Keystone Veterinarian Spring 2022

Keystone

Spring 2022

Official Quarterly Publication of the Pennsylvania Veterinary Medical Association

An Introduction to the Veterinary Nurse Initiative and Where It’s Heading

Plant Team Seeds and the Hospital Grows p. 21

My CVPM Journey

p. 18

Comprehensive Specialty & Emergency Veterinary Care Founded in 1972, VRC (Veterinary Referral Center) was one of the first specialized veterinary hospitals in the country to offer advanced orthopedic surgery. Today, we offer a multidisciplinary team of specialists who are skilled at performing a range of sophisticated diagnostic, medical and surgical procedures.

Our comprehensive services include: • 24/7 Emergency & Critical Care • Advanced Diagnostics & Radiology • Anesthesiology & Pain Management • Avian & Exotics • Cardiology • Dentistry & Oral Surgery • Internal Medicine • Medical Oncology • Neurology with on-site MRI • Opthalmology • Physical Rehabilitation

We’re always looking for the best doctors and nurses to join our team!

Visit vrcmalvern.com/careers for more information.

• Radiation Oncology • Specialized Surgery To refer a client or consult with a specialist, please call 610-647-2950, email reception@vrcmalvern.com, or visit our website at vrcmalvern.com.

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HERE WE GROW AGAIN! And we have YOU to thank for it

Since we opened our doors in 2019, with a unique approach to advanced dentistry (board-certified veterinary dentist and board-certified veterinary anesthesiologist), we have experienced consistent growth due to your confidence in us for the care of your patients. For that, we profoundly thank you.

Our clients come from all walks of life and many from miles away. But what they all have in common, is a beloved pet with oral cancer or significant dental and anesthetic needs. We are honored to help, and our consistent 5-star online reviews show our commitment to concierge-level care and service.

To accommodate our growth, please join us in welcoming our new team member, Dr. Marissa Berman: DVM: Western University of Health Sciences, College of Veterinary Medicine in Pomona, California Internship: Long Island Veterinary Specialists, New York Emergency Medicine: Five years at a private practice Residency in Dentistry: Private practice in Northern California In her spare time, Dr. Berman can be found with her family, a dog Tater Tot, husband Mike, and twin sons, Tyson and Saxon – preferably doing something on the water.

VDS is the only referral practice in the nation dedicated to advanced dentistry and oral surgery for pets where a full-time board-certified veterinary dentist and a board-certified veterinary anesthesiologist are on staff to ensure the safest and most comfortable experience… and the best possible outcome.

John Lewis, VMD FAVD, DAVDC

Marissa Berman, DVM (Residency Trained in Dentistry)

Elizabeth Goudie, DVM MS, DACVAA

Stephanie “Bryce” Dooley DVM, MS, DACVAA

455 Old Baltimore Pike | Chadds Ford, PA 19317 | (484) 775-0557 | chaddsford@vdsvets.com | vdsvets.com Practices also in Mount Laurel, NJ and Katy, TX

Spring 2022

Keystone

Official Quarterly Publication of the Pennsylvania Veterinary Medical Association

Subscriptions: The Keystone Veterinarian is mailed to PVMA Members at no charge as a member benefit.

Subscriptions are available to non-members for $30/year or $10 for a single issue. Please contact Editor@PaVMA.org if you’re interested in receiving the Keystone Veterinarian magazine.

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Notice to Readers: Neither this publication, Hoffmann Publishing, nor PVMA assumes responsibility for material contained in articles and advertisements published, nor does publication necessarily constitute endorsement or approval of the advertiser, product, service or author viewpoint by the Keystone Veterinarian, its editors and publishers or the Pennsylvania Veterinary Medical Association. In addition, neither this publication nor PVMA guarantees the accuracy, reliability or completeness of any facts, views, opinions, recommendations, information or statements contained within this publication.

Reproduction in whole or in part is prohibited without the permission of the Pennsylvania Veterinary Medical Association.

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A Message from the President PVMA Team Talk Why I Teach The Animal Care PA Scholarship Fund Needs Your Help 2022 Keystone Veterinary Conference Highlights Staff Retention Learning and Leadership with PVMA My CVPM Journey AVMA House of Delegates Winter 2022 Session Report Plant Team Seeds and the Hospital Grows

w w w. H o f f p u b s. co m

The Pennsylvania Veterinary Medical Association is dedicated to ensuring the vitality of the veterinary profession by promoting excellence in veterinary medicine, advancing animal health and welfare, and protecting and enhancing human health.

Hoffmann Publishing Group Inc. 2669 Shillington Road, #438 Sinking Spring, PA 19608

8574 Paxton Street, Hummelstown, PA 17036 717.220.1437 | Info@PaVMA.org | PaVMA.org

For Advertising Information & Opportunities Contact:

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EXECUTIVE COMMITTEE President Erica Wolbramsky, DVM President-Elect Dawn Fiedorczyk, VMD Vice President Kate Boatright, VMD Secretary/Treasurer Lloyd Reitz, Jr., DVM Immediate Past-President Delinda Zehner, DVM Board Chair Darcie Stolz, VMD

22 I Was Born for Large Animal 25 28 30

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Veterinary Medicine 5 Questions Asked of Veterinary Technician Specialists Ouch! That Hurts!

Multimodal Pain Management An Introduction to the Veterinary Nurse Initiative and Interview with PA’s Veterinary Nursing Program Directors Practice Pearls Member News Classified Ads

BOARD OF TRUSTEES District 1 – Katie Sharp, DVM District 2 – Jody Kull, DVM District 3 – Andrea Carr, DVM District 4 – Sean Smarick, VMD, DACVECC District 5 – Jennifer Koehl, VMD District 6 – Darcie Stolz, VMD District 7 – Marisa Brunetti, VMD District 8 – Kristin Fisher, DVM Veterinary Support Staff At-Large – Nicholas Rivituso, CVT, VTS (ECC) Academic Veterinarian At-Large – Dana Clarke, VMD Production Veterinarian At-Large – Rhett Proctor, DVM Equine Veterinarian At-Large – James Holt, VMD AVMA Delegate Tina Dougherty, VMD AVMA Alternate Delegate – Kate Boatright, VMD Veterinary Student At-Large – Allessandro Lamachia MAGAZINE STAFF Editor in Chief: Jennifer A. Keeler, CAE Senior Editor: Jaime Markle Editor: Kate Boatright, VMD Editorial Assistant: Julie Myers

EDITORIAL CORRESPONDENCE Editorial correspondence should be sent to Editor@PaVMA.org.

