives . . . . . . . . . . 36 Cost Benefit 101: Employee Benefits Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Planning for Long Term Care . . . . . . . . . . . . 39 Privacy & Network Security Liability . . . . . . 40
CVMA News . . . . . . . . . . . . . 42 Chapter Connections . . . . . . . . . . . . . . . . . . 42 CVMA Governance Model Update . . . . . . . 44 CVMA Student Chapter Updates . . . . . . . . . 45
Our Mission To enhance animal and human health and welfare, and advance the knowledge and wellbeing of Colorado veterinarians.
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Colorado Veterinary Medical Association 191 Yuma Street Denver, Colorado 80223 303.318.0447 or 800.228.5429 Fax 303.318.0450 firstname.lastname@example.org www.colovma.org MANAGING EDITOR Cami Cacciatore PUBLISHER Ralph Johnson The CVMA VOICE is published quarterly to members (Core and Premium members will receive a mailed print copy and Basic members will have online access only) and once a year to nonmembers free of charge. Information and advice presented in this publication do not necessarily represent the views of CVMA.
Deadlines for Submission All articles, contributions, and display ads must be received in the CVMA office by the dates below. For more information or to obtain a rate schedule, contact the CVMA office at 303.318.0447 or email@example.com. Issue Issue Issue Issue
#1 — January 15 #2 — April 15 #3 — July 15 #4 — October 15
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PRESIDENT’S POST Sam Romano, DVM President I hope you were able to attend the spring Big Ideas Forum, Advancing Cat Health and Welfare: Issues, Solutions, and Opportunities this past March. Spring at the Cheyenne Mountain Resort is beautiful, and in typical CVMA fashion, the presentations and discussion were topnotch. Experts locally, and from across the country, presented information regarding feline health and behavior. Colorado veterinary professionals are deeply committed to feline health and welfare. Many other organizations, like Metro Denver C.A.T., which also presented at Big Ideas, work at a grassroots level in our community. Often operating with minimal resources, they help ensure community cats receive basic veterinary care. I needed help from such a group several years ago as a practicing veterinarian in Denver. My mom has always been a cat person. Raised as a first-generation Italian immigrant in Golden, she relied on cats for comfort and companionship since her early childhood. A genetic defect resulting in calcification of the stapes (otosclerosis) in the middle ear rendered her essentially deaf from the age of 14, and cats as playful, yet durable little animals, became her solace and comfort. Fast forward to 1997, when my father died unexpectedly following a lung biopsy just short of their 50th wedding anniversary. Caring for her single, indoor calico cat, Patches, seemed to be the only thing keeping her from deep depression and despair. If Patches was happy, she was happy. I credit her devotion to that one little cat as keeping her active and moving forward. At least I thought she was only caring for a single cat. Over the ensuing weeks I noticed an increasing number of empty food dishes, blankets, and toys scattered across the backyard at her home in Wheat Ridge. Several eyes seemed to be peering at me from behind the storage shed and bushes when I was doing yard work for
her during the day. A tail here, a nose there. When asked how many cats she thought were in the yard, her response was always the same, “Oh, just a few.” Unfortunately, it turned out that “just a few” was actually the same as the number of neutrophils in a feline abscess- TNTC (too numerous to count). What to do with the growing feline population? As a veterinarian the solution should be clear and simple, right? Not so fast. These were not simply “feral” cats easily treated or removed. They were her treasured friends, her community of cats, a furry social network. To say I was a little embarrassed when making the call to a local feline rescue organization is an understatement. The fear of judgment was high. How could a licensed Colorado veterinarian allow this to happen? Is it a violation of the practice act to have so many cats? My mom was terrified the cats would be removed and euthanized, regardless of condition. I assured her they would not; rather, they would be examined, tested, and spayed or neutered. Although the exact name of the rescue organization escapes my memory, what they did does not. Three members of their group arrived the following day, calm and completely non- judgmental. They came around the back corner of the house and stood there observing for a while. After several minutes cats began appearing, almost as if they knew feline sympathizers were present. Eventually, they asked to speak to my mom directly. Sitting in her kitchen, we received their professional verdict. There were likely 20+ cats living as a growing community in her backyard and around the neighborhood. It was the first time in my career I heard the term “community” used to describe a group of what I thought were simply feral cats. Over the ensuring weeks, live traps were placed around the yard. Cats were carefully caught and taken for medical care. All were tested for FELV/FIV and humanely euthanized if found positive. Adult cats testing negative were vaccinated for rabies and FVRCP/FELV, President’s Post continued on page 9
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BRIEFINGS Ralph Johnson Executive Director Of Cats and Collaboration On Wednesday, March 8, we had the pleasure of hosting an open house for the Dumb Friends League (DFL) Solutions Cat Spay/ Neuter Clinic. The Solutions clinic is housed within PetAid Animal Hospital space here in Denver, in the same facility that serves as headquarters for CVMA. As reported in eVOICE and in the article on page 22, we welcomed this new venture into our space in January of this year. In attendance were leaders and staff from CVMA, PetAid, and DFL, as well as representatives from the three organizations— Animal Assistance Foundation, PetSmart Charities™ and the American Society for the Prevention of Cruelty to Animals (ASPCA)—that provided grants to DFL to make this initiative possible. The Solutions clinic is an important new resource that advances the cause all the organizations involved collectively embrace—to create better outcomes for animals in our community. The clinic is also a symbol of collaboration, something that Bob Rohde, president and CEO of the Dumb Friends League, has championed and nurtured over 40 years of work in animal welfare. Indeed, there’s an interesting backdrop about the relationship between PetAid, CVMA, and DFL. When conversations began between PetAid and DFL about the possibility of using the PetAid spay/ neuter suite (which had been dormant for some time) for the Solutions clinic, the PetAid Board of Directors quickly saw the benefits—but also quickly saw that the clinic might be of concern to private practice veterinarians who could imagine a negative financial impact on their practices should sterilization surgeries be drawn away from those practices. So the PetAid board said to the leaders of CVMA “Hey, PetAid thinks this is a great opportunity to improve outcomes for animals in our community. Would CVMA be supportive of such a clinic?”
CVMA Executive Committee Dr. Sam Romano President
Interestingly, CVMA at that time had just completed a statewide survey of its members about perceptions and opinions surrounding community cats (see page 21). Several key findings emerged from the survey. First, the majority of veterinarians believe that there is a community cat problem in their area. Second, most veterinarians believe that mitigating the problem is a responsibility shared by shelters, veterinarians, and the community. Finally, and most importantly, 85% of the responding veterinarians indicated they would be supportive of a no-fee, cat- only spay/neuter service in their community if they were not required to make an investment of time or money. With those findings, the CVMA leadership endorsed the concept of the Solutions clinic and signaled the PetAid board to proceed. What struck me the most, as I stood making my remarks to those in attendance, was that this was another ground- breaking model of working together to improve the lives of animals in our community. On behalf of CVMA and PetAid Colorado, I extended our appreciation to be a collaborator in this important initiative—and to welcome the DFL team as colleagues in the PetAid facility. The cats and the people of our community are already benefitting from Solutions, and we wish it success on a magnificent scale! Of Cats and Community CVMA’s BIG Ideas Forum | Spring 2017, held April 1 in Colorado Springs, also focused on cats as we explored Advancing Cat Health and Welfare: Issues, Solutions, Opportunities. We had a phenomenal lineup of cat advocates, including representatives from CATalyst Council, Pueblo Animal Services, Merck Animal Health, Animal Assistance Foundation, Colorado Federation of Animal Welfare Agencies, Metro Denver C.A.T., and Dumb Friends League. While I won’t go into a summary of the day’s discussion—you can read the details in the special “Focus on the Feline” section of related articles that start on page 14—I would like to comment on some notable takeaways from the day.
Dr. Will French President-elect Dr. Joy Fuhrman Secretary/Treasurer Dr. Stacee Santi Secretary/Treasurer-elect Dr. Curtis Crawford Immediate Past President Dr. Melanie Marsden AVMA Delegate Dr. Rebecca Ruch-Gallie AVMA Alternate Delegate Mr. Ralph Johnson Executive Director*
Chapter Representatives 1 – Dr. Kimberly Radway 2 – Dr. Wayne Jensen 3 – Dr. Hannah Klein 4 – Dr. Adam Tempel 5 – Dr. Colleen Carnes 6 – Dr. Heather Reeder 7 – Dr. Debra Stirling 8 – Dr. Dale Davis 9 – Dr. Kayla Henderson 10 – Dr. Marguerite Flett 12 – Dr. Randal Hays 13 – Dr. Connie Stapleton 14 – Dr. Matt Braunschmidt 15 – Dr. Mark Ryan 16 – Dr. Mark Cowan 17 – Dr. Leon Anderson
Student Chapter Representatives Fourth year – Madeline Anna Third year – Courtney Mael Second year – Amy Zug First year – Laurel Krause * Ex-officio, non-voting
Briefings continued on page 45 CVMA Voice 201 7: 2 | PAGE 5
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Nearly 1,000 Pets Receive Complimentary Wellness Exams and Rabies Vaccinations through PetCheck 2017 Lauren Gladu, MA CMVA Communications and Content Specialist
The eighth annual PetCheck was held April 8 and 9 throughout Colorado, and thanks to the generosity of CVMA members, nearly 1,000 pets received a much-needed wellness exam and a rabies vaccination (if appropriate)! Through the collective effort of PetCheck, we are afforded an unparalleled messaging opportunity that neither CVMA nor individual veterinarians could afford to undertake. Strategically, PetCheck affords a tremendous public relations opportunity for Colorado veterinarians to positively portray the profession and underscore the importance of preventive pet healthcare as well as the veterinarian’s crucial role in public health protection. The media coverage surrounding PetCheck—before, during, and after the event—puts veterinarians on the air and in the spotlight in a way we’ve only been able to dream about! With 53 clinics across the state providing wellness exams and rabies vaccinations to almost 1,000 pets this year, CVMA members have a lot to be proud of! Pets helped with the PetCheck program belonged to financially disadvantaged pet owners. With PetCheck, these owners were able to access and receive needed care for their
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cat or dog that they may not have otherwise been able to obtain. Thank you to all the generous clinics that donated their time, staff, and resources. This year, we continued to have great media coverage about the event and the importance of preventive care, thanks to 9News KUSA, KOAA News 5, and print media outlets across the state, including The Denver Post, Steamboat Pilot and Today, The Greeley Tribune, the Summit Daily News, the Daily Camera, the Longmont TimesCall, the Canon City Daily Record, and the La Junta Tribune-Democrat. Our social media efforts were ramped up this year as well, with clinics posting about PetCheck involvement and asking their community members to spread the word. Through media coverage about PetCheck, CVMA is able to educate a large audience about preventive care, and not just those receiving exams through the program. Dr. Sam Romano (CVMA President), Dr. Randa MacMillan, Dr. Wendy Hauser, and Dr. Susan Bloss served as spokespersons for the event. These CVMA member veterinarians utilized their on-air time to discuss common health issues that often go undetected by pet owners, what veterinarians look for during an exam, and the importance of annual exams. We are overjoyed to hear the response from the community members in need, who would not have been able to have their pets visit a veterinarian had PetCheck not been available to them. We heard amazing stories from so many caring pet owners that have warmed our hearts
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and shown us how much this program means to so many. “Thank you so much for doing this,” said one PetCheck client. “We wouldn’t be able to afford to take our little fur babies to the vet so we appreciate this so much. Thank you, thank you, thank you!” “We are so grateful that you do this,” said another PetCheck client. “I lost my job earlier this year, so I’m having a hard time making ends meet, but I want to make sure my little buddy is healthy—he’s my best friend and I can’t thank you enough.” Clinics that participated reflected back on the weekend, happy that they could participate in this wonderful community event. “We met some wonderful people and dogs today!” said one clinic. “It feels great to give back to the community and help those in need.” “Thank you to everyone who came out with their pet for the annual 9PetCheck this weekend and to the wonderful team of volunteers who helped make it possible,” said another. “We love our community and are so happy we can participate each year.” “Thanks to the CVMA for smooth event coordination and to 9News, and Merial for providing vaccines to help folks who need a little assistance to keep their beloved companions healthy!” said another clinic. “We are grateful to have been a part of this effort.” In addition to the veterinarians, veterinary technicians, and administrative staff that made
PetCheck possible, CVMA would like to thank our generous sponsor, Merial, who provided rabies vaccine trays to each participating clinic. CVMA also owes a heartfelt thank you to our 17 volunteers who donated their time for the phone bank on April 3, and in less than three hours had filled nearly 1,000 appointments. This also could not have been a success without the wonderful assistance of the CVMA staff team, who all helped make the program run smoothly. We couldn’t have made the event successful without the help of our volunteers and team! And a special shout out to the CSU students who came to Denver on Saturday to staff the clinic at PetAid Animal Hospital. Their enthusiasm was infectious and they served almost 100 pets in need. It was great to see the next generation of veterinary medicine in action and the pet owners were incredibly grateful for their service. Last but not least, a big thank you to the news team at 9News KUSA, and the news team at KOAA News 5, for being our media sponsors. Both 9News and News 5 did a great job of highlighting the importance of wellness exams and rabies vaccinations for pets in need. Lynne Valencia at 9News and David Reeve at News 5 were invaluable resources to our CVMA team, and they both did an amazing job coordinating their second 9PetCheck and 5PetCheck events. We hope you enjoyed participating in the PetCheck program in 2017, and here’s to another successful event next year!
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OF NOTE Looking Ahead, Educating Now: Updates from the Colorado State DVM Program Melinda Frye, DVM, MS, PhD, DACVIM Associate Dean for Veterinary Academic and Student Affairs, CSU–CVMBS Our students represent the future of veterinary medicine, and at Colorado State University, we are constantly looking ahead to anticipate the challenges and opportunities they will encounter once they graduate. Here are some of the ways we are equipping our graduates to thrive, both personally and professionally: Enhancing Rural Veterinary Services In response to the serious shortage of Food Supply Veterinarians, the Veterinary Services Grant Program (VSGP) of the U.S. Department of Agriculture National Institute of Food and Agriculture (NIFA) seeks to enhance recruitment, educational opportunities, and retention of rural veterinarians in Colorado and elsewhere. Our DVM program recently received $230,000 in VSGP funding to support a four-year program called “A Holistic Approach to Expanding Rural Veterinary Services and Improving Retention of Rural Practitioners.” Highlights of the program include: • Financial and practice management education • Spanish language instruction • Mentored experiential learning • Training in population analytics • Wellness Additionally, an interesting aspect of the project is our collaboration with the University of Colorado School of Medicine’s Rural Track program. An inaugural meeting in April brought together 18 CSU veterinary students and 10 CU medical students at the James L. Voss Veterinary Teaching Hospital. Mark Deutchman, MD, founding director of the CU Rural Track program, gave an overview of the challenges facing health professionals in rural areas. “Colorado is a very rural state. Two-thirds of our counties are rural or frontier, which is fewer than six people per square mile. Essentially the whole state that is not in the urban corridor is a health professional shortage area,” he said. Second-year veterinary student Claire Tucker spoke about One Health, the sphere that draws together human, animal, and environmental health. Associate Professor of Animal Sciences Noa Roman-Muniz, DVM, who coordinates the VSGP, spoke about the project’s diverse stakeholders, including students, rural health practitioners, producer groups, and livestock operations. “We are creating something that is unique, combining Spanish language skills and the cultural aspects of communication, epidemiology, wellness and mentorship, and externships and continuing education,” she said. Throughout the program, the unique and PAG E 8 | CV M A Vo i ce 2017: 2
impactful opportunities resulting from a robust MD-DVM partnership were highlighted. By mobilizing tremendous faculty and instructional resources within the CSU College of Veterinary Medicine and Biomedical Sciences, and in partnership with livestock producers, producer groups, the Colorado Veterinary Medical Association, and State Veterinarian’s Office, we aim to develop robust training opportunities to reflect practical and current needs. Graduate tracking and outcomes assessment will provide data for continuous program improvement. Day-one Competencies The Steering Committee of our DVM Program is taking a critical look at our curriculum, with the aim of optimally preparing our graduates for success in an evolving professional landscape. As each discipline identifies critical dayone competencies, that information will be interfaced with the DVM curriculum map to identify gaps and redundancies. The Committee is using AVMA Clinical Competencies, work being done by the American Association of Veterinary Medical Colleges, and feedback provided in focus groups by veterinarians across the state to guide the project. Changes in Admissions Our DVM Program, established in 1907, had a recordbreaking year in student applications. Our recruitment efforts, led by Ashley Stokes, DVM, PhD, attracted 2,152 applications for 138 spots, a 35 percent increase over the prior year, a 44 percent increase over five years, and the highest number of applications received by any veterinary school in the country. In January, the DVM Program faculty and staff welcomed about 350 applicants to campus for in-person interviews and campus tours, something we haven’t done since 2009. Numerous practicing veterinarians assisted in the interviews, and we are very grateful for their time and expertise. This was the first time we have used the Multiple Mini Interview (MMI) format. The MMI model is a scenario-based interview format developed for medical school admissions; it has been increasingly adopted by other health-based professional schools as a lens on non-technical skills, such as communication, critical thinking, and empathy. The information gained through this process will be considered along with conventional application information to help us enroll diverse pools of highly qualified veterinary students. Many candidates commented on the warm welcome and the efforts to make them feel valued. The array of events scheduled for the interview day allowed them to experience Fort Collins, the University, and the DVM Program. Nearly all of the candidates indicated that the interview process was not nearly as onerous as anticipated, and many even said it was “fun” in that it allowed them to convey their personality and perspectives. We are in the process of finalizing the class of 2021, the first cohort of veterinary students selected using the new Continued on next page
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MMI process. We plan a thorough outcomes assessment to determine the impact of the MMI approach and ways that we might improve it moving forward. New Admissions Director Gretchen Delcambre, DVM, is our new director of DVM Admissions. She earned her veterinary degree at Louisiana State University, and her MS in Infectious Disease and Pathology at the University of Florida. She joined CSU in 2014 as a Research Associate, and was promoted to Assistant Professor in 2015. Dr. Delcambre has conducted research in the areas of infectious disease and immunology, and continues this work at CSU. Her teaching duties include Veterinary Physiology and Histology, Microscopic Anatomy, Veterinary Neurobiology, and Foundations of Veterinary Medicine. Known for her dedication to students, she serves on the Health and Wellness Task Force, the Diversity and Inclusion Committee, the DVM Orientation Committee and the DVM Curriculum Committee, and as advisor to multiple DVM student organizations.
