The Oath fall 2023

TEACH HEAL DISCOVER FALL 2023

OUR ECONOMIC IMPACT

The return on the investment that North Carolina makes in the NC State College of Veterinary Medicine shows up in critical and diverse ways, including in the state’s oyster harvest.

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HELPING THE COMMUNITY

Diving and Thriving

It was a perfect North Carolina day when the NC State College of Veterinary Medicine hosted the American Kennel Club Diving Dogs Premier Cup this year. The event raised money to support cancer research and was held at NC State University to commemorate the 40th anniversary of Jimmy Valvano’s 1983 National Championship win and the 30th anniversary of the founding of the V Foundation for Cancer Research.

ESPN broadcast the all-star invitational competition in a two-hour presentation. The AKC Diving Dog Challenge included 36 top diving dogs from around the country competing in three divisions: Distance, Air Retrieve and Hydro Dash.

ESPN and Valvano, who was an ESPN commentator after his coaching career, founded the V Foundation in 1993. Over the past three decades, the foundation has awarded more than $310 million in research grants to 71 cancer centers and other research institutions in the United States.

The NC State College of Veterinary Medicine has received V Foundation money for its canine comparative oncology program, which allows researchers to better understand the similarities of cancers that occur in dogs and humans. The hope is that research will lead to more efficient and less costly drug trials, new treatment plans and improved outcomes for both dog and human cancer patients.

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FROM THE DEAN

This summer we completed our next strategic plan that will drive much of the college’s vision through 2029. This strategic plan has a fairly traditional emphasis on our education, research and hospital missions but also includes two new goals that focus on partnerships and community.

In this issue of the Oath, we are particularly focused on this community goal. We know that a strong, well-supported community is key to the success of all of our other goals. Our college community is very broad and includes both internal members (staff, faculty, trainees, students) and many, many important external constituents such as alumni, friends of the college and a host of other amazing supporters within the state of North Carolina.

As a college and university, we are incredibly well-supported by North Carolina. Most recently, lawmakers approved $70 million in

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funding to renovate our Large Animal Hospital and additional money to increase each incoming veterinary class size to 125.

We want to ensure that we are fulfilling our mission to support the state as well. Our cover story provides some unique examples of how NC State Veterinary Medicine uplifts the state economy.

You will also find stories about two of our alumni following very different career paths – but still supporting the state. Providing worldclass veterinarians is an incredibly important part of our mission, and our expanded class size will help us fill what’s become a shortage, especially in the rural areas of North Carolina. In addition, we support our agricultural community by providing the research that helps keep production animals healthy and farms moving forward, and you will read about an important new USDAfunded porcine epidemic diarrhea study.

With the new strategic goal of finding more innovative ways to increase our community support, we have developed a pilot Ambulatory Equine Emergency Service that allows area equine veterinarians to step away from their practices at night or on weekends knowing their clients will be well taken care of by NC State. On an October weekend, several students and faculty members visited a local community shelter to provide pet vaccinations and nutritional advice for pet owners.

As part of this new goal, we have asked a group of faculty and staff members to develop specific ideas for where our college can have the biggest impact on our state, and we will be bringing those plans forward soon.

In future issues of the Oath, I’m sure I will discuss many aspects of our strategic plan, but we know that having and supporting a thriving community is truly the key to our success.

Kate

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CONTENTS

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In the Community From the Dean

UP FRONT 4 Staff Profile 10 College Close-Ups 12 Staff Profiles

F E AT U R E S 15 Hope for Hollen NC State experts tackled every hazard head-on with a puppy’s traumatic brain injury.

OUT BACK 38 Alumni Profile 40 Welcome Class of 2027

21 Our Economic Impact How the NC State College of Veterinary Medicine has a significant impact on the state’s economy in critical and diverse ways.

32 Filling a Need NC State begins offering a new Ambulatory Equine Emergency Service, which has already been a huge success for horse owners, local vets and students.

TOP: The NC State College of Veterinary Medicine played host for the Honey Bee Veterinary Consortium’s annual conference in October (Page 9). MIDDLE: Our upgrade to the Teaching Animal Unit’s dairy barn is nearing completion. (Page 11). ABOVE: The NC State College of Veterinary Medicine’s Class of 2027 comes from all walks of life. (Page 40). .

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ON THE COVER CVM assistant professor Tal BenHorin deploys oysters to grow-out bags at a commercial oyster farm in Carteret County.

35 Food-Focused Vets Through its Food Animal Scholars initiative, the college equips veterinarians-in-training to produce healthy food that nourishes and fuels North Carolina.

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UP FRONT

S TA F F P R O F I L E

NC State Welcomes New Head of Research

By Burgetta Eplin Wheeler

The NC State College of Veterinary Medicine named Dr. Josh Stern, associate dean for veterinary medical center operations and professor of veterinary cardiology at the University of California-Davis School of Veterinary Medicine, as its new associate dean of research.

Stern, who completed his cardiology residency at NC State in 2012, succeeds Dr. Kate Meurs, who became the dean of the NC State veterinary college in 2022.

“Dr. Stern is an outstanding example of a clinician scientist, someone with both a very strong basic science and clinical research background,” Meurs says. “He understands the importance of the application of basic science research to complex clinical problems, and he is also very passionate about training the next generation of scientists.”

Stern received his doctorate of veterinary medicine from the Ohio State University. He later received a Ph.D. from Washington State University.

“I’m incredibly fortunate to return to NC State where I

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spent the most formative years of my training and to have the opportunity to join such a talented group of faculty members and industry leaders,” Stern says. “I am passionate about translational research and helping the NC State CVM community tell the story of how their incredible research is helping animals, people and the planet.”

Stern, who has contributed to more than 100 research publications in his career, has focused on veterinary cardiology, specifically inherited heart disease and how to use genetic data to guide treatment and prognosis.

Between 2011 and 2021, ​​the NC State College of Veterinary Medicine experienced more than 220 percent growth in research grant funding, the result of intentional and innovative changes that the college made to expand its research impact. The college also benefits from the increasing recognition of the translational nature of veterinary research.

“Research and discovery are critical parts of our college’s mission, and it is through research that we find the way to practice medicine better tomorrow than we do today,” Meurs says. “I am incredibly excited to see Dr. Stern expand on the college’s current research endeavors and help move to the next level of scientific impact for animal and human health and by training the next generation of biomedical researchers.

We are very fortunate to have Dr. Stern back at NC State.”

Stern says he’s especially eager to take on the role of mentor.

“Supporting training for the next generation of veterinary researchers is one of the most important parts of this role,” he says.

“I’m so excited to be a champion for this cause on behalf of NC State.”

Stern’s husband, Dr. Ron Li, a member of the American College of Veterinary Emergency and Critical Care, joined the NC State Department of Clinical Sciences.

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RESEARCH CONNECTION

Scan to watch the videos on this page

From Snakes to Rabbits Dr. Sarah Ozawa, assistant professor of zoological medicine, shared some of the challenges and joys of having to be well-versed in the research and treatment of exotic species not often studied. Dr. Ozawa’s research spans from snakes and rabbits to even tarantulas, but most recently she has worked on a project looking at injuries from fishhooks in our local turtle population.

Forensic Science Frontier Dr. Kelly Meiklejohn, an associate professor of forensics in our Department of Population Health and Pathobiology, completed a postdoctoral fellowship with the Counterterrorism and Forensic Science Research Unit of the FBI Laboratory in Quantico, Virginia.

At NC State, she’s broadening the scope of her research, like applying new technologies to scenarios where additional information could prove vital to an investigation.

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P R E S S P L AY

Taking Infection by the Horns

Jax, a 3-year-old male bongo from the Virginia Zoo, arrived at NC State with fractured and infected horns from playing too roughly in the dirt. Using the Veterinary Hospital’s new equine CT machine, the 450-pound forest antelope’s care team pinpointed the infection’s spread and amputated part of Jax’s horns to prevent it from recurring.

Dog Days of Summer

Twenty-two rising second- and third-year DVM students beat the heat this summer by immersing themselves in mentored lab research studies through the 10week Veterinary Scholars Program.

Sam Dunn, class of 2026, spent her summer with service dog puppy candidates -- and it was just as cute as it sounds!

Our Class of 2027

Whether students fresh from undergraduate degrees, professionals pivoting to new careers, lifelong North Carolina residents, newcomers to the state or country, parents of human children and fur moms and dads, the first-year students are amazing achievers and were ready to go when classes started.

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GROUNDBREAKING RESEARCH

Study’s Cystitis Remedy so Effective that NC State Immediately Offers Treatment to Cats

By Burgetta Eplin Wheeler

An NC State College of Veterinary Medicine study exploring whether low-dose radiation therapy could relieve the painful symptoms of Feline Idiopathic Cystitis has been so successful that clinicians started offering the treatment to cats at the NC State Veterinary Hospital.

The causes of Feline Idiopathic Cystitis are not well understood, though environmental stress appears to be a main factor, says Dr. Allison Kendall, an assistant clinical professor of small animal internal medicine with a focus on nephrology and urology. The condition often is chronic and leaves cats, especially male ones, straining to urinate or even unable to. About 20% of affected cats are euthanized, she says.

“This is a very serious disease, and there really is no current effective treatment,” says Kendall, the study’s lead investigator. “Once they are diagnosed with FIC and once their urethra is blocked, cats risk blocking multiple times. Once they have the disease, it just doesn’t go away on its own. It’s lifelong.”

Until now, trying to treat the symptoms and remove stressors has been all veterinarians could do, Kendall says, and too many times euthanasia is needed to stop the suffering.