A Message from the President

I have worked in the veterinary field for almost 25 years. So, when I was thinking about the impact of Veterinary Technician Specialists (VTS) on my career and the field, I figured I had a large pool from which to draw.

Erica Wolbramsky, DVM President, Pennsylvania Veterinary Medical Association

How utterly sad is it then that I had not knowingly met a VTS until I met Vickie Byard, CVT, VTS (Dentistry), in 2017 at a continuing education event at CARES in Langhorne. I say knowingly, because NAVTA developed a committee on VTS in 1994, and I can’t fathom having only known about VTS for 4 years.

Either I am completely oblivious, or we are not doing enough to celebrate VTS. If Certified Veterinary Technicians (CVTs) are the unsung heroes of the field, Veterinary Technician Specialists are the elite, covert, special forces.

Maybe it is hard to find VTS because as a state we’re not supporting them. I struggled to find where Pennsylvania led the charge in VTS history. On October 9, 1999, the second AVECCT (American College of Veterinary Emergency and Critical Care Technicians) examination was held at the University of Pennsylvania, but that feels like throwing a crumb. I work in general practice (GP) where we rarely see CVTs, let alone a VTS. For better or worse, in Pennsylvania GP hospitals there is a very small distinction between what veterinary assistants (VAs) and CVTs can do.

So, it makes sense that VTS are working in referral centers where their skills are best utilized. But I challenge you to go to the website of your local referral center and see if any of their CVTs are listed on the website, let alone their VTS. Why are we hiding these people?

Maybe it is hard to find VTS because of the lack of options? There are currently a dozen VT specialties including dentistry, anesthesia, internal medicine (subcategories of small animal, large animal, cardiology, oncology, and neurology), emergency and critical care, equine nursing, zoological medicine, surgery, behavior, clinical practice, nutrition, clinical pathology, and most recently, dermatology.

However, this list doesn’t do justice to the CVTs who are specialized in fields for which there is not an official designation. I personally know two CVTs who specialize in ophthalmology, but there is yet to be a path for them.

6 | Keystone Veterinarian

Maybe it is hard to find VTS because of the statistics? The pay for a VTS nationally is not much higher than a CVT without a specialization, and in many states that is not much different from a VA. Veterinary services has the third highest incidence rate of nonfatal injury and illness according to the U.S. Bureau of Labor Statistics (BLS).

Nationally, female registered veterinary technicians (RVTs) have a 2.3 times higher incidence of death by suicide than the general US population, while male RVTs have a 5 times higher incidence, according to Witte et al (2019).

Maybe it is hard to find VTS because all of these things lead to burnout? In her keynote address at the last Keystone Veterinary Conference, Carrie Journey, DVM, DACVIM (Neurology), of Not One More Vet listed “Protective Factors for Tech Burnout: 1) Feeling of added value, 2) Control over schedule, 3) Opportunity for career mobility & self-improvement, 4) Respect from coworkers, 5) Feeling vets are aware of skills, and 6) Current compensation.” We certainly won’t get more VTS if we can’t prevent our CVTs from burning out, and the BLS estimates over 10,000 new VT jobs each year for the next decade.

I got angry writing this. In a field where we constantly talk about uplifting veterinarians, paying them better, respect for the profession, and protecting them from burnout, we are failing our most credentialed support staff.

So, what can we do? We can go back to Dr. Jurney’s list: Encourage your VAs to become CVTs and your CVTs to become VTS. Help them pay for it. Pay your CVTs more than your assistants, and your VTS more than that.

Give them physical and mental health care.

Put your CVTs on the website and celebrate their accomplishments. Give your VTS the ability to use their skills to the fullest. But most important, don’t just listen to me, talk to them.

References: Witte TK, Spitzer EG, Edwards N, Fowler KA, and Nett RJ, Suicides and deaths of undetermined intent among veterinary professionals from 2003 to 2014. JAVMA 2019;255(5):595-608.

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Team Talk

By Lindsey Snyder, CMP

In late March 2015, I adopted a small 8-week-old Weimaraner-mix puppy we named Willow. The first few days at home, Willow didn’t act like a typical puppy.

She slept more than usual, constantly shivering, and wouldn’t eat much. A visit to our primary veterinary office and it was clear, she had some sort of respiratory infection. The next few days she would stay at our primary veterinary office during the day and then come home for love and affection at night. Unfortunately, Willow was getting worse and had stopped eating completely. It was time to move her to a facility with 24-hour care.

I will admit I was an absolute burden to the staff. Visiting, calling, asking questions, researching online, recommending treatments. I was that dog mom.

After two weeks of full-time care, time in and out of the oxygen cage, and unsuccessful treatments, the veterinary staff recommended we make the final decision. Willow’s x-rays were now showing possible signs of lung damage.

I was devastated. I felt a whirlwind of emotions during this time. I was exhausted and desperate. I had to put all my hope and trust into the veterinary staff.

Willow’s experience does have a happy ending. She did fully recover and will be turning 7 this year. I am beyond grateful for the medical knowledge of the veterinary staff through all aspects of Willow’s care. Most of all, I am changed by the emotional experience I had with veterinary staff who were full of patience and empathy. They taught me more about these simple acts than I had ever learned in my 10+ years working in the hospitality and service industries.

I respect you for your contribution to the veterinary profession. As the Director of Veterinary Education, I am grateful for the opportunity to show my appreciation and commitment to PVMA Members and look forward to working together to provide quality continuing education and professional development programs and events.

I would visit Willow at the veterinary hospital multiple times a day at the oddest hours. When she would see me, she would give all the energy she could just to wag her tail. I was typically sitting on the floor outside Willow’s oxygen cage, just talking about everything and nothing since I wasn’t able to touch her. I would bring her different concoctions of food with the hopes that she would eat. Oatmeal, honey, and peanut butter were her favorite but only a few bites until she would need to press her nose to the oxygen outlet of the cage to breathe. She weighed less than 9 pounds.

