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F V M A ADVOCATE ISSUE 3 - May | June 2014

ARE YOU PREPARED for

The hurricanE

season?

Meet Our

New Officers & Executive Board members

2014

Legislative

Wrap Up

THERAPEUTIC veterinary

Diets are TAX EXEMPT


President's

MESSAGE

I

7 207 Monetary Drive Orlando, Florida 32809 Phone – (407) 851‑3862 Toll Free – (800) 992‑3862 Fax – (407) 240‑3710 info@fvma.org | www.fvma.org

am honored to serve for the next year as your FVMA president. I am excited that I will be serving in this role as our Association is being transformed; expanding member services and employing new planning and operational tools in order to meet the growing demands of our members. These transformational efforts will make it possible for the FVMA to successfully serve our members into the future, and guard the trust the Association has built over the years in the veterinary community, as a premiere provider of world-class continuing education.

Officers Dr. Donald H. Morgan President Dr. Richard M. Carpenter President-Elect Dr. Richard B. Williams Treasurer Dr. Jerry L. Rayburn Past President Mr. Philip J. Hinkle Executive Director

District Representatives Dr. Alex M. Steverson District 1–Big Bend Dr. Richard C. Sutliff District 2–Northeast Dr. Marc A. Presnell District 3–Central Dr. Rachel Klemawesch District 4–Tampa Bay Dr. Marc D. Pinkwasser District 5–Treasure Coast Dr. Ronald W. Todd Jr. District 6–South Florida Dr. Mary Smart District 7–Southwest Dr. James M. Brechin District 8–Northwest Dr. Kelly J. Sloan-Wade District 9–Space Coast Dr. Stephen Shores AVMA Delegate Dr. Ernest C. Godfrey AVMA Alternative Delegate Dr. Amanda House FAEP Representative to the FVMA Executive Board Ex Officio Dr. James W. Lloyd, Dean College of Veterinary Medicine

FVMA Staff

Sandra P. Brooks Accounting/Membership Director Kelly Callihan Meeting and Membership Development Director Amber Coon Executive Administrative Assistant Ann Deal Executive Project Manager Ralph E. Huber Industry Relations Director Alssa Mathews Multimedia Art & Design Director Beni Jean Price Financial/Membership Coordinator Diana Ruiz Meetings and Events Coordinator Jacob Tyler Graphic Designer/Desktop Publisher Ann Wade Communications & Public Relations Director

2  |  FVMA ADVOCATE

The FVMA has had a wonderful and successful past. The past six years on the executive board representing district four has been more than a rewarding experience. Many of you are not fully aware of all this wonderful organization has accomplished and done for veterinarians and the veterinary profession within the state of Florida. To name a few, Legislative Action Days has grown from a dozen people attending in Tallahassee to over 50 this past March. The local and grass roots efforts are improving statewide. The FVMA reinstituted the Food Animal Conference in 2008, after a 10 year hiatus, and assumed the Ocala Equine Conference. In 2011, we formed a successful merger of the FVMA and the Florida Association of Equine Practitioners, strengthening the voice of organized veterinary medicine in our state. In 20122013, we purchased and moved into our new corporate headquarters at 7207 Monetary Drive in Orlando debt free. Also in 2013, we celebrated the launch of the Gulf-Atlantic Veterinary Conference, the FVMA’s new national continuing education program, in Boca Raton, which proved successful financially, with more than 1,000 in attendance from 37 states and four regional countries at our inaugural meeting. We have enjoyed a successful and historic past, and our present makes me confident we are moving forward to greater successes. I was asked recently what three things I would like to see the FVMA Executive Board accomplish this coming year. There are three items on the wish list of my presidential year which I will work to accomplish. I would like to finalize the establishment of the FVMA as the sole credentialing body for veterinary technicians in Florida. The process to effect this is well underway at this time. I will work to accomplish an executive board and committee chair retreat with a national facilitator, possibly in November this year, which would be tasked with developing a strategic plan for the Association for the next five years. And finally, is the appointment of a task force committee to review and update the FVMA by-laws. This committee will also be tasked with reviewing and designing the policies and procedures manual of the FVMA Executive Board. On a personal note, I will try to visit as many of the local meetings as possible this year. I thank you for your faith in me to be your president, and I look forward to this year of enormous responsibility with confidence that we are all looking towards another successful year. Yours in service,

Donald H. Morgan, DVM

In Remembrance Adair Alspach Bush, DVM Dr. Adair Alspach Bush, a life-long resident of Key Biscayne, passed away on May 13, 2014. A well-known veterinarian in Miami, and a member of the FVMA and South Florida Veterinary Medical Association (SFVMA), Dr. Alspach Bush died from complications of pneumonia. In a post on the SFVMA website, Dr. Alspach Bush is eulogized as “an excellent veterinarian,” who “was a great humanitarian and gave back to her beloved Key Biscayne.” Dr. Alspach Bush ran a home-visit veterinary practice on Key Biscayne. She was born in California but grew up with two siblings in the Key from 1952, when her family moved to Florida. She earned her Doctor of Veterinary Medicine degree at the University of Florida in Gainesville in 1982. She opened the Grove Gables Animal Hospital soon after graduation, and also started a house call practice on Key Biscayne which later became Island Veterinary Clinic. In 1996, the Doctor was voted Best

Veterinarian in Miami by Better Homes and Gardens. She took a break from her practice to sail around the world with her husband from 2005 to 2012, during which she travelled 40,000 nautical miles and visited 62 countries. On her return to Florida, she established KB Veterinary House Calls in 2012, and was a founder of the Trap, Neuter and Release program for Key Biscayne. Dr. Alspach Bush also served the community she loved as a member of the Rotary Club, and St. Christopher's-by-the-SeaEpiscopal Church, where her memorial service was held on Saturday, May 17. Dr. “A” as she was often called, will be greatly missed by her daughter, Marah Fortson Snoeyink and husband Craig Snoeyink, and her grandchildren, Jacob and Kayla; her husband, Clint; brother Geoff Allespach and his wife Judy; her younger sister Heidi Allespach, PhD, and niece, Summer Stanley-Pomm; and the many friends she had in Florida and around the world. Following the Doctor’s wishes, her family requests donations in her honor, to The Rotary Foundation (www.rotary.org), or to Christian Veterinary Mission (www.cvmusa.org).

Clinton J. Chew Jr., DVM Dr. Clinton J. Chew Jr., 65, of Pensacola, FL, passed away on Friday, March 14, 2014. Dr. Chew was born on December 25, 1948, at the old Sacred Heart Hospital in Pensacola, Florida. He graduated from Auburn University School of Veterinary Medicine in 1977, and opened his small animal practice in 1982, at Ferry Pass Animal Hospital in Pensacola. Dr. Chew practiced for 35 years, and cherished the

many family and friends he made along the way. He was a strong family man and enjoyed working in his yard in his spare time, and spending time with his grandchildren. Dr. Chew was preceded in death by his parents, Clint J. Chew Sr. and Clara White Chew of Pensacola, Florida. He is survived by his wife, Nancy J. Chew; children, Kim Chew Gellatly and Courtney Chew Rock; grandchildren, Jacob Gellatly, Evan Gellatly, Owen Rock and Caleb Rock; as well as many cousins, aunts, family and friends.

In This Issue 4 | Member Spotlights 6 | Hurricane Season Preparedness 9 | FVMA President 2014-2015 Installed 10 | Meet Our New Officers & Executive

Board Members 12 | 2014 Legislative Wrap Up 14 | Practice Pulse

2014 Industry Partners Contributions 2014 TGAVC Invitation UF CVM Professional Coating Ceremony Passage of Veterinary Medicine Mobility Act on the Horizon 39 | Therapeutic Diets Are Tax Exempt 40 | UFCVM Student Mentoring Panel 2014

16 | 19 | 30 | 38 |

www.fvma.org  |  3


MEMBER SPOTL IGHTS

DR. ELIZABETH DIXIE BROWN of Cape Coral 2013 BLUE CHIP AWARD RECIPIENT Elizabeth Dixie Brown, DVM of Cape Coral, is the recipient of the 19th annual Southwest Florida Blue Chip Community Business Award. The Southwest Florida Blue Chip Award recognizes business persons who find innovative ways to provide services and grow their businesses. The award recognizes Dr. Brown for determination and innovation in her business practices, which effectively steered her clinic to growth and success, despite the challenges of a failing economy. A well-attended company of some 500 business representatives and community leaders witnessed the award presentation to Dr. Brown during the awards program which was held at the Harborside Event Center in Fort Meyers.

Dr. Brown operates East West Veterinary Care Center, of 3523 Del Prado Blvd. in Cape Coral. She was one of five finalists for the award. The story of East West Veterinary Care Center is an interesting testament to Dr. Brown’s creative and relentless approach to doing business. She bought the struggling clinic in 2007, just before the recession hit. Forced into innovation to save her investment, she expanded critical care services, diagnostic equipment and availability, began to provide emergency services to established clinic clients 24 hours a day, seven days a week, lengthened her work week by a day to include Saturdays, and upgraded her marketing with a 30-second commercial, targeted mailings and a professional website. She studied acupuncture and chiropractic care in an effort to broaden her clientele. Her studies increased her client base by 25%. Dr. Brown is quoted in the New Press Business as saying, “I’ve always said adversity breeds character and I am one helluva character.” And adversity has encouraged her to add to the success of East West Veterinary Care Center as she is now building a new clinic and planning to hire 10 to 12 additional staff members for expanded services.

DR. RICHARD D. WILKES CHAMPION OF VETERINARY MEDICINE Dr. Richard D. Wilkes, of St. Petersburg, Florida is the 2014 Champion of Veterinary Medicine, in whose honor the FVMA is awarding scholarships to six outstanding students of the University of Florida College of Veterinary Medicine. The FVMA names the Champion of Veterinary Medicine, who is a member of the Association worthy of emulation, who has made significant contributions to the profession. Throughout his career, Dr. Wilkes has been actively involved in all aspects of the animal-care industry. As a dedicated professional for over 30 years, Dr. Wilkes has been a committed servant of the profession with an extensive record of achievements and contributions to veterinary medicine. He has served as President of the Pinellas County Veterinary Medical Society, the Pinellas Animal Foundation, and the FVMA. He has also shared his talents as a member of various committees of the FVMA during this time. Two years after earning his Doctorate of Veterinary Medicine, Dr. Wilkes commenced to serve - as Secretary of the Pinellas County Veterinary Medical Society (PCVMS). His service to the Pinellas County VMA ended in 1988; but not before he served in 1986, as the PCVMS President, became the Pinellas Animal Foundation’s President-elect, and started his lengthy and exemplary association with the FVMA, to provide his service on a statewide level. He joined the Executive Board of the FVMA as District 4 Representative in 1991, and then went on to serve as Executive 4  |  FVMA ADVOCATE

Board President from 1994 to 1995. Today he serves as a member of the FVMA’s Legislative Committee and Political Committee. Locally, Dr. Wilkes serves as Chair of the PCVMS’ Legislative Committee. And nationally, he has served as a member of the American Veterinary Medical Association’s Political Action Committee. His career in the veterinary profession mirrors his years of dedicated service. For nearly three decades, Dr. Wilkes has owned and practiced in multiple veterinary hospitals, and today he is the President of Purchasing Services, Inc., a company that provides buying services to independent veterinarians across the southeastern United States. He has been honored numerous times in recognition of his dedication and excellence. In 2006, the FVMA presented him with the Veterinarian of the Year Award, and in 2007, with its Distinguished Service Award. The American Veterinary Medical Association has also honored Dr. Wilkes with its Russell H. Anthony Award.

Dr. Thomas J. Holt,

to Retire after 10 Years as State Veterinarian The Florida Department of Agriculture and Consumer Services has announced the retirement of Florida’s State Veterinarian, Dr. Thomas Holt. Dr. Holt will retire on July 17, 2014, after 10 years as State Veterinarian and Director of the Division of Animal Industry at the Florida Department of Agriculture and Consumer Services. “Dr. Holt’s leadership and dedication in preventing and controlling serious diseases that threaten Florida's livestock industry and public health has been a tremendous asset to this department and the citizens of the state of Florida,” said Florida Commissioner of Agriculture Adam H. Putnam. Dr. Holt came to Florida in March 2004, after serving with the U.S. Department of Agriculture (USDA) as an Associate Regional Director. He was a leader for the USDA on a number of animal disease surveillance and control programs across the country. His experience as a nationally known expert in emergency preparedness fit well with Florida’s leading role in responding to agricultural disasters. And Dr. Holt’s strong ties to the USDA proved to be very beneficial in developing a cooperative working relationship between the USDA and the Florida Department of Agriculture and Consumer Services, notes the Department.

During his service to Florida, Dr. Holt’s strength has been building relationships among employees, divisions of the department and other agencies, as well as other partners. Most importantly, cites a release from the Department of Agriculture and Consumer Services, Dr. Holt has worked tirelessly to build working relationships with agricultural producers and the owners of Florida’s herds and flocks. He has been responsive and helpful to every sector of Florida’s diverse animal industries, and included them in the decisionmaking process. Dr. Holt is a longtime member of the Florida Veterinary Medical Association and United States Animal Health Association. He is a member of the Florida Farm Bureau, the Florida Cattlemen’s Association and a number of other organizations. As State Veterinarian, Dr. Holt supported Florida’s veterinary practitioners. He directed the modernization of the Bronson Animal Disease Diagnostic Laboratory, which is now a Biosecurity Level III lab. In the next chapter of life, Dr. Holt plans to travel and spend time with his friends and family. His four young grandchildren are looking forward to this as much as he is! A retirement celebration was held on June 13, 2014, in Tallahassee. Letters or cards to be included in Dr. Holt’s retirement album may be sent to Stephen Monroe at 407 S. Calhoun St., Tallahassee, FL 32399-0800 or e-mail Stephen.Monroe@FreshFromFlorida.com.

Dr. William “Bill” Jeter

Retires from the Florida Department of Agriculture and Consumer Services.

A host of friends from the Department of Agriculture and Consumer Servcies and the industry joined Dr. William “Bill” Jeter and his family for a retirement celebration on March 7, 2014, in Tallahassee. Dr. Jeter retired as the Chief of the Bureau of Animal Disease Control in the Department’s Division of Animal Industry. As Bureau Chief, he managed the Division of Animal Industry’s various programs to protect all of Florida’s livestock industries. Dr. Jeter received his degree as a Doctor of Veterinary Medicine from Auburn University in June of 1967. Upon graduation, he returned to his home town in Dade City, Florida, and joined a mixed animal practice as an associate veterinarian. In July 1969, he joined the United States Air Force, Veterinary Corps to work at the Military Working Dog Training Center, Lackland Air Force Base in San Antonio, Texas. In 1971, Dr. Jeter and his family returned to Dade City where he opened his mixed animal practice, Town n’ Country Veterinary Clinic. His experience as a practicing veterinarian helped to prepare him for a career in protecting Florida’s equine, livestock and poultry industries. In May 1985, he sold the practice to join the Florida Department of Agriculture and Consumer Services, Division of Animal Industry as a regulatory veterinarian. Dr. Jeter’s career spanned 29 years with the Division of Animal Industry. He led a number of animal disease surveillance and

control programs to prevent and control diseases that threaten Florida's livestock industry. These successful efforts became models for other states across the country. Dr. Jeter joined the Department at the height of the Brucellosis eradication “wars” and was on hand when Florida was declared Brucellosis Free. He became well known for leading the efforts to control Equine Encephalitis. The incidence of this lethal equine disease has been reduced through years of diligent efforts by all stakeholders! During Dr. Jeter’s tenure, the responsibilities of the Division of Animal Industry expanded to include many other species as well as emergency preparedness. If you have ever had to have the agricultural check point call someone in the middle of the night due to some misfortune, chances are that it was Dr. Jeter who was called. Dr. Jeter would always try to find a way to allow reasonable accommodations while protecting the industry. We congratulate Dr. Jeter for years of commendable service to the people of Florida and we wish him all the best in his retirement. www.fvma.org  |  5


ARE YOU PREPARED FOR

The hurricanE season?