Dr. Delcambre has participated in the Louisiana State University admissions process as a packet reviewer since 2014. She looks forward to stepping into a progressive and robust recruitment and admissions program developed by her predecessors, including Dr. Ashley Stokes, who has moved on to the Office of Engagement as Assistant Vice President for Engagement and Deputy Director of CSU Extension. As roles for veterinarians continue to evolve and broaden, we aim to actualize programmatic advances that will optimally equip our graduates for personal and professional success. We are grateful for our DVM partners across Colorado who contribute to this effort by offering experiential opportunities, externships, mentoring, and employment to our DVM students. If you are interested in learning more about these opportunities, or would like to be included in our experiential/externship, mentoring, or employment lists available to students online, please contact Adrienne Marcus at Adrienne.Marcus@colostate.edu or 970.491.7054. I welcome your questions and feedback. I may be reached at Melinda. Frye@colostate.edu or 970.491.2009. n
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OF NOTE What’s New and Exciting at CVMA Convention 2017! Kristin Payne, CMP CVMA Director of Learning
Learning Labs and Life Skills Workshops provide optional CE offered on Thursday for those who want to expand their learning, or who can’t attend convention but still want to engage in excellent education. All courses require an additional fee and pre-registration based on space availability. This year, we have seven to choose from: • Veterinary Spanish: Overcoming the Challenges of Language Divide in the Exam Room with Dr. Danielle Straatmann • Dental Radiology wet lab with Dr. Edward Eisner • Dental Extraction wet lab with Dr. John Huff and Dr. Larry Klima • Small Animal Basic Ultrasound wet lab with TBD • Practice Profitability: On the Trail to Success with Stith Keiser • Pathway to Excellence: Understanding Your Strengths with Therese Lask • Cracking the Perfectionism Code: How to Thrive in Veterinary Medicine with Dr. Betsy Charles CVMA Opening General Session with Andy Roark kicks off your convention experience on Thursday afternoon from 1:00–5:00 PM, followed by a “meet and greet” with Dr. Roark at in informal reception. Join us for an entertaining and informative day with Dr. Andy Roark, NAVC’s Practice Management Speaker of the Year two of the last three years! Learn why his popular Facebook page has over 125,000 fans and his humorous education videos have been viewed over a half million times! Open to all full convention paid registrations and Thursday daily and learning lab/workshops registrations. Sponsored by: PetPlan
CVMA Convention 2017 registration is now open. We are ready to offer you 100+ hours of world-class continuing education to advance you, 7 pre-conference wet labs and life skills workshops to enrich you, and an array of social activities to engage and connect you. All of this located at a local venue, with a convenient schedule, and at an exceptional value. What more could you ask for? Well . . . How about an Opening General Session with nationally renowned speaker, Dr. Andy Roark? How about Morning Keynote Presentations on Friday and Saturday mornings to go along with your morning coffee and light breakfast? All of this in addition to our outstanding Exhibit Hall, CVMA/CSU Reception, Celebration Luncheon, and C asino Night! We look forward to welcoming you to Colorado’s premier gathering of veterinary professionals. Education with a Purpose Design your convention experience by selecting education from whichever session or track piques your interest and earn up to 27 hours of continuing education towards your license renewal in 2018. Our 2017 session and track highlights include the following offerings. PAG E 10 | CV M A Vo ice 2017: 2
NEW! Morning Keynote Sessions kickstart your day with two outstanding offerings designed with all practitioners in mind. Join us Friday morning for “Sharpen Your Axe” with Dr. Andy Roark and Saturday morning for “Cracking the Perfectionism Code: How to Thrive in Veterinary Medicine” with Dr. Betsy Charles. These special sessions will leave you inspired and energized for the rest of the day! Six Daily Tracks offer you endless options to customize your learning experience. Choose by track or by topic to design your day around your interests and needs. Here’s what we have lined up for you this year. We have so many great sessions, you might have a hard time deciding! Agricultural Animal topics • Bovine Sports Medicine and Bucking Bulls • Poisonous Plants Case in Cattle: A Case Report • Food Animal Welfare • State Veterinarian Update • Sustainable Livestock Production • USDA Accreditation Renewal Modules (3) • USDA Accreditation Renewal Module – International Health Certificates Continued on next page
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Beyond Medicine topics • Assessing, Diagnosing, and Treating Practice Health • Entrance and Exit Strategies • Financials of Practice Ownership • Marketing Strategies for your Practice • OSHA Regulations • Drug Control: Pharmacy Regulations for your Veterinary Practice • Power of Ten (P10) Ignite • SBVM Update Complementary Medicine topics • Introduction to Integrative Medicine • Veterinary Botanicals and Nutraceuticals • Vitamin D: The Preventive Medicine Solution • An Integrative Approach to Chronic Kidney Disease • Integrative Gastroenterology • Medical Cannabis for Veterinarians: Risks and Benefits Equine topics • Joint Injection Techniques • PIP Ankyloses • Skin Grafting
• Soft Skills • Wound Immobilization • Pre-Purchase Exam • Endocrinology • Chiropractic • Acupuncture Exotic/Zoo • Bee Medicine • Exotics Update • Zoo Medicine Small Animal • Dermatology Symposium (full day) • Cardiology Symposium (full day) • Feline Medicine • Nutrition Management of Lower Urinary Tract Disease • Understanding Unconventional Diets • Leptospirosis • IMHA • ITP • IMPA n
Your CVMA Convention 2017 Registration Brochure has mailed! You can also visit colovma.org/cvma-convention for current information and to register.
President’s Post continued from page 4
spayed or neutered, and returned. Kittens were adopted out to new homes. In the end, only three adult cats were returned, as many tested positive or had other serious medical conditions precluding them from humanely living outdoors. But the greatest service the rescue group provided was the time they spent talking with my mom. They spent several hours over many days counseling her about how to prevent the same thing from happening again, and how to care for those cats ultimately returned to her yard and neighborhood. Thankfully, she listened to them. She trusted those that understood her deep emotional attachment to these animals. Although they were living outdoors, she still considered them valued pets. Once informed, many neighbors also began caring for the remaining cats and worked to prevent their neighborhood feline community from growing. I’m amazed how those cats were the catalyst (pun intended) in reconnecting neighbors. Knowing that even back then there were groups in Colorado dedicated to treating community cats as, well, community, rather than a nuisance, reminds me again how truly lucky we are to be here, in a place that wants
to collaborate and find solutions. As veterinarians, we can play an important role in helping further the work being done by the organizations like those represented at BIG Ideas Forum. Even if you don’t have the time to volunteer or the means to provide resources, you can find out who’s working in your community on behalf of cats and share that knowledge with your clients, colleagues, and neighbors, so they know there is a resource out there to help take care of the cats in our communities. Years have passed. The original Patches has been succeeded by Patches II, a feisty calico. Only one aging cat now lives in my mom’s backyard. It has a heated house, eats well, and lives a peaceful life with several blankets and toys. I get daily updates on its eating and play habits. My mom, hopefully 93 years old as of the date of this publication, spends her days looking out the back door watching it play in the yard, or simply sleeping in the sun. She often thanks God for that feline rescue group, and likes to tell her friends they helped her in a way that even her “son the vet” couldn’t. Thanks, mom. n
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OF NOTE The Biggest Lie We Tell Ourselves Andy Roark, DVM, MS Sometimes we tell ourselves lies to make life easier. We say things like, “I was walking in and out of exam rooms all day long. That counts as exercise,” or “There’s a ban on cellphones in the office, but everyone will understand that it doesn’t apply to me.” We kid ourselves to feel better, and it usually works. To be fair, most of these tall tales are pretty harmless. However, some come back to bite us. There’s one particular lie that undermines the way we practice, communicate, and provide patient care. It affects how we educate veterinarians and how we operate our clinics. Here’s the lie: If we just tell average pet owners what’s best for their pets, they’ll do it. Isn’t this a wonderful idea? The problem is that, most of the time, it’s not true. And we know it. Don’t get me wrong—this isn’t an attack on pet owners. I’m not saying people fail to follow doctors’ orders because they’re bad people or don’t love their pets. However, the question persists. Why? The case of the crappy car owner Sometimes in my lectures to veterinarians, I talk about the type of car owner I am. (Spoiler alert: I’m awful.) I love my car and use it extensively. I fully understand how much I depend on it and what a bind I would be in without it. Yet I don’t take very good care of it. When it comes to fixing problems, I head right to the shop. I’m just not so great about the regular maintenance. The auto places always give me a list of what’s best for my car. It’s just that life/work/parenthood/finances/time keep getting in the way. One day, after I made this confession in a talk, a feline practitioner shared her candid feedback with me. She said, “You know, you shouldn’t tell that story about your car.” I asked her why not. “Because it makes you look like one of those bad cat owners. The ones who never come in on time. You don’t want people to think that’s you.” But here’s the thing: That is me. And it’s probably you. It’s almost all of us. How many people have cars that are due for maintenance? How many of us are past due for a physical or a dental appointment? Is anyone putting off funding a retirement account or college fund? Don’t be THAT cat owner; visit your vet for annual checkups! PAG E 12 | CV M A Vo ice 2017: 2
Listen, I’m not actually a bad cat owner. My pets receive great care not only because I’m a certifiable animal lover, but because I’m a trained veterinary professional. That’s not the case for the vast majority of our clients. They love their pets, but they also love their kids, their jobs, their hobbies, the idea of retirement, and their teeth. Everyone has only so much money, time, and energy, and no one thinks about pet health in their real lives as much as veterinary professionals do. Let’s face it: Most people are about as consistent at keeping up with pet care as I am with handling my car maintenance. What we’ve gotten wrong—and how we can get it right For years, I believed that if we just sat down and explained things to pet owners, they would do what was best for their pets. I’m sorry to say that I don’t believe this anymore. While this idea is comforting and makes it easier for us to shake it off when we make recommendations people decide not to follow, it’s simply not true. If we can come to grips with that, I think we can modify our approach in two ways to fix the problem: 1. Innovate to communicate. Often, our idea of client education is a single conversation between the pet owner and the veterinarian in the exam room. It’s an isolated inter action between a doctor and a person who may or may not be the patient’s decision maker. It’s also generally unstructured, brief, and happening in front of a pet, a natural distraction. In short, it’s a frantic mess. Educating pet owners in this fashion can yield only limited success. If we are going to successfully compel people to take specific actions, the messages we send must be clear, focused and repeated through multiple channels. We must help pet owners understand why we are making the recommendations and what they need to do. Conversation is one way to deliver these messages. Email, text messaging, videos, infographics, blog posts, interesting articles, and smartphone apps are just a few ideas. Effective client communication is the single greatest opportunity for innovation in our profession today. 2. Stop abdicating our position. I have a friend who despises choosing a restaurant. In fact, it’s nearly impossible to get her to weigh in on any sort of dinner-related decision. The reason is that she doesn’t want to feel accountable if the place we visit is underwhelming. She takes comfort in always being able to say, “Well, it was your choice.” For a friend and a dinner decision, this is fine. But what if everyone approached choices this way? Yes, we need to present pet owners with options, but we cannot relinquish our responsibility to guide their decisions. Too often, we say “Well, you could . . . ” and then present a multiple-choice scenario with options that may seem perfectly clear to us but are confusing to our clients. We feel good about putting the choice in their hands, but then we wonder why they so often default to the cheapest option. Continued on next page
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OF NOTE Advancing Cat Health and Welfare: Issues, Solutions, Opportunities CVMA BIG Ideas Forum | Spring 2017 Complex problems with polarized opinions are an essential reason why CVMA created the BIG Ideas Forum—and our Spring 2017 meeting on April 1 in Colorado Springs, focusing on cat health and welfare, was no exception. The landscape seems different today, reflecting changes in perceptions of cats and experience gained through new strategies and collaborative approaches to cat health and welfare. Thanks to the participation of a stellar set of issue illuminators, we heard insights from experts and shared perspectives about cat health and welfare as we probed questions such as: • Do Colorado communities have a community cat problem? • Do we have a common understanding of what a community cat is? • Why are animal welfare professionals so passionate that cats are THE animal welfare issue? • How are the special needs of cats addressed in the sheltering environment? • What do data tell us about trends in Colorado cat health and welfare? • What research exists to inform decision making about community cats? • What innovative solutions have been implemented in Colorado to advance cat welfare?
• What have we learned about effective strategies in cat population control? • What models are emerging that create “win-win-win” outcomes for cats, adopters, and veterinarians? • Are we collectively making progress in changing the value perception of cats? We addressed these questions through presentations, panel discussion, and audience dialog, thanks to an all-star line-up of experts in cat health and welfare: • Lisa Pedersen, CEO, Humane Society of Boulder Valley and President, Colorado Federation of Animal Welfare Agencies • Katie Parker, Executive Director, Animal Assistance Foundation • Anna Murrin, Project Manager, Metro Denver C.A.T. • Julie Justman, Director, Pueblo Animal Services • Aubrey Lavizzo, DVM (on behalf of Sarah Swanty, Executive Director) Fort Collins Cat Rescue & Spay/Neuter Clinic • Apryl Steele, DVM, Chief Operating Officer, Dumb Friends League • Linda K. Lord, DVM, PhD, The Ohio State University • Jane Brunt, DVM, Executive Director, CATalyst Council On the following pages, each of these presenters shares information and insights into some of the issues, solutions, and opportunities to advance cat health and welfare. n
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(The one element that’s not confusing in all of this? Price. You don’t need a medical degree to understand that part.) Instead, what if we presented options in the context of making a strong recommendation? For example, we can use statements like, “Based on what we’ve discussed, the plan I’d recommend is . . .” or simply, “To address your concerns, we need to . . .” We can use these phrases and still give people options. However, they offer clear direction on how best to move forward and take advantage of our education, training and experience. If we are acting ethically, listening to our clients and their needs, and practicing a good standard of care, we should be able to give options while also making clear what path we believe will best serve the pet and owner. When we
refuse to commit to any recommendation, we abdicate our position as a guide, consultant and doctor. I believe that also means we fail our clients. Letting go of the biggest lie we tell ourselves in veterinary practice means we have to make some changes. We have to change how and what we communicate in order to increase the odds that pet owners will take the best action for their pets. In that way, we can ensure that when we tell clients what’s best, they’re hearing it and doing it. We can turn the lie into a truth. I think I’m ready. Are you? n Reprinted with permission from drandyroark.com, August 27, 2016.
MEET DR. ANDY ROARK AT CVMA CONVENTION 2017! CVMA is excited to welcome NAVC Practice Management Speaker of the Year and host of the YouTube show, Cone of Shame, Dr. Andy Roark, to CVMA Convention 2017! Join us on Thursday for the Opening General Session from 1:00 to 5:00 PM for an improv-style event that will entertain, enlighten, and educate on issues you face every day like conflict resolution and finding commonality. The session will be followed by a meet-and-greet reception with Dr. Roark. Then start your Friday with our Morning Keynote Session “Sharpen Your Axe” as Dr. Roark inspires and encourages us to re-apply ourselves to the task of molding our careers into what we want them to be. See your CVMA Convention 2017 Registration Brochure that was mailed to you in early June, or visit colovma.org for more information and to register for the convention!