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Add your voice to the conversation by donating to our Political Action Committee today!

Contributions can be sent to:

Pennsylvania Veterinary Political Action Committee (PVPAC) 8574 Paxton Street | Hummelstown, PA 17036

About the Author: Lindsey Snyder, CMP, is an event management professional currently serving as the Director of Veterinary Education since 2022. A graduate of Lebanon Valley College (LVC) with a Bachelor of Arts Degree in English Communications, she began working after graduation with Hershey Entertainment & Resorts, Inc. within the Hershey Lodge & Convention Center and the Hersheypark Sales Office. Lindsey returned to LVC as the Director of Alumni Programs and Special Events before joining the Pennsylvania Association of Area Agencies on Aging (P4A) as Event Planning Specialist. A member of Meeting Professionals International, Lindsey earned her Certified Meeting Professional credential in July 2021. Lindsey is a certified PADI open water diver, and former Ellis & Associates Lifeguard Instructor. She currently lives in Mount Joy with her husband and three weimaraners, Nala, Willow, and Heinz.

Corporate checks are not permitted by Pennsylvania law.

PVPAC may only accept voluntary donations from individuals.

Please make your personal check out to PVPAC.

Calendar of Events Check out these upcoming PVMA events!

Local PVMA District Meetings are currently being confirmed. Please visit our Calendar of Events page for the most up-to-date information and times.

May 5

PVMA District 5 Dinner Meeting

May 6-8

Keystone Veterinary Conference

October 23

Animal Care PA’s Bark in the Park 5K, 1-Mile Dog Walk & Pet Costume Contest

November 12-13 PVMA’s Veterinary Symposium Scan the QR code or visit PaVMA.org for the most up-to-date list of events.

Spring time!

Pennsylvania Veterinary Medical Association | 9

Why I Teach My passion and focus have always been enhancing the lives of animals. I started my career as a veterinary assistant in high school. After I graduated from Harcum College and became a certified veterinary technician, I continued working in private practice. I loved helping to treat and care for the patients, but surgery and anesthesia were always my favorite.

During this time, I also found myself taking a management role and training all new employees. As I was training a new employee, one of the veterinarians asked, “Have you ever thought about teaching?”

At this point, teaching was a career that had never crossed my mind. It was something I had no interest in. I chose animals for a profession, not teaching. As some questions do, this started a little fire in my stomach. I started to wonder, “Do I possess the qualities and knowledge needed to be a teacher?” I had to try! I sent my resume to local career and technical high schools, all the while thinking I would not get a call. However, a few weeks later, I received a call for an interview at Dauphin County Technical School (DCTS) for a veterinary assistant instructor position. I was offered and ultimately accepted the position.

While instructing, I earned my vocational II teaching certificate.

Twelve years later, here I am teaching the NAVTA-approved veterinary assistant program at DCTS. I instruct students in grades 9 through 12, helping them discover their career path within our amazing industry.

By Tiffany Houtz, CVT

Throughout my professional career, I have experienced many similarities between the worlds of education and veterinary medicine. As veterinary professionals, we educate clients on the best way to care for their pet. We continuously educate and share our knowledge with colleagues on best practices regarding protocols, disease processes, and treatment options.

This learning network as a veterinary assistant was a benefit when I entered education. When I first started teaching, I had no idea how devoted and passionate these young students were about our profession. Their excitement is like no other when they learn of their acceptance into the veterinary assistant program. They are thrilled to wear their scrubs, take notebooks full of theory notes, and complete clinical appointments on our patients. Their work ethic is strong. With teamwork and dedication, most of them have high expectations of themselves and their futures.

The are some concrete differences, too! Most veterinary professionals do not scream and go into complete panic when they cut a nail too short or look like they are going to vomit when observing an anal gland expression. Instead of documenting in a medical record, I am writing lesson plans. Now, I log bad behavior instead of placing a caution or muzzle sign on the patient’s file. Every day is still an adventure.

I work with great students with big hearts and a true love of learning. Their determination and unyielding potential inspires them to reach for their dreams. As they learn more medical knowledge and continue to practice their skills, their confidence grows. My students see the endless opportunities available to them in veterinary medicine. It is an honor to watch them find their passion and develop skills in our profession. It is my goal, as an educator, to support students in achieving their highest potential as a veterinary professional. I love sharing my knowledge and experience through teaching. Their successes in veterinary medicine have shown me just how bright the future is in our field.

About the Author: Tiffany Houtz, CVT, is the Veterinary Assistant Instructor at the Dauphin County Technical School (DCTS) is a comprehensive Career and Technical School located in Harrisburg, PA. She can be reached at 717.269.3261, or tbghoutz37@gmail.com.

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By Larry Gerson, VMD

The Animal Care PA Scholarship Fund Needs Your Help

Veterinary school was a challenge for me. I was accepted after 3 years at Penn State and found myself in a class of brilliant fellow students with good study habits and great time management. These were attributes and skills that I lacked.

I was also struggling financially. Having earned enough money from summer jobs to attend undergraduate school, I was forced to borrow funds for Penn Vet. My veterinary school transportation was an old VW beetle with a rusted door pillar. I had to lift the door just to get it latched.

The deteriorated wheel wells took on water in heavy rain.

The ignition did not work and I had to jump the starter with a screwdriver by laying in the street to reach the terminals. The other option was to push it and jump start the engine. Imagine my first date with my soon-to-be-wife, Barbara. I had to ask her to help me roll the car to pop the clutch to get it running. I remember fondly calling her from the New Bolton Center pay for phone. If we talked more than 3 minutes I had to reverse the charges. I did not have enough change for a long talk. Tuition jumped 50% in my junior year and I had no way to pay for the increase. During my last 5 months as a senior student, I lived out of my vehicle as I could not afford an apartment. I frequently stayed at the school doing night call in the wards for a place to sleep. When I graduated, total student debt compared to firstyear earnings was about equal.

PVMA came to my rescue with financial aid that helped me through my senior year. In appreciation, I have been dedicated to the state association for my entire professional career.