T

he National Oceanic and Atmospheric Administration (NOAA) has forecast a near-normal or below-normal Atlantic hurricane season in 2014.

The NOAA outlook calls for a 50 percent chance of a belownormal season, a 40 percent chance of a near-normal season, and only a 10 percent chance of an above-normal season. For the six-month hurricane season, which began June 1, NOAA has predicted a 70 percent likelihood of 8 to 13 named storms (winds of 39 mph or higher), of which 3 to 6 could become hurricanes (winds of 74 mph or higher), including 1 to 2 major hurricanes (Category 3, 4 or 5; winds of 111 mph or higher). NOAA says the main driver of this year’s outlook is the anticipated development of El Niño this summer. El Niño causes stronger wind shear, which reduces the number and intensity of tropical storms and hurricanes.  El Niño can also strengthen the trade winds and increase the atmospheric stability across the tropical Atlantic, making it more difficult for cloud systems coming off of Africa to intensify into tropical storms. The Atlantic hurricane region includes the North Atlantic Ocean, Caribbean Sea and Gulf of Mexico. There were only two Atlantic hurricanes last year. And although Florida has been lucky for a few years, it is the state hit the most by hurricanes. The last serious activity was 2004, when four hurricanes made landfall, namely Charley, Frances, Ivan and Jeanne; and the following year when a weaker Katrina passed over, before it went on to become a category 5 storm and devastate New Orleans and Mississippi. Two other lesser storms were experienced that year. We have not had a hurricane in eight seasons, but it is important to take nothing for granted and always be prepared.

Disaster Plan A disaster preparedness plan is important. Veterinarians should have a written disaster preparedness plan in place for their veterinary practices. It should be readily available and executable in the event of a hurricane. The following seven basic parts are necessary in a master disaster preparedness plan for a veterinary practice/clinic: • Emergency Relocation of Animals • Medical Record Backup • Continuity of Operations • Security • General Emergency Planning • Fire Prevention • and Insurance and Legal Issues. 6  |  FVMA ADVOCATE

Emergency Relocation of Boarded and Hospitalized Animals This includes leashes, carriers and other species-specific sup‑ plies. Be sure to plan for appropriate, pre-arranged animal trans‑ portation, and a temporary animal holding location. Other im‑ portant points include a 24-hour client contact list which should be appropriately stored to enable off-site access, and ensuring secure, weather-resistant patient identification. In conjunction with legal counsel, veterinarians should involve staff, clients and their pets in disaster planning and disaster drills, which help to ensure community buy-in and dedication to the plan.

Medical Record Backup Medical records should be backed up on an off-site computer. Fireproof safes do not prevent melting in the event of a fire. Keep off-site copies of important documents, an itemized inventory on- and off-site, and where possible, consider digital storage of all documentation as a backup.

Continuity of Operations Communication is vitally important during and after a disaster. In a hurricane and the days directly following, there is the possibility of interruption in electrical power, which would cause telecommunication services to be lost for indeterminate periods. An alternate electrical power source such as a generator is important. The ideal but costly choice here is a professionallyinstalled generator capable of providing long-term power to an entire facility. However, portable generators are effective even though a practice may need more than one generator. Staff should be trained in the maintenance and operation of generators, and plenty of fuel should be stored. Also to be included in the continuity of operations, is a list of supplies with current 24-hour contact information for suppliers who may be working throughout a disaster. Include alternate food and water sources in case of contamination; a five-to-sevenday supply of food and water for on-site staff and patients, and five to seven days of personal medications for on-site staff are important. Consider using an alternative practice location within the same vicinity. Check the local veterinary medical association for potential resources for an alternative site from which to operate if necessary. The main objective should be to lessen inconvenience to clients, and being able to offer uninterrupted service to clients. Adopting a sister practice in another location may also be useful. Using the facilities at a sister practice for a percentage of income earned also provides another avenue through which established clients can be provided with uninterrupted service.

Security of Building and Personnel Contact the local municipality for specific requirements. Outline preferred means of reporting emergencies, including a designated person for communicating with local emergency responders. The local fire department can provide free inspection and evacuation drills. Other security measures should include: • a water system independent from the electrical system • oxygen tanks isolated for safety • securing the practice from theft, looting and other crimes • a floor plan or diagram that clearly shows the location of all fire extinguishers, control valves, dangerous areas and unob‑ structed escape routes • emergency lighting • information sharing; a pre-arranged meeting place for staff to keep everyone accounted for is a good idea; and an office phone-tree for 24-hour numbers is necessary.

General Emergency Planning This plan should address appropriate responses to all foreseeable emergencies including hazardous chemical spills. Employee training is needed here because there is a need for information and the proper equipment required to respond to the disaster. Maintenance of equipment, surveillance and detection of leaks and containment of spills by trained employees are essential. Employees should wear protective clothing and practice proper disposal techniques. Florida occupational safety agencies can ensure full compliance of both federal and state regulations. Each county’s Extension Service has information on responding to chemical disasters.

Become familiar with tax laws and deductible disaster expenses. Make sure the business insurance coverage addresses the following elements in the policy: Business interruption (when it ends and what triggers the end); Extra Expense (payment of overtime pay and relocation expenses); Professional Extension (injury/loss/death of animals); Loss of Income; Personal Property (replacement value); Automatic Inflation; Fire Damage; Water Damage; Debris Removal/Cleanup; Comprehensive Building and Structure Replacement; Coverage of Rented and Leased Equipment; Interruption of Power, Heating/Air and Sewer; coverage of Worker’s Compensation; General and Professional Liability.

The FVMA Disaster Preparedness Committee urges members to prepare a disaster preparedness plan for their veterinary practices. The State Emergency Response Team (SERT) website, sponsored by the state of Florida, offers more useful information to assist in the preparation of a comprehensive plan. That website is www.Floridadisaster.org.

Fire Prevention Identify major fire hazards in the workplace, proper handling and storage procedures, potential ignition sources such as open flames and electrical sparks and the type of fire protection equipment necessary to control each major hazard. Regular maintenance of safeguards installed on heat-producing equipment is essential.

Insurance Coverage and Legal Issues A current and comprehensive insurance policy is necessary for the veterinary practice. Discuss the details of a disaster drill with legal counsel to make sure you are covered by insurance for any injuries that might occur during the drill. Keep receipts for all purchases, keep a videotape and photographic inventory and, in the event the practice is damaged, it is important to take measures to avoid further damage (roofs should be covered to prevent rain water damage to interior). Continued on Pg. 18 www.fvma.org  |  7


Trust.

It has to be earned.

Donald H. Morgan, DVM

FVMA President 2014-2015 Installed

D

onald H. Morgan, DVM was installed President of the FVMA on April 26, 2014. His installation occurred during the FVMA Annual Awards Ceremony and Installation of Officers held at the Buena Vista Palace Hotel and Spa, Lake Buena Vista, Florida during the FVMA’s 85th Annual Conference. Dr. Morgan has been a long-term member of the FVMA, and has served the veterinary profession with his participation in and support of organized veterinary medicine. His membership in the FVMA spans more than 45 years. He is also a long-standing member of the American Veterinary Medical Association and the American Animal Hospital Association. A small animal veterinarian, the new FVMA President graduated in 1964 from Auburn University College of Veterinary Medicine. He owned and operated Bluffs Animal Hospital in Belleair Bluffs, Pinellas County. Dr. Morgan has devoted much of his spare time in service to the veterinary profession in his district and statewide, as a member and officer of the FVMA.

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He began serving as District 4 Representative on the FVMA Executive Board in 2010, and served in that capacity until he became the Presidentelect in 2013. Along the way, Dr. Morgan has also served in various FVMA Committees. The FVMA honored Dr. Morgan in 2011, when he was presented with the Association’s Lifetime Achievement Award in recognition of his outstanding contributions to the Association and the veterinary profession. He has had a particular interest in the FVMA’s legislative advocacy program, being an avid participant in Legislative Action Days, and has held leadership positions in his community and the local VMA. He is President of the Pinellas Animal Foundation, and has held offices in the Greater Largo Chamber of Commerce. He was the Chamber of Commerce chairman, and served on the board of directors for 10 years. He is also a member of the Largo Jaycees and is the chairman of the Largo Medical Center Board of Trustees. Dr. Morgan volunteers and is supportive of the Pinellas County Veterinary Medical Association (PCVMA) and has been the driving force of the monthly PCVMA newsletter for many years. www.fvma.org  |  9


Dr. Mary Smart

Meet Our

New Officers & Executive Board members Dr. Richard M. Carpenter

R

Installed As FVMA PRESIDENT-ELECT

ichard M. Carpenter, DVM of Fort Myers, Florida, is the President-elect of the FVMA. He was recently installed at the FVMA Annual Awards and Officer Installation Ceremony held during the FVMA’s 85th Annual Conference in Orlando. Dr. Carpenter is a small animal practitioner, and he operates the Animal Clinic At Kelly Crossing of Fort Myers. Dr. Carpenter graduated from Iowa State University School of Veterinary Medicine, and he practiced in Iowa after graduation until 1986. He relocated at that time to take a position as Assistant Professor at the University of Virginia Medical School. Dr. & Mrs. Carpenter moved to Florida in August of 1995, and since that time has owned and operated two companion animal clinics in Fort Myers. Dr. Carpenter joined the FVMA Executive Board in 2010, as District 7 Representative, and has served on the Association’s Veterinary Assistant/ Technician Certification Committee, UFCVM Admissions Committee, and Farm Animal Welfare Task Force. He has also made time to be of service to his local VMA, as a member and officer of the Caloosa Veterinary Society of Lee County for the past 18 years.

Installed As District 4 Representative

Rachel Kelly Klemawesch, DVM represents District 4 on the FVMA Executive Board, which is comprised of Citrus, Hernando, Hillsborough, Pasco, Pinellas and Sumter Counties in West Central Florida. The local veterinary associations in District 4 include Hillsborough VMA, Pasco Hernando VMA, Pinellas County VMA and Suncoast VMA. Dr. Klemawesch holds two degrees from Auburn University. She earned a Bachelor of Arts in Foreign Language (German), graduating Cum Laude from Auburn University in 1992, and then received her Doctor of Veterinary Medicine in 1996, from the university’s College of Veterinary Medicine. To further her veterinary career, Dr. Klemawesch completed a preceptorship with renowned avian specialist, Dr. Don Harris, before 10  |  FVMA ADVOCATE

spending several years working in a group of small animal hospitals in the Fort Lauderdale/Miami area. She was the Medical Director at Gulf Breeze Animal Hospital in Gulf Breeze, Florida prior to moving to the Tampa/St. Petersburg area. Dr. Klemawesch is presently Medical Director and associate Veterinarian at Northeast Animal Hospital in St. Petersburg, President-elect of the Pinellas County VMA, was a member of the Hillsborough County Animal Advisory Committee in 2010-2011, and serves on the FVMA’s Animal Welfare Committee. Dr. Klemawesch confesses that she has great appreciation for her colleagues who serve the profession and would like to find ways to get new veterinarians involved in organized medicine.

Dr. Rachel Klemawesch

Installed As District 7 Representative

Mary Smart, DVM is the new Representative on the FVMA Executive Board for District 7, Southwest Florida, which is comprised of Charlotte, De Soto, Hardee, Lee, Manatee and Sarasota Counties. She is a native of Maryland and grew up on the outskirts of Washington D.C. Dr. Smart attended the University of Maryland from 1976 to 1980, where she received a B.S. in Animal Science. After graduating from Maryland, she moved to Gainesville, Florida and entered the University of Florida School of Veterinary Medicine, going on to earn her Doctorate in Veterinary Medicine in 1985. Dr. Smart has spent most of her career

Installed As District 8 Representative

Jim Brechin, DVM is the new District 8 Representative on the FVMA Executive Board. District 8 is comprised of Escambia, Okaloosa, Santa Rosa and Walton Counties in Northwest Florida. Dr. Brechin was born and raised in Birmingham, Alabama. After graduating from Auburn University, School of Veterinary Medicine in 1974, he practiced in Jacksonville, Florida and in Nashville, Tennessee before settling in Destin, Florida in 1977. Since then, he has operated Destin Animal Clinic. He met and married Auburn native Jo, while attending Auburn University. Dr. Brechin has been active in his community,

Dr. kelly J. Sloan-Wade

working in Sarasota and Manatee counties. She has worked in both large and small animal practice, and has practiced as an associate veterinarian, a relief veterinarian, an emergency medicine practitioner, and a practice owner. She is currently employed at Westbay Animal Hospital in Bradenton. Dr. Smart is a member of the American Veterinary Medical Association, the Florida Veterinary Medical Association, and is a member of and the past president of the Manatee County Veterinary Society. She spends her free time with her family – husband, children, and pets – and enjoys outdoor activities.

Dr. James M. Brechin

as President of the Destin Chamber of Commerce, Chairman of the Destin Deep Sea Fishing Rodeo and Rotary Club President. He has been Chairman of the Board, Treasurer, and Missions Chair of his local church. In service to his profession, he founded the Miracle Strip Veterinary Society. He has previously served as District 8 Representative on both the FVMA Finance Committee and Executive Board, and served as the FVMA President for 2009-2010. Dr. Brechin and his wife Jo are proud parents of daughters Mandi and Leslie, and enjoy the company of their Greyhound, Gabby, and Bull Mastiff, Zoe, as well as their aquarium of Tiger Barbs.