Wanting to address the pain is what led Dr. Michael Nolan, professor of radiation oncology, to approach Kendall to discuss whether treating the feline bladder with low-dose radiation therapy could help relieve FIC symptoms.

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“You can actually treat arthritis and other inflammatory conditions with low-dose radiotherapy, and it works really well,” Nolan says. “Nobody knows why it works, but it does. So I said, ‘Why don’t we just try and see if maybe radiation could help with this?’”

Kendall and Nolan collaborated on setting up a study, and Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine, used the Feline Gift Fund to pay for it. In April, the college created a new Feline Health Center to elevate its focus on cats and to combine all of its feline expertise under one umbrella, making collaborations such as the FIC study even easier.

Over the past two years, with some delays because of the COVID pandemic, Kendall, Nolan and their teams have used low-dose radiation to treat 15 male cats suffering from FIC. Data is pending on the study’s final cat, but the researchers say every other cat has shown improvement, with most never having another episode of cystitis.

These findings were compelling enough for the NC State Veterinary Hospital to begin offering these radiation treatments to patients.

“I feel confident enough in the study to start recommending it,” says Kendall, noting that oral medications, the only available treatment, are themselves stressful for cats and their owners. “Pet owners might think it’s too expensive, but radiation therapy can be cheaper than continuously paying to treat a blocked and suffering cat. If it were my cat, I would definitely be looking at radiation therapy.”

Archer Seaman, a black and white, pink-nosed boy, was the first cat enrolled in the study in April 2021.

Danielle Seaman, a radiologist in Durham, says she had noticed Archer in his litterbox straining to urinate with nothing coming out, and she immediately took him to her local veterinarian.

“They did the full workup, but there wasn’t an obstruction, and he didn’t have any stones,” says Seaman, who has three other cats. “There was no good underlying reason for it. We think it was stress-related. But once it started, it was a never-ending battle.”

Every two or three weeks, Archer would have blood in his urine and be so uncomfortable he’d urinate in inappropriate places, Seaman says. Oral

medications would bring limited relief.

When her veterinarian mentioned that NC State was looking to study cats in Archer’s predicament, Seaman quickly called and enrolled him.

“We took him in for one low-dose treatment in 2021, and it really has been life-changing, to be honest,” says Seaman, who notes that Archer had one episode shortly after his treatment and none since. “He was miserable and making us miserable. And now he is one happy, healthy cat. I feel so lucky that my vet had known about the study and was able to refer us.”

Kendall presented the initial data at a national conference this summer and will be publishing the results by next year.

“I had multiple texts, emails, phone calls, from colleagues I’ve known a long time and people I’ve never met in my life, reaching out after that conference wanting to figure out how to do it in their clinics,” says Nolan, who cautions that the data are not confirmatory and that more studies are needed. “There are still questions, but this is super encouraging, one of the most surprising things I’ve seen.”

PREVIOUS PAGE: Dr. Allison Kendall was the lead researcher on the study.FAR LEFT: Dr. Mike Noland had an idea that low-dose radiation therapy might help.LEFT: Archer Seaman was the first cat enrolled.

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Honey Bee Bonanza NC State hosts national consortium conference The NC State College of Veterinary

Medicine played host for the Honey Bee Veterinary Consortium’s annual conference in October, welcoming more than 100 bee lovers to campus for lectures and hands-on labs.

Honeybees are essential to a third of the world’s food production and have been dying off across the globe in recent years because of poor nutrition due to land-use changes, pesticide exposure and introduced pests and diseases.

In 2017, the FDA declared honey bees as food animals and began requiring veterinary oversight of the antimicrobials used in treating them.

Since then, NC State has been at the forefront of bee education. A group of North Carolina veterinarians, mostly NC State faculty and graduates, started the Honey Bee Veterinary Consortium in 2016 to let beekeepers and veterinarians connect about the coming FDA rules. The consortium now includes veterinary students and veterinary medicine and animal science professionals who care about bees and beekeeping. Lectures at the N E W S . C V M . N C S U. E D U

2023 HBVC conference included “All About Queens” and “The Buzz on Bee Toxicology.” The event also offered two hands-on lab sessions: “Introduction to Hive Inspections” for beginners and “Honey Bee Anatomy and Diagnostics” for advanced attendees.

“The USDA has an excellent module on honey bees, so a lot of it fortunately I was like, ‘Oh, I already know some of this from reading about it,’ but there’s just no substitute for hands-on learning,” said Dr. Kelsey Walker, a faculty member at the University of Missouri College of Veterinary Medicine who traveled to Raleigh for the event. “To be able to do this handson is amazing. I’m really grateful to NC State for hosting this.”

Walker said she was trying to get more of her students interested in bee care.

“As veterinarians, we are now an integral part of this, but there are so few people willing to see bees,” she said.

“It’s not something we spend a lot of time on curriculum with. So I’m trying to expand that.”

Last fall, the NC State College of Veterinary Medicine offered its students a selective course in apiary work or honey bee keeping. The selective gave students crash courses in topics including bee anatomy and physiol-

ogy, common diseases and pests, hive inspection techniques and bee sting therapy.

Training more veterinarians to help bees is critical to the at-risk insect’s survival, said Dr. Greg Lewbart, NC State professor of aquatic, wildlife and zoological medicine, the selective’s coordinator. From April 2020 to April 2021, beekeepers across the United States lost 45.5% of their managed honeybee colonies, according to the Bee Informed Partnership.

This year’s honey bee conference also gave seasoned veterinarians a chance to learn the latest in bee care.

Dr. Pat Gorman, who received her DVM from NC State in its second class in 1986, is a small animal veterinarian in Pennsylvania who wants to help her community with bees.

“This was very helpful today in building up confidence even on something as basic as making the smoker work, getting dressed in a beekeeper suit — things that you would be judged on your competence of,” Gorman said.

“You can have a lot of book knowledge, but unless you know how to handle the tools, they’re not going to have confidence in what you’re saying.”

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UP FRONT

COLLEGE CLOSE-UPS

Evolution Earth Featured in the premiere episode of the new PBS series “Evolution Earth” were NC State Vet Med faculty Greg Lewbart and Eli Cohen and students Alyssa Valentine (‘25) and Emily Inkrote (‘24) and their research into how the marine iguanas of the Galápagos have adapted their size in response to El Niño events.

Lewbart, professor of aquatic, wildlife and zoological medicine, and Cohen, clinical professor of radiology, have been part of a team that has been radiographing the iguanas since 2016. PBS says the series will embark “on a global expedition to reveal the animals keeping pace with a planet changing at superspeed.”

The goal is to study the iguana’s unusual adaptation.

They have evolved the ability to shrink and regrow their vertebrae in response to changes in food availability.

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The score, out of 10, that second-year DVM student Briana Horne-Reid gave her experience in NC State’s first Immersive Clinical Experience, or ICE, in Oncology this summer. Dr. Michael Nolan designed the program to help students explore important medical specialties they could pursue as careers and understand more about animal cancers and their treatment.

Holy Cow!

At the annual American Association of Bovine Practitioners convention in Milwaukee, our NC State College of Veterinary Medicine quiz bowl team won first place not just among other student teams but also against the “Dream Team” of AABP leaders. Way to go, Abigail Dupuis, Nick Collier, Mallory Flanagan and Maddie Kuwada, who were completely undaunted by anatomy, diseases, reproduction, food safety, pharmacology, farm management and all questions cow!

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S TAT E - O F -T H E - A R T FA C I L I T I E S

PHOTO BY JOHN JOYNER/NC STATE VETERINARY MEDICINE

A New Dairy Barn Rises Peek over the pastures of the College of Veterinary Medicine and you may see a new building on the horizon. Our upgrade to the Teaching Animal Unit’s dairy barn is nearing completion, and soon students and faculty will have access to a modernized facility with state-of-the-art equipment reflecting the latest innovations in cattle care. We think our cows will love it, too.

Dairy production is one of North Carolina’s key industries, producing over $175 million in farm cash receipts in 2021. By providing our cows with the most comfortable, safe environment possible to produce milk, we improve their health and happiness and set a standard for our student veterinarians interested in pursuing food animal medicine.

Thanks to the generous continued support of the R.B. Terry Charitable Foundation, the $5.5 million investment in the new barn also ensures these veterinarians-in-training learn how to use leading-edge technologies in farm animal

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care and safety and can carry that knowledge with them wherever they go next.

As the food animal industry is changing, veterinarians are taking on a greater role at farms and leading efforts to improve animal welfare like never before. The barns and pastures of NC State’s Teaching Animal Unit strengthen students’ understanding of veterinary medicine in a contemporary living classroom.

The NC State College of Veterinary Medicine is one of just a handful of veterinary medicine schools in the United States that feature an on-site working farm. DVM students complete labs at the Teaching Animal Unit during their first three years and continue to visit the farm during their fourth-year senior rotations.

The barn modernization project broke ground in October 2021 and is expected to be completed this winter. But we’re not done enhancing our hoofstock facilities just yet: Our next project is updating our Large Animal Hospital to include a new Equine Veterinary Center to better meet the needs of horses and livestock visiting our Veterinary Hospital.

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S TA F F P R O F I L E

Comfort for Caregivers At the NC State Veterinary Hospital, clinical social workers are on a mission to encourage faculty, staff and clients

By Katie Rice

It’s 9 a.m. in the Terry Center’s internal medicine area, and clinical social workers Rebecca Maher and Morgan Josey have performed a minor miracle: getting tired fourth-year students to participate in a group mindfulness activity during clinical rounds.