I recall my speech as PVMA president in 2000 when I spoke about what my fellow veterinarians had taught me. I talked about how my first and only employer as a veterinarian, Dr. Tom Moore, insisted that it is important to give back to the profession and how it is critical to become active in the local and state veterinary associations. I recalled Dr. Borger who worked tirelessly all year making woodworking auction items for the

foundation (now called Animal Care PA). He taught me it is the little things we do in life that really count. I was saddened to read the obituary of Dr. Don Herr. He and his wife, Dr. Patricia Thomson, showed me by example that to survive veterinary medicine, one has to have a life and interests outside of the profession. They would bring prize-winning plants for the scholarship auction. Twenty years later I still have a large daylily garden from them. Finally, my wife taught me that family is by far the most important part of life.

The scholarship committee has been a special part of my giving back. This year we had applications from 54 veterinary students and were overwhelmed with deserving veterinary technician students applying for our limited funds. With less than $10,000 to distribute, we struggled on how to help bridge the gap for their financial need. Current debt-to-first-year-earning ratio is at least 3 to 1 now. New graduates often pay $1000 a month for 30 years on their loans.

It is the responsibility of all veterinarians to support student scholarships. The demand is great and the profession needs everyone who can give to help our future colleagues. Please contribute to the Animal Care PA Scholarship Fund. The need is now.

About the Author: Larry Gerson, VMD, is a 1975 graduate of the University of Pennsylvania, School of Veterinary Medicine (Penn Vet).

He was a past president of the Western Pennsylvania VMA and served as a long-term trustee. He is president of the PVMA in 2000 and then chaired the foundation now called Animal Care PA. He was also a past president of the Veterinary Medical Alumni Society at Penn Vet and also served on the Dean’s Alumni Council. Additionally, he was the vice chair of the State Board of Veterinary Medicine. Larry retired in 2020. He and his wife Barbara have two children and four grandchildren. Larry can be reached at lgersonvmd@gmail.com.

Pennsylvania Veterinary Medical Association | 11

Staff Retention

Full Stop—Retain Not Retrain Now, by saying this, I am NOT saying we should disregard the new teammates our veterinary practices so desperately need. What I am saying is to instead, switch the effort. Bring up, build up, boost up the reserves, those team members who have been in the trenches, buried in cases, and all the muck that goes with them. Let me elaborate.

Actions Speak Louder I am most definitely a hands-on learner, as are the majority of us in our profession. It’s difficult to learn how to place an IVC theoretically. You have to feel that “pop” into the vein to fully appreciate and understand what it is that you’re doing. And I can say with a fair amount of certainty that most veterinary team members will tell you they learned so much more on the job than from a textbook.

That being said, we cannot learn all that we need to within 1 to 2 months, and sometimes not even in 1 to 2 years in practice.

Having the education and credentials to back up your what (skills) with the why (science) is essential in becoming a fully integrated member of a veterinary team. Honing any skill takes time, and mastering that skill takes more of it, along with effort and determination. No one is going to be able to run a solo TIVA case within their first week (just entering the field, freshly graduated, but if you’ve got the experience and are simply new to a practice you might!). Gaining the trust of your teammates, supervisors, and doctors is crucial. Fine-tuning your skills and gaining confidence—not arrogance—is critical. All of this takes— you guessed it—time.

It’s Not Easy Being Green Kermit spoke the truth, it’s NOT easy. But I’m clearly not speaking about the color here. Being the new kid at work is challenging—learning names, finding your way around, 14 | Keystone Veterinarian

protocols, processes, workflow, oh and yes, all the veterinary medical skills on top of that! Every practice, regardless of its location and/or size, should have some type of orientation or onboarding program in place.

Depending on a person’s work and life experience, skill set, learning type, and communication style, this can—and should—encompass anywhere from 2 to 8 weeks. The first week should be spent, ideally, off the floor and focusing on workflow, computer skills, and acclimatization. Unfortunately, this is the exception, not the rule, which is what Empowering Veterinary Teams (EVT) is aiming to change, but I digress.

It’s worth noting that the recruitment, interviewing, hiring, and training of a new veterinary team member in the United States costs anywhere from 50 to 75% of their annual salary,¹ and that’s only for them. Take into consideration the extra time of their trainer(s). And let’s please, please not forget to address the mental and emotional toll this can take on the entire team— trainee and trainer, management, doctors, and patients. The entire team dynamic changes when any one member leaves and then again when a new member joins.

This is an essential process and one that is incredibly rewarding and worth every penny and each ounce of blood, sweat, and tears. But (you knew there was going to be a but), it’s a LOT, especially with short staffing, exponentially amidst a pandemic.

What are we to do? Read on.

Remember Me? Heads down, noses to the grind, not a complaint, and getting completely and utterly burnt. The pillars of the veterinary practices, those dedicated and determined to “do it all” and “save everyone” teammates. They’ve been in the field for more years than most know, and sometimes more than they’d like to admit. Backs and knees aching, creaking, and breaking. Brains

fried; hearts broken. And yet, they keep going. Coming back for more and making a difference in everyone’s lives that they come into contact with.

How are we supporting them? Raises are great. Incentives, bonuses, and benefits are wonderful too. Provide them wellness resources and materials? Yes, please! But how will they use them? When will they be able to enjoy it? Most cannot because they simply aren’t given the time. Minimal breaks, if any. Paid time off (PTO), they’ve got it, but it’s sitting there, unused. And why? Because who else is there to do their jobs? No one can do it like they can, and they don’t have the time, energy, or resources to teach anyone else. Whose fault is that? All of ours. Another problem to solve, but how?

There’s more.

The Future of Compounding is

MANUFACTURING

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Be the Change



Here’s where we come to a full stop. Head back to the proverbial drawing board, not for recruitment, but for retention. Provide training aimed at growth and enhancement (CE, events). Make it integral, not optional, and MAKE THE TIME for it. You provide a CE allowance, fabulous! Now make it work for everyone, and add that in addition to a PTO allotment. Find out each team member’s “why”—what makes them excited about veterinary medicine. Give them the materials, the resources, and the means to get the education for their professional growth. Or bring it into your practice; what a great day that would be and one that actually warrants a pizza party!



Train your trainers, coach your coaches, and instruct your teachers. These roles aren’t for everyone and even those of us who love to train, coach, and teach (all are different, all equally important) need to know how to do it, not just what to tell people. Workshops, reading material, and mentorship, provide it. All of it. Meetings—have these regularly so they’re not dreaded. Give the team something to work toward while ensuring they know that it’s about progress and NOT perfection. Focus on the process and take the onus off of the individual, all the while cementing the foundation of support that you’ve got their backs.