Installed As District 9 Representative

Kelly J. Sloan-Wade, DVM is the new District 9 Representative on the FVMA Executive Board. She was sworn in as one of the FVMA’s newest Board members during the Association’s Annual Award and Officer Installation Ceremony which was held on April 26, 2014. Dr. Sloan-Wade represents veterinarians in the counties of Flagler, Volusia and Brevard on Florida’s Space Coast. She is a 1991 graduate of the University of Florida College of Veterinary Medicine, and practices small animal medicine at Atlantic Animal Clinic of Cape Canaveral, Florida. Atlantic Animal Clinic is a full-service veterinary medical facility that provides medical care, surgical care and dental care to Cape Canaveral and surrounding areas. Dr. Sloan-Wade received undergraduate

and post graduate degrees in Science and Cell/ Molecular Biology from Florida Institute of Technology in 1981, and 1985, respectively. She is presently Veterinary Civilian Officer at Patrick Air Force Base, Brevard County, and is an adjunct faculty member of Eastern Florida State College Veterinary Technology Program. She is an FVMA Political Action Team member and a member of the AVMA. She has served as treasurer of the Brevard County Veterinary Medical Association, and was the recipient of the Outstanding Adjunct Award 2013, from Eastern Florida State College Dr. Sloan-Wade lives on Merritt Island with her husband Randy who is a NASA engineer, her son Wyatt and daughter Katie, and three dogs, a cat and a bearded dragon www.fvma.org  |  11


2014

Legislative

Wrap Up

Legislative Advocacy and Monitoring

Legislative Monitoring

Of the many bills filed annually that relate to veterinary medicine and animals, there are several recurring themes that the FVMA has opposed in each session over the past several years. These bills tend to deal with what is often referred to as “animal rights” versus “animal welfare” issues. Over the past decade these bills have been filed with a variety of approaches and ever changing language, but the intent has always been the same: regulating the sale and breeding of dogs and cats, and creating not-for-profit organizations utilizing governmental funding with little or no oversight by an elected governing body accountable to the citizens being taxed. This has been a divisive topic within the Florida Legislature. When reviewing the title of proposed legislation, many of these bills appear to make sense and seem benign. However, when the bills are read in their entirety, the content often poses practical and ethical questions for those considering the legislation.

While the above was the top legislative priorities for the FVMA, staff monitored 30 other pieces of legislation that had the potential of affecting veterinary medicine. Also indicative of the success of the FVMA’s advocacy efforts is that none of the bills opposed by the FVMA passed during this legislative session:

This is a challenge that the FVMA Executive Board, Legislative Committee and Staff have when they review the legislation in order to educate our members and recommend positons on proposed legislation.

Pet Services and Advocacy Program Opposition to House Bill 1213: “Pet Services and Advocacy Program” was a high priority of the FVMA during this Legislative Session. HB 1213 was almost identical to the bill known as the “Pet Trust Act” that the FVMA successfully defeated in 2013.

Left to right Front Row: Philip Hinkle, FVMA Executive Director; Dr. Stephen Shores, Legislative Committee Chair; Dr. Richard Carpenter, FVMA President-elect; Mrs. Kristina “Buttons” Carpenter; Dr. Dale Kaplan-Stein; Dr. Julia Roberts Reynolds; Dr. Jenifer Chatfield; Dr. Christy Layton; Dr. Adriana Odachowski; Ms. Caitlin Spindler; Dr. Robert Hase; Dr. Jacqueline Shellow; Mr. Barry Faske 2nd Row: Dr. Paul Nicoletti; Dr. Ann Penn; Dr. Jerry Rayburn; Mr. Don Thompson; Dr. Rick Sutliff; -; Dr. Marc Presnell; Dr. Theresa Parrott; Mr. Brett Zager 3rd Row: Dr. Kelly Sloan-Wade; Dr. Gerardo Diaz; Dr. Christine Storts; Dr. Michael Epperson; Dr. Grant McMillian; Dr. Steve Steverson

T

he Florida Veterinary Medical Association (FVMA) had a successful 2014 Florida Legislative Session. Not only did the FVMA draft, file and pass its priority bill, but we helped defeat legislation that posed threats to the practice of veterinary medicine and animal patients entrusted in our care. A review of the 2014 Legislative Session reveals that fewer bills passed this year than during any session in the past decade. Lawmakers passed 264 bills in the 60-day legislative session that ended in early May, which was the fewest number of bills passed since at least 2001. That passage rate represented a 22 percent decrease based on a 10-year average, from the 2004 through 2013 sessions. It is noteworthy that of the 264 bills passed this year, many were local resolutions, license plate adoptions and

12  |  FVMA ADVOCATE

declarations, meaning, a portion were not substantive or contro‑ versial. Even in this climate of declining passage of substantive legislation, the FVMA succeeded in passing bill language that is important to veterinarians, pets and consumers. House Bill 5601, which included the language proposed by FVMA, passed unanimously by both the Senate and House on the final day of the Legislative Session and was signed into law by Governor Scott on May 12, 2014. The bill establishes that therapeutic veterinary diets shall be exempt from state sales tax, and was effective July 1, 2014. (Tax Exemption legislation is discussed more fully in a separate Advocate article on page 39 of this issue.)

HB 1213, formerly known as the “Pet Trust Act,” proposed that counties be allowed to establish Independent Special Tax Districts and levy Ad Valorem taxes to provide funding of “Pet Services and Advocacy Programs.” It proposed the creation of a governing body of 14 (including one non-voting member) to administer the “program.” The members were to be appointed by the respective County Commission, not elected; thus they would not be accountable to the people who are being taxed. The 2013 Statewide Taxable Value is $1,313,088,962,719. (Source: Florida Department of Revenue published November 2013.) The potential revenue that could have been generated statewide by the .10 mill cap, established in the proposed legislation, was estimated at more than $131 million per fiscal year. Pet Services and Advocacy Programs are a local, not state issue, and local governments currently have the authority to provide funding for these special interest programs through their ability to create Special Tax Districts and/or allocate funds from Ad Valorem Taxes; which would be much more transparent and would have more accountability. The FVMA whole-heartedly supports charitable programs that make a significant improvement to the health and welfare of Florida’s animals. However, we do not support the use of tax revenue to fund activities of non-profit organizations (501 C (3)) for which a tax-exempt status has been granted.

Supported: S.B. 414/H.B. 993, Public Records/Animal Researchers- Adopted and signed into law. Opposed: S.B. 1504/H.B. 637, Animal Cruelty Died in Committee. Opposed: S.B. 1574/H.B. 1305, Commercial Breeding and Selling of Animals-Died in Committee. Opposed: S.B. 1624/H.B. 1377, Sale of Dogs or Cats Died in Committee. Opposed: S.B. 1534, Animal Control Agencies and Animal Shelters- Died in Committee. Monitored: S.B. 558/H.B. 1, Genetically Engineered Foods; H.B. 217 and 857 Streamlined Sales and Use Tax Agreement; H.B. 687 Medical Gas; S.B. 780/H.B. 697 Controlled Substances; S.B. 742/H.B. 933 Greyhound Racing Injuries; and H.B. 1033 and H.B. 1383 Horse Racing Industry/Gaming.

Grass-roots Legislative Advocacy: “All for One and One for All” The 2014 FVMA Legislative Action Days was a great exhibition of the tremendous grass-roots legislative advocacy that is growing within our veterinary medical community. We cannot rest on our laurels, because the legislative process never stops. As one Legislative Session ends it is time for us to prepare for the next. There is a political adage “If you’re not at the table – you’re on the menu!” Members can rest assured the FVMA leadership, Legislative Committee, staff and our lobbyists are actively engaged and representing the best interests of the veterinary profession, small business and the pets trusted in our care. Our opposition is very vocal, organized and engaged. It is important for all members to become involved in the legislative process and to become part of the FVMA’s ever growing grass-roots advocacy network. This year’s legislative success was a direct result of members becoming personally engaged in our grass-roots advocacy efforts. The FVMA is pursuing other initiatives that impact our profession. Continued member engagement will ensure future legislative victories as we work diligently on our memberships’ behalf. If you would like to get involved contact the FVMA on our member support Help-Line, 800-992-FVMA (3862) or email us at info@FVMA.org.

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PRACTICE Got a question? The FVMA can help. One of the benefits of membership in the FVMA is our Helpline, (800) 992-3862, available to members daily, Monday to Friday, 8:00 am to 6:00 pm. Our Helpline also provides insight to the FVMA staff, of the challenges and concerns of our members. In this feature we will highlight topics from the questions we received in preceding weeks, in an effort to keep our members up-to-date on current concerns as well as regulatory and legislative changes.

Mr. Ed Bayó, JD, FVMA legal advisor, answered member questions on computer records in a veterinarian’s practice, the responsibility to prescribe medications, and the doctor’s liability when treating a not-vaccinated pet.

Question: Is the computer record not considered a part of the medical record at all? Often times for routinely rx'd medications like HW or flea control, the medication and size are listed in the written medical record, but directions for use are only found in the computer record. Is it still acceptable to make changes to the computer record when there is no way to note that a change has been made or who made that change? At what point does the information in the computer system become a part of the medical record, rather than just an invoice? If the written records do not match the computer invoice records, is that a problem? Are computer invoice records ever involved in a board complaint, or just the written records? EB: All records, paper or computer, that contain clinical

information about the patient are part of the patient records. Invoices that only contain financial type information are not considered part of the records. The problem usually is that some vets capture information about vaccines or treatments in their billing records only. When that happens those records then are considered patient records. Changes to patient records (paper or computer) should be made in a way that can capture who made them and when. Late entries should be noted as late entries. A change in the price of something or something similar (not having to do with clinical information) is ok by anyone at anytime.

14  |  FVMA ADVOCATE

Computer invoice records can be involved in board complaints especially when they become patient records as described above. If the invoices don't match the written medical records that can be a problem.

Question: We do not typically note in the record that a patient is authorized for future refills - each time a refill is requested, a doctor reviews the chart and authorizes the refill at that time. This doctor may or may not be the one who has previously examined the patient - the patient's valid VPC relationship is with the hospital, not an individual doctor. What the particular doctor would like to happen is for non-doctor staff members (technicians or receptionists) to authorize refills for medications like HW or flea control without a doctor, based on our hospital's requirements (annual exam and HW test). Is the doctor able to delegate this prescribing ability to designated staff members based on hospital standards, or does it need to be noted in the record that x number of refills are authorized by the original doctor. And if refills are designated in the record for a particular medication, do the refills all need to be dispensed under the original prescribing doctor's name? EB: I disagree with the statement that the VCP relationship

is "with the hospital." The hospital does not prescribe or practice veterinary medicine. Because several vets work at the hospital and they are aware of their relative skills, one vet can authorize a prescription without having to conduct a full blown examination. A quick review of the chart would be sufficient to establish the VCP relationship. My suggestion is that the original doctor that initiated the drug therapy be the one under whose name the subsequent refills are

dispensed. He or she can authorize the refills consistent with the hospital requirements. If that doctor leaves the practice another doctor can perform the quick check, confirm everything, and create the new VCP relationship. When the tech or receptionist fills the refill, they are not prescribing. The vet is not delegating the decision to prescribe or authorize the refill (something the vet can't do). What the vet is doing is delegating the task of delivering the medication the vet previously prescribed or authorized to the client. Once again, the prescribing vet should be the one that initially authorized or the one that took over. It should not be the vet owner that never examined the patient.

Question: Q. What is the veterinarian’s liability when treating a client, if it is determined the pet cannot be vaccinated, and there is a biting incident involving said animal? EB: There is no simple answer to such an open-ended question. If the question is "can the vet be sued," the answer is anybody can sue for just about anything. Vets carry insurance because of that. What vaccinations to give and when are matters that the vet considers in the best interest of the patient. Presumably the vet looks at the animal’s condition as well as environmental factors (i.e. outside cats should get Feline HIV but it is not as necessary with indoor cats). There are other well-established parameters and considerations which are not legal, but professional medical matters. As long as the vet is acting with due diligence, the vet should not be held responsible for damages. Certainly no more than a vet that takes care of a dog that then ends up biting someone in the street.

Jenifer Chatfield, DVM, Co-Chair of the FVMA’s Disaster Preparedness Committee, took the following question on the FVMA’s behalf.

Question: Q. I just renovated my practice and my contractor assures me that it is now “hurricane-proof!” Can I board pets for people who are evacuating due to a storm? What is my responsibility?

Kudos to you for your efforts in preparedness! How lucky your clients are that their veterinarian feels such an obligation to provide for their pets during less than ideal circumstances! However, I would caution any practice owner from the feeling of being “hurricaneproof.” A hurricane or tropical storm brings strong winds and lots of water. Most contractors mean to say that a building is able to withstand hurricane-strength winds, rather than hurricane proof. Indeed, the number one cause of death during Hurricane Sandy was actually drowning.1 Unless you can guarantee that your building will never flood (difficult to do on a peninsula such as Florida), a truly “hurricane-proof” building seems unlikely. The second question relates to continued boarder intake during voluntary evacuation of your area. Once a practice commits to provide for a pet in the absence of the owner, liability is certainly attached should something untoward befall the animal. A practice owner should consider that weather is unpredictable. A storm may be small at the time that the pet owners drop off their beloved animal. Then, over the next 24-48 hours, the storm can strengthen, even becoming large enough to prompt mandatory evacuations. What then does a practice owner do with full kennels? No one wants to face an attorney with that question. In the end, if you wish to provide such a service, the FVMA encourages you to find out more information from authorities. A good starting point is the following: 1. County Emergency Management 2. Business liability attorney 3. FEMA – Check out flood zones in your area The FVMA also recommends helping your clients avoid a bad situation by providing them with tools to better prepare themselves for hurricane season. Some examples of available tools are: 1. AVMA Disaster guide 2. www.fldisaster.org Now, let’s all hope for a quiet hurricane season and good health! Reference: 1 Deaths Associated with Hurricane Sandy — October– November 2012. CDC’s Morbidity and Mortality Weekly Report. 2013. 62(20);393-397.

www.fvma.org  |  15


In Grateful Appreciation

Sincere thanks, on behalf of the members and leadership of the FVMA, for their invaluable contributions to the continued growth of the Association, and for making the FVMA’s yearly Membership Recruitment and Retention Campaign successful.

A

t the end of May, membership renewals and new applicants in the FVMA stood at 3,600. Each year, the FVMA conducts a membership recruitment and retention campaign which is largely underwritten by partners in industry, to expand outreach to veterinarians, and to encourage their membership in the Association. This is a program that the Association has undertaken for more than a decade, and proving very successful, it has been a valuable avenue to bring veterinarians

licensed to practice in Florida into the FVMA fold, and to deepen relationships within the industry that serves the profession. Industry support for the campaign this year was in excess of $640,000. Six companies joined the FVMA in uniquely welcoming new and renewing members to the FVMA. New and renewing members in 2014, were offered free products from partnering companies, which carried a total wholesale value of more than $640,000. This partnership

rewards Industry’s generosity by providing an exclusive opportunity to visit our members at their practices, for face-toface interactions. The 2014 Membership Recruitment and Retention Campaign continued through June 30, and the FVMA is proud to share that at the end of May, the Association had added more than 380 new members. The FVMA appreciates our Membership Recruitment and Retention Campaign partners, and extend thanks to these companies for their collaboration.

Invaluable Contributions

The FVMA Extends Its Thanks for Your in Support of the FVMA's 2014 Membership, retention and Recruitment Campaign

Industry's support this year provided more than $640,000 (wholesale Value) in free product to veterinarians who renewed their membership or joined the FVMA this year!

More Than $640,000 Contributed By Industry 14 Fvma Membership ca 0 2 e h mpa To T ign

Boehringer Ingelheim Boehringer Ingelheim supported the Membership Recruitment and Retention Campaign by providing $115,850 of free product. New and renewing members received a tray of Bronchi-Shield® Oral Vaccine and one tray of ULTRA Duramine 4L. The combined wholesale value gifted to each member is $331.