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FOCUS ON THE FELINE The Challenges and Opportunities with Cats in Our Communities Lisa Pedersen CEO, Humane Society of Boulder Valley President, Colorado Federation of Animal Welfare Agencies Animal welfare in Colorado has achieved a high level of success through the collaboration of organizations from shelters and rescues, to animal care and control, the veterinary community, and the people of Colorado who have worked on addressing the needs and challenges facing companion animals throughout the state. Through these efforts we have greatly reduced the number of animals coming in to the shelter system and have seen increased rates of adoption, especially in the canine population. In large part we no longer have a dog overpopulation issue in Colorado and have begun reaching out to communities outside of Colorado to meet the demand for families here. While behavioral and medical issues are still a challenge with dogs, we have comprehensive support and science to assist with management and rehabilitation of these conditions. Our focus turns now to the increasing needs of our cat populations, and while we have seen attitudes shift slightly, we still see traditional volume issues and pet overpopulation in felines. In addition, the level of behavioral support and science doesn’t exist to the same degree for felines as it does for canines. Add to this the fact that cats live their lives very differently than dogs—scent, familiarity with surroundings, and routines are more crucial and central to cats’ lives—and this poses a challenge in the shelter to maintain an ideal environment for cats to thrive and remain healthy and happy while awaiting a new home. The presence of other cats and dogs in a shelter can be difficult for many cats, posing yet another barrier to success in the shelter environment. All of this exacerbates the stress cats experience and can lead to longer lengths of stay for the cats in our care. Other trends affect the number of cats in the shelter system as well. Studies have shown people tend to wait longer to look for cats that go missing, leading to lower reclaim rates, and many cats are simply abandoned rather than rehomed or surrendered to a shelter. Additionally, while we have greatly increased the knowledge of people in our communities about dog behavior and ways to live successfully with canines, the public perception of cats has not reached that same level. This affects the acceptance of normal cat behavior and people are often less forgiving of cat behavior versus what they will tolerate with dogs. There is a wide spectrum of categories for cats that we don’t have complete consensus on identifying and supporting in the animal welfare community: feral, community cat, free-roaming, indoor/outdoor, and indoor only, and we may only be seeing the more easily handled populations of cats. Additionally, as many guardians shift to maintaining their pet cats in an indoor-only capacity to mitigate the PAG E 14 | CV M A Vo ice 2017: 2
risks of an indoor/outdoor lifestyle, shelters find that when these families then sometimes need to separate from their cats, the smaller, predictable home environment they have enjoyed leaves them ill equipped to cope with the stress of the shelter. Cats that arrive as strays or have had previous outdoor exposure are more likely to have encountered stressors in their lives (barking dogs, strangers, smells, and sounds) that sometimes help them to be less overwhelmed by the unfamiliar and startling environment of the shelter. We also see a wide range of complicating medical issues in cats in shelters; dental disease and ringworm are very prevalent. Both concerns can be resource intensive to address. In the case of ringworm, due to the highly contagious nature of the condition and the lengthy duration of treatment, and in the case of dental disease, the expense and specialized equipment and expertise needed. Additionally, the cats with such conditions are often behaviorally compromised, and the potential behavioral fallout of an intensive or invasive treatment can be significant. So given all of these issues, what are the opportunities for cats in our community? We need to start by taking new approaches to thinking about the challenges cats in shelters and in our communities present. As demonstrated in many of the presentations at BIG Ideas that you will read about on the following pages, we can find great success with rolling targeted projects, innovation, and veterinary practice intersections. n
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FOCUS ON THE FELINE Metro Denver C.A.T.— It’s All About the People! Katie Parker, Executive Director Animal Assistance Foundation Anna Murrin, Project Manager Metro Denver C.A.T. Metro Denver C.A.T. (Cats Around Town) is a collaboration of animal welfare groups working together to make metro Denver a place where cats are valued and cared for by an engaged community. The two main goals of Metro Denver C.A.T. are to improve the welfare of the entire cat population and to increase the value of cats, whether they are owned, feral, or fall anywhere on the spectrum:
often unpredictable circumstances of the people in the community. It requires constant follow up to gain trust, access, and to ensure the cats get the services they need. After just one year, Metro Denver C.A.T. is proud to have provided assistance to 1,577 cats, facilitated 1,072 spay/ neuters, and removed 502 cats that have been placed with partners for adoption. Less than 3% (36) of the cats had to be euthanized due to serious medical issues that could not be resolved. n
The initiative works for cats that are owned, homeless in shelters or on the streets, and community or feral cats, providing services in underserved areas throughout metro Denver, with a focus on the 80219 zip code. Starting in April 2017, the focus was expanded to include the 80204 and 80223 zip codes. Metro Denver C.A.T. provides free spay/neuter resources and vaccines for pet and community cats, resources and supplies for outdoor management, and advice and resources for a variety of other cat related issues. Metro Denver C.A.T. works with the community it serves, as residents are key to finding and accessing cats. The biggest obstacle in the community is fear for the cats’ wellbeing; their caretakers fear they will be removed and euthanized. Bi-lingual community outreach coordinators help reach people and cats who would never access services otherwise. Metro Denver C.A.T. customizes solutions for each cat, whether it is part of a colony or a single stray being fed by many people. They have successfully put 502 kittens and social adults into adoption, often working through sensitive situations with the community members who are attached to the cats. They reduce pain and suffering where they can, provide extra care when necessary, and work with the community as a whole, seeing it as a community responsibility. The outreach also extends to education about spay/ neuter and regular veterinary care, which is not a priority in this community and is rarely considered. It’s more than just a lack of awareness that keeps them disconnected from services, it’s a lack of transportation, funds, knowing how to handle and transport a cat, and the chaotic and
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FOCUS ON THE FELINE A “Tail” of TNR in Pueblo, Colorado Julie Justman, Director, Pueblo Animal Services Pueblo Animal Services (PAS), a division of the Humane Society of the Pikes Peak Region, began serving Pueblo and Pueblo County in 2002. In 2011, faced with high cat intakes per capita, they began changes to services and policies that would dramatically raise the live release rate for cats in the area. PAS began with halting field impounds for cats, except in cases of illness, injury, or bite quarantines. The next step was to close the after-hours drop off facility, which was responsible for 800 to 1,000 intakes annually, most without any information or identification. The next step was to begin developing a TNR program by working with municipal leaders to make changes to the animal ordinances in the city of Pueblo. This process took about six months to accomplish. While the ordinance revisions were in progress, PAS staff worked on program design and process development. The model they decided was the best fit for the Pueblo community was one that was both professional and grassroots. The program consists of one FTE coordinator responsible for the documentation, permitting, and management of community cat colonies throughout Pueblo County. Funding was sought and approved from multiple granting organizations, with Animal Assistance Foundation and PetSmart Charities being the major funders. The program became fully operational in January of 2012 and immediately launched a targeted initiative focusing on zip code 81004, the area responsible for the highest number of stray cat intakes to the PAS shelter. To gain early support from those providing care for community cats, PAS sponsored a contest with prize dollars being paid to the charity of the winner’s choice; whoever brought in the most cats won. The contest program was used in the initial two years of the TNR program, then found to be unnecessary by year three. From 2012 through 2015, PAS targeted three zip codes, resulting in over 4,000 cats being sterilized through the TNR program. All targeted initiatives included between 150 and 200 owned cats from those areas being sterilized and vaccinated as well. In addition to the targeted initiatives, PAS was also permitting colonies throughout Pueblo County. Permitted colony managers (caretakers) are responsible for providing food, water, and shelter for their colony members. They are also responsible for making surgery appointments, trapping, transporting, recovering, and releasing the cats in their colony. Colonies may only be permitted on private property with landowner permission. Progress toward 100% sterilization must be made for them to remain permitted through the program, and annual census reports also are required. The TNR Coordinator provides mediation in cases of upset neighbors and offers trial cat deterrents, such as ultra-sonic devices, motion-activated water sprink lers, and both chemical and natural sprays and liquids. PAG E 16 | CV M A Vo ice 2017: 2
Since its inception in 2011, PAS has sterilized, vaccinated, and ear-tipped nearly 7,500 feral / community cats in the Pueblo area. The impact of this program has been evident in the lower intake numbers to the PAS shelter. Comparing 2012 to 2016 statistics, we have seen a 40% decrease, or 730 fewer stray cat intakes, from all areas in Pueblo County. Comparing specific targeted zip codes, there has been between a 42% and 53% (118 to 223 cats) decrease in stray cats entering the shelter. The effect on cat euthanasia within the shelter has been dramatic. From 2003 to 2010, cats entering the Pueblo shelter were facing a 70% to 74% chance of being euthanized. In 2016, that percentage dropped to 30%. The percentages do not tell the entire story however, because the number of cats entering the shelter at the highest year (in 2007), was 3,739. In 2016, the number of cats entering the Pueblo shelter was 1,283. In 10 years, PAS had lowered the number of cats at risk of euthanasia by 66%, meaning 2,456 fewer cats were entering the shelter. Currently the Pueblo TNR program has 334 permitted colonies that contain 3,487 documented cats. The program- wide sterilization rate is now 77%. Over the last year, there has been a reduced volume of applications to permit new colonies. Many of the applications received now are a result of contact being made by Animal Law Enforcement officers in the field or by the TNR Coordinator coming across colonies in her day-to-day field activities. The success of the TNR program in Pueblo is attributed to many things: supportive grant makers, participation from colony managers, guidance from HSPPR leadership, dedication of the TNR coordinator and support staff, and also the overall acceptance and support from the community itself. The positive impact for cats this program has had in the Pueblo community is very significant, and we continue work to sustain it into the future. n
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FOCUS ON THE FELINE Making Every Pet a Healthy and Wanted Pet Sarah Swanty, Executive Director, Fort Collins Cat Rescue & Spay/Neuter Clinic Fort Collins Cat Rescue & Spay/Neuter Clinic (FCCRSNC) was founded in 2006 with a mission to prevent pet homelessness and a vision that every pet is a healthy and wanted pet. They fulfill their mission by adopting out homeless cats, reducing unwanted animals through spay/ neuter, and helping struggling families care for their pets. FCCRSNC serves Northern Colorado and Southeastern Wyoming, primarily Larimer and Weld counties, with 35 paid staff members and about 475 volunteers, and an annual operating budget of $1.7 million. Dr. Gloria Matsushita is the full-time staff veterinarian, and they have other veterinarians who also perform spay/neuters for them. They have developed partnerships with local veterinary hospitals and the CSU Veterinary Teaching Hospital and are one of the few shelters that treats ringworm. Through their efforts, over 45,000 spay/neuter procedures have been done since 2006. FCCRSNC adopts out cats that have come from owner surrenders, transfers from other shelters and rescue groups, hoarding or abandonment situations, strays, and returns. They have a detailed adoption q uestionnaire, and ask that the cats they adopt out be kept indoors and not be declawed. The shelter is based on an adoption- guarantee, limited-admission structure, and all cats are sterilized, vaccinated, microchipped, tested, and dewormed. They offer a lifetime “return” policy to help ensure that the cats are not abandoned in the future and special adoption programs for “Working Cats” or those with special needs. In 2014, the shelter started a low-cost spay/neuter clinic open to the general public that also provides wellness exams, and they offer on-site and mobile vaccination clinics.
Community Cat Program Another hugely successful endeavor has been the Community Cat Program, which provides assistance for feral and outdoor cats and their caretakers. Of the 270 cats trapped in 2016, 101 were returned after spay/neuter, 107 kittens were placed into foster care, and 62 adult cats were brought into the shelter. Loveland-Windsor Free Roaming Cats Project Also of note is the Loveland-Windsor Free Roaming Cats Project, a two-year, grant-funded (primarily by PetSmart Charities) project that started in 2015, and has so far provided spay/neuter and rabies and FVRCP vaccinations for 1,400 cats. The services are offered to any cat that spends any amount of time outdoors, whether owned or community cats. Results, Challenges, and the Future So are all of these programs working? Yes! In 10 years, FCCRSNC has seen an 84% decrease in euthanasia at our local open-admission shelter! Like any ambitious mission, the FCCRSNC and its programs face challenges, including medical, behavior, and senior cats; ringworm treatment; and finding the resources for Healthy Pet Clinics. They also see transportation barriers for pet owners needing services, and issues with building trust with cat colony caretakers. As FCCRSNC looks to the future and potential growth, they would like to see a “Cats Indoors” partnership with Audubon of the Rockies and the Larimer Humane Society. They also want to work with veterinary partners to emphasize the importance of regular veterinary care for cats, and to find ways to increase adoption of special needs cats through exclusive, discounted veterinary care partnerships. n
Pet Retention Services FCCRSNC has created several programs to help pets and to keep cats in their homes. Through the Prevent A Litter Plus (PAL+) program, which offers financial assistance for spay/neuter and vaccines for low-income pet owners, 3,665 pets have been spayed/neutered since 2008. The Kibble Supply Pet Food Pantry helps low-income families feed their dogs and cats and has distributed 160,000 pounds of food since 2010. They also have a Cat Retention Specialist who provides behavior resources and guidance to prevent cats from being surrendered. Their Healthy Pet Clinics visited two locations in 2016, helping 554 at-risk pets receive services, and over 100 have since been altered in the clinic. CVMA Voice 2017: 2 | PAGE 1 7
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FOCUS ON THE FELINE Advancing Cat Health and Welfare: Issues, Solutions, Opportunities Jane Brunt, DVM, Executive Director, CATalyst Council Formed in 2008, CATalyst Council’s mission is to transform the health, welfare, and value of companion cats. It is the outcome of two grassroots efforts: Re-Branding Felix and the CATalyst Summit. Following these two meetings, CATalyst Council, a non-profit entity, was created and includes three distinct groups: veterinary medicine, shelter/ animal welfare, and related industry entities such as foundations and cat fanciers, the media, and commercial companies. By virtue of the open and inclusive structure of the board, these bodies are able to represent a broad range of diverse stakeholders in feline healthcare and welfare. Many of these stakeholders participated in the CATalyst Summit. Working together, the Council intends to make a difference in the way the United States sees and experiences cats. CATalyst’s purpose addresses our desire to change society’s image of cats as aloof and not needing human contact or care and our vision is to raise the level of care and welfare of cats by cat owners—one that any owner will embrace through the human-animal bond and can achieve—supported by the highest quality veterinary care, preventive medicine, and cat-specific products. “Connecting Cats to Care” is the foundational concept which drives each of the evidence-based efforts and initiatives led by CATalyst Council. CATalyst published Stats on Cats, a compilation of various feline-related statistical resources in 2015, and it will be updated this year after the release of both AVMA and American Pet Products Association (APPA) pet owner survey data. Some of the more telling statistics show that only 47% of companion cats visit a veterinarian, 3.2 million cats enter shelters every year, and 46% of cats are adopted from animal welfare organizations. Catalyst Connection: Forever Homes. Forever Health For years, shelters and veterinarians have often operated independently with very little collaboration. Now, C atalyst Connection is helping to bridge that gap and develop a sense of community for the betterment of animals. C atalyst Connection’s mission is to enhance and protect the lives of animals by promoting successful adoptions and lifetime veterinary care, which ultimately translates to better, longer-lasting relationships between pets and their owners. Resources, materials, and toolkits are available to those interested in developing a strong shelter-veterinary relationship in a community. Iterations of the Catalyst Connection program piloted in four communities (Portland, OR; Columbus, OH; Wilming ton, DE; and Douglas County, CO) as a way to enhance shelter-veterinary relationships and place post-adoption PAG E 18 | CV M A Vo ice 2017: 2
healthcare for cats and dogs into veterinary practices. The program has been designed to create collaborative relationships and enable diverse stakeholders to participate in promoting positive outcomes for problems in their individual communities. The pilot program process starts at the shelter—when the pet is adopted, the new owner chooses a local veterinarian who has agreed to participate in the program and offer a free new-pet examination (in some communities additional services are provided). The shelter emails the pet’s health records and adopter contact information to the chosen veterinary clinic, who calls the adopter to schedule the appointment. CATalyst Council is developing software to automate and streamline the process. In Colorado (Douglas County), this Return for Care program was piloted through CVMA and the Dumb Friends League Buddy Center. In the first year, of the 662 eligible adoptions, 87% selected a veterinarian at the time of adoption, 58% completed the free exam, and 84% of adopters returned for additional care. The average cost to the veterinarian to acquire a new patient through the program? A little more than $16. The plan is to scale the program statewide with other Colorado shelters in 2018 once the technology platform is finalized by CATalyst so that more data can be accumulated. In Portland, the Oregon Humane Society and Portland VMA data showed 10,767 dog and cat adoptions (during the first year), with 180 practices visited as 20% of adopters completed the free exam—and 60% of free exam users forward booked their next visit. In Columbus, the Capital Area Humane Society and the Columbus Academy of Veterinary Medicine reported 2,835 adoptions (266 for dogs and 470 for cats) where 758 owners selected a veterinarian. In the first six months, 42% of cat adopters completed the free exam and 36% of dog adopters completed the free exam. In Wilmington, the Delaware Humane Association reported 1,255 adoptions during the first year with 21 practices visited after 71% of owners selected a veterinarian at the time of adoption, 5% scheduled their first appointment at the time of adoption, and 20% of adopters completed the free exam. Connecting Cats to Care . . . or Care to Cats CATalyst helps the veterinary and sheltering community explore options to improve the lives of cats, whether they are in homes, in shelters, or in the community at large. But innovation isn’t limited to the animal welfare arena. We need to look at all the facets that affect cats, from encouraging cat friendly housing (private and public), serving underserved and at risk populations of pet owners, addressing behavioral issues that affect cats’ lives and wellbeing, to studying and promoting enrichment and even considering telehealth as a vehicle to make sure more cats connect with veterinary care. n
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FOCUS ON THE FELINE Colorado is Connecting Cats to Care Jane Brunt, DVM Executive Director, CATalyst Council