Recognize, respect, and reward—give these heavy hitters their due. Shout outs on social media are great as a start, and even more impactful when the accolades pay out, literally.

If someone is a true cat whisperer, they’re the ones that lead the low-stress handling workshop for the team.

The person who can hit any vein, anytime, in any situation is your go to for phlebotomy practice.

Have your team set their own high expectations and keep yours up there as well. It will be that much more incredible when they’re met and exceeded.

Reference ¹Pownall M. The high cost of employee turnover in a veterinary clinic.

Veterinary Business Matters. Last modified July 19, 2018. Accessed February 15, 2022. bit.ly/33ltROc

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About the Author: Alyssa Mages, CVT, is the Chief Visionary Officer (CVO) of EVT (Empowering Veterinary Teams), where she oversees the content development, clinical skills training, and overall vision of the company. She cofounded EVT to provide training programs, materials, and coaching/learning opportunities for veterinary practices, as well as content development and training directives for veterinary industry service providers. The EVTeam consists of veterinary professionals, industry leaders, and coaches.

Alyssa graduated from the University of Rhode Island with a BS in Marine Biology, which led her to the education/conservation track.

Ultimately, her desire to learn and do more led her to transition to the veterinary field where she attained an AS in Veterinary Technology from Manor College and added CVT to her credentials. She has 18 years of veterinary experience and has worked in numerous sectors of the industry. Throughout her tenure, she has held multiple leadership roles including Lead Veterinary Technician, Adjunct Professor, and Education and Development Coordinator. Alyssa’s love of teaching and her passion for the education, evolution, and empowerment of support team members in veterinary medicine led to the launch of EVT in October 2019. Throughout 2021, Alyssa and EVT’s cofounder Caitlin Keat have coauthored a book with Get MotiVETed! titled ClinLife-21 and have also been speaking nationally at multiple veterinary conferences on team training, coaching, and how to implement EVTraining throughout the veterinary industry. Alyssa’s goal has been incorporated into EVT’s mantra: Inspire, Instruct, Impact – Together.

Pennsylvania Veterinary Medical Association | 15

Learning and Leadership with PVMA

By Kate Boatright, VMD

Power of 10 is a national leadership development program for early career veterinarians that has been adopted by many state veterinary medical associations and is run at the state level. It is designed to cultivate leadership traits in PVMA Members and provide learning that will enrich them both personally and professionally. P10 is designed to develop skills in leadership, communication, and business. The Power of 10 Scholarship has also been made available to Certified Veterinary Technicians in the Commonwealth.

The P10 Program provides 10 PVMA Members with leadership development sessions over the course of 2 years. Sessions will include face-to-face and virtual roundtable discussions and attendance to PVMA continuing education programs.

The “Learning” component includes team communication, veterinary finances, animal welfare, legal and ethical topics, networking, and legislative and advocacy issues. The “Leading” component provides a variety of opportunities to use the recently acquired knowledge in PVMA, such as writing for the Keystone Veterinarian magazine, serving on the Board or with a committee, mentoring, volunteering with ACPA or other event, and mentoring new PVMA Members.

More information is available at bit.ly/PVMA-P10.

Meet the Class of 2021-2023 Korin D’Ascenzo, BVetMed, grew up in Penn Township, Westmoreland County.

After graduating from high school, she attended Delaware Valley University earning her bachelor’s in Large Animal Science. After a year working in the equine industry, she was accepted into the Royal Veterinary College in London, UK, and graduated in 2005 with her veterinary degree. After returning to the United States, she worked in various practices in Eastern Pennsylvania, until taking a Chief of Staff position for Lawrence Animal Hospital in Princeton, NJ. Eventually, her family brought her back to Western Pennsylvania where she started work as a relief veterinarian. She has since committed to working with two AAHA hospitals while raising her family. During this time as well, she has earned her Fear Free elite status and certifications in the Human-Animal Bond, Nutrition, and AAHA Hospice and Palliative Care.

16 | Keystone Veterinarian

Savannah L. Gibson, VMD, attended Delaware Valley College where she earned her B.S. in Biology. She completed her graduate studies at the University of Pennsylvania School of Veterinary Medicine in 2019. She returned to her hometown and joined Highland Animal Hospital immediately after graduate school. She has a passion for end-of-life care, diagnostic imaging, and her feline patients. Savannah’s hobbies include horseback riding, kayaking, and yoga, and she is adventurous in trying new foods and restaurants. She loves her Quarter Horse, Levi, and two dogs, Dawson and Red. Savannah hopes to eventually visit all of the National Parks in the USA. Ashley Klein, VMD, graduated from PennVet in 2016 and went on to work at various general practice and emergency hospitals until she found her true passion for leadership. She now works as a Medical Director at Aston Veterinary Hospital, both seeing appointments and working to support a growing business while ensuring a positive culture and work-life balance for her coworkers. During her time outside the hospital, she loves to spend time outdoors with her family!

Tiffany Ruiz Dasilva, VMD, CVA, received her Bachelor of Science degree in Biology from Brown University.

Following graduation in 2011, she lived in Africa, working in wildlife conservation and rehabilitation.

She attended veterinary school at the University of Pennsylvania and graduated in 2017. Since then, she has worked in general practice and on telehealth platforms, and received her Fear Free certification, which aims to prevent and alleviate anxiety and stress in the animals she cares for. In 2021, Dr. Ruiz Dasilva became certified in acupuncture and began working at a rehabilitation practice. She is passionate about veterinary behavior,

rehabilitation, and pain management. She hopes to improve the quality of life of many pets, and in doing so, give their families the gift of having more time with them. Her hobbies include scuba diving, boating, and photography.

She currently lives in Philadelphia with her husband and two children.