“I’m not good at self-care,” one student volunteers.

“This is a no-judgment zone,” Maher responds. “As the year goes on, I hope you start thinking about things you can do for yourself.”

This exchange exemplifies what Maher calls “teaching in the moment,” part of her and Josey’s day-to-day work reminding veterinary caregivers how to care for themselves and become better advocates for patients who express their

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needs with whimpers and whinnies.

Their team, Family and Community Services, also supports owners and community partners whose animals are receiving treatment at the NC State Veterinary Hospital.

Josey and Maher help them navigate the hospital system, approach treatment decisions and honor departed companions.

The NC State College of Veterinary Medicine was one of the first veterinary schools in the country to embed social workers within its hospital team. Josey joined the service in August, enhancing the hospital’s ability to offer support.

“The Family and Community Services team really helps us focus on the entire family,” says Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. “We care deeply about providing the very best medical care to all of our patients, but this team ensures that we are also addressing concerns and needs of the families who love them. This is a critical part of our entire medical approach and our educational mission.”

Maher and Josey typically begin and end their days conducting rounds within the hospital to check in on patients and care teams. In between, they field calls from people

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UP FRONT

whose pets are in the hospital and counsel them through their animals’ treatment options, offering comfort to those whose pets have complex or terminal diagnoses. They also console owners, students and faculty when patients pass away.

Their schedules can shift at a moment’s notice to respond to emergencies. Maher also serves on the Veterinary Hospital’s ethics committee.

Josey, from Knightdale, North Carolina, studied human development and family studies at the University of North Carolina at Greensboro and earned her Master of Social Work from North Carolina Central University. She worked with patients in Duke Health’s endocrinology service for over two years before joining the NC State CVM. “Everybody’s been pretty welcoming here,” she says, recounting how she was invited to shadow a surgeon on her second day. “That was a lot! I enjoy being invited into these spaces so graciously — even if it is surgery.”

Maher has worked at the CVM for four years.

She grew up around Europe and the United States, earning her bachelor’s degree in biological anthropology at Harvard University.

Working in vocational rehabilitation for adults with serious and persistent mental illness brought her into social work, and she earned her master’s degree from the University of North Carolina at Chapel Hill. She also worked in Duke Health’s endocrinology service and spent over 30 years working within that hospital system, including in newborn and pediatric intensive care units, administration

and ethics clinical consulting.

Josey and Maher say their backgrounds in human medicine translate well to veterinary medicine, but Josey’s new job still comes with surprises unique to vet med, like meeting a client’s emotional support chicken.

Working at a teaching hospital also allows them to help shape a compassionate learning environment for residents and students. Every day, they work to equip care teams to approach difficult situations and celebrate their accomplishments.

And every day they learn something in return. Maher describes herself as a “gatherer of tales.”

“I love the idea of being able to accompany people on journeys, learn from them and be able to offer what I’ve learned as a gift to the next person,” she says. “I go home very moved by the variety of ways that people co-create spaces with animals and what the benefit is to a person.”

Josey and Maher fondly recall the animals that have touched their own lives. Josey grew up with a boxer, Mace, who passed away late last year as she was applying to jobs. She jokes that her finding the NC State position was a sign from him. Maher has owned a variety of pets but now shares her home with a black goldendoodle called Tinker Bear and a Birman cat named Boo Radley.

Maher’s Terry Center office is recognizable by its decor reflecting all species of the animal kingdom, so anyone who enters can find their favorite animal represented, and by the tea tins lining the hallway window ledge, so passersby can help themselves to a comforting cup.

Josey is settling into her office in the Health and Wellness Center, but she is eager to meet the CVM community and guide its members through life at a veterinary hospital.

“This whole thing has been a learning experience, and I’m excited to keep learning and grateful to contribute to such a supportive environment,” she says.

“I love the idea of being able to accompany people on journeys, learn from them and be able to offer what I’ve learned as a gift to the next person. I go home very moved by the variety of ways that people co-create spaces with animals and what the benefit is to a person.”

— Rebecca Maher LEFT: Rebecca Maher and Morgan Josey

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PAT I E N T P R O F I L E

Hope for Hollen A German shorthaired pointer puppy’s traumatic brain injury and surrounding symptoms didn’t fluster NC State veterinarians, who tackled every hazard head-on.

By Katie Rice

Hollen Tovar prances toward the waves of an Outer Banks beach on summer vacation, her spindly legs kicking up sand with eager puppy energy.

In the family’s video, her owners, Chelsea and Maurice Tovar, jog to keep up with the German shorthaired pointer, grinning as she pulls them along the shore. Just three months before, this picture-perfect scene would have seemed impossible to them as they rushed Hollen to their vet near Chesterfield, Virginia, after an encounter with another dog left her unresponsive.

Diagnosed with a traumatic brain injury, Hollen remained nearly comatose in two different animal hospitals before one referred her to the NC State Veterinary Hospital for intensive care.

In Raleigh, the veterinary staff recognized a life-threatening depressed skull fracture and performed brain surgery. When Hollen then developed a sodium syndrome so rare it apparently has no other documented cases in dogs,

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NC State again rose to the occasion.

The Tovars are so grateful for the hospital’s life-saving care that they are dedicating a brick to Hollen’s lead clinician on the College of Veterinary Medicine’s Walk of Honor.

“I was just blown away by NC State’s vet teams,” says Chelsea Tovar. “They see thousands of animals a year but still treated Hollen with such personal care, love and concern. We’d have trusted them to operate on one of us!”

THE PERFECT DOG’S PERFECT STORM

It was love at first sight when 10-weekold Hollen joined the Tovar family in May. “She’s so sweet, a total love, and she’s smart,” Chelsea Tovar says of the brownand-white-speckled pup. “She’s really the perfect dog, behavior-wise: wonderful with our kids, great with our other pointer. She’s calm in the car, playful, curious — everything you would want in a dog.”

But within a day of Hollen’s arrival, disaster struck.

The Tovars didn’t see what happened that May 24 afternoon, but they heard their two young sons screaming, saw Hollen unconscious and pieced together that their German shepherd had bitten her head.

Their local veterinarian gave her medicine to reduce brain swelling but referred her to an urgent care facility.

The neurologist there recommended surgery when a CT scan showed a skull fracture pressing on Hollen’s brain, but the urgent care was closing for Memorial Day weekend and Hollen needed treatment ASAP. “They said, ‘We can start calling places if you want, but the best place for her really is NC State,’” Chelsea Tovar says.

“And we said, ‘Tell them we’re coming,’” adds Maurice Tovar. “We loaded up the car and told our kids, ‘There are no stops.’”

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NC State vet techs met them at the door with a stretcher.

Neurology resident Dr. Gilad Fefer had already reviewed Hollen’s chart and realized her unresponsiveness suggested damage to a deeper part of her brain. He immediately ordered an MRI to look for brain damage or bleeding that couldn’t be seen on a CT. “The MRI showed the obvious piece of bone that was well-embedded within the tissue of her forebrain, but Hollen also had a pretty big bleed, or a stroke, secondary to trauma within her midbrain,” says Fefer, the primary veterinarian in Hollen’s case. “That bleed likely explained her severely abnormal mentation.”

The midbrain is responsible for the body’s sleep-wake cycle and is a difficult and high-risk area for surgeons to access, Fefer says. Doctors wanted Hollen to show signs of recovery from her stroke, proving her midbrain was healing on its own, before operating on her forebrain.

So Hollen’s care team waited. ICU technician Jamie Walls says she was guarded about Hollen’s prognosis at first, but the pup surprised her.

“By the second day, she was kicking and eating a little slurry of food,” she says. “Hollen was already making progress and showing that she was going to be a little fighter.”

And 36 hours after her arrival, Hollen started responding to voices and touch and was cleared for a craniotomy.

A UNIQUE COMPLICATION

On May 28, Dr. Fefer and the surgery team removed a roughly 1-by-2-inch bone fragment wedged under Hollen’s skull, instantly relieving pressure on her brain, and flushed out bone chips and potential bacteria.

Hollen began reacting to stimuli in

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the ICU just two days later.

“One of the first things she did was smell food, and she just instinctively started licking,” Fefer says. “That was the first sign of, ‘There’s a puppy still in there.’ It was really amazing to see her go from not responding to anything to trying to stand, rolling around in her cage and trying to do puppy things within a week.”

Shortly after surgery, a complication emerged. No matter how much Hollen ate or drank, she remained dehydrated with dangerously low sodium levels, Fefer says, suggesting a condition known in humans as cerebral salt wasting syndrome.

“We suspected that she’d been excreting excess sodium in her urine,” he says. “And this is something that’s reported in people with traumatic brain injuries and described in veterinary textbooks as a potential complication, but it has not actually been described in a dog before.”

The ICU team responded by giving Hollen IV infusions of concentrated saline. Wanting to get the pup home, they needed to come up with a salt

replacement method her family could continue until her levels stabilized.

Emergency and critical care veterinarian Dr. Bernie Hansen devised a plan to administer sodium through Hollen’s nasogastric feeding tube, then have Hollen’s family add a salt solution to her food once she could chew.

“I was fascinated to see such a rare syndrome firsthand,” Hansen says. “Most animals initially suspected to have cerebral salt wasting syndrome don’t actually have it. I’ve never had a convincing case before in three decades of practice.”

Hollen was released June 7 with detailed instructions for her continued care. Chelsea Tovar says it was like being sent home with a new baby.