Elanco

TM

This year, Elanco committed $154,000 of free product to new regular members, recent graduate members and part-time employed members. Members received a 6-pack of of Trifexis®, Comfortis® or Cheristin , at a wholesale value of $56 each. TM

TM

MWI Veterinary Supply MWI Veterinary Supply offered our new members eight free boxes of VETone® Advita Powder or 12 syringes of Advita Paste to Equine Vets. The wholesale value of VETone® Advita Powder is $120. The wholesale value for the gift of Advita Paste for horses is $75. MWI’s total commitment to the program was $42,000. TM

TM

Roadrunner Pharmacy Roadrunner Pharmacy provided credit to new and renewing members in the amount of $75 toward the purchase of a new compounding prescription order. Their contribution to the campaign is valued at a total $26,250.

Veterinary Products Laboratory

The contribution of Veterinary Products Laboratory to the campaign is valued at $165,000, wholesale. They provided new members with a choice of a tray of Ovitrol® X-TendTM Fleas & Tick, or Spot On® for Dogs or Cats, or Duralactin® Family of Products for cats, dogs or horses. The value to each new member is $60.

Zoetis

Zoetis committed $137,500 to the 2014 campaign. All members received a free 10-pack WitnessTM Heartworm Diagnostic Test Kit valued at $50.

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Continued from Pg. 7

Join The FVMA Vet Corps Now To Be Trained And Ready To Help

The Vet Corps was founded in 2007, comprised of veterinarians and veterinary technicians to provide the infrastructure for the veterinarians and their staffs during disasters.  The FVMA, UFCVM, and the Florida Department of Agriculture and Consumer Services established the volunteer corps of veterinarians and veterinary technicians to support response measures in the event of an emergency involving animals and animal health. In the aftermath of any emergency, veterinarians and veterinary technicians may be needed to assist local, state and national response teams to meet the needs of animals

and people. These professionals would be a part of the Florida State Agriculture Response Team (SART), serving under Emergency Support Function (ESF) 17, and the state Emergency Response Team.  Veterinary staff may serve in assessing veterinary response capabilities and provide for emergency animal treatment in the aftermath of a natural disaster, or may serve in support of disease surveillance and control efforts in combating devastating diseases affecting Florida’s animals. To join the Vet Corps, send your name, address, telephone numbers (including cell phone number) and email address to info@fvma.org

Waiting Until A Disaster To Volunteer Is Too Late! PALM BEACH COUNTY

medical reserve corps GEARS UP

WANTS LOCAL VETERINARIANS INVOLVED The Medical Reserve Corps (MRC) is in need of the services of Veterinarians in Palm Beach County. If you would like to be involved and can volunteer to be of service in the event of a disaster, the MRC is looking for you. Palm Beach County MRC: • • •

Pre-identifies, pre-credentials, trains and prepares MRC members BEFORE a disaster. Supports the operation of special needs shelter, medical aid stations, mass immunization clinics, hospital surge and other emergency health and medical needs of the community. Prepares members to become an immediate part of the solution.

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For All the Information Contact: Natalie Gonzalez Palm Beach County Medical Society 3540 Forest Hill Blvd, Suite 101 West Palm Beach,FL 33406 Tel: (561) 433-3940 Fax: (561) 412-2104 Email: NatalieG@pbcms.org Website: www.pbcms.org/MRC


The

Gulf-Atlantic Veterinary Conference

C 4

Enjoy first-rate amenities at the Boca Raton Resort & Club,

T G 2 A0 V1 C4 Join Us at the

A Waldorf Astoria Resort!

September 18-21, 2014 | Boca Raton, Florida

T G 2 A0 V1

2 nd Annual Gulf-Atlantic Veterinary Conference

Situated on 356 acres in fabled South Florida, the Boca Raton Resort & Club, carefully combines a fresh look and modern amenities, while embracing the purpose and design of the original vision. This eclectic, private village offers the best of all worlds: a famous spa, championship golf and tennis, expansive beach and luxury marina just steps from sumptuous rooms and suites. With deep roots in the past, this completely unique hotel is truly a destination for the future. • • • • •

Experience the Difference

Daily self-Parking will be available on Thursday, Friday, Saturday and Sunday in the employee garage adjacent to the Mizner Center. The price will be $6.00 per entry and only cash will be accepted. Early checkouts prior to attendee’s reserved checkout date will incur an early checkout fee equaling to one night’s room plus tax, if attendee does not inform the hotel of the change in planned length of stay at or before check-in.

Fitness Center Sport Clinics & Amenities Golf Tennis Camp Boca Family Fun Activities

• Exclusive On-Site Shopping • Sculpture Tour of the Resort’s Baker Sponder Gallery • Boca Raton Surf School

◘ Urology ◘ Canine and Feline Nutrition ◘ Dermatology ◘ Neurology ◘ Practice Management ◘ Pharmacology ◘ Internal Medicine

◘ Surgery ◘ Ophthalmology ◘ Pain Management ◘ Emergency and Critical Care ◘ Cytology / Hematology ◘ Dentistry ◘ Cardiology

◘ Endocrinology ◘ Euthanasia Practices ◘ Rehabilitation ◘ Avian Medicine ◘ Internal Medicine ◘ USDA Accreditation ◘ Avian / Pet Chickens

Welcome to

Boca Raton Resort & Club, A Waldorf Astoria Resort 501 East Camino Real, Boca Raton, Florida, 33305

our featured s peaker s

Customize your Resort Experience

modern-dayluxury resort living

Old world elegance with

TGAVC Special Room Rates

(Rates Include the Hotel’s $27 Daily Resort Fee)

Bungalow Room Bungalow Suite Cloister Room Tower Room Tower Junior Suite Beach Club Standard Room Beach Club Ocean Vista Room Yacht Club Room

$159.00 $199.00 $159.00 $189.00 $229.00 $209.00 $229.00 $229.00

race approved: This program was reviewed and approved by the AAVSB program for 325 hours of continuing education. Participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education. Please contact the AAVSB/RACE program at race@aavsb.org or (877) 698-8482 should you have any comments/ concerns regarding this program’s validity or relevancy to the veterinary profession, or if you have questions regarding this notification.

As an incentive for attendees to extend their stay, the resort will offer a $200.00 room folio credit for guests staying six nights or more

Schedule At-A-Glance

VALET PARKING: There is a discounted $20.00 overnight valet parking charge for guests driving in. Complimentary self-parking is only available for guests with Bungalow accommodations.

• • • • •

LECTURE TOPICS:

Friday, september 19, 2014

thursday, september 18, 2014 7:00 am – 1:30 pm Wet Lab Attendee Check-In 7:30 am – 12:00 pm TGAVC’s Annual Fishing Tournament 7:30 am – 12:00 pm TGAVC’s Annual Golf Tournament 8:00 am – 5:30 pm Wet Labs

7:00 am – 5:30 pm Pre-Registration Packet Pickup 7:00 am – 5:30 pm On-Site Registration Hours 8:00 am – 5:10 pm Continuing Education Sessions / Wet Lab 11:30 am – 6:15 pm Marketplace Hours 5:10 pm – 6:15 pm TGIF Exhibitors’ Reception

Saturday, september 20, 2014

Sunday, september 21, 2014

7:30 am – 6:00 pm Pre-Registration Packet Pickup 7:30 am – 6:00 pm On-Site Registration Hours 8:00 am – 5:50 pm Continuing Education Sessions / Wet Lab 8:00 am – 4:00 pm Marketplace Hours 7:00 pm – 10:00 pm TGAVC’s Dinner Cruise

7:30 am – 12:30 pm Pre-Registration Packet Pickup 7:30 am – 12:30 pm On-Site Registration Hours 7:00 am – 7:50 am Complimentary Continental Breakfast 8:00 am – 8:50 am General Assembly - Scott Burrows - Keynote Address 7:00 am – 7:50 am Christian Fellowship Breakfast 9:00 am – 12:50 pm Continuing Education Sessions / Wet Lab

• Program Subject to Change •

Dr. Mark Acierno

Dr. Rick Alleman

Ms. Elaine Anthony

Dr. Ellen Behrend

Dr. Adam Birkenheuer

Dr. Dennis Chew

Dr. Craig Datz

Dr. Todd Duffy

Dr. Mark Epstein

Dr. Mary Gardner

Ms. Karyn Gavzer

Dr. John Harvey

Dr. meghan Herron

Dr. Robert Kennis

Dr. Teresa Lightfoot

Dr. Gary Oswald

The Boca Raton Resort & Club, a Waldorf Astoria Resort, has reigned as an icon of elegance for more than 80 years. It was built by legendary American architect Addison Mizner, and today, the resort remains faithful to its glamorous past, while radiating a vibrant energy, offering infinite modern ame‑ nities to every type of guest.

RESORT FEES: Resort Fees include wireless internet access in guest rooms and public areas, resort transportation to/from Beach Club, access to the Fitness Center and specialty classes, daily newspaper, local and 800 calls, bellman gratuities and in room coffee/tea. The Resort Fee is posted to individual room accounts and does not cover housekeeping gratuities.

Seven Luxurious Resort Pools Opulent Beach Amenities The Palace Spa Exclusive Marina Water Sport & Excursions

Over 40 Nationally and Internationally Acclaimed Speakers will deliver more than 320 hours of first-rate, cutting-edge, interactive CE and wet labs

Reserve Your Room Today! Special Room R ates End August 18, 2014! Dr. Thomas Schubert

Dr. Brian Speer

Dr. Alan Spier

Dr. Joe Taboada

Dr. Eric Storey

Mr. Jason Wernli

Dr. Michael Willard

Dr. Alice Wolf

ot h er d i s t i n gu i s h ed s peaker s • • • • •

Dr. Elizabeth Bailey Dr. Cherie Buisson Dr. CARMEN COLITZ Dr. Linda Ellis Dr. WADE GINGERICH

• • • •

Dr. Dunbar GraM Mrs. Michelle Guerico-Winter Ms. Alicea Howell Dr. Matthew Johnson

• • • • •

Dr. Lloyd Meisels Dr. Ann Penn Ms. Jeannie Perrone Dr. Suzanne Plamondon Dr. Andre Shih

• • • •

Dr. christopher smithson Dr. Robert swinger Dr. Elizabeth watson Dr. Cristopher Young

AN EXCEPTIONAL VALUE AT AN AFFORDABLE PRICE! www.fvma.org  www.tgavc.org

CE Approved By:

|  21

■ race - American Association of Veterinary State Boards RACE, Provider #532 ■ Sponsor of Continuing Education in New York State ■ Florida Board of Veterinary Medicine, DBPR FVMA Provider #31 ■ Attendees can earn up to 26 ce credits!

www.fvma.org  |  22


TECH

• WET LAB

T

WORKSHOP

Perineal Hernia Repair

Basic Abdominal Ultrasound - Normals Seminar and Wet Lab

8:00 am - 12:00 pm

1:00 pm - 5:30 pm

8:00 am - 5:30 pm

Matthew Johnson, DVM, MVSc, CCRP, DACVS-SA

Equipment Co-Sponsored by

Equipment Co-Sponsored by

Matthew Johnson, DVM, MVSc, CCRP, DACVS-SA

Wet Lab Only Fee: Vets $595 With Conf. Reg. Fee: Vets $395

Cranial cruciate injury is the most common cause of hindlimb lameness in canine patients. This laboratory will discuss the underlying pathological processes that contribute to the disease process. You will learn how to diagnose complete and partial cruciate injuries. This laboratory will teach you how to do a complete stifle exploratory examination for meniscal injury, meniscal repair or release, as well as extracapsular suture placement using isometric principles of the stifle joint.

Perineal hernia is a relatively common condition in older male intact dogs. The anatomy of the perineal region is challenging and intimidating, with a relatively high recurrence rate of hernia necessitating simple hernia repair. This laboratory will discuss relevant anatomic structures and techniques to decrease recurrence rate in this condition. Attendees will learn how to perform a cystopexy and colopexy, as well as the obturator muscle flap transposition.

8:00 am 8:50 am 9:00 am 9:50 am 10:10 am 11:00 am 11:10 am 12:00 pm 1:30 pm 2:20 pm 3:20 pm 4:10 pm 4:20 pm 5:10 pm

Feline Medicine Case Studies in Feline Medicine - Wolf

Urology Acute Kidney Injury – An Update

Gems from ACVIM - Wolf Gingivitis, Stomatitis, and Other Oral Lesions in Cats - Wolf

Improving the Quality of Life for Cats with Chronic Kidney Disease - Acierno

- Acierno

Hypertension - Acierno

Now How Do We Turn Off This Spigot??? (Diagnosing and Treating Canine Incontinence) - Acierno The Geriatric Cat

Help! Help! I Can’t Pee!! (Feline Lower Urinary Tract Disease) - Acierno

- Wolf

Hematemesis/GI Blood Loss

1:10 pm 2:00 pm

Protein-Losing Enteropathies: Hypoalbuminemia Is Not Always Terrible - Willard Chronic Small Bowel Disease: IBD Is The Cytologic Evaluation of Effusions in Not the Most Common Problem You the Dog and the Cat - Alleman Will Deal With - Willard Tick-Borne Diseases of People and Pets: Chronic Large Bowel Disease The Ehrlichias - Alleman - Willard

Urology

Diagnosis of Canine Hyperadrenocorticism: A Case-Based Approach

Chronic Kidney Disease (CKD) − Diagnosis and Initial Management Part 1 - Chew Chronic Kidney Disease (CKD) – Further Management Part 2

Diagnosis and Treatment of Canine Hypothyroidism: A Case-Based Approach - Behrend Diagnosis of Hypercalcemia: A Case-Based Approach

Idiopathic/Interstitial Cystitis in Cats (FIC) − Diagnosis and Management Part 1 - Chew Idiopathic/Interstitial Cystitis in Cats (FIC) − Further Management Part 2

- Willard

- Willard

- Willard

Sample Collection, Slide Preparation and Cytological Classification of Lesions from Tissue Masses - Alleman The Cytologic Evaluation of Lymphoid Tissue in the Dog and the Cat: Cats Can Be Trouble! - Alleman Ocular and Respiratory Cytology in Clinical Practice - Alleman

Tick-Borne Diseases of People and Pets: Anaplasma and Borrelia

5:00 pm 5:50 pm

- Alleman

- Behrend

- Harvey

Case-Based Approach to the Patient with Increased Liver Enzymes - Taboada

A Logical Approach to Glaucoma Part 1 - Storey

The Neurological Exam, Keep It Simple and It Won’t Be Mysterious - Schubert

Diagnosis and Treatment of Canine Mitral Valve Disease – An Internist’s Perspective - Oswald

Nutritional Support of Pancreatitis and Gastrointestinal Diseases - Datz

Antiparasitic Agents Part 2

3 Keys to Periodontal Disease Decision Making Part 2 - Smithson

Cytology of Neoplasia

Case-Based Approach to the Canine Patient with Increased Liver Enzymes:

A Logical Approach to Glaucoma Part 2

Keeping the Head on Straight, A Review of Vestibular Syndromes

Diagnosis and Treatment of Feline Cardiomyopathy – An Internist’s Perspective - Oswald

Client Retention − Implementing Protocols That Will Keep Pet Owners Coming Back! - Wernli