Kaitlyn Wyrick, DVM, CVT, is a 2013 graduate of Lebanon Valley College where she received her Bachelor of Science degree. She is a 2015 graduate of Lehigh Carbon Community College/Northampton Community College where she received her Associate’s Degree in Applied Science specializing in Veterinary Technology. She then worked as a Certified Veterinary Technician (CVT) prior to attending vet school. Dr. Wyrick graduated Summa Cum Laude from St. George’s University School of Veterinary Medicine in 2021 after spending three years in Grenada, West Indies, and completing her fourth-year clinical training at North Carolina State University. She remains a member of the Phi Zeta International Veterinary Honor Society, AVMA, PVMA, AAHA, and AAFP, and is a Certified Cat-Friendly Veterinarian (CFV). Dr. Wyrick works at Anthracite Animal Clinic, a small animal general practice located in Ashland, PA. She is passionate about small animal wellness and preventative medicine, radiology, and surgery. She enjoys reading, painting, and spending time with her family, her husband, and their two cats, Morris and Goose.

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Pennsylvania Veterinary Medical Association | 17

My CVPM Journey

By Bethany Mihalik, CVPM, MHRM, CVT, CCFP

To claim that challenging times are upon us would seem like an understatement to many of us soldiering through these past two years. The steady increase in demand exacerbated by a rapidly shifting workforce, combined with efforts to mitigate the spread of a potentially deadly virus, has changed our profession in unprecedented ways. This environment confronts the most seasoned of industry veterans, pushing many past their breaking points. One word I’ve repeatedly heard to describe our current reality is relentless.

During this whirlwind rollercoaster of a pandemic-spurred voyage, I’ve found myself leaning into my professional certification heavily. I’ve rummaged through dusty employment law textbooks, read countless articles by trusted peers, and spent hours scrolling through the Veterinary Hospital Managers Association (VHMA) forum and other professional social media pages. I hunted, rabidly, for refreshers, new concepts, encouragement, camaraderie, and sometimes just simple acknowledgment from others who understood the pain and frustration of trying to manage during unmanageable times. Yet, I’ve never been so grateful to be a CVPM and have such trusted resources at my fingertips.

solid understanding of how a veterinary practice operates. For example, I worked in varying capacities within the field for nearly seven years before earning my CVPM credentials.

To apply for the two-year testing window, a qualified applicant will need: To be actively employed as a practice manager for a minimum of three years within the last seven. To be (or have been) responsible for 26 of the 30 duties enumerated in the application for a minimum of three years.

The 30 duties enumerated in the application include staff (development, maintenance, computer training, communication, interaction, records, safety, benefits, payroll); accounts receivable; income reconciliation; credit policies; accounts payable; inventory; financial reporting; budgeting; purchasing; fee setting; patient medical records; medical knowledge; hospital medical logs; client service; client communication; client interaction; client grief protocol; client education; client education programs; client/patient/staff comfort; professional liaison; and community involvement.

•

18 college semester hours in management-related courses such as accounting, economics/finance, computer science, marketing, management, labor relations/human resources, and law/taxation.

•

48 hours of continuing education courses, seminars, and so on, specifically devoted to management.

•

Four letters of recommendation.

As a certified veterinary practice manager (CVPM), the two questions I am asked most often are: 1.

How do I become a CVPM?

2.

Is it worth it?

How to Become a CVPM Earning one’s CVPM credential is a journey requiring self-discipline, motivation, and a sincere desire to learn best practices from the most reputable industry experts. Most candidates begin this process after successfully managing in the field for several years and have a 18 | Keystone Veterinarian

Once all of the above criteria are met, a candidate can begin the application. The application is a three-step process that documents a candidate’s educational and professional background, achievements, and veterinary management leadership

knowledge. Once an application is approved, candidates have two years to take and pass the CVPM examination before their application expires. Those who do not earn certification prior to their application’s expiration must reapply to qualify to take the examination. Test fees are due at the time of application submission.

Studying for the exam is self-guided and primarily consists of reading and comprehending the themes presented in the 13 texts included in the CVPM Study Guide and Recommended Reading List and CVPM Task Analysis outline. A test preparation workbook (print or digital) is available for purchase. Additionally, some candidates benefit from enrolling in an online preparation course. The one that I completed was through VetMedTeam, which was approximately eight weeks, and consisted of written weekly assignments directly from the Recommended Reading List. VHMA also offers a virtual test preparation program.

The examination itself is composed of true-false and multiple-choice questions pertaining to relevant management knowledge in the areas of human resources, law and ethics, marketing, organization of the practice, and finance.

Most of the questions are traditional knowledge-based multiple-choice questions, and some are scenariobased. The total number of questions on each test administration varies, but the maximum number of points is 200.

Candidates have three and one-half hours to complete the examination.

Worth the Effort For me, passing the CVPM exam in 2015 and earning my credentials instantly instilled a sense of confidence, which was especially important as a young leader.

So many of us suffer from “imposter syndrome” as a result of our often haphazard appointment into veterinary

management. While some of us possess some college education in broader-based subject areas such as business management, human resources, marketing, or communications, most of us become managers with little to no industryspecific training and have to rely solely on background, instinct, and a lot of trial and error. With the exception of a weeklong crash course in practice management basics back in 2011 and a three-month office management class in tech school, studying for my CVPM examination over a two-year period served as my formal industry-specific education.

I didn’t know it at the time, but earning my CVPM was the catalyst for intense professional career growth and a deeper understanding of the entire veterinary management field.

I was embraced by this amazing community of industry experts who were eager to share their knowledge and experience with the upcoming generation and challenged us to be better leaders. During some of the darkest days of the pandemic, far

removed from my baby-manager years, it was this community that provided me with unconditional support and guidance. It was this community from which I pulled my strength.

So, getting back to that second question of “Is it worth it?” Is it worth it to gain a thorough understanding of the vast scope of responsibilities involved with successfully managing a veterinary practice? Is it worth it to possess proof of that knowledge for career advancement and greater income potential? Is it worth it to be inducted into an elite group of 800+ professionals possessing a designation that is recognized as the highest level of credential for veterinary managers? Is it worth it to be part of a community of progressive, innovative leaders who are shaping the future of our industry? Is it worth building friendships with people who genuinely understand what it means to be a veterinary practice manager?

Undoubtedly!