“We kept Hollen in a soft-sided playpen right next to our bed, with a camera attached,” she says. “We came up with a routine: Every four hours, she was taken out to go to the bathroom and fed. We made this ridiculously detailed Excel spreadsheet to track her medications and bathroom breaks.”

Hollen’s healing had other challenges. She was blind for weeks after her surgery and developed a sizable seroma, or fluid build-up, under her incision.

She was prescribed an anticonvulsant after having a seizure at the hospital and needed weekly sodium blood tests at her regular vet.

But as Hollen grew stronger and recovered her vision and mobility, nothing could hold her back.

Maurice Tovar once found her wandering the bedroom after she clambered out of her playpen. After recovering more vision, Hollen later took off running across the yard during a potty break, and Chelsea Tovar had to chase her down in a bathrobe.

Now, Hollen enjoys a pampered life with plenty of attention from her humans

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PREVIOUS PAGE: Neurology resident Dr. Gilad Fefer immediately ordered an MRI to look for brain damage or bleeding that couldn’t be seen on a CT. LEFT: Chelsea Tovar and her sons visit their German shorthaired pointer puppy, Hollen, at NC State Veterinary Hospital in May. Hollen had a naso-gastric feeding tube giving her sodium supplements.

and the family’s other pointer pup, Jack.

The Tovars rehomed their German shepherd with a relative.

“Hollen is going to be her own spokesperson,” Chelsea Tovar says.

“We’re going to let her be the guide as to what and how much she wants to do.”

‘EVERYTHING THAT COULD GO RIGHT DID’

The Tovars say the NC State Veterinary Hospital helped turn a harrowing experience into an uplifting one. Hospital staff even connected them to a grant that offset Hollen’s surgery costs.

“I feel so fortunate and grateful to the vet hospital and Dr. Fefer, and so lucky that Hollen’s with us and that we were able to receive that grant,” Chelsea Tovar says. “Things have a crazy way

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of working out, and as awful as it was, everything that could go right did — and I don’t believe it would have turned out this way had she been elsewhere.”

Maurice Tovar shares Hollen’s story with everyone who asks about his NC State CVM T-shirt.

“When I’m out in public, people will be like, ‘Hey, did you go there?’ And I’m like, ‘Nope, but my dog did!’” he says. “I tell them, ‘If your pet needs specialized care, go to NC State.’”

Fefer took Hollen back to the ICU during her recheck in June so everyone could see her progress. Walls said she was delighted to witness her come full-circle.

“I saw Hollen at her worst and at her best,” she says. “Being able to see the extensive work and time we invest in our

patients have such a great outcome is so gratifying.”

Fefer says Hollen’s recovery demonstrates the life-changing results of collaboration between hospital teams, pet owners and referring veterinarians.

“It’s amazing to see what animals can bounce back from and how much of an impact we make for families like the Tovars,” he says.

And soon, an engraved brick along the path into the CVM will celebrate Fefer and team’s efforts for years to come: HONORING DR. FEFER YOU SAVED ME! LOVE, HOLLEN TOVAR

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RESEARCH PARTNERS

Working with USDA to Combat Deadly Pig Virus

In human medicine, the word “coronavirus” conjures images of masks, vaccines and nasal swabs. But in swine medicine, a different coronavirus causing gastrointestinal symptoms has plagued pig populations and stymied veterinarians for a decade.

Porcine epidemic diarrhea virus, or PEDV, is a highly infectious microbe that causes severe diarrhea and vomiting in pigs. It has a mortality rate of between 50 and 100 percent in infected piglets but generally is not fatal in adult hogs, the U.S. Department of Agriculture notes.

A single outbreak can cost a swine farm upward of $600,000, NC State food animal epidemiologist Dr. Gustavo Machado says. As the third-largest pig producer in the U.S., North Carolina is all-too-familiar with the virus’ cost.

Now, supported by a nearly half-million-dollar grant from the USDA, NC State College of Veterinary Medicine researchers are launching the largest study of its kind focusing on a likely culprit of the virus’ spread: possibly contaminated vehicles.

The NC State team will track vehicles hauling pigs, feed and other materials between swine facilities across Eastern North Carolina, swabbing the trucks and trailers at wash stations for evidence of the virus to

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By Katie Rice

assess how effectively these vehicles are being disinfected between stops.

“Veterinarians in North Carolina’s swine industry have identified PEDV as a major problem,” says Dr. Juliana Bonin Ferreira, the study’s primary investigator. “PEDV can be spread pretty easily and cause a lot of losses for state and national swine industries, because where we have pigs, we have PEDV. We are trying to help them identify a critical point of transmission and overcome and minimize that spread, which minimizes their economic losses.”

The team on the two-year study — Bonin Ferreira, Machado, forensic scientist Dr. Kelly Meiklejohn and virologists Dr. Barb Sherry and Dr. Michael Rahe, plus their labs’ staff — aims to recommend best practices for disinfecting vehicles between farms and provide an epidemiological model of how other porcine viruses could be transmitted between hog populations.

They were awarded the funding through a USDA program dedicated to preventing the spread of foreign animal diseases, like the extremely contagious African swine fever, in the United States. African swine fever, or ASF, has not yet been recorded domestically but is fatal and has no known treatment or

vaccine.

“Essentially, if we can prove that the decontamination protocol of these vehicles is effective for PEDV, it’s likely going to be effective for ASF,” Bonin Ferreira says.

Between October 2023 and May 2024, when infections from the typically seasonal virus are at their peak, team members will swab various parts of the vehicles, including the animal trailer, the tires and the driver’s floorboard, before and after they are disinfected. The group will collect around 3,500 samples from 49 vehicles.

Meiklejohn’s lab will process the samples, looking for viral RNA signaling PEDV’s presence. This method is similar to how qPCR tests detect traces of COVID-19, Meiklejohn says.

But just as people with COVID can continue testing positive for the virus after they’re no longer contagious, these samples could test positive for PEDV that has stopped being infectious.

That’s where Sherry’s lab comes in: Her group looks for evidence of infectious virus in samples taken from PCR-positive vehicles to see whether the hog facilities’ disinfection procedures are removing the actual contagions.

Machado’s lab then combines that data with information from GPS

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PHOTO BY JOHN JOYNER/NC STATE VETERINARY MEDICINE

By studying the role unclean vehicles might have in transmitting a swine coronavirus, researchers help boost North Carolina’s food animal industry and support federal agencies in fighting other devastating diseases.

trackers on 410 trailers paired with the vehicles to trace the origins of PEDV outbreaks and model where and how it is spreading.

As part of the study, researchers are also testing two different vehicle disinfectants in two concentrations each to determine which kills the virus most effectively.

Machado previously created an algorithm predicting where PEDV outbreaks would occur and tracked the role of vehicles in spreading swine diseases.

He says the NC State team’s research is happening at a necessary time: The low price of pigs this year means farms will have fewer resources to combat viral epidemics.

“By working to reduce the infections of this disease, we’re not only impacting PEDV itself, we’re impacting

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“Team science is how we move things forward. I love the opportunity to be involved in something that has a very real application right now.”

— Dr. Barb Sherry the whole health of the herd,” Machado says. “We’re using PEDV as an example of a viral infection, but making our overall recommendations for disinfection will impact the whole health of all farms.”

The team’s researchers with backgrounds outside of swine medicine, Meiklejohn and Sherry, say the study demonstrates NC State’s commitment to cross-disciplinary research with wide-ranging impact.

“It’s exciting to get the opportunity to do research that could be benefitting

not only veterinary medicine, but our key industry stakeholders here in North Carolina,” Meiklejohn says. “And it’s really great to have this federal funding and continue building our relationship with the USDA.” Sherry, who heads the College of Veterinary Medicine’s Department of Molecular Biomedical Sciences, says she is grateful NC State recognizes the importance of collaborative research and enthusiastically supports it through its Integrative Sciences Initiative.

“This is where science is these days,” she says. “Team science is how we move things forward. I love the opportunity to be involved in something that has a very real application right now, and I’m learning every time I talk to my colleagues.”

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Dollars In, Excellence Out The NC State College of Veterinary Medicine has a significant impact on the state’s economy in critical and diverse ways.

PHOTOS BY JOHN JOYNER/NC STATE VETERINARY MEDICINE

By Katie Rice and Burgetta Eplin Wheeler

In the 40 years since the NC State College of Veterinary Medicine dedicated its main facility, the college has repaid the state’s continuing investment by becoming a generator of graduates schooled in the latest cutting-edge care and a hub of transformative research into animal and translational medicine.

Though the full impact of each veterinarian’s legacy is impossible to quantify, our nearly 3,500 veterinary graduates have gone on to improve the lives of countless animals and their loved ones across the state, country and world.

The majority of NC State CVM graduates choose to stay and practice in North Carolina. At least 80% of students in each class are from North Carolina, and about 60% of them remain in-state when they graduate, giving back to the communities that gave them their foundation.

Soon, there will be even more NC State-trained veterinary doctors to help fill a national shortage and to support

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North Carolina’s economy after state lawmakers this year approved increasing each class size from 100 to 125 students.

Many North Carolinians know the CVM from trusting its world-class veterinary hospital with their pets’ care. Nearly 60% of North Carolina households have pets, and over 30,000 animals – dogs and cats, plus birds, horses, rodents, reptiles and more – come through the NC State Veterinary Hospital each year.

But pets are just the start. From farms to fisheries, stables, zoos and research labs, NC State veterinarians and clinician scientists have a hand in caring for nearly every type of animal that calls North Carolina home, contributing to the state’s economic output in myriad ways.