Colorado is for Cats and the CVMA, Dumb Friends League, and other members of the Metro Denver Animal Welfare Alliance have always been leaders in coalitions across the state, the U.S. and North America. Many collaborative Colorado programs and initiatives have been designed to promote cat health, welfare, and value: Chip the Cat; Rebranding Felix; Dumb Friends Leagues—Solutions Cat Spay/Neuter Clinic; this spring’s BIG Ideas Forum on Advancing Cat Health and Welfare: Issues, Solutions, and Opportunities; and especially R eturn For Care, a cat (and dog) pilot program already being tested with the help of (and benefit for!) CVMA members in Douglas County. Return for Care is a CVMA program to promote veterinary visits to local practices immediately after adoption from participating animal shelters. In the first year of the pilot coordinated by CVMA and the Dumb Friends League Buddy Center, of the 662 eligible adoptions, 87% selected a veterinarian at the time of adoption, 58% completed the free exam, and 84% of adopters returned for additional care. The average cost to the veterinarian to acquire a new patient through the program was a little more than $16. The plan is to scale the program statewide with other Colorado shelters in 2018 once the technology platform is finalized by CATalyst Council so that more data can be accumulated. Catalyst Connection: Forever Homes. Forever Health (http:// catalystcouncil.org/connection) is a program with robust resources already available to help local communities communicate about their animal issues and enhance cooperative relationships including and especially those involving cats. The Catalyst Connection cloud-based platform and data hub will: 1. Implement, monitor and measure Connecting Cats to Care 2. Host CVMA’s Return for Care program
3. Provide connected communication with both shelter and veterinary practice software systems 4. Provide access to shelter pet health reports of adopted pets to adopters and veterinary practices (no more “I left the records at home . . .”) 5. Allow more cats to be adopted into homes where, with an already great veterinary relationship established through the program, they will be able to receive much needed lifelong care Highlights of upcoming events in October 2017 This October, Denver will be the site of two feline-focused national meetings. On October 18–19, CATalyst Council will hold their Annual Board Meeting and Networking Event at the CVMA office and from October 19–22, the American Association of Feline Practitioners’ Annual Conference will be held at the Sheraton Denver Downtown Hotel, focusing on Feline Infectious Diseases and Pediatrics (www.catvets. com/education/conference/). Also during the AAFP conference, registrants will be able to learn more about AAFP’s Cat Friendly Practice program, how to elevate feline care (www.catvets.com/cfp/veterinary-professionals), and earn the Cat Friendly Practice designation for your practice. In Colorado, It’s All About the CAT and Connecting Cats to Care! n
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FOCUS ON THE FELINE Pioneering Solutions in Colorado Cat Welfare Apryl Steele, DVM, Chief Operating Officer Dumb Friends League Bear with me while I reel off some numbers—because these numbers tell a story that offers both inspiration and motivation: Metro Denver’s population in 1980 was 1,618,461, and by 2015, it had almost doubled to 3,075,701. Back in 1983, 84,250 animals were taken to animal shelters in the Denver metro area, of which 48,651 were euthanized (57.75%). From the mid-1970s to the early 1980s, the Dumb Friends League (DFL) was at times forced to euthanize as many as 250 cats and kittens a day. In looking at just one year during that period—1982—DFL received 14,710 felines; of those, 11,046 (78%) were euthanized. By comparison, in 2016 the shelter took in 10,057 cats, and only cats that were suffering had to be euthanized, which equated to 1,251 cats (12%). Something obviously has changed in the past 30-plus years. What has led to such a dramatic decrease in feline euthanasia? Collaboration Works! Colorado is exceptionally lucky to be so far ahead, in comparison to other states, when it comes to collaboration in the realm of animal welfare. Not only do our shelters work together to tackle common issues and improve animal care, but no other state that I’m aware of has shelters that work hand-in-hand with their state VMA, as we do with CVMA. We are very grateful for that partnership, and we are also extremely proud of it. As partners, we have come together to address numerous animal welfare issues, including ongoing veterinary care for shelter pets, the accessibility of rabies vaccinations for shelter pets, and the problem of cat overpopulation. And while the number of cats coming into shelters has declined, along with the number of cats being euthanized, we still have much more to do to resolve “the cat challenge.” Part of the work that still needs to be done is around the issue of community cats—cats that are often not valued. Another part is addressing the underserved segment of cat owners, many of whom take care of their cats’ needs before their own. The cat in these individuals’ lives might be their only source of companionship—and yet they struggle to provide adequate care for that companion. We need to honor that bond and find ways to provide both these cats and their owners with the care and services they need. Continuing to find strategies to do so is vital, and collaboration is key. One way DFL, with the help and support of so many, is addressing some of the ongoing challenges is through our new Solutions – Cat Spay/Neuter Clinic that opened this January 8 at 191 Yuma Street, home to PetAid Colorado PAG E 20 | CV M A Vo ice 2017: 2
and the CVMA offices. This unique partnership—the only one of its kind in the country—was undertaken after many discussions, much planning, and in collaboration with the veterinary community. We surveyed CVMA members regarding their input on a free cat spay/neuter clinic before moving forward. You can read a summary of the survey and results on page 21 and learn more about the clinic on page 22, including FAQs. The Solutions clinic has been highly successful, with 2,040 cat sterilization surgeries performed from early January through April 30. The cats we see at the clinic are a mix of owned, loosely owned, community, and feral, and 84% of the patrons we’ve served so far report that the cat they brought in has never seen a veterinarian. Our ambitious goal is to perform 10,000 spay/neuter procedures per year. Even coming close to that goal will make a tremendous impact on our community and on the lives of the cats that live here—none of which could happen without the collaboration and innovation we are so fortunate to enjoy here in Colorado. n
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FOCUS ON THE FELINE Community Cats: CVMA Members Speak In an effort to gather more information about member perceptions of community cats in Colorado, CVMA undertook a member survey in 2016. Thank you for sharing your views on this complex issue. Respondent Characteristics A total of 96 CVMA members responded to the survey. Over half of the respondents (54.2%) identified that they practice in a suburban location, with 24% identifying an urban and 21.9% a rural practice location. General small animal practice accounted for 56.3% of the respondents’ veterinary service with mixed practice the second most frequent response at 13.5%. Respondents were mostly female (71.9%) and ranged from veterinary students to veterinarians practicing for over 50 years covering a wide range of age categories.
No-fee Clinic Concept When asked how they would feel about a no-fee, cat-only spay/neuter service in their community in which they were not required to make an investment of time or money, 84.3% of respondents indicated they strongly supported (33.3%), moderately supported (30.2%), or were neutral (21%) about the question. There were no differences in answers based on the respondents’ gender, age category, practice location or role in practice. Supporters believe that this service could positively impact the quality of cat lives and decrease populations. Those not in support worry about the impact on the profession, both the respect for services and business impact. Concern for wildlife impacts and a lack of perceived need were also reasons for non-support.
Perceptions Over half of respondents (53.1%) answered yes when asked if there is a community cat problem in their area; no statistical differences were found between age or gender when answering this question. Associates in practices were less likely to identify community cats as a problem than were those in education or government and retirees (p=0.02). Those in rural practice were more likely to identify community cats as a problem than those in urban or suburban practices (p<0.01). Mitigating the Issue When asked who is responsible for mitigating the community cat problem where it does exist, citizens/community was most frequently selected (83.3%) followed by shelter (72.9%), trap-neuter-return groups (67.7%) and veterinarians (51%). Fewer than half of responding veterinarians participate in outreach or services around community cats. Providing education was the most common form of service reported (47.9%) and even fewer report that their practices provide services to the community cat population. However, 61.5% of veterinarians are aware of community cat programs within their area. Over half of veterinarians in practice (54.2%) would be willing to provide spay/neuter services for community cats at a reduced fee.
Member Ideas Survey respondents were asked “What great idea do you have to help address the cat overpopulation problem?” Public education emerged as a theme, with focal points including responsible cat ownership and the impact of free- roaming cats on wildlife. The benefits of spay/neuter were mentioned by many respondents; others believe alternative contraceptive methods are needed. Multiple respondents suggested that free-roaming cats should be illegal, just like free-roaming dogs. Summary Similar to other regions, Colorado veterinarians responding to this survey are split in identifying community cats as a problem in their area and, if there is a problem, how to resolve it. Education of the public through schools, media and one-on-one with clients were identified as key components in solving issues of community cats. n
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FOCUS ON THE FELINE Dumb Friends League Solutions— Cat Spay/Neuter Clinic Opens at 191 Yuma Street
The Denver area has a new resource focused on reducing cat overpopulation! With thousands of reproductively intact cats roaming free within the Denver metropolitan area, animal welfare organizations are consistently overwhelmed with cats and kittens. The large number of cats living on the streets or waiting for homes in shelters and rescues is one of the biggest challenges in animal welfare across the country and in Colorado. While the Dumb Friends League (DFL) performs approximately 4,500 spay/neuter surgeries on cats at their shelters prior to adoption each year, and another 5,600 spay/neuter surgeries on owned and community cats through its mobile spay/neuter clinics, there remains a need to make fully subsidized spay/neuter services for cats more accessible in our community. To help address this growing issue in our community, the Dumb Friends League (DFL) has opened a cat spay/neuter clinic, operated by DFL and housed at PetAid Colorado’s facility at 191 Yuma Street. Appreciating the potential to positively impact cat welfare through a more intensive sterilization initiative, PetAid is pleased to be able to lease the space to DFL for this no-fee cat sterilization clinic. DFL also sought the input of Colorado veterinarians before undertaking this effort. CVMA surveyed its members PAG E 22 | CV M A Vo ice 2017: 2
to assess the level of support for a fully subsidized, no-barrier spay/neuter clinic. The survey revealed strong support for such a cat-only spay/neuter clinic (see page 21). Consequently, the CVMA Executive Committee voted to fully support the clinic as a way to reduce cat overpopulation and enhance the wellbeing of cats. The Dumb Friends League Cat Spay/Neuter Clinic is being partially funded for a three-year period by generous grants from the Animal Assistance Foundation, PetSmart Charities™ and the American Society for the Prevention of Cruelty to Animals (ASPCA), as well as by the Dumb Friends League. DFL will be working closely with other local organizations, including Denver Animal Protection, Metro Denver C.A.T., and a number of rescues and TNR groups, for trapping and transporting services. The new clinic will augment—not replace—the Dumb Friends League’s mobile spay/neuter program. The goal of the Dumb Friends League Cat Spay/Neuter Clinic is to help reduce cat overpopulation in metro Denver and beyond by spaying or neutering an additional 10,000 cats each year. CVMA is supportive of this effort, which is the right thing to do for the cats and people of our community, and we welcome the DFL clinic to 191 Yuma Street! n
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FOCUS ON THE FELINE Dumb Friends League Solutions—Cat Spay/Neuter Clinic FAQs Q: Why is the Dumb Friends League opening a spay/neuter clinic for cats? A: The large number of cats living on the streets or waiting for homes in shelters and rescues is one of the biggest challenges in animal welfare across the country and in Colorado. While the Dumb Friends League performs approximately 4,500 spay/neuter surgeries on cats at their shelters prior to adoption each year, and another 5,600 spay/neuter surgeries on owned and community cats through its mobile spay/neuter clinics, there remains a need to make fully subsidized spay/neuter services for cats more accessible in our community. The goal of the Dumb Friends League Cat Spay/ Neuter Clinic is to help reduce cat overpopulation in metro Denver and beyond by spaying or neutering an additional 10,000 cats each year. Q: Why isn’t the clinic also open to dogs? Cat overpopulation is a much greater challenge than dog overpopulation in metro Denver, so the focus of this facility and program will be to spay and neuter cats. The Dumb Friends League will continue to offer reduced fee spay/neuter surgeries for dogs, subsidized by its donors, on its Lulu Mobile spay/neuter clinic. Q: What kind of cats are eligible for surgery at the clinic? The clinic is open to all Colorado cats, including feral cats, trap-neuter-return (TNR) cats and community cats (defined as free-roaming cats, whether tame or feral), and owned cats. Q. How will feral, TNR, and community cats get to the clinic? The Dumb Friends League will work closely with other local organizations, including Denver Animal Protection, Metro Denver C.A.T. and a number of rescues and TNR groups, for trapping and transporting services. Q: Will the cats get vaccinations along with their spay/neuter surgery? Yes, cats that undergo spay/neuter surgery at the clinic will receive age-appropriate vaccinations, including rabies. Q: Will any other services be available at the clinic? For cats admitted for spay/neuter surgery, the owners can elect to have them tested for Felv/FIV and/or microchipped for a fee. Q: Who performs the surgeries at the new clinic? Dumb Friends League veterinarians who are licensed to practice in the state of Colorado perform the surgeries, assisted by Dumb Friends League veterinary technicians. Q: Do clients need to have a low income in order to get cats spayed or neutered at the clinic? No, anyone can bring a cat(s) to be spayed or neutered at the clinic, regardless of income. There are no income qualifications for clients who bring cats to the clinic. Q: How will you let people know about the clinic? As part of this proactive new program, the Dumb Friends League humane education staff will be going out into the community to teach the value of spaying and neutering to people in underserved areas that would be most likely to use the services of the clinic. In addition, the Dumb Friends League outreach staff will be canvassing neighborhoods and speaking to community groups. Q: Does the Colorado veterinary community support the new clinic? Yes, the Colorado Veterinary Medical Association (CVMA) surveyed its veterinarian membership to assess the level of support for a fully subsidized, no-barrier spay/neuter clinic. The survey revealed strong support for such a cat-only spay/neuter clinic. Consequently, the CVMA Executive Committee voted to fully support the clinic as a way to reduce cat overpopulation and enhance the wellbeing of cats. Q: Is the new clinic going to replace the mobile spay/neuter clinics operated by the Dumb Friends League? A: No, the new clinic will augment—not replace—the Dumb Friends League’s mobile spay/neuter program. The Dumb Friends League Meow Mobile and Lulu Mobile will continue to travel to underserved areas of metro Denver to provide free spay/neuter surgeries for cats and low-cost spay/neuter surgeries for dogs (Lulu Mobile only), subsidized by Dumb Friends League donors. Q. Who is funding the clinic? The Dumb Friends League Cat Spay/Neuter Clinic is being funded for a three-year period by generous grants from the Animal Assistance Foundation, PetSmart Charities and the American Society for the Prevention of Cruelty to Animals (ASPCA), as well as by the Dumb Friends League. n CVMA Voice 201 7: 2 | PAGE 2 3
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FOCUS ON THE FELINE Cats Can Wear Collars! An Evaluation of Visual and Permanent Identification in Pet Cats Linda K Lord, DVM, PhD Academic and Allied Industry Liaison Merck Animal Health I’ve always had an interest in recovery of lost pets, and especially identification, spurred by a personal experience when my own two dogs ran away. One came home on its own in four days, and the other was returned to us in five because of his ID tag. This led me to my research interest in how owners search for their lost pets and differences in people’s perceptions between dogs and cats. In a public perception survey, only 33% of people believe cats should be indoor only and 63% believe stray cats can find their way home on their own. Owners themselves often believe that if their cat is indoor-only, ID is unnecessary because their cat won’t get lost in the first place. They also believe that cats won’t tolerate wearing collars or that collars pose a danger to the cat. Add into this the reality that cat owners, in general, wait longer to start searching for a lost cat and visit the shelter less often than dog owners, and far fewer cats are returned to their owners than dogs in shelters. In one Ohio study, 41% of the cats that owners considered lost were indoor-only. Reactions are very different when people see cats outside (they belong there, they’re fine outside, they will find their way home) as opposed to when they see dogs running loose (it must be lost, it needs to be returned to its owner). Only 14% to 18% of cats have visual identification and 3% to 7% have microchips (which don’t offer an outwardly visible cue that this animal is owned and perhaps needs to find its way back home). Dogs are far more likely to have proper identification, and to be wearing a collar and ID tags, or at least rabies tags, than cats. Why is that? That question led me to a research project to look at cats and collars, focused on the whole misconception there seems to be that cats can’t or won’t wear collars. With other colleagues interested in this topic as well, we enrolled 538 cats owned by veterinary students, other university students, and the general public from four university communities to evaluate if cats would tolerate wearing collars, if owners would continue to keep collars on cats, and to test for migration and functionality of microchips. We randomized cats to one of three collar types (breakaway, elastic stretch, and adjustable nylon) and implanted the cats with microchips, then checked collars monthly and microchips at the end of the six-month study period. Owners could drop out of the study at any time for any reason. Before we started, we asked perception questions of the owners as well.
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When asked how well they thought their cat would tolerate wearing a collar, 17% responded extremely well; 25% moderately well; 37% fairly well; and 21% poorly/not at all. In reality, the study showed 62% tolerated the collars extremely well; 19% moderately well; 10% fairly well; and 9% poorly/not at all. Owners perceived cats wearing the adjustable nylon collar as having tolerated the collar much better than the other two collar types (78% for adjustable nylon vs. 60% for breakaway and 46% for stretch elastic for extremely well category). At the end of the study, overall 77% of the cats were still wearing the collars, with the highest percentage of 88% for the adjustable nylon. When asked, 89% of owners said they plan to continue to keep collars on their cats. Additionally, owners’ expected vs. actual assessment of their cat’s toleration of a collar improved for all three collar types, but less for elastic stretch collar (78% for adjustable nylon and 75% for breakaway vs. 59% for elastic stretch). For those owners that did not complete the study, they gave the following reasons: 38% said the collar was lost; 13% the collar kept coming off; 19% said the cat was scratching/rubbing at the collar, 8% said the cat caught its foot/mouth in the collar; and 22% replied “other” reasons. As for the microchips, there has been only one failure to date, one migration of chip to the elbow area, and no loss of microchips reported. At the end of the study, we found that 73% of the cats were able to successfully wear collars for the whole six months. There was a low incidence (3.3%) of issues—cats caught a forelimb in their collar or caught their collar on an object or in their mouth—and no injuries from wearing collars. We were confident in concluding that cats can successfully wear collars, and the vast majority of owners thought their cats tolerated collars extremely well, especially those using the adjustable nylon collars. What we would like veterinarians to know is that they are key in educating cat owners on the importance of cat collars and identification. Our study shows that cats can— and will—wear collars and most of the misconceptions we’ve all had for years aren’t actually true. With this knowledge, our hope is that veterinarians will take the time to show their clients how to properly put a collar on their cats and how much to tighten it for the cat’s comfort and security. A simple demonstration in the exam room can go a long way in getting more cats in collars with identification, ensuring that more of them get home safely. n
A M E R I C A N A S S O C I AT I O N O F F E L I N E P R A C T I T I O N E R S
Feline Infectious Diseases and Pediatrics Distinguished Speakers
Elizabeth Bailey, DVM Jennifer Brandt, PhD, LISW Ellen Carozza, LVT Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CCRP Mark Epstein, DVM, DABVP (Canine/Feline), DAAPM, CVPP Tammy Grubb, DVM, PhD Michael Lappin, DVM, PhD, DACVIM Justine Lee, DVM, DACVECC, DABT Annette Litster, BVSc, PhD, FANZCVS (Feline Medicine), MMedSci (Clinical Epidemiology) Susan Little, DVM, DABVP (Feline) Karen Moriello, DVM, DACVD Maryanne Murphy, DVM, DACVN Niels Pedersen, DVM, PhD Jessica Quimby, DVM, PhD, DACVIM Jane Robertson, DVM, DACVIM Kersti Seksel, BVSc (Hons), MRCVS, MA (Hons), FACVSc, DACVB, DECAWBM John Volk Craig Webb, PhD, DVM, DACVIM *Subject to change
Conference Features ■ ■
Feline-specific material presented by expert speakers. Sessions for veterinarians who see cats at all levels of their career. Two Veterinary Tracks and one Para-professional Track. Lunch & Learns – additional CE is offered through lunch with speakers. Attendance is limited.