About the Author: Bethany Mihalik, CVPM, MHRM, CVT, CCFP, currently serves as the Hospital Administrator of Neffsville Veterinary Clinic, a 10-doctor, AAHA accredited small animal practice in Lancaster, Pennsylvania. She has been managing practices in the veterinary industry since 2008, and briefly worked for the “dark side,” as an Account Training Manager for Vetstreet in 2011. She is a 19-time NCAA All-American and college record holder (Clarion University of Pennsylvania - 200 butterfly), and attributes her success in the veterinary industry to decades of “resilience” training in the pool. She is the co-author and presenter of the “Leadership Through Partnership” workshop, a VHMA and AVMA continuing education program for practice owners and managers, offered at the Veterinary Leadership Conference.

She earned her B.S. in Communications from Clarion University of Pennsylvania in 2004, M.H.R.M./M.B.A. from Saint Francis University of Pennsylvania in 2006, A.A.S. in Veterinary Technology in 2010 from the BelRea Institute in Denver, CO, and Certified Veterinary Practice Manager (CVPM) credentials in March of 2015.

She recently earned her Certified Compassion Fatigue Professional (CCFP) credentials in 2019. In addition to her duties at Neffsville, she serves as the President of the Lehigh County Humane Society in Allentown, PA. She is an active member of the Veterinary Hospital Managers Association, a content contributor for Veterinary Team Brief and a Podium Speaker for Zoetis Animal Health. She resides in the remote Pennsylvania wilderness with her husband, Mike, lovable rescued mutt, Tickers McSnickers, and feisty feline, Tuna Badfish Loafnoodle.

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www.simmonsinc.com The Confidentiality Agreement link is on the bottom of the home page. You can also register for the Simmons Practice Watch—when we have a new listing, a notice is sent to the Practice Watch list first.

Pennsylvania Veterinary Medical Association | 19

By Dr. Christina Dougherty, Delegate Dr. Kate Boatright, Alternate Delegate

The AVMA House of Delegates winter session was held in a hybrid format during the 2022 Veterinary Leadership Conference in January.

While many interesting presentations were made by officers and staff of the AVMA during the Plenary Session that took place before the HOD meeting, one such offering touched on a few insightful concerns reflecting the issues facing the profession in the near future.

Dr. Matthew Salois, the AVMA’s chief economist, gave a prediction of a somewhat slow economic recovery for the profession following the impact of COVID-19. He indicated what many suspect: that a complete return to pre-pandemic conditions may never occur, based on a number of factors impacting veterinarians and veterinary practice now, as well as what may be coming on the horizon.

1.

2.

3.

4.

5.

The changes in workforce numbers affecting patient care and revenue flow.

The extremes of expenditures by pet owners during lockdown periods, causing a roller-coaster effect on hospital revenues.

With increased consumer pricing in all sectors, the marginal end-increase in revenue in the pet sector may not be sustainable long term because consumers will need to choose where to spend discretionary funds.

The lack of productivity in hospitals because of staff turnover affecting mental health as well as the bottom line.

The stress and anxiety accompanying the pandemic may drive more veterinarians out of the profession.

One other significant concern raised by Dr. Salois had to do with the recent introduction of the mid-level professional concept being developed at the veterinary university level in the US. While not yet validated under state practice acts, he brought forth the possibility of legal risks to veterinarians and their practices employing these individuals, as well as worries that the degree, if not eventually recognized, may cause a huge financial burden to graduates of such programs.

During its regular Winter session, the HOD discussed two topics during the veterinary information forum (VIF). On the topic 20 | Keystone Veterinarian

of license portability, members of the HOD shared input from members across the country that license portability would be beneficial in some lines of work and for those living in close proximity to multiple state borders. The HOD approved a recommendation for the AVMA Board of Directors to explore the topic of license portability further.

On the topic of expanding AVMA membership, the HOD recommended that the AVMA discuss with the National Association of Veterinary Technicians in America (NAVTA) and the Veterinary Hospital Managers Association (VHMA) how best to collaborate and strengthen all organizations and the profession as a whole.

Five resolutions were considered during the business session. The full text of each resolution is available at bit.ly/2022AVMAHOD: • Resolution 1: Policy on rabies • Resolution 2: Revised policy on annual rabies vaccination waiver • Resolution 3: New policy on food safety • Resolution 4: New policy of supporting the collection of antimicrobial use data of antimicrobial stewardship • Resolution 5: Revised policy on guidelines for classifying veterinary facilities Resolutions 1 through 4 were approved. Resolution 5 was referred back to the Board of Directors for continued consideration.

Finally, Dr. Grace Bransford and Dr. Renee Carlson, both running for the position of AVMA President-Elect, offered their thoughts on the future of the AVMA and their visions of the organization as its future leader, while Dr. Jennifer Quammen spoke as the only candidate for the AVMA Vice-Presidential position. Elections for these offices will take place during the summer HOD meeting.

The next House of Delegates meeting will be held in late July in Philadelphia, when the AVMA Convention comes to our home state. We hope you will join us in Philadelphia! As always, it is our pleasure to represent you on the AVMA House of Delegates and we encourage you to reach out with any questions or concerns.

Plant Team Seeds and the Hospital Grows

By Ashley Elliott, CVT

A coworker once told me she wanted to make being a receptionist a career, and that statement has stayed with me.

Too often, non-credentialed veterinary professionals feel like they have no room to grow and that they are stuck in their position exactly as it is, unless they go back to school or become team leaders.

It is important to provide opportunities for professional growth for the entire team, including those without letters behind their names. It is an investment in the most valuable part of your hospital.

You are planting team seeds so you can harvest hospital growth.

Here are some ways this can happen: 1. Offer outside training for all positions. This could be in the form of specialists from outside of your hospital coming in to teach valuable skills or as a continuing education (CE) allowance for all positions. An example would be a technician from a specialty hospital coming to your hospital to train the staff on dental radiography or online CE to train the customer care team on telephone etiquette.

2. Promote from within when appropriate. Not everyone is leadership material and obviously you can’t have a whole team of managers. Focus on your staff’s strengths and interests, and consider empowering them to take charge of that area of focus. This could be promoting an assistant to being in charge of laboratory equipment maintenance.

3. Talk to your team! Communicate with your customer care and patient care team members regularly—as

a hospital is lack of opportunity for growth or feeling like they are being held back from learning new skills they had expressed interest in previously. Team members need to feel like they are able to learn new things and apply them and that they can grow within the hospital, with or without letters behind their name.

a group and individually. Find out what they want and need for their own professional growth, as a team, and as a whole hospital. These conversations remind them how important and valuable they are and give them opportunities to be heard.