Nonpharmacologic Approaches to Common Behavior Problems - Datz

Resistant Staph Skin Infections Part 1 - Kennis

Differential Diagnosis of Anemia in Dogs Part 1

Clinical Update: Use of Nutraceuticals in the Treatment of Liver Diseases in the Dog and Cat - Taboada

Progressive Management of KCS

Seizures, You May Be Surprised That They Are Not All Emergencies - Schubert

What’s New with CHF Treatment – My Favorite Cardiac Drugs

Increasing Customer Compliance Part 1

Differential Diagnosis of Anemia in Dogs Part 2 - Harvey

Case-Based Approach to the Vomiting Cat: Hepatic Lipidosis - Taboada

Uveitis

- Storey

The Dog’s A Dragging, How to Diagnose and What to Do About Paraplegia - Schubert

Management of the Cardiorenal Syndrome Patient - Oswald

Protozoal Infections of Blood Cells

Case-Based Approach to the Vomiting Cat: Inflammatory Liver Disease

Making Heads and Tails of Keratitis

Down in All Four? Causes and Treatments

Chronic Coughing Dogs and Cats – Simple Testing and Favorite Drugs - Oswald

Increasing Customer Compliance Part 2 - Wernli Winning the Battle with Online Pharmacies - Wernli

Module 4: Preventing Disease Introduction and Spread - Young

Case-Based Approach to the Vomiting Cat: Pancreatitis - Taboada

Making the Fundic Exam Simple - Storey

How to Treat CNS Trauma of the Head and Back - Schubert

An Update on Feline Bronchitis/Asthma Complex - Oswald

Marketing My Practice in 2014 Part 1 - Wernli

Module 9: Interstate and International Health Certificates for Category 1 - Young

Beastly Bug Rounds: Feline Fungal Disease

Differentiating Causes of Blindness - Storey

Sterile Inflammatory CNS Disorders, We Used to Lump Them All as GME but We Now Know Better - Schubert

Current Concepts in the Management of Diabetes Mellitus

Marketing My Practice in 2014 Part 2 - Wernli

Pain Management/ Practice Management

Respiratory Distress in Dogs - Spier

Fluid Therapy

Thoracic Radiographs: A Cardiologist's Persective

Putting It Together: An Evidence-Based Interesting Cases in Emergency Approach to Management of Acute and & Critical Care Part 1 - Duffy Chronic Pain - Epstein Case Studies in Pain Management: Interesting Cases in Emergency Workshop Part 1 - Epstein & Critical Care Part 2 - Duffy

Feline Cardiomyopathy - Spier

- Duffy

Pain Management

- Kennis - Kennis

NSAID: New Understandings of Wisest, Highest, Safest Use

The 5 Most Common Oral Exam Findings in Dogs - Smithson

Opioids: New Understandings and New Developments

Evidence-Based Approach to Feline Gingivitis/Stomatitis

Practical Pruritus - Gram

Adjunctive Pain-Modifying Analgesic Medications – What Is the Evidence? - Epstein

Dental Radiography Interpretation

Rational Steroid Use - Gram

Locoregional Anesthesia: Principles and Applications Part 1 - Epstein

Things I Tell Clients

Locoregional Anesthesia: Principles and Applications Part 2 - Epstein

Equipping the Dental Operatory - Smithson

“Double Down” Flea Control - Gram Cytology/Hematology

- Epstein

Hospice/Euthanasia

Assessing Quality of Life – Helping the Undecided Client - Gardner

- Smithson

- Smithson

Clinical Pathology/Pharmacology

Practice Management

Behavior

Neurology

Unique Features of Feline Hematology

Teamwork! How to Make It Work and What to Do When It Doesn't Part 1

Bite Prevention: Reading Body Language and Predicting Behavior Part 1

Bugs in the Brain, Infectious CNS Disorders of Dogs and Cats

Teamwork! How to Make It Work and What to Do When It Doesn't Part 2

Mitigating the Environment to Keep You Safe and to Keep Your Patients Happy Part 2 - Herron Canine & Feline Handling Tools: Use Them Early and Use Them Often! Part 3

- Gavzer

Anticipatory Grief & Pet Loss Prepara- Case-Based Discussions of Feline tion - Gardner Hematology - Harvey

Cytology: Take, Make & Evaluate: Take The Art of Euthanasia and the Sci& Make Part 1 - Anthony ence of Death Part 1 - Gardner

- Gavzer

Differential Diagnosis of Bleeding Disorders in Dogs - Harvey

Do You Know How to Get to the 3rd Level of Client Care? Friend Me, Tweet Me – 5 Things Every Veterinary Practice Should Be Doing Online - Gavzer Go Local to Build a Marketing Advantage for Your Practice

- Gavzer

The Art of Euthanasia and the Science of Death Part 2 - Gardner

Lymphoid Neoplasms

- Chew

Cytology: Take, Make & Evaluate: Evaluate Part 2 - Anthony

Diagnosis of Polyuria/Polydipsia: A Case-Based Approach

Management of Canine Heart Disease - Spier

DKA in the ER

- Behrend

Management of Cats with Urethral Obstruction − Methods of Relief and Approach to Acute Metabolic Crisis - Chew

Stem Cell and Other Biologic Modalities in the Treatment of Chronic Pain – What’s the Evidence and Is It the Future? - Epstein

Cytology: Take, Make & Evaluate: Interactive Cases Part 3 - Anthony

Compassionate Closure: Basics of Euthanasia - Buisson

Case Studies: Hematologic Findings in Dogs with Neoplasia - Harvey

Mitotane Vs. Trilostane: What’s the Evidence? - Behrend

Treatment of Routine and Recurrent Urinary Tract Infections - Chew

Controversies in Cardiology Part 1 - Spier

Thoracic Trauma Management

Hematology: Use It or Lose It: RBC Morphology Part 1 - Anthony

Compassionate Closure: Euthanasia Words and Wisdom - Buisson

Pharmacology & Medical Math for Smarties Part 1 - Penn

I Found an Adrenal Tumor I Wasn’t Expecting. Now What?

Hypercalcemia in Dogs and Cats – Diagnosis and Management

Controversies in Cardiology Abdominal Trauma ManagePart 2 - Spier ment - Duffy

Pet Insurance – Why the Success of Quality Veterinary Medicine and Your Future Depends Upon It - Meisels Optimizing Referral Relationships to Win-Win-Win - Meisels

Hematology: Use It or Lose It: WBC Morphology Part 2 - Anthony

Compassionate Closure: Veterinary Hospice Care - Buisson

Pharmacology & Medical Math for Smarties Part 2 - Penn

- Behrend

Equipment Sponsored by

Jeannie Perrone, CVT, VTS-Dentistry

Wet Lab Only Fee | Techs $125 With Conf. Reg. Fee | Techs $75 Take your dentistry skills to the next level. Perform dental charting, appropriate hand scaling techniques, power scaling, and sharpening. The use of dental sealants will also be covered.

W E T L A B

- Chew

- Duffy

- Duffy

Wet Lab Only Fee | Vets $595 With Conf. Reg. Fee | Vets $395 This seminar series and combined wet lab are designed for veterinarians who want to further their training in small animal ultrasound. Lectures will review ultrasound physics and artifacts, and assist the participants in fine tuning the image. Normal intraabdominal structure will be reviewed and abnormal intra-abdominal pathology will be emphasized.

- Smithson

- Harvey

- Harvey

W E T

- Elizabeth Watson, DVM, MS, DACVR

Sponsored by

- Epstein

Case Studies in Pain Management: Workshop Part 2 - Epstein

- Behrend

- Herron

- Herron

Don’t Leave Me Home Alone! : Diagnosis and Management of Canine Separation Anxiety - Herron Starting off on the Right Paw: The Basics of Puppy Behavior and Problem - Gavzer Prevention - Herron Take a New Look at an Old Problem & Starting off on the Right Paw: The Basics of Do More for Senior Pets! Kitten Behavior and Problem - Gavzer Prevention - Herron 3 Telephone Mistakes Even the Best Feline Inappropriate Elimination Receptionists Make - Herron - Gavzer

- Harvey

L A B

- Harvey

Internal Medicine

Ophthalmology

Rabbit/Avian/Ferret Medicine

Dentistry/Tech Radiology Wet Lab

Cushings Disease – Testing Protocols and Current Treatment Recommendations - Oswald

Assisted Feeding – All about Feeding Tubes and What to Put in Them - Datz

- Kennis

Learning Theory for Veterinary Technicians - Howell

Beastly Bug Rounds: Weight Loss and Vomiting? - Taboada

Lesions in the Lens - Swinger

Rabbit Medicine and Surgery Part 1 - Lightfoot

Dental Home Care: How to Make It Work for Radiology Rounds – Thorax - Watson Everybody - Perrone

Lameness or Weakness? Orthopedic or Neurological? How to Tell - Schubert Call It Syringohydromyelia or Just SM, Caudal Occipital Malformation Syndrome (COMS) Is Becoming More Prevalent - Schubert

Addison’s Disease and Atypical Hypoadrenocorticism - Oswald

Chronic Kidney Disease in Dogs And Cats – What and When to Feed? - Datz

Chronic Otitis - Kennis

Training Plans as Easy as ABC! - Howell

Diagnosis and Treatment of Canine and Feline Pancreatitis - Oswald

Cats and Carbohydrates – Diabetes and Beyond - Datz

Dermatology Tips and Tricks

Master Class

Diagnosis of the Common Immune-Mediated Conditions – Imha, Itp, Impa - Oswald Advances in Immunotherapy for Imha and Itp – My Favorite Immunosuppressives - Oswald

Nutritional Management of Lower Urinary Tract Disorders - Datz

Dermatophytosis - Gram

- Schubert

Intervertebral Disc Disease - Schubert

How to Recognize the Neurological Patient - Schubert Special Needs of the Neurological Patient - Schubert

Avian / Pet Chickens

Culture & Sensitivity Interpretation Workshop

Fluid Therapy

Blood Film Evaluation Part 1

Urinalysis: U'rine What? Part 1

Don’t Up-Sell... Up-Serve

Compassionate Closure: Compassion Fatigue

How to Make the Value Proposition with Clients

Feline Aggression: An Overview of Human-Directed Aggression in Cats Part 1 - Herron

Chickens! The Basics

Culture & Sensitivity Interpretation Workshop

Triage & Initial Treatment of the Emergent Blood Film Evaluation Part 2 - Harvey Patient - Duffy CPR Update − Recover Project - Duffy

Nursing Pearls in the ER - Duffy

experience delivered

Leukogram Interpretation Part 1 - Harvey

Leukogram Interpretation Part 2 - Harvey

- Speer

Elizabeth Bailey, DVM

Assisted By Heidi Ward, DVM, DACVIM

Motivate Your Staff and Be an Effective Leader - Gardner

Compassionate Closure: Adding a Hospice Program to Your Practice (P.S. You’re Already Doing It!) - Buisson

New, Innovative Ideas to Wake Up Your Veterinary Practice - Gavzer

Feline Aggression: An Overview of Inter-Cat Aggression Problems Part 2 - Herron

Pet Chicken Diagnostics and Therapeutics

Prime Real Estate on Google − How to Get on the FIRST Page - Gardner

Compassionate Closure: Adding In-Home Hospice and Euthanasia to Your Practice - Buisson

The Marketing Secrets That Can Take Your Practice to the Top! - Gavzer

Managing Animal Stress in the Kennel

Feather Picking!

Your Personal Curb Appeal − Body Language in the Exam Room - Gardner

Compassionate Closure: Discussion and Q&A

How to Make the Value Proposition with Clients − Pricing Issues - Gavzer

- Buisson

Expectations exceeded!

- Herron

- Speer

- Speer

Skull and Beak Problems - Speer

Reception Training Workshop - Jason Wernli

Sponsored by How to Get More Mileage out of those Old Kidneys”– This workshop is aimed at the new receptionist to increase Current Recommendations for Chronic Renal Failure client service and communication skills. Further, it is for the experienced receptionist who wishes to acquire necessary Patients - Oswald skills to train personnel back at the practice. The program ”Plug The Leaks”– Treatment of Lower Urinary Tract Disorders Incontinence, Urethral Spasms, Feline Lower focuses on enhancing essential skills in the areas of teamwork, client service, and both oral and written communication. Urinary Tract Issues - Oswald

Behavior

Urinalysis: U'rine Luck This Time! Part 2 - Anthony

- Oswald

Internal Medicine/Avian Medicine

Practice Management

- Anthony

- Schubert

- Wernli

Behavior

Hospice Compassionate Care

- Gavzer

- Storey

- Oswald

Dermatology

Practice Management

- Buisson

- Taboada

- Storey

- Schubert

Antipruritic Agents

Urinalysis

- Gardner

- Taboada

- Storey

Practice Management

Nutritional Medicine/ Receptionist Workshop

Clinical Pathology - Harvey

Inflammatory Liver Disease - Taboada

- Harvey

Emergency Critical Care - Duffy

Improve your proficiency in performing practical eyelid, conjunctival, corneal and orbital surgeries. Receive step-by-step instructions on entropion correction, eyelid reconstruction, prolapsed third eyelid gland replacement, corneal debridement techniques, conjunctival grafting, corneal laceration repair and enucleation.

Overview of Exfoliative Cytology

Biophysical Modalities in the Treatment of Pain - Epstein

- Spier

This 4-hour lecture/lab will open with an overview of laser technology and its uses in general practice. This session will include innovative ways to market the laser to your clients. Following the lecture, students will participate in an interactive presentation of cases, protocols, treatments on live canines, and outcomes. The program is open to DVMs (who examine the patient and prescribe treatment) and technicians (who perform the laser treatment).

The Cardio Workup: How to Analgesia & Anesthesia of the Best Use Your Clients' Emergent and Critically Ill Dollar - Spier - Duffy

Tech Dentistry Wet Lab

Tech Dental Techniques

- Chew

This lab is useful for veterinarians at all skill levels when it comes to surgical extractions in the dog. Participants will be given instruction on surgical extraction techniques for the major teeth, including maxillary and mandibular canines, maxillary fourth premolars, and mandibular first molars. Using cadaver specimens, principles of proper instrumentation, flap development, alveolar bone removal and management, tooth sectioning, and tension-free closure will be discussed and practiced. Participants will have the flexibility to choose which procedures to perform based on their own experience level.

Advanced Abdominal Ultrasound Seminar and Wet Lab

Emergency/Critical Care

Cardiology

We all know how challenging feline dental extractions can be; and when it comes to dental extractions, cats aren’t small dogs! This lab will focus on the techniques, equipment and instruments that will ensure successful and complication-free feline extractions and crown amputations. Using cadaver specimens participants will be instructed on how to surgically extract the maxillary and mandibular canines, maxillary fourth premolar, and mandibular first molar, as well as crown amputation of the mandibular canine and third premolar with tension-free flap closure.

Wet Lab Only Fee: Vets $150 | Techs $125 With Conf. Reg. Fee: Vets $125 | Techs $75

3 Keys to Periodontal Disease Decision Making Part 1 - Smithson

Veterinary Professional Liability: Managing the Risk Part 2 - Ellis

Endocrinology

Wet Lab Only Fee: Vets $495 With Conf. Reg. Fee: Vets $295

A Division of I-MED Pharma Inc.