Poster sessions presented in the exhibit hall.
Networking and social activities with colleagues.
SAVE THE DATE!
Meals and coffee breaks in our interactive exhibit hall. Feline-friendly Handling Lab – attendance is limited.
Pre-conference Day Sessions: topics such as Neuropathic & Neurogenic Pain Conditions, NSAIDs & Opioid Updates, Pain Modifying Drugs, Wellness & Compassion Satisfaction, Nutritional Management of Obesity & Arthritis and Local Anesthesia & Loco-regional Techniques. Infectious Diseases: topics such as FIP, Zoonosis, Flea & Tick Associated Illnesses, Dermatophytosis, Infectious Otitis, Bacterial & Yeast Overgrowth, Infectious Diarrhea, Upper Respiratory Infection, Emerging Feline Pathogens, Update on Diagnostic Tests, Clinical Uses of Probiotics, and more. Pediatrics: topics such as Preventive Healthcare, Pediatric Anesthesia, How to Treat the Small & the Sick, Kitten Development, Problem Intervention, Socialization, Retrovirus Updates, and more. Sessions for para-professionals will also be offered on topics such as Kitten Kindy, Taming the Cantankerous Cat, Trouble Shooting Fading Kitten Syndrome, and the New AVTCP Technician Feline Specialty.
October 19 – 22, 2017
Sheraton Denver Downtown Hotel Denver, CO For more information including the agenda, abstracts and to register, visit www.catvets.com/education.
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FOCUS ON THE FELINE Cats I Have Known Curtis Crawford, DVM CVMA Past-president On a small family farm, everybody has a job. Even the cats. Mouse and gopher control topped the duties list for my mom and dad’s cats, followed by official fresh cow milk tasters and obligatory lap warmers. Our herd ran the gamut from the true feral ones that were never seen to “almost” pure house cats. Mom insisted that a farm wasn’t complete without a black tomcat named “Top Cat” around and we had several of that ruling dynasty throughout the years. However, there was usually an alpha female in the mix who would argue that designation by beating the tar out of the current “Top Cat” on a regular basis. My younger brother and I shared a fold-down couch as a bed in the living room until we started gradeschool. That arrangement had its pluses and minuses. On the plus side, we kept each other warm on those cold winter nights. We could double up that heat by bringing the dogs and cats to bed. On the minus side, sibling bladder control could be an issue, especially after eating a good, ripe watermelon with salt just before bedtime on a summer evening. One night, I woke to wetness spreading across the sheets from my brother’s side of the bed. An exasperated cry of “MOM!!!” brought her stumbling out of the bedroom to turn on the light revealing that my brother was not the culprit (this time). Our favorite cat, Momma Kitty, had nested and d elivered her kittens there. I reckon it was her way of showing us how much she trusted us. Another cat that has captured my affection is our current clinic cat. She is named 8-Mile because she was found on 8-Mile Road by a Good Samaritan. There are no shelters licensed to handle cats in our five-county area and we had recently lost our old clinic cat, so we got suckered into taking her. She was a moth-eaten, rangy, long-haired calico with no meat on her bones. A good deworming and excellent diet was prescribed to get her back into shape. But after a month, it was evident that in spite of a great appetite and attitude and being kept in our indoor large animal facility, this cat was not looking any better. She was as embarrassing as a skinny cook in a truck-stop diner. The staff should reflect the quality of the grub. A little blood worked revealed the issue to be diabetes. By now we were too attached to her to give up on her and she proved to be a willing recipient of daily insulin injections. And she blossomed! The ratty, greasy hair coat sleeked up and her eyes took on a beautiful green glow. We fed the recommended diabetes diet and within a short time, she started maintaining her blood sugar levels without insulin. Her muscles filled out, but that rotund belly didn’t change. She looks like a long haired football on legs. She gets high-centered on the door threshold. It has become a regular conversation with large animal clients coming into the barn, “No, she is not pregnant, she is our self-propelled PAG E 26 | CV M A Vo ice 2017: 2
dust mop.” We even tried the dreaded 4-letter word, “di-e-t.” 8-Mile wouldn’t have anything to do with that. We store our extra dogfood inventory in the barn and every time 8-Mile sees the bottom of her food bowl between the pieces of kibble, she tears into a bag. And it ain’t the small, least expensive bag either. 8-Mile has made the barn her domain. People are welcomed with a purr and a rub around their boots. Horses and cattle are tolerated. Dogs and cats are loudly cursed with hisses and growls from her bed behind the pallets of dog food. Since our radiograph machine is also in the barn, 8-Mile gets to practice her vocal complaining quite regularly. But last month, something happened that shocked the entire office. We were trying to radiograph one of those rotten, large dogs with no manners. A quick x-ray that shouldn’t take anytime at all had become a major ordeal. The dog had to be muzzled and was fighting the whole way to the machine. He finally balked at the table and went into an alligator death-roll on the end of the leash with fluid spewing out of every secreting and excreting orifice. Kinda like one of those spinning firework pinwheels, but not near as pretty. Urine, stool, anal sac juice, saliva, tears, and ear wax flung far and wide as he shrieked like a stuck pig. Then over the dog’s vocalization, a low buzz-saw sound rose in a quick crescendo from 8-Miles’ boudoir (bet you didn’t think I knew that word). Suddenly 8-Mile flew from her bed and over the stacks of dogfood like an Olympic pole-vaulter to tear into that dog, slapping him multiple times across the face quicker than Jackie Chan. The dog abruptly stopped his panic attack as he crossed his eyes trying focus on the blur of cat paws whacking his nose. The techs were as flabbergasted as the dog. No one knew that cat was capable of such explosive speed and agility. Worried that 8-Mile was going to scratch this dog’s eyes out like a jilted prom date, they pulled her off and set her back on the dog food. The dog was now sitting stone still and subdued. But as they started to lift him onto the table, the stupidity synapse fired once again. This time there was no warning as 8-Mile swooped down to land in the middle of that dog with an audible thud and commenced to schooling him on proper behavior in the Kingdom of 8-Mile. Chagrined for the second time, the dog relented to being picked up out of 8-Mile’s righteous wrath. With her tail high in the air and that little swagger that only a cat can have, 8-Mile sauntered around the end of the dog food back to her bed and began licking off all the dog cooties from her paws. Why did I tell you the heroic tale of 8-Mile, Crouching Cat, Defeated Dog? Cats are the focus of this issue of the VOICE. Our partners in animal control and welfare have done a fantastic job of addressing dog overpopulation in Colorado and are now taking steps to address the unique issues that come with unowned cats. It requires some Continued on next page
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thinking outside the box and we as the CVMA have an opportunity to make a significant impact in feline overpopulation once we fully understand the dilemma and grasp the programs that have the potential to reach cats that would probably never otherwise see a veterinarian in their lifetimes. Unlike Top Cat, Mama Kitty, 8-Mile, or our dogs, these cats may not have a home, but they are often still cared for by Good Samaritans and they do have a special place in their community. Will we make a difference? Go back to 8-Mile. Whatever possessed that crazy stray to whup up on that dog? Was she coming to our defense? I like to think that 8-Mile just wanted to let us know that we are important to her and she appreciates what we have done for her. But I could be wrong. Could be that she was just fed up with the noise and crap. Either way, we have made a difference in that cat’s life and she has in ours, too. CVMA, Welcome to the herd. n
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CVMA Voice 201 7: 2 | PAGE 27
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FOCUS ON THE FELINE Confessions of a Not-so-crazy Cat Lady Cami Cacciatore, MS, CVJ CVMA Director of Communications and Marketing I have three cats. My husband says more than that is grounds for divorce and if I want to bring home another one, I have to trade one in. I told him I might trade him in for the right cat. He was not amused. My office at CVMA is filled with beautiful cat photos that said husband has taken, as well as lots of cat kitsch I’ve collected over my nine years here. While I’m pretty sure I’m not a crazy cat lady, I do love cats and can’t imagine my life without one (or three). There has literally been a cat in the house since the day I was born. My parents were cat people and we had 3 over the 18 years I lived at home. My college roommate and I adopted one. I always had cat-loving friends who rescued and I helped corral and socialize my share of kittens over the years. From that first cat in college, over my adult life, I’ve had nine, including the three we live with now. I always thought I knew a lot about cats. I’d lived with so many, and had enough rescue friends, that I learned a lot about feline behavior and needs. So much so that when any of my friends or family members had cat questions, they usually asked me. Once I started working with the veterinary community in my role at CVMA, I realized how little I actually knew. Like many people (you know, the ones that make you sigh in frustration), when I was younger, I hadn’t always taken them to see a veterinarian consistently unless they were sick. I had them front declawed. I didn’t think they needed ID because they were indoor-only cats that would never get outside. In my defense, this was well over 20 years ago. I didn’t know dental disease was common in cats until my childhood cat had to be euthanized at the age of 18 because of severe dental disease (that one still breaks my heart). Then again, back then, I don’t remember our family veterinarian taking x-rays or ever talking to us about dental care. Of the three cats I have now, two are declawed. They are 12 and 10. The veterinarians who performed the procedures (one in Arizona and one here) didn’t question my request or talk to me about alternatives. Then, it was routine. Now, I would never do it. My youngest cat (he’s five) is a monumental pain in the butt, very domineering, and he bullies my tiny female mercilessly. He ignores his scratching post and attacks my (fairly new) furniture when he’s mad at us. He sporks us on a regular basis with the claws he refuses to keep to himself. Some areas of my carpet have seen better days. Would my life (and furniture and skin and other cats) be easier if he was declawed? Yes. But now, knowing what I know, after working here, I just can’t do it. I didn’t even know about microchipping until about four cats ago. Shortly after I started working here, we helped DFL launch the Chip Your Cat initiative, and I had all of mine chipped. I’m on my fourth veterinary clinic since moving here in 2006 (more on that later) and have seen PAG E 28 | CV M A Vo ice 2017: 2
probably nine different doctors in that time. I may have been asked once if my cats were chipped. And a discussion about identification? I don’t remember that ever happening. I try to be a good cat owner. I take them for regular exams. I get their teeth x-rayed and cleaned. I keep current on vaccinations and do yearly blood work as life-stage appropriate. I feed them the prescription food (dental and kidney) they need. They have toys, a water fountain bowl, and I get the soft food they love so much as treats. They have endless scratchers and toys and boxes to play in. I love them unconditionally, even when they scarf and barf, scratch my stuff, or wake me up in the middle of the night (or way too early with a delicate little paw to the face). Part of this is my relationship with my veterinarian (you know who you are!). As I said earlier, it took me several years, about nine different veterinarians, and four clinics to find one that stuck. Why so many? When we first moved here, I went to the one nearest my house (the less time in the car with a yowling cat the better). I liked the first doctor I saw, but he moved on. I liked the second a lot, and he was particularly kind when I lost my 18-year-old tabby in 2007. But he, too, moved on. I finally ended up at a clinic I loved, owned by someone I really respected, and was happy there—until the clinic was taken over by a corporate chain. That wasn’t the issue so much as the fact that every year when it was time to go back in, the doctor I’d seen before had left, and I had to start over with someone new. After about four different doctors, I gave up. I then went to a feline-only clinic. On the very first visit, the doctor put hands on my cat and pet him. Didn’t take a temperature. Didn’t weigh him. Didn’t ask me about diet or ID or any of the things I’d learned during my time at CVMA were important parts of a good exam. Then they drew blood for testing, and sent me out to reception—where I was promptly charged $450 for the exam and the blood work. When I questioned the practice manager on the cost, especially in light of how little “exam” was actually involved, I was told “The doctor knows cats, and can just tell if they are sick or have a temp.” So I said, “But the doctor didn’t even weigh my cat. Or ask me about diet.” Her response? “Oh, if the cat didn’t feel overweight, the doctor assumes you are feeding it okay and it’s fine.” Needless to say, I never went back. And it wasn’t even the cost of the bill I was given. Working at CVMA, I’ve heard our members talk about clients who price shop and how hard it is to convince them of the value of veterinary care and the services provided. I truly do understand the value of wellness exams and preventive care and the benefit of partnering with my veterinarian to keep my cats healthy and happy. I just couldn’t find someone I felt I could do that with. With my CVMA-educated standards firmly fixed in my mind, I finally—happily—found one that I have that Continued on next page
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relationship with. He owns the practice and has only one associate. I don’t have to worry about a revolving door of doctors, which keeps my care consistent. The staff is wonderful and they truly treat me and my pets like family. I know my cats are getting the best care possible and I know I’m being charged fairly for that care and the services the clinic provides. Even with as much as I’ve come to understand about cats and veterinary care over the years, I’m happy to say that I’m still learning every day. This past BIG Ideas was a perfect example… I knew I’d enjoy it because, well, cats. But I didn’t know I’d learn so much more, like the findings from Dr. Lord’s research (see page 18) on identification that shows cats really do tolerate collars and there is very little chance of harm to them from wearing them. I myself was skeptical, having tried, once, to put a collar on an escapeartist tabby I had in Chicago who liked to sneak out the door and wander down the hall. I got her the cutest collar, with the cutest little mouse ID tag. So perfect! Until the day
I came home and found her sitting by the door, her back leg stuck through the collar at her neck. That was the end of my collar days. I’m sure you’ve heard that story before from clients, or even thought yourself that cats and collars might not always mix. But, according to the research, they do! Who knew? It’s “ah ha” moments like this that make me feel incredibly grateful to be working within this amazing community of veterinary professionals. I know so much more than I did when I started nine years ago, and I am still learning new things every day, from the articles we publish here in the VOICE, from taking your calls and questions, and communicating the “need to know” information each week in eVOICE, from our staff, from you, from our industry and collaborative partners. Working with CVMA has not only made me a better professional, but, I hope, a better cat owner. I’m not sure my cats would agree as they are foisted into a carrier and driven to a clinic to be poked and prodded. But I know I’m doing what’s best for them, and I have you all to thank for that. n
A partnership with you to provide the best care for them. At VRCC Veterinary Specialty & Emergency Hospital we consider ourselves to be an extension of your practice. Working as a team with you and your clients, we can help provide the finest specialized care for your patients. Our ongoing commitment to communicating with you and your client is key to building positive client and referral relationships. We endeavor to offer the best technology and highest caliber of specialists and technical staff in the Rocky Mountain region as a resource you can depend on.