“We are the veterinary school in the state of North Carolina,” says Dr. Barb Sherry, head of the Molecular Biomedical Sciences department. “We are training the workforce that helps

safeguard not only our food animals but also the pets that are our companions and help us with our health and well-being. That is a big mission.”

RAISING HEALTHIER FOOD ANIMALS

NC State’s research, diagnostics, hospital care and veterinarians help power North Carolina’s food animal industry, which produced $13.3 billion in farm cash receipts in 2021.

Nearly 70% of these cash receipts came from livestock, dairy and poultry production. The vet school excels at research into improving these industries and trains the veterinarians looking out for these animals’ welfare.

Dr. Harrison Dudley is a member of NC State’s DVM class of 2012 and a former clinical professor at the College of Veterinary Medicine, focused on beef cattle production and medicine.

Now an associate veterinarian with Livestock Veterinary Services in Kinston, one of the largest food animal-focused practices in Eastern North

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Carolina, Dudley still specializes in beef cattle but works with all types of livestock across the state. A typical day could take him to farms from the mountains to the coast, or from the Virginia border to the South Carolina border.

“Some of our biggest state revenues come from animal protein generation,” Dudley says. “When I went to vet school, being born and bred in North Carolina, I wanted to make an impact on my community, and I decided this was my way of doing that. I’m trying to put food on the American family’s plate and keep animals healthy along the way.”

Farm animal medicine is a small specialization with high demand, Dudley says. Farmers statewide rely on him for their herds’ health, and he would not be equipped to assist them without the education, mentorship and

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connections that he gained at NC State.

“I didn’t know anything about cows until I got to NC State, but the College of Veterinary Medicine encouraged and inspired my drive to work with food animals,” he says. “The faculty are very good at facilitating experiences and fostering relationships. Having the connections, both internationally and domestically, that the CVM professors had when I was going through is what got me to where I am today.”

Swine-focused veterinarians are a necessity in North Carolina, given that the state has the third-largest hog population in the nation – 8 million pigs in September, per the USDA. Many of those responsible for ensuring the health and safety of the nation’s pork supply are NC State graduates. Dr. Glen Almond, professor of

swine health and production management, estimates alumni oversee about 33% of the United States’ total pork production, based on breeding sow numbers at alumni-tended facilities.

The CVM’s swine experts work closely with veterinarians in the hog industry to identify and solve problems affecting pigs state- and nationwide.

One example is an ongoing USDAfunded research study into porcine epidemic diarrhea virus, headed by Dr. Juliana Bonin Ferreira, clinical assistant professor of swine health and production medicine.

“When we join our forces, we can work together to give them some answers,” she says. “And we also have swine-oriented students completing externships or internships at these farms, spending time learning in the

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industry, so it’s a two-way road.”

Epidemiologist Dr. Gustavo Machado is frequently contacted by swine production companies across the U.S. for his work modeling infectious diseases, including the devastating African swine fever. His lab is currently running projects in 18 states.

“Together with the other folks working with swine at the CVM, we make a huge contribution to increasing and improving the health of hog populations,” he says of his lab. “We help the industry build their biosecurity plans and support traceability, so in the case of an emergency we’re able to trace disease movements effectively and be able to actually stop it from spreading further.”

Poultry and eggs make up the single-largest share of North Carolina’s farm cash receipts, and our poultry experts are focused on nurturing healthier flocks at home and abroad.

Assistant professor Dr. Ravi Kulkarni recently received a nearly half-million-dollar grant from the USDA to develop the first vaccine to prevent clostridial dermatitis, an increasingly severe and often fatal disease in turkeys.

OPPOSITE PAGE:Veterinary students feed the newest additions to the CVM dairy herds.

BELOW : NC State alumni Dr. Harrison Dudley is a livestock veterinarian in Eastern North Carolina. “When I went to vet school, being born and bred in North Carolina, I wanted to make an impact on my community, and I decided this was my way of doing that.”

large animals is so important, lawmakers approved a $70 million appropriation for expanding the college’s Large Animal Hospital and including a new Equine Veterinary Center in their latest budget.

“Horses are a critical part of the agricultural industry here, as well as important family members for many people throughout the state,” says Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. “The NC State College of Veterinary Medicine has been proud to provide critical medical care for these animals when they need us most. This facility also will allow us to provide better care for goats, sheep and cows, too.”

CASTING A WIDE NET

North Carolina’s commercial fishing industry brought an estimated $300 million to the state in 2021, providing over 5,500

THE EQUINE INDUSTRY

North Carolina’s horse industry has a $2 billion impact statewide, and NC State has been at the forefront of equine care since the beginning.

Our equine center was established in the 1980s and features state-of-theart imaging equipment including 3T MRI – the highest-quality MRI machine available – a standing CT new this year, nuclear scintigraphy, ultrasound and endoscopy equipment as well as cutting-edge surgery equipment. Because the care NC State provides the state’s

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jobs for fishers, retailers, restaurateurs and more.

Marine ecosystems are essential to North Carolina’s economic and environmental health, and the NC State College of Veterinary Medicine supports their well-being through its research and training facility called the Center for Marine Sciences and Technology in Morehead City. This coastal classroom also guides students in caring for the breadth and depth of aquatic life.

“At CMAST, we have faculty who are engaged in research, in commercial fisheries, toxicology, food processing and across the board,” says Dr. Tal BenHorin, an assistant clinical professor and an aquatic pathologist. “CMAST is very much involved in applied strengths, applied research, in natural resources and conservation. We work in fisheries, coastal health, beach toxicology and commercial fishing, both here near the coast and even offshore.”

Ben-Horin specializes in helping the shellfish industry, particularly oysters, a nearly $7 million industry in 2021 and a favorite in North Carolina.

“We’ve seen a massive shift in the state to aquaculture, and oysters are at the top of the list,” Ben-Horin says.

“There’s a market for it, there’s demand, and people want to produce them.”

Unfortunately, a lot of coastal oyster farms, which rely on seed oysters produced in regional hatcheries, experience “mortality events,” and Ben-Horin studies why. Some oysters transplanted from the unique environments of regional hatcheries can struggle to adapt to the isolated environment of coastal sounds, he says.

Ben-Horin’s research focuses on oyster breeding and understanding their pathology, including what carries across the genetic line.

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“CMAST is very much involved in applied strengths, applied research, in natural resources and conservation. We work in fisheries, coastal health, beach toxicology and commercial fishing, both here near the coast and even offshore.”

— Dr. Tal Ben-Horin “Like any new fishery or aquaculture or agriculture, when you do something new, you’re going to learn new things,” he says. “The ultimate goal is to develop genetic lines that work really well in North Carolina.”

WILD ABOUT ANIMALS

Our passion for all members of the animal kingdom also drives us to help conserve native species and protect those that now reside in North Carolina.

NC State CVM graduates support the animals of North Carolina’s zoos, aquariums and science and nature centers that contributed to a record-shattering $33.3 billion total spending by domestic and international visitors to North Carolina in 2022.

Dr. Tara Harrison, associate professor of zoo and exotic animal medicine, is among the faculty members who have cared for zoo animals at the NC State Veterinary Hospital and on field calls. She says zoos count on the CVM’s expertise and advanced technology when their animals are in need.

“CVM faculty are also actively involved in national organizations that support zoo and aquarium animals and are publishing and presenting new research regularly for these animals,”

she says. “Additionally, the CVM has a residency program that is educating future leaders of the zoo, exotics and aquarium veterinary field.”

NC State alumni are the lead veterinarians at the North Carolina Zoo, the North Carolina Aquariums at Fort Fisher and Pine Knoll Shores, the North Carolina Museum of Natural Sciences and the Greensboro Science Center.

Faculty members also help care for the animals at the North Carolina Museum of Life and Science.

The college also plays a vital role in helping save critically endangered species on campus grounds. NC State faculty and students care for a captive pack of red wolves in partnership with the Saving Animals From Extinction program.

Fewer than 30 red wolves live in the wild, all on the North Carolina coast, and the Carnivore Conservation Crew works to breed and prepare members of our red wolf pack to join their numbers. NC State also cares for injured wild wolves and those living at our partner agencies, the Museum of Life and Science in Durham and the North Carolina Zoo. “The NC State CVM is very involved in the care and conservation of wildlife in North Carolina, including protecting the most endangered canid in the world,” Harrison says. “Additionally, our Turtle Rescue Team cares for and rehabilitates hundreds of turtles, snakes and amphibians per year for re-release into their natural habitats.”

MAKING RESEARCH BREAKTHROUGHS

Innovation is at the heart of everything we do at the NC State College of Veterinary Medicine, and every day our researchers make strides to improve animal and human health globally. Our

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LEFT: NC State alumni are the lead veterinarians at the North Carolina Zoo, the North Carolina Aquariums at Fort Fisher and Pine Knoll Shores, the North Carolina Museum of Natural Sciences and the Greensboro Science Center. This turtle was seen at the NC aquarium at Fort Fisher.

100,000-square-foot college Research Building includes state-of-the-art facilities for research teams, as well as BioSafety Level 3 lab for investigations into infectious diseases.

Our faculty researchers, research technicians and graduate students address critical issues in biomedical, agricultural and biological sciences through a variety of experimental approaches and techniques, ranging from basic discovery in molecular biology to application of new technology in the veterinary teaching hospital or the state livestock industry’s herds and flocks.