Wet Lab Only Fee: Vets $525 With Conf. Reg. Fee: Vets $325

Antiparasitic Agents Part 1

Critical Aspects of Managing Inventory - Guerico-Winter

Clinical Pathology/Infectious Disease

Wet Lab Only Fee: Vets $495 With Conf. Reg. Fee: Vets $295

ANIMAL HEALTH

Internal Medicine

Leptospirosis - Birkenheuer

- Acierno

Robert Swinger, DVM, DACVO Carmen Colitz, DVM, DACVO

Suzanne Plamondon DVM, MBA, CVA, CCRT, DABVP

Neurology

Protein Losing Nephropathy

- Wolf

10:50 am 11:40 am

12:00 pm 12:50 pm

Unconventional Diets – Are Grain-Free, Raw, and Holistic Diets Really Better? - Datz

Equipment Sponsored by

Ophthalmology

Potpourri of Feline Infectious Diseases

Esophageal Disease: More More Than Just Megaesophagus Part 2

11:00 am 11:50 am

Understanding and Meeting the Needs of the New Consumer - Guerico-Winter

1:00 pm - 5:30 pm

Internal Medicine

The Evolution of Financial Metrics - Guerico-Winter

9:00 am 9:50 am

10:00 am 10:50 am

Veterinary Hospice – It Is NOT about Prolonging Suffering Part 3 - Gardner

Obesity Management in Dogs and Cats – Right and Wrong Resistant Staph Skin Infections Part 2 Ways to Achieve Weight Loss - Datz - Kennis

8:00 am - 12:00 pm

Clinical Pathology/USDA Program

Cytauxzoonosis: A TREATABLE Disease That Is Already in Your Backyard - Birkenheuer

- Acierno

8:00 am 8:50 am

9:00 am 9:50 am

Veterinary Hospice – It Is NOT about Prolonging Suffering Part 1 - Gardner Veterinary Hospice – It Is NOT about Prolonging Suffering Part 2 - Gardner

Ophthalmic Surgery

Ultrasound Wet Lab

Canine Geology (Uroliths)

- Wolf

Christopher Smithson, DVM, DAVDC Assisted By Wade Gingerich, DVM, DAVDC

Rehabilitation & Laser Therapy

Dentistry

Degenerative Joint Disease in Cats

Esophageal Disease: More More Than Just Megaesophagus Part 1

4:00 pm 4:50 pm

Dermatology

Veterinary Professional Liability: Managing the Risk Part 1 - Ellis

Gastroenterology

2:10 pm 3:00 pm

Nutritional Medicine/Professional Liabilities

Fever of Unknown Origin - Birkenheuer Practical Approach to Anemia and Thrombocytopenia - Birkenheuer Addison’s Disease: How to Catch the “Great Pretender” - Birkenheuer Birkenheuer's "Bone Pile" − Interesting Internal Medicine Cases - Birkenheuer

This seminar series and combined wet lab are designed to introduce the veterinarian to entry level abdominal ultrasound in small animal practice. The seminar consists of four, 50-minute lectures. The basic physics, an overview of instrumentation, common artifacts, and scanning techniques will be reviewed. The normal ultrasound appearance of intra-abdominal organs, the peritoneal space, and the retroperitoneal space will be discussed. The workshop is focused on entry level abdominal ultrasound.

Co-Sponsored by

1:00 pm - 5:30 pm

Wade Gingerich, DVM, DAVDC Christopher Smithson, DVM, DAVDC

Food Allergy and Intolerance – Nutritional Perspectives on Itchy Animals - Datz

Hospice/Practice Management Old Age is Not a Disease – But It Sure Is a Killer - Gardner

Co-Sponsored by

Assisted By

Wet Lab Only Fee: Vets $595 With Conf. Reg. Fee: Vets $395

Internal Medicine Vector-Borne Diseases: What Tests to Run and What to Do with the Results - Birkenheuer

Canine Dental Extraction

8:00 am - 12:00 pm

Sponsored by

Elizabeth Watson, DVM, MS, DACVR

Wet Lab Only Fee: Vets $495 With Conf. Reg. Fee: Vets $295

Feline Dental Extraction

Beastly Bug Rounds: A Case-Based Approach to Hemolytic Anemia - Taboada Small Animal Internal Medicine: Bitten, Kicked, and Scratched! Calm- Unusual Case Presentations ing the Reactive Patient - Howell - Taboada

Management of Common Ocular Emergencies - Swinger

Rabbit Medicine and Surgery Part 2 - Lightfoot

Other Beneficial Treatments in Veterinary Dentistry - Perrone

Radiology Rounds – Abdomen - Watson

New Developments in Veterinary Ophthalmology – Surgical and Pharmacological Advancements - Swinger

Weird Exotic Facts – Some Rated “R” - Lightfoot

Dental Units and Handpiece Maintenance

Radiology Rounds – Appendicular Skeleton - Watson

Keeping Good Puppies from Going Bad - Howell

Parrot Behavior: Normal and Disorders - Speer

Improving Your Ophthalmic Exam Skills - Swinger

Ferret Medicine and Surgery Part 1 - Lightfoot

Frustrating Feline “Furitus” - Gram

Behavior Mythbusters - Howell

Management of Aggressive and Frightened Birds - Speer

Ocular Procedures and Surgery in Your Practice - Swinger

Ferret Medicine and Surgery Part 2 - Lightfoot

Otitis “Extrema” - Gram

De-Stressing the Multi-Cat Household - Howell

How I Treat: Auto Mutilation in Birds Feline Ophthalmology - Speer - Swinger Coelomitis in Birds Corneal Ulcers – Why Some Just Won’t - Speer Heal! - Swinger

- Kennis

W O R K S H O P

Immunodermatology for Practioners: Exam Room Fun!! Low Stress Your Receptionist Is a Langerhans Restraint and Handling - Howell Cell! - Gram

Gastroenterology

Sponsored by

W O

No Charge - Limited Seating - Must Pre-Register

The workshop will begin with a presentation introducing principles of culture and sensitivities and interpretation of results to maximize antimicrobial efficacy. Discussions will include approaches to culture and sensitivity information - Location of Infections, Antimicrobials, Formulary and Antimicrobials vs. Pathogens.

TGAVC Lived up to Its Promise!

R K S H O P

Radiology

Clinical Pathology

The Complete Hemogram of the Dog and the Cat Canine Pancreatitis: No Such Thing as a “Typical Case” - Alleman - Willard Portosystemic Shunts: More Common and Confusing than We Knew - Willard Canine Hepatic Disease - Willard Canine Hepatobiliary Tract Disease - Willard

Hematology Case Challenges Part 1 - Alleman

Hematology Case Challenges Part 2 - Alleman

Cytology Case Challenges - Alleman

Avian Neoplasia - Lightfoot

Anesthesiology/Pain Management

Urology

Anesthesia Monitoring Basics to Advanced

Urinalysis Revisited

Anesthesia and Challenging Cases Part 1

Fixing the Dripping in Dogs - PPA or Estrogens?

- Shih

- Shih

Anesthesia and Challenging Cases Part 2 - Shih

Analgesia Acute and Chronic Pain - Shih

- Chew

- Chew

Management of Idiopathic Hypercalcemia in Cats - Case Based - Chew

- Perrone

Technician Radiology Lab

- Jeannie Perrone CVT, VTS-Dentistry

Wet Lab Only Fee | Techs $125 With Conf. Reg. Fee | Techs $75 This session provides hands-on instruction in the area of dental radiology. Participants will be trained on all commonly used positioning techniques using a digital dental radiology system. Equipment Sponsored by

W E T L A B

Radiology Rounds – Axial Skeleton - Watson The Use of Contrast in Diagnostic Imaging - Watson An Introduction to Mis-Diagnoses in Diagnostic Imaging Part 1 - Watson More Mis-Diagnostic Imaging Part 2 - Watson

THURSDAY− SEPTEMBER 18 FRIDAY− September 19 SATURDAY− SEPTEMBER 20

Extracapsular Suture Stabilization

G 2 A0 V1 C4

SUNDAY− SEPTEMBER 21

SUNDAY− SEPTEMBER 21 SATURDAY− SEPTEMBER 20 FRIDAY− SEPTEMBER 19 THURSDAY− SEPTEMBER 18

DVM • DVM/ TECH/ STAFF •

Attendees from more than 37 states as well as Canada, Puerto Rico, and other regional countries joined us in

Boca Raton for the first national TGAVC which presented world-class CE in an enriching environment that stimulated the mind and refreshed the body and soul.

visit us at www.tgavc.org


tGAVc tGAVc

SepteMber 18-21, 2014 | boCa raton, Fl SepteMber 18-21, 2014 | boCa raton, Fl

Mailing inforMation Mailing   Dr.   Mr. inforMation     Ms.     Mrs.   Dr.   Mr.     Ms.     Mrs. Name: Name: Business/Clinic/School: Business/Clinic/School:

PaYMEnt inforMation

Before Aug. 18th After Aug. 18th

$495.00 $570.00 $495.00 $370.00 $570.00 $295.00 $295.00 $470.00 $370.00 $395.00 $395.00 $370.00 $470.00 $295.00 $295.00 $370.00

Before Aug. 18th After Aug. 18th

Email: Address: Email:

T G 2 A0 V1 C4

Zip:

Discover

Discover

Zip:

125.00

125.00

T G 2 A0 V1 C4

State:

State:Fax:

City: Address: Phone: City:

Fax:

. Golf

$

(407) 240-3710

fAX (407) 240-3710

fAX

ToTal social evenT/guesT social even T / guesT FeeFee $ C CTOTal

Handicap ______

Handicap . Golf ______

  American Express

  American Express

Phone:

    Visa     Mastercard     Visa     Mastercard Expiration Date Expiration Date Signature

Signature

Wet Lab Only Fees With Conf. Reg. Fees

$295.00 $395.00 $395.00 $395.00 $395.00 $295.00 $295.00 $295.00 $295.00 $125.00 $125.00 $75.00 $75.00 $325.00 $325.00

$$

CC PHone PHone

(407) 851-3862

(800) (800)992-3862 992-3862 (407) 851-3862

BB

$295.00

Lab Only Fees Thursday weTSuture labsStabilization..............Wet$495.00 Extracapsular Extracapsular Stabilization.............. $495.00 Perineal HerniaSuture Repair..................................... $595.00 Perineal Hernia Repair..................................... Basic Abdominal Ultrasound........................ $595.00 $595.00 Basic Abdominal Ultrasound........................ Feline Dental Extraction Wet Lab ............... $595.00 $495.00 Feline Dental Canine DentalExtraction ExtractionWet WetLab Lab............... ............. $495.00 $495.00 Canine Dental &Extraction Wet Lab ............. $495.00 Rehabilitation Laser Therapy(Vets)......... $150.00 Rehabilitation & & Laser Laser Therapy(Vets)......... Rehabilitation Therapy(Techs)...... $150.00 $125.00 Rehabilitation & Laser Therapy(Techs)...... $125.00 Ophthalmic Surgery......................................... $525.00 Ophthalmic Surgery......................................... $525.00

$395.00 $395.00

With Conf. Reg. Fees

Advanced ........................ $595.00 $595.00 AdvancedAbdominal Abdominal Ultrasound Ultrasound........................

$75.00 $75.00

ToTal ToTalweT weTlab labFee Fee

sunday sundayweT weT lab lab // workshop workshop

saTurday saTurdayweT weT lab lab

Friday FridayweT weT lab lab

Technician Lab ............................. ............................. $125.00 $125.00 TechnicianRadiology Radiology Lab

$75.00 $75.00 charge NoNo charge

BB

onLIne onLIne

www.tgavc.org www.tgavc.org info@fvma.org info@fvma.org

aa

Technician Dental Techniques...................... $125.00 $125.00 Technician Dental Techniques...................... Culture Workshop.................... NoNocharge charge Culture&&Sensitivity Sensitivity Workshop....................

Thursday weT labs

PaYMEnt inforMation Method of Payment   Check/Money Order   Charge My Credit Card Below $ Method of Payment   Check/Money Order   Charge My Credit Card Below $ Credit Card Number Credit Card Number Name as It Appears on Card Name as It Appears on Card

2013-2014 2013-2014 2011-2012 2011-2012 2013-2014 2013-2014

a a

MAIL MAIL

GuLf-AtLAntIc GuLf-AtLAntIc VeterInAry conference VeterInAry conference 7207 Monetary Drive 7207 Monetary Drive orlanDo, Fl 32809 orlanDo, Fl 32809


TGaVC’s Annual Fishing Tournament Limited Availability. Reserve Your Reel Today! Thursday, September 18 7:30 a.m. – 12:00 p.m. Boats depart promptly at 8:00 a.m. Cost: $175 per person (6 people per boat)

Only

$ 175

Fishing Charter Includes: Transportation, License, Tackle, Bait and 1/2 Day of Fun! This is your opportunity to experience and enjoy the best fishing off the Southeastern Florida coast. A half day on the deep blue for fun and competition – just a great affair on the waters off Boca Raton! DEEP SEA FISHING! Fish for the big ones! Sailfish ■ King Mackerel ■ Wahoo ■ Mahi-Mahi

TGAVC’s Annual Golf Tournament Thursday, September 18 Only

TGAVC Activities

It’s a soft chew. Kills both fleas and ticks. It’s prescription only.

Cost: $125 per person $125 Includes Lunch Format: 4-man scramble (Best Ball) Please include your handicap with your registration form. Teams will be determined based upon handicap.

Sponsored By

Immerse yourself in the rich history and tradition of one of the finest golf resorts in Florida. Delight in the beautifully maintained links delivering the perfect blend of history, amenities, luxuries and challenges for your next golf vacation in Florida.

TGaVC’s dinner cruise Saturday, September 20 7:00 p.m. – 10:00 p.m. | The Boca Resort Dock Cost: $95 per person Children 4-17 - $47.50 Children 3 and Under - Free

Co- Sponsored By

Only

$9

5

Now a pprove d to kill m ore ticks!

Experience the difference of the Gulf-Atlantic Veterinary Conference on the yacht, Lady Windridge, for our Intracoastal Dinner Cruise. The Intracoastal Waterway provides one of the finest boating experiences in the world, while the Lady’s corporate chefs delight you with their incomparable culinary skills.

The Lady Windridge begins boarding at 6:45 p.m. and sails promptly at 7:00 p.m.

TGAVC offers an unmatched opportunity for networking with representatives of industry. Our industry partners will showcase an unparalleled display of the very latest innovations and advancements available to veterinary professionals.

TGAVC marketplace Marketplace Hours Friday, September 19 .............. 11:30 a.m. - 6:15 p.m. Saturday, September 20.......... 8:00 a.m. - 4:00 p.m.

Special Thanks

to our 2014 sponsors

NexGardTM (afoxolaner) is the protection you asked for, and patients will beg for. NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill Black-Legged (deer) ticks, Lone Star ticks and American Dog ticks. NexGard is available only with a veterinarian’s prescription, and features anti-diversion technology monitored by Pinkerton® Consulting & Investigations.

NexGard and FRONTLINE VET LABS are trademarks of Merial. ®PINKERTON is a registered trademark of Pinkerton Service Corporation. ©2014 Merial Limited, Duluth, GA. All rights reserved. NEX14TTRADEAD (06/14).