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GOVERNMENT AFFAIRS 2017 Legislative Session: Thanks to Members Who Accepted Calls to Action! CVMA is committed to advocating effectively for the veterinary profession and animal health and welfare in Colorado. During the 2017 session, CVMA’s legislative team was agile and responsive as it monitored, supported, or opposed 18 bills. CVMA’s short list of bills covered many topics and promised varying degrees of potential impact to the veterinary community on animal health and welfare, public protection, the scope of veterinary practice, professional regulation, and the opioid epidemic. The session again demonstrated the reality that regulators, legislators, and citizen advocates all have the ability to quickly capture the spotlight with a wide range of animal care perspectives that demand attention. Through the combined efforts of CVMA’s professional lobbyist, member connections, outreach and testimony, staff engagement, and established relationships with key legislators, CVMA and its members fared well representing the interests of the profession on behalf of its 2,300-plus members. Working together through CVMA, members have the benefit of legislation that protects both veterinary practice and animal welfare in Colorado. These three bills required most of CVMA’s attention in 2017:
a bill that eliminated the restriction to companion animals contained in the 2016 bill. As a result, Colorado veterinarians can now treat all species with compounded medications—including exotic animals, zoo animals, laboratory animals, and horses—in addition to companion animals. The bill was signed by the governor on June 6. Rural Veterinary Education Loan Repayment Program (HB17-1282) Together, CVMA and Colorado State University College of Veterinary Medicine and Biomedical Sciences took a lead role in sustaining the vitality of livestock producers and communities in rural Colorado through House Bill 17-1282. By providing an education loan repayment incentive for veterinarians to practice in rural areas, the bill will benefit rural communities in Colorado that have underserved veterinary needs, and veterinary students who desire to practice in those communities. House Bill 17-1282 establishes a five-member council, on which CVMA will be represented, to administer the program, and provides funding for two veterinarians for four years each. HB17-1282 passed on May 10 in the final hours of the session, and CVMA president Sam Romano, DVM and member Lora Bledsoe, DVM who testified in support of the bill, attended the signing ceremony with Governor Hickenlooper
Veterinary Pharmaceutical Compounding Animal Patient (HB17-1274) Over two legislative sessions, CVMA has invested deeply to significantly improve the landscape for veterinary compounding in Colorado. In 2016, CVMA and its sponsors successfully passed House Bill 16-1324 that made a number of significant improvements in the compounding landscape for Colorado veterinarians, as it: • Provided access to controlled compounded medications • Provided access to resident and non-resident compounding pharmacies • Allowed practices to maintain office stock of compounded medications • Provided for limited dispensing from office stock To broaden the impact of compounding access improvements made in 2016, CVMA in the 2017 session requested
In concert, these two bills provide clarity and afford veterinarians a wider range of options to treat patients effectively. CVMA is proud to lead the effort to improve veterinary medicine in Colorado and is grateful to sponsors in both the Colorado House and Senate who commitment to enact these important changes.” —Will French, DVM
on June 5. Sam Romano, DVM, testified, “We’ve heard far too many stories from disheartened young veterinarians whose dream has been to care for large and small animals in rural communities, but whose dream evaporated because what they could earn in a rural practice is not adequate to cover their basic needs and service their educational debt load. Their inability to pursue their dream has larger ripples too, from the farmers and ranchers who depend on having a veterinarian available to keep their herds healthy, to the community children who rely on a veterinarian to treat Continued on next page
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GOVERNMENT AFFAIRS Continued from previous page
their sick or injured furry friend. We support SB17-1282 because it provides a mechanism to support the wellbeing and vitality of rural Colorado communities. The investment required is modest to fund loan repayment for veterinarians willing to serve in rural Colorado—but the dividends from that investment will be significant to the individual, his or her animal patients, animal owners, the community, and society at large.” Remove Medical Release Requirement for Animal Chiropractic (SB17-135) In spirited testimony before the House and Senate Ag committees, CVMA countered an attempt to dismantle the unique and progressive veterinary medical clearance (VMC) requirement for the legal practice of animal chiropractic in Colorado. Animal chiropractors presented vigorous testimony from 26 witnesses on perceived restraint of trade, denial of care, and protecting the rights of animal owners. CVMA experts spoke to protecting patients, owners, care providers, and public health and cautioned about potentially disastrous patient safety outcomes when contraindications to chiropractic care are not identified. While the bill passed the Senate, CVMA was able to halt its progress in the House. CVMA appreciates the support of the many members who reached out to their Representatives and Senators to oppose the bill. The bill was introduced without warning, and without the opportunity for stakeholder consultation. In anticipation of continued legislative interest in this issue during the 2018 session, CVMA and the Colorado Chiropractic Association have agreed to conversations to improve mutual understanding of the VMC and to support pathways for collaborative patient care. Other 2017 Legislation In addition to the three discussed above (and bolded below), CVMA was also carefully following the many bills listed below (CVMA position on each denoted as follows:
S = support, O = oppose, M = Monitor). For full bill descriptions, actions, and information, see the CVMA Bill Tracker, available at colovma.org/legislative/. • HB17-1112 Immunity Unauthorized Practice of Profession (Postponed Indefinitely) O • HB17-1121 Patient Safety Act (Postponed Indefinitely) S • HB17-1158 Charitable Solicitations Regulation (Governor Signed 4/28/17) M • HB17-1165 DORA Boards Disciplinary Action Resolution Process (Sent to the Governor (5/18/17)) S • HB 17-1179 Immunity for Emergency Rescue from Locked Vehicle (Governor signed 4/13/17) S • HB17-1228 Pet Animal Care Technology Platform Regulation (Governor signed 6/5/17) M • HB17-1274 Veterinary Pharmaceutical Compounding Animal Patient (Governor signed 6/6/17) S • HB17-1282 Rural Veterinary Education Loan Repayment Program (Governor signed 6/5/17) S • HB17-1350 Pharmacist Partial Fill Opioid Prescription (Postponed Indefinitely) M • SB17-030 Exempt Injectable Anabolic Steroids for Cattle (Governor signed 3/16/17) S • SB17-032 Prescription Drug Monitoring Program Access (Postponed Indefinitely) M • SB17-033 Delegate Dispensing Over-the-counter Medications (Governor signed 3/30/17) M • SB17-054 Create Rotation Schedule for Tax Checkoff Programs (Postponed indefinitely) O • SB17-109 Industrial Hemp Animal Feed (Governor signed 3/20/17) M • SB17-135 Remove Medical Release Requirement for Animal Chiropractic (Postponed Indefinitely) O • SB17-136 Reporting and Limiting Civil Forfeiture (Postponed Indefinitely) M • SB17-146 Access to Prescription Drug Monitoring Program (Governor signed 4/6/17) S • SB17-242 Modernize Behavioral Health Terminology in Colorado Revised (Governor Signed (5/25/17)) M n
CVMA | PAC Reception Friday, September 22 | 7:00 – 8:00 PM at CVMA Convention 2017 Join us for dessert, wine, and an evening of lively conversation to benefit the CVMA Political Action Committee (PAC). Hear from CVMA Lobbyist Leo Boyle, CEO Ralph Johnson, and a partner in the state legislature about the critical advocacy work that takes place throughout the year to defend and advance veterinary medicine, and animal health and welfare in Colorado. A special invitation for the reception will be sent later this summer, so stay tuned for more information! If you have any questions or would like to join the host committee for the reception, please contact Katie Koch at firstname.lastname@example.org or 303.539.7273 or visit colovma.org/legislative/PAC. About CVMA | PAC The CVMA Political Action Committee (PAC) helps advance CVMA’s public policy initiatives in Colorado. CVMA | PAC pools campaign contributions from members and donates those funds to campaign for or against candidates, ballot initiatives, or legislation. Those pooled resources help elect candidates to public office who share CVMA’s interests and concerns about policy issues.
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SCIENCE UPDATE Canine Distemper a Growing Threat to Animals in the Front Range Anna Fagre, DVM, MPH, CSU Microbiology, Immunology and Pathology Veterinary Resident Canine distemper virus (CDV), the etiologic agent of canine distemper, may result in the rapid manifestation of multisystemic clinical signs ranging from respiratory to neurologic disease and has been responsible for multiple outbreaks across the United States.1 Canine distemper affects all carnivores, and the disease is well-known for its ability to quickly attack the respiratory, gastrointestinal and neurologic systems. The virus is easily shed in respiratory secretions and urine, and remains endemic in some locations due to the presence of susceptible wildlife species contributing to transmission, including ferrets, foxes, most large cats, coyotes, badgers and otters. In 2015, the CSU Veterinary Diagnostic Laboratory detected 166 canine distemper cases, of 833 submitted, via real-time reverse transcription PCR (rRT-PCR). Since 2016, 272 of 995 submitted cases have been detected. Reports of CDV nationwide have increased, and clinicians should be aware of the diverse array of clinical signs animals may present with, as early identification and supportive treatment are essential for patient recovery. Clinical Signs and Disease Progression Due to the rapid progression of clinical disease and fair to poor prognosis, CDV should remain a differential for any febrile dog with systemic clinical signs. Unvaccinated dogs are generally affected between 3 to 6 months of age, when maternal antibodies begin to wane. The disease is most often diagnosed in areas with low vaccination rates or settings with high densities of naïve dogs, such as shelters. The virus initially replicates in the respiratory epithelium before moving to the tonsils and lymph nodes. Following respiratory infection, viremia causes leukopenia and subsequent immunosuppression. Subsequently, the virus spreads systemically to the gastrointestinal, urinary and central nervous system, should the dog not mount an immune response sufficient to curtail the course of the disease. Neurologic signs generally occur weeks to months after the disease and may occur in the absence of previous clinical disease. “Old dog encephalitis” may result years later due to the persistence of the virus within central nervous tissues. Diagnosis of Canine Distemper Virus The CSU VDL offers several assays to aid in the diagnosis of distemper in dogs, including both antigen/nucleic acid tests and antibody tests. They include: Real-time reverse transcription PCR (rRT-PCR). Our rRTPCR is a highly sensitive and specific diagnostic assay used to detect virus in tissues, respiratory secretions, urine or whole blood. Certain sample types may be pooled together in one rRT-PCR assay, not including whole blood, which must PAG E 3 2 | CV M A Vo ice 2017: 2
be run individually. Submission of urine with a conjunctival or preputial swab is indicated to increase sensitivity; these two samples may be pooled and run at the cost of one assay plus a pooling charge. It is important to note that canine distemper virus may be shed in the urine and other secretions for several months after resolution of clinical signs. Fluorescent antibody (FA). The second option for canine distemper virus antigen detection is FA testing, which utilizes a fluorescent-labeled antibody to detect antigen within the cells of particular tissues or swabs from infected animals. This test is not as sensitive as rRT-PCR, as it relies upon the antigen’s presence in the specific area of submitted tissue. As a result, a false negative is more likely. Additionally, it should be noted that the only acceptable antemortem sample type is conjunctival smear or swab. Lung, kidney, or cerebellum may be submitted for post-mortem diagnosis. Indirect immunofluorescence antibody (IFA) serology. Utilizing the IFA assay, serum or cerebrospinal fluid (CSF) may be tested for the presence of IgG or IgM antibodies to the virus. This assay requires a single serum/CSF sample, with results reported as an IgG/IgM antibody titer. IgM antibodies persist for about five to 12 weeks in natural disease, while IgG antibodies may be present for years. IgM titers in serum or CSF above 1:2 may indicate recent or active infection, aiding in the diagnosis of CDV. In a previously vaccinated animal, the IgG serum titers should be interpreted cautiously due to long duration of antibody persistence. The presence of IgG antibodies within a CSF sample is highly suggestive of exposure, as antibodies mounted during a post-vaccine immune response should not traverse the blood/brain barrier. However, when looking for IgG antibodies in a CSF sample from a previously vaccinated animal, note that any trace amount of blood contamination occurring during collection may result in a false positive. Serum neutralization (SN) serology. In using the SN assay, CDV is incubated with serial dilutions of the patient’s serum to quantify the titer of neutralizing antibody for the virus. This is the preferred assay for interpretation of acute and convalescent titers. Titer Interpretation When using titer levels to detect disease, we recommend submitting paired titers, also referred to as acute and convalescent titers. SN is the preferred assay for testing acute and convalescent titers, as it directly measures the concentration of circulating IgG antibodies. A four-fold rise over the course of two weeks is highly suggestive of active or recent infection. Due to our limited understanding of IgG titer levels and corresponding protection against CDV, it is difficult to determine an appropriate cutoff titer that may protect against disease. Further, titer levels fluctuate and lapses in protection may occur in ill, stressed or immunocompromised animals. Some clients may request CDV titers in lieu of revaccination, and in these cases it is crucial to discuss risks Continued on next page
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associated with unknown protection and the importance of annually checking titers. Case Control and Outbreak Prevention In the event a case of canine distemper is diagnosed, reducing contact with other dogs is critical to curb further spread of the disease. This disease is particularly devastating in shelter situations, as an infected dog entering from the community may rapidly transmit the disease to other naïve shelter dogs. Early diagnosis and treatment via ASSAY
supportive care are critical to prevent disease progression. Subsequent isolation of clinically affected animals, coupled with close monitoring of susceptible dogs, helps reduce the chances of a shelter-wide outbreak. The variable incubation period also highlights the importance of quarantining all incoming animals, and maintaining barrier and isolation precautions for affected animals due to potentially substantial shedding periods. In light of the complex epidemiology of distemper and the multiple species susceptible to the virus, vaccination is crucial to maintaining herd immunity and preventing future outbreaks. n
SAMPLE TO SUBMIT
Antigen; detects presence of nucleic acid in tissue or sample
Reported as positive, suspect or negative
whole blood, 0.5 mL urine, conjunctival, preputial swab or nasal swab in 0.5 mL sterile saline, cerebrospinal fluid, or lung tissue (postmortem diagnostic).
3 business days
Fluorescent antibody (FA)
Antigen; detects presence of antigen in tissue of sample
Reported as positive or negative
conjunctival smear; fresh lung, kidney, or cerebellum tissue; or a swab of conjunctival cells
IgM serology (IFA*)
Detects presence of antibodies in serum or CSF
Reported as titer; indicates recent infection
0.5 mL serum or CSF
IgG serology (IFA*)
Reported as titer; difficult to interpret without both acute and convalescent samples
0.5 mL serum or CSF
IgG serum neutralization (SN)
Reported as titer; preferable to run acute and convalescent samples
0.5 mL serum or 0.3 mL CSF
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Practicing with Excellence, Compassion, Integrity, Approachability and Teamwork | RMVCcolorado.com CVMA Voice 201 7 : 2 | PAGE 33
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SCIENCE UPDATE Rats and Seoul Virus Leah Colton, PhD Medical Entomology and Zoonoses Epidemiologist Communicable Disease Branch Colorado Department of Public Health and Environment Background Pet rats, or more specifically fancy rats, are Norway rats (Rattus norvegicus) bred to produce desirable physical traits such as certain hair colors and textures, markings, dwarfism, tail-lessness, or ‘dumbo’ ears. Fancy rats are bred to conform to written standards and can have extensive lineages. Breeders often spend time learning the genetics of different traits so they can improve their lines. In addition, rattery owners may also breed their rats for temperament to ease their handling and care. Rats are born without hair and with their eyes closed. Their coat begins to grow in at about one week, and they will open their eyes after about two weeks. Babies can be weaned as early as four weeks. Sexual maturity occurs around five weeks; however, female rats should not be bred at this early age. It is best to separate male young from their sisters and mothers before five weeks of age to avoid accidental litters. Male rats reportedly make better pets than females, but like all animals, each rat will have its own personality. Male rats do have a stronger odor than females, somewhat musky, but this can be reduced by bathing the rat weekly or as often as necessary. Owners may also consider neutering male rats as an option to reduce odors. Rats are highly social and do best when housed with at least one other rat as a companion. Rats can be surprisingly finicky about which rats they will live with. Some males cannot live with other males; some females cannot live with other females. Pet rat owners should avoid co-housing males and females unless they want more rats. However, since some males will only tolerate female rats, you can neuter the male so it can live with females without breeding. Seoul Virus In December 2016, the Wisconsin state health department, with assistance from the Centers for Disease Control and Prevention (CDC), confirmed Seoul virus infection in a rattery owner and one of the owner’s family members. Seoul virus is an Old World Hantavirus that is closely related to Hantaan Hantavirus. A public health investigation revealed that a significant proportion of the rattery’s rats were infected with Seoul virus. Like other Hantaviruses, Seoul virus demonstrates little to no deleterious effect on its rodent host, the Norway rat. Infected rats do not display signs of infection, and following the acute phase of infection, rats can continue to intermittently shed virus in urine, feces, and saliva throughout their lives. Rats are exposed to Seoul virus through contact with infected rats including aggressive interactions (biting/scratching), via mucous membrane exposures to infectious virus contained in excreta and PAG E 3 4 | CV M A Vo ice 2017: 2
saliva, and possibly during mating. There is no treatment for rats infected with Seoul virus. There is a serological assay for the detection of Hantaan antibodies that cross- reacts with Seoul virus. For additional information on testing including which assays have been validated by the CDC, please visit www.colorado.gov/pacific/cdphe/seoul-virus. People contract Seoul virus from exposure to infected rats or contaminated materials such as used cage bedding. You may or may not develop symptoms from a Seoul virus infection following a one-to two-week incubation period. People with symptomatic illness will have a fever that may be accompanied by headache, chills, nausea, back and/or abdominal pain, blurred vision, flushing of the face, ocular inflammation or redness, or rash. Rarely, the illness may develop into Hemorrhagic Fever with Renal Syndrome, which is characterized by low blood pressure, acute shock, and kidney failure. Veterinarians concerned that their clients may have rats infected with Seoul virus should wear appropriate personal protective equipment when examining these animals. The Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel outlines standard precautions for aerosol (airborne and droplet) transmissible infections. The compendium is available at http:// nasphv.org/documentsCompendia.html. Disinfection of surfaces, materials, and instruments following a visit is also recommended. For questions about Seoul virus in rats in Colorado, you may call the state health department at 303.692.2700. n
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ANIMAL HOSPICE CONSULTING
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IN PRACTICE Helping Cats Live Happier Lives Suzanne Hetts, Ph.D., CAAB and Daniel Estep, Ph.D., CAAB Both the animal welfare and veterinary communities in the United States have long recommended cats be kept indoors. Contrast this with other countries, including the UK and Australia, where almost half of cat owners allow their cats free range access outside.1 Attitudes about allowing cats outdoor access in the U.S. vary by region, and are influenced by a variety of factors including where the cat was acquired.2 Unrestricted outdoor access exposes cats to risk of injury from fights with other cats, motor vehicles, and people, as well as contagious disease. Indoor-only cats are claimed to have a longer lifespan than those allowed outside. However the empirical evidence for this is elusive and there is anecdotal evidence to the contrary. It’s also being recognized that an indoor-only lifestyle comes with its own risks including obesity and behavior problems. One author has made a case for emotional over-eating in animals, motivated by negative emotional states, which opens up the possibility that obesity in indoor cats has a behavioral and/or welfare component.3 There is no question that the outdoors presents a more diverse and stimulating environment than indoors. In fact, studies have shown that spending time outdoors has mental health benefits for people.4 Given the behavioral biology of cats, and the fact that their physical and behavioral characteristics are much more similar to their wild ancestors than those of dogs compared to wolves, it would make intuitive sense that cats may not be well adapted to an indoor only environment. Much can be done, however, to configure an indoor environment to better meet the behavioral needs of cats. There are also options for providing cats outdoor access in a manner that keeps them safe and minimizes or prevents potential predation on song birds and other wildlife, while still allowing for the enrichment that outdoor access can add to a cat’s life. A Quality Indoor Environment Let’s start with the indoor environment. Aspects to consider include the density of cats; number of “resource stations” including food, water, litterbox, scratching posts, and perches relative to number of cats in the household; characteristics and location of litterboxes and scratching posts; and opportunities for mental stimulation and physical exercise or activity. The characteristics of scratching posts and litterboxes should be carefully considered and chosen to first meet the behavioral needs and preferences of cats in general. Characteristics can be adjusted based on the preferences of the individual cat. For more details, see our downloadable handouts at CatBehaviorHelp.com. One study of indoor cats found that indoor densities can be as much as 100 times greater than those of outdoor freeranging cats.5 While cats vary dramatically in how much social crowding they will tolerate, warning signs that densities have reached an unhealthy level include frequent fights, one or more PAG E 3 6 | CV M A Vo ice 2017: 2
cats that are hiding and not making full use of the available space, and one or more cats that are urine marking frequently. Providing additional hiding places and easy access to more raised perches can decrease social stress. Tall cat condos or a simple cushion on top of the refrigerator or tall bookcase, and a clear pathway to reach these perches increase useable vertical space. Hiding places can easily be created using boxes or paper bags. Placing a cat bed under a chair or behind a couch is another way to create a secluded spot. When there are multiple cats in the family, it’s also important to have multiple locations for food, water, litterboxes, scratching posts, hiding places, and vertical space to minimize competition for these resources. Ideally these resources should be strategically placed so that it is difficult for one cat to “ambush” or trap another cat making use of them. The goal of environmental enrichment is to increase behavior (and physiological) indicators of good welfare, and decrease the signs of poor welfare. From a practical standpoint, this means increasing the opportunities to display species typical behaviors and decrease behaviors associated with stress or distress. While increased aggression and urine marking can be signs of social stress as mentioned, cats often become less active and less engaged with their environment when stressed. A cat that spends most of its time sleeping or hiding may not be just a mellow cat but instead be reacting to stressors in the environment. Providing enrichment means considering both species typical behaviors and individual preferences. Because cats are predators, toys that allow for expression of components of predator behavior such as running, jumping, stalking, and grabbing are usually good choices. Appropriate outlets for these normal behaviors can also prevent their inappropriate expression that result in behavior problems. Puzzle toys that require cats to work to access hidden food can provide mental stimulation and a bit of exercise. Cats seem to get bored easily with the same toys, so rotating play objects from time to time can help to keep up them engaged. Training is another way to provide mental stimulation. Shaping simple behaviors such as sitting up, touching a hand or object with a paw or nose not only engages cats mentally but also increases social interactions. What About Outdoor Access as Enrichment? What does the outdoors provide that an enriched indoor environment may not? Indoors is a fairly static environment. While there may be a few new odors that come in with the owner, and sights that change a bit if a cat can look out windows, by and large the indoor environment is unchanging. Outdoors on the other hand, is dynamic. Temperature, wind velocity, humidity levels, sights, noises, and odors fluctuate. There are many options to give cats outdoor access in a safe way. Most cats can easily be acclimated to a harness, allowing for supervised tethering or even walks. The Kitty Holster and the Mynwood Cat Jacket are two possibilities. Pet strollers allow cats to experience the outside while riding in safety. Continued on next page
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IN PRACTICE Conclusions It’s exciting and encouraging that more attention is being paid to cats, what they need, and what makes them happy. As we learn more about what’s best for cats, it may be time to rethink how we can create an optimum habitat for them. Rather than holding firm to the “indoor only” approach, more thought can be given to the pros and cons of indoor and outdoor environments for individual cats. We now have more options than ever for providing safe enrichment to cats both inside and outside. n
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Outdoor enclosures such as the KittyWalk® enclosures, Habitat Haven®, Catio Spaces®, or even a do-it-yourself space can give most cats safe, stimulating outdoor options in all but the most urban high rises without balconies. For cat owners with more outdoor space, there is another option, and that is a “virtual” electronic containment system. We aren’t referring to “hot wires”, but instead the systems consisting of a receiver collar the cat or dog wears and the transmitter in the form of the boundary wire. While long controversial, a new study evaluated the effect of long-term exposure to an “invisible” (The Invisible Fence Brand® was not the fence used in the study) or “virtual” electronic containment system on the behavior and welfare of cats.6 The study was conducted in the UK where outdoor access for cats is much more accepted. Two different groups of cats were compared—one that had experienced the electronic containment system for more than one year, and a group of control cats that had access outside (at least one hour per day) and with no specific containment system in place. While the methods are beyond the scope of what we can talk about here, the bottom line is that the study concluded that an electronic boundary fence with clear pre-warning cues does not impair the long term quality of life for cats.