These innovators guide leading-edge studies in genomic sciences, gene therapy and vaccine development and cultivate diagnostic tests, new cancer immunotherapies and genetic research to prevent diseases in these populations. Our biomedical

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researchers collaborate with national and international organizations to advance cures for animal and human diseases including cancer, lung disease and more. Our campus is one of 18 centers worldwide that collaborate with the World Health Organization on researching antimicrobial resistance and supporting the organization’s programs.

And, yes, our scientists’ work improves pets’ lives, too.

One recent study exploring whether low-dose radiation therapy could relieve the painful symptoms of feline idiopathic cystitis was so successful that clinicians immediately started offering the treatment to cats at the NC State Veterinary Hospital.

A LEGACY OF EXCELLENCE

The success of the NC State College of Veterinary Medicine leads to inspired

and thankful community members, who in turn donate to the school. The NC State CVM has received over $231.4 million in private donations since 2016, with 91% coming from grateful clients of our veterinary hospital.

Every dollar goes toward training the next generation of veterinary healers and providing the resources for research that changes lives in the literal field and at home.

“By training the veterinarians in this state, we touch everybody,” says Sherry, the MBS department head. “‘Economic impact’ doesn’t just mean ‘food animal.’ When you talk about somebody’s ability to come home at the end of a hard day and have a wonderful pet that gives them companionship and reduces their stress, they’re ready to go in that next day and give everything they have. That’s economic impact.”

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S TAT E B U D G E T N E W S

$70 Million for Large Hospital, New Equine Center In their budget approved in September, North Carolina lawmakers included $70 million for expanding and renovating the college’s Large Animal Hospital to include a new Equine Veterinary Center to better serve horses and livestock.

The budget also includes money to increase the number of students the college can accept in each veterinary class.

“We are so grateful for the support of the state of North Carolina as we move forward with this important construction project,” says Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine. “This new funding will allow us to provide cutting-edge care in a cutting-edge facility and to make sure our trainees know and have access to the most modern techniques as we continue to serve our community.”

With our research, diagnostics, hospital care and graduates in the field, the NC State College of Veterinary Medicine supports North Carolina’s food

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animal industry that contributed to the state’s $13.3 billion farm cash receipts in 2021. Almost 70% of the receipts involve livestock, dairy and poultry production.

“We are thrilled to see the Large Animal Hospital expansion gain budgetary approval,” says Dr. Anthony Blikslager, new director of Veterinary Medical Services. “This could not come at a better time. We have been working toward developing state-of-the-art facilities over the last 20 years, and now we routinely fill our facility with patients from all over North Carolina. We desperately need new facilities for critical care and for managing patients from disease outbreaks from across the state.”

North Carolina’s equine industry adds more than $2 billion to the state’s economy each year and employs more than 25,000 people. Meurs says the new Equine Veterinary Center will allow NC State to continue playing its pivotal roles in providing

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OUT BACK

specialty equine care on campus and training the majority of veterinarians who are central to the health of the more than 250,000 horses in the state.

“Horses are a critical part of the agricultural industry here, as well as important family members for many people throughout the state,” Meurs says.

“The NC State College of Veterinary Medicine has been proud to provide critical medical care for these animals when they need us most. This facility also will allow us to provide better care for goats, sheep and cows, too.”

OUT OF SPACE NO MORE

Large numbers of farm animals mean NC State’s Veterinary Hospital stays busy, often with limited room to accommodate additional animals in need.

“Our Farm Animal Service was one of the busiest large animal services over the past year, and we have outgrown our facility and don’t have enough space to see the patients who come to us on a daily basis,” says Dr. Derek Foster, associate professor of ruminant medicine. “We need more stall space. We need more space to treat the animals, both cattle and goats — not to mention the sheep and alpacas and llamas that North Carolinians have.”

Additionally, the state budget granted approval for the College of Veterinary Medicine to increase the size of its incoming classes from 100 to 125 veterinary students per year.

“One of the most common things that we hear from friends of the College of Veterinary Medicine, whether that’s pet owners or people in the agricultural industry, is how difficult it is for them to find enough veterinary care and veterinary expertise these days,” Meurs says. “Our ability to increase our class size is one small step in the right direction with that.”

At NC State, 80 percent of the students in each doctor of veterinary medicine class come from North Carolina.

“We know that approximately 60 percent of our students stay in North Carolina after graduating,” Meurs says. “So we’re very focused, and we’re very excited that through growing our class size we’ll be bringing more students directly back to the state.”

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GIVING FARMERS A HAND

Increasing the College of Veterinary Medicine’s class size helps NC State tackle the veterinarian shortage in rural areas, which are particularly hard-hit by staffing issues yet house the vast majority of North Carolina’s farm animals.

The CVM is expanding its outreach efforts in these areas to prospective students, many of whom are interested in returning to their home communities to practice medicine.

“Since the needs for veterinarians in those areas are so great, we really are increasing recruitment strategies for working with regional universities and community colleges in more rural areas to encourage their students to think about veterinary medicine and for them to feel this is an accessible and incredibly rewarding career,” Meurs says.

The expansion of the Large Animal Hospital also will allow the college to better train students for those rural roles.

“We need more practitioners in nonurban areas, and our students are integrated into our veterinary services,” Foster says. “They get an opportunity to get hands-on training with cattle and small ruminants here in the teaching hospital, and they also get field experience with cattle, goats, pigs and poultry so that they are prepared to go out and serve our state’s agricultural areas.”

The General Assembly established the NC State College of Veterinary Medicine in 1978. The college admitted its first class of DVM students in August 1981 and graduated its first class of veterinarians in May 1985. The college dedicated its main facility in April 1983.

In the Large Animal Hospital at NC State, Dr. Derek Foster works on a bongo from the Virginia Zoo. Expanding the facility is critical, he says, to keep seeing all of the animals the college cares for.

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Helping Horses

NC State hosts training on assessing animals in danger

By Burgetta Eplin Wheeler As a sergeant for Cumberland County Animal Services, Christy Barber gets three or four calls a month from residents wanting her to check on haggard-looking horses, a number she says has been ticking up over the past couple years.

“We’re starting to get more cases, and I attribute it to the economy,” said Barber, a 15-year veteran of the agency and the only officer on staff who investigates equine and large animal abuse cases. “A lot of people have this mentality, ‘Oh, I always wanted a horse because I think they’re pretty,’ and they know absolutely nothing, and they jump in way over their head.

People now can’t afford the horses they have.”

When Barber saw that the NC State College of Veterinary Medicine and Reedy Creek Equine Farm were hosting an event to train law enforcement and animal control officers on identifying and handling equine abuse, she immediately signed up and drafted seven staff members as well.

The all-day training, organized by the Humane Society of the United States with NC State and the Raleigh Police Department as partners, drew more than 30 officers from across North Carolina. Joining the Cumberland County contingent were representatives from Raleigh and Anson, Chatham, Guilford, Johnston, Lenoir, Mecklenburg, Mitchell and Wake counties, among other places.

The event included presentations by Humane Society experts in a lecture hall on the College of Veterinary Medicine’s campus and hands-on learning with NC State equine experts and horses at NC State’s Reedy Creek Equine Farm.

“We are pulling from a lot of the state, which is really great,” said Gail Thomssen, the North Carolina state director of the Humane Society.

“Raleigh is a great location, and the vet school is phenomenal, and that people are willing to drive in for this event says a lot about how much it

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was needed.”

Numerous agencies had asked Thomssen when the Humane Society, which offers seminars on feline and canine abuse, could hold similar training on how to assess and handle horses.

“Officers see equine cruelty, and they don’t have the knowledge to investigate or know what questions to ask, what they should be looking for and how to apply the laws,” Thomssen said. “They don’t know the standards of care, the feed, what horses should have, and they want to.”

HERE FOR THE COMMUNITY

Thomssen was riding her bicycle along the Reedy Creek trail in Raleigh when she saw a sign for NC State’s Reedy Creek Equine Farm. She started wondering whether NC State would be interested in providing the space, the horses and some extra expertise to train officers in horse handling.

A couple of emails and calls later, she had her answer: NC State would love to help.

“It’s wonderful because that’s what we want, for the community to feel that we are here to help them,” said Dr. Kate Meurs, dean of the NC State College of Veterinary Medicine.

“We’ve made it one of the goals of our strategic plan to be even stronger partners and expand our relationship with shelters, with public service organizations, with any group that might need our expertise or that might offer opportunities for our own trainees.”

At the event, Humane Society experts shared information

The all-day training, organized by the Humane Society of the United States with NC State and the Raleigh Police Department as partners, drew more than 30 officers from across North Carolina.

on how to identify health concerns and common conditions in horses and how to document critical evidence, prepare for investigating cases and interpret laws as they relate to equine cases.

In the afternoon, attendees moved to the horse farm, where NC State equine experts including Dr. Allison West demonstrated general horse behaviors and herd dynamics at feeding time to show the importance of safe equipment and ample space. Participants learned how to halter and lead a horse, to catch and lead in emergency situations and to identify basic equine anatomy.

West shared with the officers how to tell whether a horse is in immediate or no danger and everything in between.

Maybe a horse could use some weight, but it recently had a foal or it works six days a week, she said. Maybe owners don’t understand that an average horse drinks 30 gallons of water a day or that it won’t touch food that’s the least bit moldy because horses can’t vomit.

“There’s a real need for law enforcement to be trained because not everybody has the best intentions,” West said. “We’re teaching them how to assess these horses and how to help owners. Sometimes it’s not willful. They just don’t know: ‘Does the horse need medical care? Or does the owner need education?’ It’s not all doom and gloom.

Sometimes we’re helping them help people.”