TM

IMPORTANT SAFETY INFORMATION: For use in dogs only. The most common adverse reaction is vomiting.  Other adverse reactions reported are dry/flaky skin, diarrhea, lethargy, and anorexia.  The safe use of NexGard in pregnant, breeding, or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures.


Coating Ceremony

UF CVM PROFESSIONAL

T

he FVMA Foundation presented scholarships to two veterinary scholars, on May 9, 2014, during the University of Florida College of Veterinary Medicine’s Professional Coating Ceremony. A fifteenhundred dollar check, along with a commemorating plaque, were presented to sophomores, Brittany Martabano and Cameron Biggs, in honor of Dr. Richard D. Wilkes, who was named the FVMA’s 2014 Champion of Veterinary Medicine. The FVMA established its scholarship fund fourteen years ago to recognize outstanding students at UFCVM, and has made it a tradition to award two sophomore students in this way during this important ceremony which marks a great milestone in their academic life. The Professional Coating Ceremony gives recognition to the students completing their sophomore year, who are each presented with professional white clinic lab coats as a symbol of their transition from their preclinical classroom and laboratory training to the initial phase of their clinical training. The ceremony, was held at the Phillips Center on the UFCVM campus, where family members and friends, distinguished guests, faculty, staff and students of the college gathered to honor and congratulate the successful sophomores.

Dr. Richard M. Carpenter, FVMA President-Elect, Mr.Biggs, and Dr. Richard D. Wilkes.

Dr. Richard M. Carpenter, FVMA President-Elect, Ms. Martabano, and Dr. Richard D. Wilkes

Cameron Biggs and Brittany Martabano receiving their FVMA Foundation Scholarships award plaques from Dr. Richard D. Wilkes and Dr. Richard M. Carpenter.

Dr. Richard M. Carpenter, FVMA President-Elect

FVMA President-elect Dr. Richard Carpenter made the scholarship presentations along with Dr. Wilkes, who President-elect Carpenter described as a dedicated professional worthy of emulation. During the ceremony, the FVMA also gifted the 111 sophomores being coated with indirect ophthalmic lens for use during their two-year clinical rotation.

Mr. Benjamin Brunson is coated by Dr. Fred Schirmer and Dr. Deborah Cottrell

(Photos by Cheuvront Studios, Gainesville, Florida) Mr. Lucas McClain shakes hands with his coat presenter, Dr. Dennis Geagan

30  |  FVMA ADVOCATE

Ms. Robin Bast is coated by Dr. David Nichols

www.fvma.org  |  31


h1 – White Alt

White Caption for Photos

Subhead 11pt with color rule

References:

1. Center for Food Security and Public Health. 2007. Screwworm myiasis. Online technical factsheet accessed January 26, 2011 at http://www.cfsph. iastate.edu/Factsheets/pdfs/screwworm_myiasis.pdf. 2. Vargas-Terán M, Hoffman HC, Tweddle NE. 2005. Chapter 7-1, Impact of screwworm eradication programmes using the sterile insect technique. In: Dyck VE, Hendrichs J, Robinson AS (eds.), Sterile Insect Technique, Principles and Practice in Area-Wide Integrated Pest Management. Dordrecht, Netherlands: Springer, pp. 629-650.

Congratulations to The

Class of 2014 On Their Outstanding Achievements Welcome To The Veterinary Profession

32  |  FVMA ADVOCATE

3. Smith WG, Mertins J. 2011. Case report: Canine, Old World screwworm, Massachusetts, confirmed. VMO Observer. Accessed February 6, 2011 at http://animalhealth.we.aphis.gov/observer/home/Lists/Posts/Post. aspx?ID=45.

Courtesy of Kendra Stauffer, DVM, DACVPM Area Emergency Coordinator USDA/APHIS/Veterinary Services, Gainesville, FL

Dr. Clarence Campbell, left, retired Florida State Veterinarian; Dr. Greg Christy, FDACS, and Dr. Alejandro Parra, Mexican Agricultural Service, participated in the simulated Screwworm outbreak exercise.

www.fvma.org  |  33


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CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: NEXGARD™ (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5[3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl. Indications: NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of Black-legged tick (Ixodes scapularis), American Dog tick (Dermacentor variabilis), and Lone Star tick (Amblyomma americanum) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month. Dosage and Administration: NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg). Dosing Schedule: Body Weight 4.0 to 10.0 lbs. 10.1 to 24.0 lbs. 24.1 to 60.0 lbs. 60.1 to 121.0 lbs. Over 121.0 lbs.

Afoxolaner Per Chewable (mg)

Precautions: The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures (see Adverse Reactions). Adverse Reactions: In a well-controlled US field study, which included a total of 333 households and 615 treated dogs (415 administered afoxolaner; 200 administered active control), no serious adverse reactions were observed with NEXGARD. Over the 90-day study period, all observations of potential adverse reactions were recorded. The most frequent reactions reported at an incidence of > 1% within any of the three months of observations are presented in the following table. The most frequently reported adverse reaction was vomiting. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses in both groups. Five treated dogs experienced anorexia during the study, and two of those dogs experienced anorexia with the first dose but not subsequent doses. Table 1: Dogs With Adverse Reactions. Treatment Group Afoxolaner

Chewables Administered

11.3 One 28.3 One 68 One 136 One Administer the appropriate combination of chewables

NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If it is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration, redose with another full dose. If a dose is missed, administer NEXGARD and resume a monthly dosing schedule. Flea Treatment and Prevention: Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly treatment with NEXGARD should continue the entire year without interruption. To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product. Tick Treatment and Control: Treatment with NEXGARD may begin at any time of the year (see Effectiveness). Contraindications: There are no known contraindications for the use of NEXGARD. Warnings: Not for use in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a physician immediately.

Oral active control

N1

% (n=415)

N2

% (n=200)

Vomiting (with and without blood)

17

4.1

25

12.5

Dry/Flaky Skin

13

3.1

2

1.0

Diarrhea (with and without blood)

13

3.1

7

3.5

Lethargy

7

1.7

4

2.0

Anorexia

5

1.2

9

4.5

Number of dogs in the afoxolaner treatment group with the identified abnormality. 2 Number of dogs in the control group with the identified abnormality. In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the first dose and on the same day after receiving the second dose of NEXGARD. This dog experienced a third seizure one week after receiving the third dose. The dog remained enrolled and completed the study. Another dog with a history of seizures had a seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study. A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study. To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at 1-888-637-4251 or www.merial.com/ nexgard. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at http://www.fda.gov/ AnimalVeterinary/SafetyHealth. Mode of Action: Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA), thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes. Prolonged afoxolaner-induced hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines. The selective toxicity of afoxolaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors. 1

Veterinary Practices for Sale (800) 636-4740 psbroker.com Florida: Dixie County - 3,500sf on +1 acre, Unlimited Possibilities. FL20. Florida: St Lucie County - 2,200sf SA on +1/2 acre on major hwy. FL71. California: Fresno County - 2,500sf SA in San Joaquin Valley. CA7. Idaho: Ada County - 2,000sf SA with nearly double-digit growth. ID2. Maine: York County - 2,000sf SA on +3.6 acres prime RE and area. ME5. Maine: York County - 2,600sf SA on +1/2 acre prime RE and area. ME4. Michigan: Bay County - 2,500sf SA on +1/3 acre, nice family area. MI1. Nevada: Clark County - 2,400 SA on +1/3 acre, busy corner lot. NV2. New York: Onondaga County - 2,400sf ER in Central New York! NY7. Oklahoma: Oklahoma City - 4,500sf SA w/RE in active area. OK2. Pennsylvania: Lycoming County – SA attached to 1,400sf home. PA4. Texas: Jackson County - 2,500sf on +5.5 acres. Wonderful area. TX1. Virginia: Central - 3,900sf on +1.5 acres; in a prime location. VA6. West Virginia: Cabell County -Busy practice on +¼ acre, great area. WV1. West Virginia: Central Cabell County – 1,800sf SA w/RE. AAHA. WV2. Visit our website for new listings!

> Buyer Representation > Seller Representation > Practice Appraisals > Free Non-Binding, Confidential Consultation

Effectiveness: In a well-controlled laboratory study, NEXGARD began to kill fleas four hours after initial administration and demonstrated >99% effectiveness at eight hours. In a separate well-controlled laboratory study, NEXGARD demonstrated 100% effectiveness against adult fleas 24 hours post-infestation for 35 days, and was ≥ 93% effective at 12 hours post-infestation through Day 21, and on Day 35. On Day 28, NEXGARD was 81.1% effective 12 hours post-infestation. Dogs in both the treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment (0-11 eggs and 1-17 eggs in the NEXGARD treated dogs, and 4-90 eggs and 0-118 eggs in the control dogs, at 12- and 24hours, respectively). At subsequent evaluations post-infestation, fleas from dogs in the treated group were essentially unable to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs). In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively. Collectively, the data from the three studies (two laboratory and one field) demonstrate that NEXGARD kills fleas before they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations. In well-controlled laboratory studies, NEXGARD demonstrated >94% effectiveness against Dermacentor variabilis and Ixodes scapularis, 48 hours post-infestation, and against Amblyomma americanum 72 hours post-infestation, for 30 days. Animal Safety: In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment. In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of NEXGARD with other medications. Storage Information: Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F). How Supplied: NEXGARD is available in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each chewable size is available in color-coded packages of 1, 3 or 6 beef-flavored chewables. NADA 141-406, Approved by FDA Marketed by: Frontline Vet Labs™, a Division of Merial Limited. Duluth, GA 30096-4640 USA Made in Brazil. 1050-4493-02 Rev. 4/2014

™NexGard and FRONTLINE VET LABS are trademarks of Merial. ©2014 Merial. All rights reserved.

Florida Practice Listings! FREE PRACTICE CONSULTATION New! East Coast– 4-5 Dr. Prx 2013 Gross $2.9mm, 8800sq. ft. office, excellent staff, great cash flow. S.W. Fl. Coast– Solo Dr. Great semi-retirement Prx. Gross $330k on 25 hrs./wk. Low overhead in a lease space. North Florida– Solo Dr. small animal, 2013 gross $750k, Well established, well equipped, well staffed. Quaint small town atmosphere. Prx. & RE. New!- Eastern Panhandle– Solo Dr. Small animal, 2013 Gross $866k, 2400sq. ft. office, 3 exam rooms, Prx. & RE. SOLD-N. Central Florida 3 Dr. prx grossing $1.9mm 6800SF lease space. Well est, nicely equipped & fully trained staff. SOLD-Coastal Panhandle-Est prx w satellite. 2013 Gross $1.15mm and growing! New equip & digital xray, solid staff. SOLD-Pompano Beach– Solo Dr. great location. Very well established w/ 2800 sq.ft. office. 2013 gross $734K. Owner motivated to sell. Prx & R/E.

Contact Dr. Richard Alker for further practice information.

850.814.9962 or Richard@tpsgsales.com Showcase Properties of Central Florida, Broker

CLASSIFIED ADVERTISEMENTS RELIEF VETERINARIANS

Relief or part-time veterinarian available in the Tampa area  – 30 years of experience as a practice owner. Enjoy surgery and working with people, small animal only. Call Dr. Joe Priest at (813) 230-5998. (Exp. Issue 4/14:1289) EXPERIENCED SMALL ANIMAL VETERINARIAN-Available anytime, anywhere! R. A. Swiezy, DVM-(772) 418-1939. (Exp. Issue 4/14:557) Associates Wanted: Central FL 3 positions available. 1) Zephyrhills FL Adkins 301 Pet Hospital We are looking for a relief vet for two to three days per week. Or If willing to work full time, 75 K annually, plus revenue sharing. Need compassionate, caring individual, who puts the clients first. Having a special interest is a plus. Eventual ownership of the practice is possible. Dr. Adkins & Dr. Maynard 2) Orlando FL Lee Rd. Pet Hospital Full time, minimum of 75 K annually, plus revenue sharing. Eventual ownership of the practice is possible Dr. Adkins & Dr. Melendez 3) St. Cloud FL St. Cloud 192 Pet Hospital Full time ,minimum of 100 K annually, plus revenue sharing. Eventual ownership of the practice is possible Dr. Adkins & Dr. Pilip For more info. please call Dr. Adkins 407-529-5651 Or email Dr. Adkins larry@netlojic.com http://lowcostanimalhospital.com/ (Exp. Issue 3/14: 9)

Associates wanted

veterinarian wanted in st. cloud  – Veterinarian with clinical and surgical experience wanted in St. Cloud. Annual Salary of 100 K plus revenue sharing after 6 months of satisfactory employment. Can start immediately! Dr. Larry Adkins, 407-529-5651, larry@netlojic.com, http://lowcostanimalhospital.com/ (Exp. Issue 3/14: 9)

Equipment for sale

For Sale  – Pre-owned patient lifts at a fraction of the cost. Electric and portable, able to be wheeled from room to room. Used to lift heavy animals on and off of exam tables. Can lift up to 400 lbs. Save your backs in your veterinary clinic! I use it and now I don’t worry about heavy lifting any longer! Prices from $600-1200! BCI 3303 Hand-held Pulse Oximeter. Used to monitor pulse rate and oxygen level with alarms. Comes with new batteries and new veterinary transducers. Sells for $1200 normally. We are selling them for $350! We have 30 for sale. Call Dr. C at 727-548-8387 for bulk purchase pricing! (Exp. Issue 3/14:11686)

practice for sale

Mobile Veterinary clinic for sale: In gorgeous S.W Florida. Owner leaving the country Selling a turn- key beautiful Mobile Veterinary Clinic with client list . fully equipped: CO2 laser, full Idexx lab ( chemistry with T4, bile acids), QBC, Electrolytes, I-Stat machine, autoclave, anesthesia machine, dental machine, 2 centrifuges, Pulse oxymeter ( with esophageal cardiac probe , rectal probe, multiple lingual probes, doppler),doppler blood pressure, latest,otoscope all surgical instruments needed with some orthopedic equipment including Arthrex Acl repair kit and much more. Florida Practices for Sale For a vey attractive price.Serious inquiries Call 239-908-1343. (Exp. Issue 2&3/14:11640)

NEW! Palm Beach County. 1.5 miles to beach. $157 average transaction charge. Solo doctor, small animal. Minimal boarding and grooming. $1.4M for Practice & Real Estate. (#FL22B)

Veterinary Hospital for sale: Veterinary Hospital in Winter Garden. 2013 revenues 11%. To $425K. doctor,was small affluent Orlando/Kissimmee, FL area are forup sale. 2013 grossSolo revenue animal. No boarding, grooming, or emergencies. Quaint, leased facility $600K. Hospital is in 2,500 sq/ft leased space. Neighbors include Publix, centrally located blocks from downtown. $220K for Practice (#FL35G) Coldstone Creamery, GNC and other national brands. Hospital is well Polk County. Impeccable 3,000SF facility on busy 4-lane highway. Gross in equipped including direct digital radiography. Forowner’s more information: email: excess of $2M with continual growth. New income to exceed $370K! FloridaVetClinic.Sale@gmail.com phone: 813-812-4318 (Exp. $2.530M for Practice & Real Estate. ,(#FL72S) Issue 3/14:10767) Panhandle. Enjoy the emerald waters across from this beautiful practice in a highly desirable beach community. No grooming or boarding. $562K gross on a 5 day work week. Affluent clientele. $1.115M for Practice & Real Estate. Practice(#FL30S) for sale: Jacksonville, FL Solo. Small animal only.