References 1. Howell, T.J. , Mornement, K. and P.C. Bennett, 2016. Pet cat management practices among a representative sample of owners in Victoria, Australia. J. of Veterinary Behavior 11: 42–29. 2. Haydee, A.D., Atwill, R. Gardner, I.A., Miller, M.A. and P.A. C onrad, 2006. Outdoor fecal deposition by free-roaming cats and attitudes of cat o wners and nonowners toward stray pets, wildlife, and water pollution. JAVMA 229:1, 74–81. 3. McMillan, F. 2013. Stress-induced and emotional eating in animals: A review of the experimental evidence and implications for companion animal obesity. JAVMA 8 (5): 376–385. 4. Bratmana, G.N.J., Hamilton, J.P., Hahn, K.S., Daily, G.C. and J.J. Grossc, 2015. Nature experience reduces rumination and subgenual prefrontal cortex activation. Proc. of the Natl. Academy of Sci. 112 (28): 8567–8572. 5. Bernstein, P.L. and M. Strack, 1996. A Game of Cat and House: Spatial Patterns and Behavior of 14 Domestic Cats (Felis Catus) in the Home. Anthrozoos 9 (1): 25–39. 6. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162073
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CVMA Voice 201 7: 2 | PAGE 37
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IN PRACTICE Cost Benefit 101: Employee Benefits Package Darren Osborne, Director of Economic Research Ontario Veterinary Medical Association Many veterinarians are directing their clients and patients to wellness plans, and it is paying off both clinically and financially. Some are even taking the wellness concept and turning it on their staff. Focusing attention on improving the wellness of staff can have similar rewards; data from the recent economic survey shows that investing in staff wellness not only improves the health of the staff, but also decreases staff costs and improves revenue. We know that wellness plans increase both clients and revenue (FOCUS: March / April 2014). Focusing more attention on clients and their pets pays off because wellness plan clients come back more often and are spending more than average. After the initial set-up, ongoing administration and e-commerce costs are marginal, so the benefit is obvious. Trying to measure the effectiveness of a wellness plan for your staff is not as easy. According to a 2015 Study by Quantum Workplace and Limeade (Source: limeade.com), when employees feel like their employers actually care about their wellbeing, they’re 38 percent more engaged and 18 percent more likely to go the extra mile. So how do you measure “care”? One method is to look at hospitals that provide a group health program (health and dental benefits) for their staff. If we assume that providing an optional group health plan is a metric to measure caring, we should see a difference between hospitals with and without a benefits plan. Results from the 2016 Ontario Economic Survey show 43% of companion animal hospitals provided a group benefits plan for their staff. Of that group, the cost or contribution from the hospital varied from 100% (hospital paid for the total cost of the plan for all employees) to zero (employees paid Hospital Contribution for Group Benefits Plan entirely for the plan). The 5% 5% 100% most popular Between 50% - 100% method was 38% for the hos50% pital to split Between 0 and 50% 44% the cost of the 0% (Employee pays) plan with em8% ployees 50/50 with 44% of hospitals opting for this method. A close second (38%) was for the hospital to pay 100% of the plan. According to the OVMA Insurance Program, providers of the OVMA Group Benefits Program, the average cost for a basic plan in a one-doctor hospital with five staff in total would be $8,000 per year. This cost would vary depending on how many single staff, couples, and families are PAG E 3 8 | CV M A Vo ice 2017: 2
insured. For hospitals paying 100% of the plan, the cost per dvm would be $8,000 per year and for hospitals splitting the cost with staff, the cost would be $4,000 per year. In 2016, hospitals that provided group benefits to their staff had higher revenues. Per dvm, revenues were 4.3% higher than average if there was a group benefits plan in the hospital. This means that hospitals that spend up to $8,000 on a group benefits plan earn an extra $23,800. Where is the causality? The folks at Limeade, who do the research on staff wellness, would tell you that when employees are offered health and dental benefits, they recognize the gesture as “caring for their wellbeing” and they try harder. Think of it as a quid-pro-quo; “you give me health and dental benefits and I will work harder, do more lab work in the same time, clean the exam room without being asked, try harder to book the appointment, close the sale on the parasite medication, and treat the clients better because I am being treated better”. Even more interesting is the fact that employment costs did not go up for hospitals with group benefits plans. To account for different hospital sizes, we examined nondvm staff wages as a percentage of gross revenue and found that hospitals that provided group benefits paid out 0.3% lower total wages. This does not mean hospitals with group benefits plans paid lower hourly wages. What it does mean is that hospitals with group benefits generally had fewer, more productive staff than hospitals without group benefits. Other wellness type metrics we looked at were staff discounts for veterinary services and products. There was a lot of variation in discounts and considering veterinary staff expect some form of discount, we wanted to focus on a discount that represented “caring” the most. We decided hospitals that offered a 100% discount to services (46% of hospitals) and products at cost (20% of hospitals) fit this image. Similar to group benefits finding, hospitals that gifted their services to staff and sold them products at cost had 5% higher revenues and lower staff costs. Admittedly, a lot of the hospitals who offered group benefits plans were the same hospitals that offered the most generous discounts. Change in Revenue
Change in Staff Cost
Group Benefits Plan
100% Discount on Services
Veterinary Supplies at Cost
While there may not be a direct causality between ffering group benefits and higher revenues, we had a o hunch that caring more for staff would create a more productive environment. After looking at the evidence, it is clear that the benefit from the benefit (plan) far outweighs the cost. n
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IN PRACTICE Planning for Long Term Care What is Long Term Care? Long Term Care is defined as the inability to care for one’s self due to an illness, injury, or disability for an extended amount of time. This care provides assistance with the activities of daily living (ADLs) and is provided in a home environment, assisted living, or nursing facility. It can last for just a few days to many years, or change from one level of care or setting to another. Those requiring care can be of any age. Today’s modern approach through medical advances, new facilities, and new continuum of care communities offers those in need with many choices. What Does Long Term Care Cost? Long Term Care can cost between $60,000 to over $100,000 per year, depending on your location and care required. Medical inflation, outpacing general inflation rates, factors about 4% per year. Private health insurance and Medicare are not intended to pay for Long Term Care. It is why traditional Long Term Care Insurance as well as Hybrid Product solutions have surged to their present-day importance. Can It Happen To Me? As we age, statistically, our chances of needing some type of care in our lifetime increases. Three times as many females will require care, primarily a function of longer lives for women, as well as the traditional caregiver role of females. Hospitals have shifted recovery, even for the short term, to other types of settings, such as Long Term Care facilities. We generally no longer rely upon family for even short term care. All this leads to a 40% risk of needing care sometime in our life.
Why Buy Long Term Care Insurance? Access Care Faster. If you need assistance and don’t have long term care insurance, what do you do? You get help from family and friends. Loved ones are essentially forced to help, or you go without assistance. When family and friends can no longer provide the level of care you need, you spend down your own assets to pay for care until you have little left, and at that point government assistance programs pick up the cost of your care in a qualified nursing facility. You are likely to access care faster when you have long term care insurance. This is one of the reasons people buy long term care insurance—so they have the ability to access care faster and use the insurance company’s money to pay for it. Freedom of Choice. When you buy long term care insurance you will have the necessary resources to afford quality care, and you will have the ability to choose how and where you receive this care. Those without substantial resources of their own, or those who did not buy long term care insurance, simply won’t have as many choices. Does that mean everyone should run out and buy long term care insurance? No, like any financial decision, you have to educate yourself, evaluate the pros and cons, and make a decision that is right for you. How Do I Get More Information? To receive more information on the Long Term Care Insurance Solutions being made available to CVMA members and their families through LTC Global, please contact: Gregory D. Peterson, AIF Gregory.Peterson@alliant.com 303.645.4713 Paul Clifft Paul.Clifft@alliant.com 303.645.4709 n
Insurance vs. Self-Pay Insurance is not right for everyone. Some cannot apply due to existing medical conditions. Others would rather take the risk and pay for any Long Term Care costs out of their own assets. There is no right answer, only a personal choice and tolerance for risk. Cost of Waiting If the decision has been made to purchase a policy, when is the right time? Younger when premiums are lower? Later, saving the premium, yet risking acceptability to the carrier? The average age of a Long Term Care policy purchaser today is 56, which indicates people are thinking of this as a financial planning strategy. However, people of all ages apply for coverage. The only issue everyone shares is the ability to be accepted for coverage by a carrier based on health conditions. Waiting too long has a financial impact; however, waiting until a medical condition arises to consider purchase makes it impossible at any cost. CVMA Voice 201 7 : 2 | PAGE 39
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IN PRACTICE Privacy & Network Security Liability: Are You Prepared? Mara T. Roberts, CLU, RHU, REBC, President, WDAISC Are you aware that businesses must be able to notify all parties that were affected by a breach, communicate effectively the scope of the possible damage, and provide credit monitoring assistance and identity restoration case management to those affected by the breach? In addition, they may also face legal defense and settlement costs in the event an action is brought against them because of a breach. You may believe you don’t have this exposure. If you are like most small business owners (an estimated 78 percent per a recent Harris Poll on behalf of Nationwide insurance), you don’t have a cyber attack response plan. The same Harris Poll survey found that 54 percent of small business owners were victim to at least one type of attack: virus, phishing, or malware. Other exposures include hacking, unauthorized access to customer or company info, software, data breach, and ransomeware. The U.S. Small Business Administration claims that small employers are becoming an increasingly attractive target because they not only have valuable customer data but provide access to larger networks and lack the personnel to provide cyber security. Even if you outsource or have dedicated IT staff, it cannot protect you from lost or stolen devices or internal threats. How you respond to and survive a breach depends upon whether you have given this exposure much thought and, if you have cyber coverage, how broad that coverage is. Take time to develop a response plan—just like an emergency response plan, knowing what to expect and how to respond before an emergency ensures better outcomes for all involved. Develop policies for your practice that address mobile computing, personal devise use (BYOD), sensitive information handling, and basic security of protected information. Do NOT wait for a data breach to happen. Inventory all of your stored Personal Identifiable Information (PII) and know what a “worst-case” breach scenario could look like. Should a hacker get into your system, all of your files (HR, clients, healthcare, communications, etc.) could be compromised at the same time and you won’t have the advantage of calmness and time to respond. Questions will need to be answered in the event of a breach such as: • How many records were exposed? • What type of data was exposed? • Is this the organization’s first breach? • Was the data stored in a centralized system/location? • Is fraud expected? • Is a class action lawsuit expected? Common costs incurred with a data breach include Incident Investigation costs, notification/crisis management costs, regulatory fines and penalties, and class action lawsuit costs. PAG E 4 0 | CV M A Vo ice 2017: 2
Consider the cost for notification for example. How many notices would you need to send (potential victims), how many different versions of the notification letter, and the cost for both printing and postage of the notification? How will you handle in-bound calls once notification has gone out? Customer questions could tie up a considerable amount of staff time and a source of considerable disruption for your practice. If you are considering the use of cloud computing for all or part of your business operations, you should carefully review the contractual language prior to entering into any agreement. Many contracts have not been updated to reflect new technology and the impact of cloud computing on current data security/privacy laws. • Who owns your data once it resides in the cloud? • Does your cloud provider guarantee the security and privacy of your data? • Will you be alerted if there is a breach of your customer data inside the cloud? • Will you have the right to investigate the breach? • Who will notify your customers of a breach incident? Everyone purchasing cloud services will need to address its unique requirements in the contracting process, and each contract should be the result of due diligence and a negotiated transaction. If you have a breach, notify your broker or your insurance company claims representative as soon as possible. You should be sure to have your staff gather and document facts surrounding the incident. If you have an IT person, they would be instrumental in working with the insurance company. Network security event logs are often vital in helping verify the date, time, and machine involved in an incident. If you have a cyber liability policy, this will trigger coverage and your carrier will step in to direct and assist. If you have any coverage under your business owner’s policy, the carrier will again step in to direct and assist per the policy language. If you do not have coverage, you will need to spearhead the recovery and notification process with the assistance of specialists in this area—a privacy attorney or breach response professional. As wonderful as technology is, it exposes those who use it to new and emerging perils. Awareness and mitigation of the inherent risks associated with our connected world are critical to any well rounded risk management program. Reprinted with permission from the author and the Wisconsin Veterinary Medical Association. n
Boone the border collie was referred to CSU after being hit by a truck. He suffered head injuries, lung damage, pelvic bone fractures, nerve damage affecting his right hind limb and elimination function, and a large skin wound. He was stabilized by emergency/critical care specialists in ICU, with consultations from neurologists, surgeons, and radiologists. He underwent multiple surgeries by orthopaedic and soft-tissue specialists with help from board-certified anesthesiologists. Our critical care team managed each post-operative recovery. With the help of our rehabilitation team, Boone slowly recovered much of his function and is now active and pain-free.