‘I’M ALL ABOUT LEARNING’

West and the equine staff encouraged the officers to get hands-on with the horses by feeling them and labeling the docile animals’ anatomy with sticky notes. A trainer later said the latter exercise was designed to let the officers get accustomed to being close to what can be unpredictable animals.

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“I’m glad we got to do that,” said Ciara Reband, an officer with the Cumberland County Animal Services.

“It was intimidating for me.”

Even with her experience assessing large animals in Cumberland County, Barber said she was eager to see what she could take away from the training.

“I’m all about learning,” she said as her square-toed boots churned up the rocks on a path through the Reedy Creek Equine Farm. “Every person and every organization does something different. Some of our folks have never laid hands on a horse so this is good training for them. And the more we can do for them, the better we can serve our community.”

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Participants learned how to halter and lead a horse, to catch and lead in emergency situations and to identify basic equine anatomy, among other things.

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COMMUNITY PARTNERS

New Emergency Equine Service an Immediate Success

By Burgetta Eplin Wheeler By all accounts, the pilot Ambulatory Equine Emergency Service that the NC State College of Veterinary Medicine began offering July 14 has been a mission-fulfilling marvel.

The service is addressing a desperate community need by supporting area equine practices, increasing emergency medical experience for veterinary students and proving that a subscription-based financial model is viable enough to possibly expand the critical service later.

It’s also more than satisfying horse owners, such as Toni H., whose mare

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had a lameness emergency on the first day of the partnership. When she called her local veterinarian’s emergency number, she was connected with the NC State emergency service doctors, who arrived within 30 minutes.

“They texted me along the way letting me know what their ETA was,” Toni said in a Facebook post. “This was a wonderful experience all the way around. And I have to add that the charge for an early Saturday morning call was extremely reasonable! I, as a personal horse owner and as the Horse Coordinator for Helping Horse, feel very confident in this partnership and know that my horses will have excellent care 24/7.”

NC State, a leader in equine medicine, has wanted for years to offer local equine veterinary

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practices help with covering emergency hours.

Having to be on-call during nights and weekends is one of the No. 1 reasons that equine veterinarians leave the profession and that veterinary students don’t choose it. Having a state-funded university provide the help, though, required that the service at least break even.

“What is new this time is the subscription component of this initiative,” says Dr. Callie Fogle, clinical professor of equine surgery, who shepherded the project through the necessary bureaucratic steps. “We’ve entered into agreements with three local practices that pay a monthly fee to have emergencies covered by the NC State Equine Ambulatory Emergency Service. It was finally financially feasible for the CVM to take this on.”

Fogle says she saw the idea in an article in The Chronicle of the Horse about an equine emergency-only practice in Louisville, Kentucky, and engaged practices within 40 miles of the NC State campus in Raleigh to see who might be interested in a pilot project.

“We wanted to keep the commitment from everyone reasonable and make sure we could successfully provide excellent service on a small scale before growing it or offering it to all practices in the area,” she says.

MORE THAN 100 CASES

After NC State College of Veterinary Medicine Dean Kate Meurs approved the project, the college hired two of its Ph.D. students – Dr. Emily Hellstrom and Dr. Elsa Ludwig, who already had specialized training in equine veterinary medicine – to start covering 50 percent of emergency hours for the three practices.

In October, the college also hired Dr. Amanda Silva, a full-time working equine veterinarian with 10 years of equine experience, to take over the other half of the off-hours coverage. Between July 14 and the end of September, the NC State veterinarians have gone out on 60 emergency cases and handled more than 50 consultation calls.

Dr. Bob Meyer owns Neuse River Equine Hospital, one of the practices participating in the pilot, and he is simply ecstatic by the win-win-win

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nature of the service.

“I’ve been on call in one form or another since 1984,” says Meyer, whose practice in Wendell, North Carolina, has about 1,200 clients. “Not being on call is an amazing feeling. You can go to dinner at a nice place and not worry about getting interrupted. I’m used to eating fast-food just in case. It changes your whole outlook on your evenings and weekends.”

After graduation, equine veterinarians face many challenges to making equine practice a lifelong career, one of which is trying to maintain a healthy work-life balance. Emergency and on-call expectations force equine veterinarians to constantly choose work over family and contribute to burnout in the profession, Fogle says.

Only 5 percent of veterinary graduates are interested in equine medicine and only half of those still specialize in horses five years later, Meyer points out.

“Being able to say you’re going to have less on-call duty is going to be huge for us when it comes to hiring quality people and keeping them for the long run,” Meyer says. “A lot of new graduates want to have a family, want to have a life outside of work, and having little emergency duty or no emergency duty ideally makes that balance between work and life a bit better.”

FILLING A COMMUNITY NEED

Meyer also cites the emergency experience veterinary students will get as they go out on calls with Silva and with Hellstrom, whose Ph.D. focus is on researching how to improve postoperative outcomes for equine colic patients, and Ludwig, a board-certified large animal surgeon working on a Ph.D. and researching tissue viability following a severe intestinal injury.

“It’s a small percentage of the cases we see that we have to refer to the teaching hospital, but those are the only ones the students see,” Meyer says. “This is a great opportunity for them to see other kinds of emergencies that aren’t critical care but can’t wait until 8 a.m. Students will be better prepared when they go out into the field, because they’ll be able to see the emergencies that aren’t catastrophic enough to make it into the hospital.”

Fogle says the NC State College of Veterinary Medicine also is thrilled about how well the service is working for everyone involved.

“The driver to start with most definitely was the community need to find a sustainable way to cover an emergency,” she says. “But the education of the students is a great opportunity and one of the reasons that vet schools are uniquely positioned to do something like this. It addresses a critical community need and gives students valuable experience.”

Expanding the service next year to solo equine veterinarians and other practices is the goal, says Fogle, who hopes to find flexible ways for the service to accommodate smaller practices and practices that see more than just horses.

“If it wasn’t for Dr. Fogle, it wouldn’t have gone anywhere,” Meyer says. “Her support staff has done their share of the work, too. Dr. Fogle has done a patient and thorough job of getting this done, and we couldn’t be happier.”

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T H E N E X T G E N E R AT I O N

Scholars Program Fosters Food-Focused Future Vets Through its Food Animal Scholars initiative, the NC State College of Veterinary Medicine equips veterinarians-in-training to produce healthy food that nourishes and fuels North Carolina.

PHOTOS BY JOHN JOYNER/NC STATE VETERINARY MEDICINE

By Katie Rice

When Kinnidy Coley started college at North Carolina Agricultural and Technical State University in 2016, she knew her future involved caring for food animals.

She had chosen NC A&T for its Animal Sciences program, hoping to continue working with farm animals like she had done through the National FFA Organization in high school.

Plus, she recognized that the Food Animal Scholars program, an NC State offering run in collaboration with NC A&T, granted qualified students early admission to the NC State College of Veterinary Medicine and could help her kickstart her interest in becoming a food animal veterinarian.

Coley was named a Food Animal Scholar in spring 2019. Now a thirdyear student at the NC State College of Veterinary Medicine, she says the program connected her with mentors and internship opportunities that prepared her to excel at the CVM while still an

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undergraduate and enriched her animal education as she earns her DVM. “There’s a lot of need for more food animal veterinarians, and this program helps in filling that need by helping students find pathways in their pre-vet and veterinary studies,” Coley says. “It helps support that next generation.”

The Food Animal Scholars program, now in its 20th year, was designed to do just that: Give top-notch undergraduate students studying animal or poultry science the resources to pursue that passion within veterinary medicine, says Dr. Glen Almond, program committee chair.

Interested NC State and NC A&T students apply in the fall of their undergraduate junior year.

“We’re graduating veterinarians that are truly dedicated to food animal production and the poultry industry in North Carolina,” says Almond, a professor of swine health and production management. “And we’re trying to

produce enough veterinarians to oversee the health and welfare of livestock production: the animals’ health depends on their vets, and that’s what we’re supplying.”

Food animal veterinarians make up a small percentage of U.S. veterinarians in clinical practice, but they play a key role in ensuring the welfare, health and safety of livestock in North Carolina and nationwide. Just 3.9% of U.S. vets are food animal-focused, according to the American Veterinary Medical Association.

The CVM has graduated over 100 Food Animal Scholars so far, Almond says. Graduates have gone on to lead production at big-name swine farms across the U.S., found their own large or mixed animal practices helping individual farmers, and work for state and federal government food safety inspection programs, among other careers.

Dr. Derek Foster, a Food Animal Scholars program mentor and committee

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member, says he has seen previous scholars now with their own practices hire younger graduating scholars.

Agriculture, including animal production, is the largest industry in North Carolina’s economy, he says, and few states have the same diversity of food animals. These veterinarians are critical for North Carolina’s farmers to be successful and for consumers to have confidence that their food is safe and comes from animals that have led good, healthy lives.

“The College of Veterinary Medicine has an obligation to support our livestock owners in the state of North Carolina,” Foster says. “That is a key mission of our college. As the food animal industries have changed, the needs of those producers are changing.

And so by being able to identify these

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“The Food Animal Scholars Program advisers are phenomenal for helping students find their pathways into what they want to do and what they like.”

— Kinnidy Coley, below students early in their education, it helps us give them the skills they need to be valuable to the changing animal agriculture in the United States.”

NC State offers a Food Animal Production Medicine focus area open to all DVM students, but those in the Food

Animal Scholars program start specializing early. Scholars are required to do a food animal-focused summer internship between their junior and senior years of undergrad, Almond says.