Florida Practices for Sale NEW! Palm Beach County. 1.5 miles to beach. $157 average transaction charge. Solo doctor, small animal. Minimal boarding and grooming. $1.4M for Practice & Real Estate. (#FL22B) Winter Garden. 2013 revenues are up 11%. To $425K. Solo doctor, small animal. No boarding, grooming, or emergencies. Quaint, leased facility centrally located blocks from downtown. $220K for Practice (#FL35G) Polk County. Impeccable 3,000SF facility on busy 4-lane highway. Gross in excess of $2M with continual growth. New owner’s income to exceed $370K! $2.530M for Practice & Real Estate. (#FL72S) Panhandle. Enjoy the emerald waters across from this beautiful practice in a highly desirable beach community. No grooming or boarding. $562K gross on a 5 day work week. Affluent clientele. $1.115M for Practice & Real Estate. (#FL30S)

904-724-8866 for details. Real estate included. SOLD IN 6Call MONTHS! Congratulations to Dr. Chris Thompson and his wife, Kim, on the sale of Thompson Animal Hospital in Lakeland, Florida to Dr. (Exp. Issue 2.3&4/14:1110)

SOLD IN 6 MONTHS! Congratulations to Dr. Chris Thompson and his wife, Kim, on the sale of Thompson Animal Hospital in Lakeland, Florida to Dr. Dawn Morgan-Winter! (#FL23D)

SOLD! Congratulations to Dr. Joe Harper and his wife, Edda, on the sale of

SOLD! Congratulations to Dr. Joe Harper and his wife, Edda, on the sale of Animal Clinic of Dunlawton! Dr. Tom MacPhail, the owner of Deland Animal Hospital, is the new owner creating a satellite office. (#FL50A)

Dawn Morgan-Winter! (#FL23D)

Animal Clinic of Dunlawton! Dr. Tom MacPhail, owner small of Deland Animal small animal Practice for sale: Singlethedoctor animal is the new owner creating a satellite office. (#FL50A) 6 years, practice for Hospital, sale in the Panhandle area near Destin. Established BUYERS—If you haveAaperfect practiceopportunity in mind that you like tograduate purchase, we currently open 28 hours/week. formay a recent can help you. Contact us for ayou complimentary to learn or a snow bird looking to relocate, where can be yourconsultation own boss and takehow. Also, visit our website to be added to our buyer database and to view all control of your time. Beaches, boating, fishing, etc. just a stone throw away. listings nationwide. Inquiries at biopro@hotmail.com. (Exp. Issue 3/14:11868)

1610 Frederica Road * Saint Simons Island, GA 31522

TollPRACTICE Free: 800.333.1984 * www.simmonsinc.com SMALL ANIMAL FOR SALE – JACKSONVILLE, Email: southeast@simmonsinc.com FL: Thirty four year old small animal practice at the five point intersection Licensed Florida Real Estate Broker of Normandy Blvd., Jacksonville , Florida. 7500 square foot building, two story, facing two streets, vacant site. Owner is retiring. Call Dr. Devegowda Gopal, (904) 786-4919. (Exp. Issue 3, 4&5/14:1106)

36  |  FVMA ADVOCATE Florida Practices for Sale

BUYERS—If you have a practice in mind that you may like to purchase, we can help you. Contact us for a complimentary consultation to learn how. Also, visit our website to be added to our buyer database and to view all listings nationwide.

1610 Frederica Road * Saint Simons Island, GA 31522 Toll Free: 800.333.1984 * www.simmonsinc.com Email: southeast@simmonsinc.com Licensed Florida Real Estate Broker

www.fvma.org  |  37 Florida Practices for Sale


Passage of Veterinary Medicine

FVMA's Priority Legislative Initiative Passes in the 11th hour

Mobility Act on the Horizon (H.R. 1528/S. 1117) The House version of the legislation, H.R. 1528, was introduced last April by Representatives Kurt Schrader (D-Ore.) and Ted Yoho (R-Fla.), both veterinarians. The bill, which has 184 bipartisan cosponsors in the House, is now available to be placed on the House agenda for a vote. It is reported, with cautious optimism, that it is likely to be placed on the agenda after the House members return from the July 4th break. Please thank the following members of the House of Representatives from Florida who signed on as cosponsors of this important legislation: Rep. Vern Buchanan, Rep. Kathy Castor, Rep. Ander Crenshaw, Rep. Theodore Deutch, Rep. Joe Garcia, Rep. Alcee Hastings, Rep. David Jolly, Rep. Richard Nugent, Rep. Bill Posey, Rep. Ileana Ros-Lehtinen, and Rep. Ted Yoho. For further information concerning this legislation and its history please go to: https://www.avma.org/Advocacy/National/ Congress/Pages/VMMA-Campaign.aspx

As previously reported, the Drug Enforcement Administration’s (DEA) interpretation of provisions within the Controlled Substances Act (CSA) and resulting federal regulations make it illegal for registrants to transport controlled substances for use outside of a registered location. The DEA has informed organized veterinary The DEA has informed organized veterinary medicine that transporting controlled substances is illegal per the CSA and thus would require a medicine that transporting controlled substances statutory change to allow veterinarians to legally is illegal per the CSA and thus would require a provide complete veterinary care. It is imperative veterinarians be able to legally transport controlled statutory change to allow veterinarians to legally substances to the locations of the animal patient not only for animal health and welfare, but for public provide complete veterinary care. safety. The FVMA Governmental Relations staff has been continuously assisting the AVMA Governmental Relations If you need more information or have any questions please Division in securing legislative support for the Veterinary contact Ann Deal at ann.deal@fvma.org or the FVMA’s Medicine Mobility Act. FVMA staff has been successful in Membership Support Help Line: 800-992-FVMA (3862). disseminating information about the legislation and in garnering cosponsorships from Representatives from Florida. The Veterinary Medicine Mobility Act (H.R. 1528/S. 1117) is commonsense legislation that will allow veterinarians the ability to provide complete care to their animal patients beyond their clinics. Upon passage, it would amend the Controlled Substances Act to permit veterinarians to carry controlled substances outside of their primary places of registration, and across state lines into states where they also hold a veterinary license, to treat their patients. This means that licensed and registered veterinarians who treat patients on the farm, in the wild, at a client’s home or in other mobile settings will be allowed to bring and use controlled substances for pain management, anesthesia or euthanasia. The Senate passed the Veterinary Medicine Mobility Act (S. 1171) by a unanimous consensus on January 8, 2014. 38  |  FVMA ADVOCATE

Effective July 1, 2014

THERAPEUTIC veterinary Diets are TAX EXEMPT

W

e have all heard the saying “It ain’t over 'til it’s over.” That has never been as true as it was in the 2014 Florida Legislative session. We had previously reported that, for all intents and purposes, it appeared the FVMA’s priority legislation, Senate Bill 534 and House Bill 257, the tax exemption on Therapeutic Veterinary Diets, was dead for the 2014 Legislative Session. Two days before the end of the session Senator Jack Latvala (our Senate Bill Sponsor and a member of the Senate Appropriations Committee) informed us that he was going to facilitate the amendment of the Appropriations bill to include the verbiage of our proposed statutory change. He met with Senator Joe Negron (Senate Appropriations Committee Chair) that evening and with Senator Negron’s support, the comprehensive Senate Appropriations’ bill (HB 5601) was to be amended to include the language of SB 534 and HB 257. On Thursday, May 1st, the amendment to the bill was approved by the Senate and it was placed on 3rd reading. On Friday, May 2nd, the bill was then approved by a unanimous vote of the Senate on 3rd reading and forwarded to the House of Representatives. The House then voted to approve the bill and it was sent to the Governor for signature. Governor Rick Scott signed the “Appropriations Bill,” which included the tax exemption for Therapeutic Veterinary Diets, into law on May 12, 2014. House Bill 5601, amended Florida Statute 212.08 Tax on sales, use and other transactions- subsection (2) Exemptions; Medical, paragraphs (i) through (k), to add the following language:

FS 212.08(2)(i): Sales of therapeutic veterinary diets specifically formulated to aid in the management of illness and disease of a diagnosed health disorder in an animal and which are only available from a licensed veterinarian are exempt from the tax imposed under this chapter. The effect of this law restores the sales tax exemption on therapeutic veterinary diets, commonly referred to as prescription diets, to their pre-2010 sales tax exempt status. As a result of this legislation, therapeutic veterinary diets eligible for sales tax exemption are diets that manufacturers only make available to the public through a licensed veterinarian.

BACKGROUND: Therapeutic veterinary diets, commonly referred to as prescription diets, enjoyed tax exempt status for more than 30 years. In 2010, as a result of a review by the Florida Department of Revenue (DOR), of the Florida Sales Tax Exemption Statutes, the DOR determined that the law did not support tax exempt status for prescription diets. The DOR’s interpretation was that, contrary to their commonly referred to name, “Prescription Diets” were not government regulated drugs that require a Federal Caution Label in order to be classified as a prescription. After several attempts with the DOR to appeal this determination, the FVMA leadership abandoned this time consuming and potentially costly process in favor of pursuing a legislative remedy to amend FS 212.08 to solidify once and for all tax exempt status of Therapeutic Veterinary Diets. FVMA owes a big THANK YOU to Senator Jack Latvala and Senator Joe Negron for making this happen. Our bill would have been dead had these two Senators not breathed life into it by making the decision to include “our bill” in the appropriations package. We also thank Governor Scott for signing the bill, and thus making it a law. We also need to remember the following Senate and House Members who sponsored and co-introduced our initial legislation: Sponsors: Senator Jack Latvala and Representative Ed Hooper. Co-Introducers: Sen. Miguel Diaz de la Portilla, Sen. Darren Soto, Rep. Larry Ahearn, Rep. Neil Combee, Rep. Travis Cummings, Rep. Amanda Murphy, Rep. Keith Perry, Rep. Gregory Steube, Rep. John Wood and Rep. Carl Zimmerman. FVMA members who live in the above Legislators’ districts are encouraged to please make an effort to write, call or stop by their local offices and simply thank them for their support of making Therapeutic Veterinary Diets tax exempt. (The tax exemption went into effect on July 1, 2014.) A special “Thank You” to the FVMA Executive Board, Legislative Committee and all of the Members that supported and lobbied for this effort. A very special note of appreciation to Senator Jack Latvala who was our “Legislative Champion” in achieving passage of this law. For more information call the FVMA member support Help Line at 800-992-FVMA(3862) or email us at info@FVMA.org. www.fvma.org  |  39


UFCVM FIRST STUDENT MENTORING

T

he FVMA invited members to volunteer for its 2014 Student Mentoring Panels that are held annually for students of the University of Florida College of Veterinary Medicine (UFCVM). In response to that call, we received overwhelming support from veterinarians from around the state, who welcomed this special opportunity to serve. The first Panel was subsequently convened on March 26, at the appropriately named forum, Following Footsteps, which was a tremendous success. Participating in the March 26 Student Mentoring Panel were Dr. Charli Braun (UFCVM 2010, small animal) of Winter Park; Dr. Bob Encinosa of Riverview (UFCVM 1987, small animal); Dr. Patti Gordon (UFCVM 1984, small animal/feline practice) and Dr. Mike Raposo (UFCVM 2011, small animal emergency) from Gainesville; Dr. Margaret Sermersheim (Auburn University College of Veterinary Medicine 2013, small animal) of Belleair Bluffs; Dr. Kate Stephenson (University of Edinburgh 2010, equine sports medicine) of Ocala; and Dr. Christine Storts, (University of Illinois College of Veterinary Medicine 1982, small animal) of Cape Canaveral.

PANEL IN 2014

A Tremendous Success

The UFCVM Student Mentoring Panel was organized by FVMA Student Class Representatives Brett Zager, Geoffrey Landau, Kaitlynn Earnshaw and Kelsey Cox, and hosted by the FVMA in conjunction with SCAVMA, the student chapter of the AVMA. It brought students and practicing veterinarians face-to-face for frank discussions and sharing. This event is intended to assist students in envisioning their future career paths more clearly. The FVMA is convinced this activity offers an invaluable opportunity for students to be guided by the experience and wisdom of established practitioners, as well as recent graduates who just recently were facing the same challenges and uncertainties being experienced by current students, as they begin their preparation to transition from the classroom to the veterinary exam room. FVMA Executive Director Phil Hinkle notes that FVMA members’ participation in this important program is a distinctive demonstration of the commitment of Florida veterinarians and the FVMA to ensuring the success of these young professionals. Dr. Bob Encinosa, who operates Boyette Animal Hospital in Riverview, told the FVMA Advocate how useful this special forum was. “The Following Footsteps mentoring event was an enormous success in my opinion.” said Dr. Encinosa. “The diversity represented in the veterinary panel allowed the students to get answers to some of their most pressing questions, questions that really weigh heavily on all students as they prepare to enter the workforce. The student organizers did a fantastic job of putting this together. It was informative and actually a lot of fun for everyone involved. The auditorium was filled beyond capacity and I think this forum presents a great resource for students that will become even more popular in the future.”

Special Thanks To Our Distinguished Panelists For Brett Zager the Feedback from this year’s FVMA Mentoring Panel was overwhelmingly positive. “All of the panelists contributed a unique perspective to the questions and concerns from veterinary students,” he said. “It was extremely valuable to hear the opinions on these topics from both new grads and veteran practitioners,” he continued, then adding, “I think there is a gulf separating veteran practitioners from new grads and veterinary students. Events like this panel help to close that gap and unify the veterinary profession.” The March 26th Student Mentoring Panel was held on the University of Florida campus, following a students’ dinner which was hosted by the FVMA. The event lasted for two hours and engaged the students and panelists in interactive and lively discussions on topics ranging from medical ethics to contract negotiation, and looked at the challenges encountered by students, and the key factors that will contribute to their professional growth and success. Following the discussion panel, students had the opportunity to network and talk one-on-one with the panelists. Members interested in serving on future Student Mentor Panels are encouraged to send an email to the FVMA at info@fvma.org.

Charli Jane Braun , DVM Winter Park Veterinary Hospital University of Florida-2010

Small Animal

Bob Encinosa, DVM Boyette Animal Hospital, Riverview University of Florida-1987

Small Animal

Patti Gordon, DVM Small Animal-Feline Practice All Cats Healthcare Clinic, Gainesville University of Florida-1984 Mike Raposo, DVM Small Animal Emergency Affiliated Pet Emergency Services, Ocala University of Florida-2011

Margaret Sermersheim, DVM Bluffs Animal Hospital, Belleair Bluffs Auburn University-2013

Small Animal

Kate Stephenson, BVM&S, MRCVS Equine Sports Medicine Central Florida Equine Medical Center, Ocala University of Edinburgh Scotland-2010

Christine Storts, DVM Atlantic Animal Clinic, Cape Canaveral University of Illinois-1982 40 |

FVMA ADVOCATE

Small Animal

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2014 advocate issue 3  
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