UNDER ONE ROOF
As the tertiary referral center for the Intermountain West, we house 79 veterinarians on clinics â€“ representing 28 boarded specialties. Theyâ€™re backed by leading technologies and a team of 650 additional caregivers. All here for you, your clients, and your patients. 300 W. Drake Road, Fort Collins (970) 297-5000 csuvth.colostate.edu
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CVMA NEWS C O L O R A D O
V E T E R I N A R Y
M E D I C A L
A S S O C I A T I O N
Chapter Connections Welcome to your CVMA Chapter update page. If you have anything you would like to see included here, please send your items, information, or articles to camicacciatore@ colovma.org. CVMA Chapter 6 | Denver Area Follow Us on Facebook! We’re excited to announce we’ve created a page just for Chapter 6 members! Join us to get event invites and reminders and to keep in touch with your C hapter 6 colleagues. Find us on Facebook at www.facebook.com /CVMAChapter6DenverArea. Upcoming Meetings and Social Events Join other Chapter 6 members at an upcoming event to connect in a non-veterinary environment to just have fun and get to know each other! Have a suggestion for an event or location? Email Dr. Ashley Ackley at email@example.com. SOCIAL EVENTS Sunday, July 9 | 4:00 PM Lakeside Amusement Park 4601 Sheridan Blvd | Denver 80212 Host: Dr. Jeff Fankhauser Bring family and friends to check out this blast from the past amusement park in NW Denver! Saturday, Aug 12 | 9:00 AM 4th Annual Wild Mushroom Foray | Hoosier Pass Host: Dr. Jeff Fankhauser Please join me for our 4th annual Wild Mushroom Impaction. In past years we have collected a wide variety of species including Hawk’s Wings, Hedgehogs, Shrimp Russulas, Saffron Milky Caps, Puffballs, Sheep Polypores, the infamous Fly Agaric, and of course “the King” aka Porcini. We are targeting Hoosier Pass and will likely hit several spots in the area to try our luck. If you are interested in joining us, or for other possible forays in August, please contact Dr. Jeff Fankhauser at jsfankhauser@gmail. com or 303.619.0112 for more details or to RSVP.
Thursday, July 13 | 5:30 PM Cat Yoga! | Denver Animal Shelter 1241 W Bayaud Ave | Denver 80223 Hosts: Drs. Ashley Ackley and Louisa Poon Come do some yoga and hang out with cool shelter cats, all while supporting Denver Animal Shelter. Join us for an hour of yoga while socializing and loving some adoptable shelter cats. Who knows, you might come home with a new friend! A $10 donation to the shelter is requested. Sunday, August 27 | 9:30 AM Hiking at Matthew/Winters Park -Red Rocks Trail Hosts: Drs. Ashley Ackley and Michelle Larson Join us for a family/dog friendly hiking event! We would like to meet at the Village Walk trailhead (turns into the Red Rocks Trail) at 9:30. Brunch afterwards TBD if everyone is up for it! Please RSVP to either Michelle Larsen (michellelarsen18@ gmail.com) or Ashley Ackley (firstname.lastname@example.org). Sunday, September 10 | 12:00 to 3:00 PM Station 26 Bluegrass Brunch 7045 East 38th Ave | Denver 80207 Host: Dr. Ashley Ackley TRIVIA NIGHTS Thursday, July 6 | 7:00 PM Nighthawk Brewery 2780 Industrial Ln | Broomfield 80020 Host: Dr. Ashley Ackley Wednesday, July 26 | 7:30 PM Stem Ciders 2811 Walnut Street | Denver 80205 Host: Drs. Jennifer Garner and Ashley Ackley Tuesday, August 22 | 8:00 PM Lowry Beer Garden 7577 E Academy Blvd | Denver 80230 Host: Dr. Kasey Carter Thursday, September 7 | 7:00 PM Someplace Else Brewery 6425 W 52nd Ave | Arvada 80002 Host: Dr. Jeff Fankhauser Continued on next page
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CVMA NEWS Continued from previous page
WELLBEING Finding Meaning in Veterinary Medicine FMVM meetings will continue in 2017 and will be held at 6:30 PM on the third Tuesday of each month and will be hosted by Dr. H. Howells. For details and to RSVP, email email@example.com. Tuesday, July 18 6:30 PM | Cultivate 10474 W 38th Avenue | Wheat Ridge 80033 Upcoming Meetings August 15 | September 19 | October 19 | November 16 | December 21 Note: meetings are subject to change, so please check your email for updates. n
CVMA CVA Program Grow Your Team—While Growing Your Bottom Line! CVMA is proud to recognize and certify the designation of CVMA Certified Veterinary Assistant (CVA). The CVMA CVA program provides continuing education for veterinary medical personnel, enabling them to become more informed, skilled, and trusted members of the veterinary medical team. This program was designed to help staff to pursue veterinary medicine as a career, not just a job. Investing in your employees saves your practice from having to deal with less turnover for your practice and costly replacement and re-training efforts! To learn more and to enroll today, visit www.colovma.4act.com. Now offering CVA Levels II, with level III coming soon! Contact Kara Basinger, CVMA’s manager of membership, at 303.539.7275 for more information. Did you know? If you are a CVMA Premium or Core member, the $325 enrollment fee for the CVA program is waived as part of your membership level!
2017 CVA Graduates Please join us in congratulating the newest graduates of the CMVA Certified Veterinary Assistant program! Hollie Hardman, CVA I A Pet’s Place Animal Hospital Longmont, CO
Alice Nye, CVA I Alpine Veterinary Clinic, PC Monte Vista, CO
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CVMA NEWS CVMA Members to Vote on Governance Model Updates The veterinary profession is evolving and dynamic, and CVMA must be strategic, efficient, and accountable to serve its members well in such an environment. To ensure that CVMA’s leadership team can be even more effective and agile, the Board of Directors has unanimously recommended that members vote to approve updates to CVMA’s governance model. In today’s fast-paced environment, decisions and policy development require a nimble, responsive governance structure. CVMA’s Board of Directors has built a spirit of unity, a rewarding social fabric, diverse perspectives, a grassroots communication flow, and encouraged the engagement of chapter leaders and organizational liaisons. In addition, CVMA’s dedicated and experienced Executive Committee has provided a strong, balanced foundation for all the organization does. However, it can be challenging for the current Board of Directors to be an effective fiduciary for CVMA by meeting for only 90 minutes twice yearly. Acting on the Board’s behalf and between its two meetings, the Executive Committee holds at least six full-day meetings each year, and has exercised its leadership diligently, effectively, and without issue. The Proposal To preserve the desirable attributes and benefits of the current Board and Executive Committee and to evolve to a more agile decision-making model, the CVMA Board of Directors has unanimously recommended that the membership adopt a new governance model in which the current Board of Directors will become the CVMA Leadership Council, and the current Executive Committee will become the Board of Directors. In this new structure, the CVMA Leadership Council will have formal and informal opportunities for personal development and bi-directional communication with chapter representatives, while engaging in environmental scanning for emerging issues, professional issue discussions, and strategy formulation to provide advisory recommendations to the board. Meetings of the Leadership Council will be focused on issues identified by the Leadership Council itself or referred by the Board of Directors and will occur twice a year at CVMA BIG Ideas Forums. The Leadership Council will be composed of: • Chapter representatives (17 total, appointed by each chapter, equal vote) • Commission chairs (4 total, appointed by the board, equal vote) • Organizational liaisons (appointed by the board, voice but no vote) • Board of Directors (elected by members, voice but no vote)
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With the Leadership Council in place, the newly constituted CVMA Board of Directors will focus on association health, day-to-day decision making, policy formulation, oversight of the CEO, fiduciary responsibility, budget, dues and rates, legal compliance, and the association governance. The CVMA Board of Directors will be composed of: • 7 at-large voting positions elected by members • 1 CEO appointed by the board (non voting) The Advantages The proposed governance model clarifies authority, supports agile decision making, sustains a connected community of chapter leaders and organizational liaisons, and utilizes CVMA’s connected community in more engaging, satisfying, and productive ways, while providing personal development opportunities for members of the Leadership Council. Next Steps The current board discussed and approved this concept in October 2016 at CVMA BIG Ideas Forum | Fall 2016. The Executive Committee developed a narrative to describe the model change to members and drafted appropriate bylaws amendments. The Board reviewed these materials at CVMA BIG Ideas Forum | Spring 2017 and made the recommendation to approve the new model (and the attendant changes in both the Articles of Incorporation and the Bylaws), and to put the changes to a vote of the members. All voting members were sent a letter in late May outlining the voting process, which will be conducted through a secure, online voting platform this year. Voting opens June 15 and remains open through July 15. CVMA has posted the recommended changes to the Articles of Incorporation and Bylaws online for member review. Please visit colovma.org/member-balloting/ to see the documents. You may contact the CVMA office at 303.318.0447 if you have any questions about the documents, the member vote, or the proposed governance model changes. Conclusion These discussions and decisions have been developed by the Board through a deliberate, thoughtful, multi-year process. This evolution began as a question at the 2014 CVMA strategy workshop as part of a larger consideration of how CVMA operates, including the shift to chapters and offering membership tiers. The driving force behind these types of strategic initiatives is always “How can we work better? How can we serve our members and the profession more completely?” Based on the recommendation of CVMA’s leadership, we strongly believe that this new structure positions CVMA for the future, ensures that your professional association is relevant, agile, and responsive to the challenges the future will bring. n
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CVMA NEWS Briefings continued from page 5
In regard to cats in shelters and in communities, Colorado (no surprise here!) is a leader in efforts to create better outcomes. We can be proud there are so many initiatives underway across the state that are doing highly informed and incredibly effective work, such as providing behavioral enrichment for cats in shelters, and developing creative population control efforts to reach cats that are loosely owned or free roaming or owned by individuals who lack the economic resources to sterilize their feline friend. It was encouraging to hear updates on a range of cat initiatives, and also to hear from Dr. Linda Lord about her research findings around cats wearing collars—you might be surprised by what she found, presented in her article on page 24. (Hint: After her presentation, one veterinarian in the audience declared that her perspective about cat collars had taken a 180 degree turn and that she would be discussing external identification with all of her cat clients!). The first component of CVMA’s mission statement is “To advance the health and welfare of animals and people in Colorado.” Clearly that happens in veterinary practices every day as you address the medical needs of your feline patients and keep healthy cats bonded to the humans who love them. And just as clearly, CVMA’s collaborative work
CVMA Student Chapter Update Amy K. Zug, MBA DVM Candidate, Class of 2019 CVMA Student Representative The Student Chapter actively participates in CVMA events by attending convention and other CE opportunities, outreach programs, and learning lunches. These experiences allow students to expand their understanding of organized veterinary medicine and opportunities in the veterinary field. Here is a brief description of our recent involvement. BIG Ideas The BIG Ideas Forum attracts many new students each fall and spring. First time registrants return from the weekend with a new appreciation for CVMA. Jaemi Yoshioka, a second year CSU veterinary student, decided to attend the Spring 2017 BIG Ideas Forum in Colorado Springs based on the illuminating issue of community cats. She reflected on her experience as “a fantastic insight into the various strategies utilized by different professionals to achieve the same goal. 10/10! I would recommend this event to any student interested in catching a glimpse of the veterinary profession outside of the clinic.” These great opportunities would not exist for veterinary students if not for the generous sponsorships from CVMA members!
with many partners in Colorado helps to drive positive outcomes like a lower population of unwanted cats, more adoptions into lifetime homes, higher levels of identified cats being returned to their owners when they stray, and a generally higher level of health and wellbeing for ALL cats whether they are owned or are community cats. Governance Model I hope that you’ve been unable to escape the cascade of communications from CVMA about proposed changes to the bylaws and Articles of Incorporation. I won’t repeat the rationale for these changes, because the case for change has been articulated in several different ways and there’s a summary on page 44. What I do want to reinforce, however, is that your Board of Directors has thoughtfully and carefully considered these proposed changes since the concepts emerged during the October 2014 strategy session—and as those changes have come to be reflected in the governing documents, the Board of Directors has recommended, unanimously, that members approve the proposed changes during the balloting process. If you haven’t exercised your vote just yet, move quickly—because voting concludes on July14. Thank you for taking the time to become informed about the issues, and to register your vote to guide CVMA into the future. n PetCheck at PetAid On Saturday, April 8, more than 20 CSU veterinary students woke early to volunteer during 9PetCheck in Denver at PetAid Animal Hospital. Student teams interacted with clients, performed physical exams on their patients, and administered vaccinations. Stephen Pannone, a second year, noted that this experience was a great opportunity to work on client communications. “If you bombard owners with tons of detail on everything from heartworm to dental disease to weight loss they get overwhelmed. Using our time with them to focus on a couple major issues allows us to maximize our impact with the few minutes that we have with these patients and clients.” Participating in these outreach programs serves as a reminder of our dedication to this field of work, especially towards the end of textbook-heavy semesters. Open House at the CSU Veterinary Teaching Hospital Every spring, the CVMA student representatives join the Open House festivities by setting up a booth. Visiting children get to identify animal skulls and then enthusiastically color their own certificates and business cards (it is never too early to start networking)! CVMA’s Student Representatives As our 2017 graduate, Dr. Madeline Anna, steps into the real world, Courtney Mael, Amy Zug, and Laurel Krause inch onwards to next year’s classes. We are excited to meet the Class of 2021 CVMA student representative after the upcoming class elections. n CVMA Voice 201 7 : 2 | PAG E 4 5
[theer-ee-oh-juh-nol-uh-jee] noun 1. the branch of veterinary medicine encompassing all aspects of reproduction. Want to learn more about theriogenology and get up to date on the latest reproductive techniques? Want to attend CE sessions specifically geared towards the study of animal reproduction? Want to meet other theriogenologists, network among your peers and attend fun conference events?
This is the conference for you! Join us for the 2017 Therio Conference and Equine Symposium August 2-5, 2017 | Hilton Fort Collins Veterinarian Equine Embryo Transfer Symposium and Wet Lab Student Equine Wet Lab Small Animal Sessions Equine Sessions Production Animal Sessions Student Case Abstracts Scientific Abstracts Educators’ Forum Exhibit Hall Student Quiz Bowl Fun Special Events for everyone
Therio Conference 2017 Fort Collins | August 2-5 For registration and event information visit
We’re going back to our roots this year in historical Fort Collins, CO. The first official meeting of the group that eventually became known as The Society for Theriogenology was held in Fort Collins in February of 1954. Join us as we return to the place where it all started.
Each year the Society for Theriogenology and the American College of Theriogenologists meet at the annual Therio Conference for cutting-edge CE sessions, abstract presentations, seminars, symposia and networking opportunities in addition to fun events. The abstract competition is always a favorite, and student case presentations and an educators’ forum round out the offerings. The Therio Conference is a great opportunity to learn, network, and enjoy visiting with colleagues in an intimate setting. Make plans to join us for this fun, educational event! Visit www.therio.org for registration information.
theriogenology foundation The Future of Animal Reproduction
Society for Theriogenology | 761 Tiger Oak Drive | Pike Road, AL 36064 Phone: 334.395.4666 | Fax: 334.270.3399 | TherioConference@franzmgt.com
Specialists you trust. When you need them. CARDIOLOGY Carrie Ginieczki, DVM, MS, DACVIM firstname.lastname@example.org
DENTISTRY John F. Huff III, DVM, FAVD, DAVDC email@example.com
DERMATOLOGY David Beadleston, DVM, DACVD firstname.lastname@example.org
EMERGENCY & CRITICAL CARE Leilani Way, DVM, MS, DACVECC email@example.com
Shaila Raj, DVM, MS firstname.lastname@example.org
Molly Comiskey, DVM email@example.com
Jorge Alvarez, DVM firstname.lastname@example.org
Douglas Santen, DVM, DACVIM (SAIM) email@example.com Ji-Yeun Rha, VMD, DACVIM (SAIM) firstname.lastname@example.org Katherine Scott, DVM, DACVIM (SAIM) email@example.com William Whitehouse, DVM, DACVIM (SAIM) firstname.lastname@example.org
ONCOLOGY Anne Skope, VMD, MS email@example.com
Gina Kettig, DVM firstname.lastname@example.org
Shana Oâ€™Donnell, DVM email@example.com
Katherine Hebert, DVM firstname.lastname@example.org
NEUROLOGY Kelli Kopf, DVM, MS, DACVIM email@example.com
RADIOLOGY Debra S. Gibbons, DVM, MS, DACVR firstname.lastname@example.org Benjamin Young, DVM, MS, DACVR email@example.com
Maggie Vandenberg, DVM, DACVIM firstname.lastname@example.org Samantha Emch, DVM, MS, DACVIM email@example.com
CLIENT CARE COORDINATOR Diana Davila, DVM, DACVS firstname.lastname@example.org
Lori Amos email@example.com
John S. Stephan, DVM, MS, DACVS firstname.lastname@example.org
Weston Buker email@example.com
Specialty Line: 720.975.2804 vcaaevh.com Fax: 720.975.2854 www.facebook.com/vcaaevh 9770 E. Alameda Avenue, Denver, CO 80247
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