The program is a joint effort between the NC State College of Agriculture and Life Sciences and the College of Veterinary Medicine.

Faculty from those NC State colleges and NC A&T’s College of Agriculture and Environmental Sciences select six scholars each year, with a preference for at least one swineand one poultry-focused student in each cohort, to be granted admission to the College of Veterinary Medicine.

“As a veterinary community, we are serving a diverse population, and so ensuring that our professionals are also coming from diverse backgrounds

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PAGE 34: Dr. Derek Foster conducts a dairy lab at the Teaching Animal Unit on the NC State College of Veterinary Medicine campus. LEFT: Veterinary students participate in a poultry lab.

and can work with diverse populations is going to be key,” says Dr. Andrea Gentry-Apple, a coordinator of veterinary education at NC A&T. “And so A&T plays a large role in recruitment within the Food Animal Scholars program.”

Gentry-Apple is a former Food Animal Scholar from the class of 2015.

She applied while studying Animal Science at NC A&T, and she shares her own experiences in the program when advising interested students.

“I enjoyed being able to expand my knowledge from different practitioners around the country, and being a Food Animal Scholar allowed me to go out and experience what real-world medicine looked like,” says Gentry-Apple, who completed a large animal rotating internship at Tuskegee University in

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Alabama after earning her DVM. As Coley’s pre-vet adviser at A&T, Gentry-Apple encouraged her to apply to the program.

Coley, who had worked primarily with poultry in high school, developed an interest in small ruminants during college and entered the Food Animal Scholars program wanting to work with goats and sheep.

That led to her completing an animal husbandry internship at Purina, where she spent a summer raising baby goats.

“The Food Animal Scholars program advisers are phenomenal for helping students find their pathways into what they want to do and what they like,” Coley says. “Especially when you get to vet school, there’s a ton of

opportunity for exploration into different career fields.”

Now an experienced scholar, Coley serves as a program representative for interested students, supporting them just as Gentry-Apple and others did for her.

“There are only two land-grant schools in the state, North Carolina A&T and NC State, and the Food Animal Scholars program forms an awesome partnership between them,” she says.

“We’re combining the powers of the two schools to train future agriculture veterinarians and improve state agriculture together.”

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ALUMNI PROFILE

Veterinary Medicine, Done ‘Taylor’s Way’

By Katie Rice

Dr. Taylor Gregory is the first to admit she has done everything “Taylor’s way,” by forging her own path and stubbornly sticking to it, yet she is usually the last to realize when she has changed course.

As the Greensboro Science Center’s vice president of animal health, Gregory is the sole veterinarian in charge of the complex’s zoo and aquarium menagerie. But despite her affinity for wildlife, the NC State College of Veterinary Medicine Class of 2021 alumna almost didn’t pursue exotic medicine.

She entered veterinary school with a declared mixed animal focus, hoping to eventually start a mobile practice for dogs, cats and horses. The call

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to work with wildlife grew stronger in student clubs, and she soon felt most at home in the red wolf pens of NC State’s Carnivore Conservation Crew and the tanks of its Turtle Rescue Team.

The summer after her second year, while driving back from her second trip to the Chattanooga Zoo in as many weeks to examine a snow leopard, she had a revelation. She had already spent her winter break on a multi-state, multi-zoo “Snowleopardpalooza” trip to see the big cats.

“I looked at the classmate I had gone with, and I’m like, ‘This summer, I have spent five days on a boat with the South Carolina Department of Natural Resources, pulling up sea turtles for research and releasing them, and we have driven 30 hours to ‘play’ with a snow leopard; why the heck am I telling everybody that I want

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OUT BACK

to do small animal medicine?’” Gregory recalls, laughing.

“And she’s like, ‘Taylor, everyone else has known this since Day One,’” she continues. “It just took me realizing that I need to stop being stubborn.”

Gregory, 28, has continued blazing her own route through zoological medicine, a trail marked by the COVID-19 pandemic and other setbacks but defined by her drive and determination.

FINDING A BALANCE

Gregory decided she wanted to be a veterinarian at age 2.

She split her childhood between the Charlotte area and California before settling in Raleigh for college, studying biological sciences with a minor in outdoor leadership at NC State.

Her pre-vet prep included working at small animal and wildlife hospitals and shadowing equine veterinarians. In college, Gregory occasionally put veterinary medicine on the back burner to work on a high ropes course, assistant teach a rock-climbing class and study abroad in Australia.

“I don’t know that I would recommend people do the route to vet school that I did, because it was very risky, but it worked for me,” Gregory says. “I got a lot more life experience. That’s actually helped me in zoo med, because sometimes you have to think about problems from outside a veterinarian’s perspective.”

As a DVM student, she served as president of the Carnivore Conservation Crew and the Wildlife, Avian, Aquatic and Zoological Medicine club and as a lieutenant on the Turtle Rescue Team. She also conducted research and authored a few published papers.

Yet one of her proudest accomplishments was starting the “What the DVM Am I Talking About?” lunch series, which featured professors ad-libbing presentations on a mystery topic for fun.

The COVID-19 pandemic emerged just before her fourth-year clinical rotations.

Students’ time within the Veterinary Hospital

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was condensed, and quarantining upended their schedules.

Gregory’s externship at the Omaha Zoo was canceled, too. She found another at the Greensboro Science Center, but COVID shortened it.

“Our class’ transition into the field was harder, but it’s going to make less and less of a difference as we move forward,” she says. “We learned how to be more resilient.”

Gregory did not match into a zoo and small animal rotating internship after graduation. She scrambled and ended up in Houston before matching into a year-long zoological medicine and surgical internship at the Fort Worth Zoo. Afterward, she entered the match for a residency but again did not place. She took this challenge in stride.

“There’s a stigma about people who don’t match not being successful, and I think that’s absolute crap,” she says. “I kind of knew I wasn’t gonna match into a residency, and I was very OK with that.”

She planned to pause before job searching, but then learned the Greensboro Science Center was hiring a veterinarian.

BRINGING THE PACK TO THE PIEDMONT

With the encouragement of Dr. Tara Harrison, an associate professor of exotic and zoological medicine and one of Gregory’s closest mentors, Gregory began working at the center in August, thrilled to return to North Carolina and her NC State support system.

“The GSC is a really good community of really good people who all really care about these animals,” Gregory says.

Glenn Dobrogosz, Greensboro Science Center CEO, says he’s proud to have another NC State-trained veterinarian on staff. Dr. Sam Young, Gregory’s predecessor, is also an alumnus.

“We could not be more excited to have Dr. Gregory on our team and to have such an amazing relationship with the university,” Dobrogosz says.

Gregory has quickly become acquainted with the center’s many residents, including mammals, birds, fish, reptiles and more.

She says her experiences at NC State and the Fort Worth Zoo prepared her to handle each species’ unique needs. She knows she can count on Harrison and the NC State community for challenging cases.

“I clearly remember when Taylor told me she wanted to become a zoo veterinarian,” says Harrison, who often works with the Greensboro Science Center. “It has been so exciting for me to have had Taylor as a student and now as a colleague to collaborate with and continue to teach future zoo veterinarians.”

Gregory says she learns best by following her interests and doing things firsthand. Nothing in zoo medicine prepares you to deal with a lunging tiger except having that experience, she says.

“We all have to find our own way into being a veterinarian,” Gregory says. “Every time I tried to match what someone else did, it didn’t work. So I just decided to do my own thing.”

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OUT BACK

Meet the Class of 2027

The NC State College of Veterinary Medicine’s Class of 2027 comes from all walks of life.

Students fresh from undergraduate degrees mingle with professionals pivoting to a new career, lifelong North Carolina residents meet newcomers to the state or country, and parents of human children swap stories with dog, cat, ferret and turtle moms and dads.

Regardless of their backgrounds, members of the newest cohort had at least two things in common as they began orientation: typical first-day-of-school jitters and a profound love for animals.

Students exercised the college’s core values of community, inclusivity, innovation and passion as orientation activities took them across campus, from classrooms to the anatomy lab and the Teaching Animal Unit farm. They partnered to balance balloons and form a human chain in team-building activities that Sarah Ho, director of student engagement, says were just as formative as they were fun.

“It’s not just school – this is a community,” she says. “We have a culture here, we have people from all different backgrounds, and we want them to feel like they can build a home here with each other.”

The group has an average age of 24.5 and includes 17 students from other states, territories or countries. At the NC State College of Veterinary Medicine, 80 percent of the students in each class are from North Carolina.

The majority of students plan to specialize in some form of small animal medicine, with mixed animal medicine being a close second followed by food animal medicine, zoological medicine and clinical sciences.

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NC STATE VETERINARY MEDICINE NC Veterinary Medical Foundation 1060 William Moore Drive, Raleigh, NC 27607 Give Now: Give online at cvm.ncsu.edu/giving.

Giving Office: 919-513-6660 Email: cvmfoundation@ncsu.edu The Oath is published by the NC State Veterinary Medicine Communications and Marketing office. Contact us at CVMCommunications@ncsu.edu

Make an Impact Your support helps save and change lives.

Generous donors like Mary Walton help us advance our work in education and discovery.

“Goat husbandry can be tricky in the wet, humid South, but the benefits have far outweighed the struggle, thanks to having a valued client relationship with Ruminant Health Management. I’ve seen firsthand the vital role ruminants play in the transition to regenerative agriculture. I proudly contribute to the NCSU CVM Ruminant Fund to promote their important and necessary ruminant research and to support their collaboration with all North Carolina farmers, large and small.” — Mary Walton 42

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