In times when staffing is most difficult to find and secure, it is important to value the staff you have, but also to utilize them to their full potential. This mentality will not only help your hospital by maximizing your staff’s potential, but also make your individual team members feel that much more important and invested in your hospital. Like many other hospital managers within the Commonwealth, I have interviewed numerous candidates for various positions. In my experience, one of the leading causes for nondoctor veterinary professionals to leave

Secondary education is not necessarily possible for every working veterinary professional, so we need to provide opportunities for these individuals to still feel valued for the skill set they have to offer. As a practice manager, my hospital needs a mix of credentialed and noncredentialed veterinary staff to succeed.

It’s important that we acknowledge that as an industry. I need my receptionist and veterinary assistants as much as I need my credentialed veterinary technicians and veterinarians. One of the scariest things to say in a veterinary hospital is “this is the way we’ve always done it” and it also applies to professional growth.

Continue to provide your team with opportunities to grow, but also continue to hire team members who want to grow and learn as well. Veterinary medicine is always changing and your team should grow and change along with it!

About the Author: Ashley Elliott, CVT, is the practice manager at the Animal Hospital of Chester County, located in West Chester, Pennsylvania. She was the 2021 PVMA Practice Manager of the Year. She has had a well-rounded career in numerous areas of veterinary medicine including academia, general practice, and specialty and emergency medicine. Her current focus is on building team relationships and growing as a leader.

Pennsylvania Veterinary Medical Association | 21

I Was Born for Large Animal Veterinary Medicine

By Sarah Shade, CVT

Performing dental float and flushing out a horse’s mouth.

My name is Sarah Shade. I live in a small town in Pennsylvania called Montandon. I love being in the outdoors, hunting, fishing, and having a good time.

I found the passion for working with animals when I was very young. I had a cat that ran away and came back pregnant. We kept her and allowed her to have her babies in our home. This was a great experience for me. As I got older, I started working on a dairy farm and discovered an even greater passion for large animals. The day I learned this was when I was able to save a calf’s life. The mother was having a hard time giving birth and I helped her by pulling the calf out. The calf was stuck for so long she was not breathing. My boss told me to go grab a bucket of hot water and put it on her. The theory behind this is to shock her body with the hot water. After about 3 buckets, she was breathing. She lived to be a great cow and have babies of her own. My dream was to become a veterinarian, but I took a different route. I decided to become a veterinary technician instead. This was a difficult decision, but I did not have the money to go to veterinary school. I started working at Sunbury Animal Hospital, which is a large and small animal practice, in September 2015. I started as a kennel attendant and worked my way up to Certified Veterinary Technician. I received my bovine artificial insemination certification in February 2018. I graduated from YTI Career Institute in October 2020, and then I passed my VTNE in March 2021.

A Typical Day in LA (and I Don’t Mean California)

Veterinarian performs joint injection while Sarah restrains the equine patient.

22 | Keystone Veterinarian

My morning starts at Sunbury Animal Hospital by checking the voicemail and email to see if anyone is looking to schedule an appointment, has questions, or is calling with an update on a patient we have been monitoring. Sunbury is a large and small animal practice so there is a setting on our phone to speak with the Large Animal (LA) department specifically, but we recommend if they have an emergency to select the emergency option. This will get them help faster because there is not always someone in LA monitoring the phone. I then help the veterinarian get their truck ready for the day. This includes getting any equipment they may need (portable x-ray and/ or ultrasound), along with medications that are not typically kept in the truck (small animal medications) and vaccines. I also print out direction sheets for the doctors so they can write down everything they did at the farm call, which they bring back for us to enter into the computer. We currently don’t have a system to take payments in the field, so once an invoice is generated, we call the client for payment over the telephone or mail out the invoice as we work with many Amish clients.

Usually one day a week, I am scheduled to go out on the road with the veterinarian, helping with anything from restraint to x-rays, blood draws, vaccinations, medication administration,

Sarah and Gypsy

IV catheter placement, and more. If the veterinarian does not need help, I will stay on site to manage phone calls and charges, check inventory, take care of any patient that may be in hospital, and keep the area cleaned. If we do have a hospitalized patient, the veterinarian will do a full exam on the patient in the morning and let us know the treatment plan, and then we will administer the treatment throughout the day. We handle a lot of phone calls, both emergency and routine calls to be scheduled.

Our practice covers anything farm-related: cows, horses, goats, sheep, donkeys, and sometimes chickens and ducks. Part of LA veterinary medicine is monthly herd checks on dairy cows for pregnancy status. We use a rectal ultrasound that can determine if there is a calf, how far along, or if the cow is close to coming into heat. This is all important information for the farmer to know in case it is time for a specific shot or when to prepare to move the cow for birthing. Winter months can be pretty quiet except when farmers may be expecting babies.

Farmers try to breed their animals to be due in the warmer months, but this cannot be controlled all the time. Babies born in the winter months can become hypothermic quickly. Spring, summer, and the beginning of fall can be very busy. This is typically the “start to show” season and everyone will need to get their animal health checks, vaccines, proper blood work/ testing, and certifications for the shows. There are rodeos that we complete certifications for as well, which is where we see a lot of our dental floats. We have to pull specific blood on some horses to make sure that they don’t have a contagious disease that could be passed on to other horses. We do specific ear tagging and ear notching on cows to prevent disease transfer.

We also perform breeders’ puppy checks prior to them being purchased. This can be a steady process throughout the year, but we see an increase around the end of the year due to Christmas puppies.

Veterinary Medicine on the Farm Made Easier with a CVT Experienced in LA

There are many benefits of having a licensed CVT experienced in LA on field/farm calls. Restraints are something I pride myself in. If a 1500-pound animal is properly restrained, then the veterinarian is able to focus on the medical issue. Some clients do have a cattle shoot or head lock to keep that animal in, which makes it a little safer, but it can be pretty challenging without those tools, especially if you are tending a cow or horse in an open field. It is important to monitor your surroundings, the patient, the veterinarian, and the owners, and know when you make a move, how that will impact others. For example, if a horse is getting tense and is going to rear up on you, you want to get out of the way and make sure everyone around you gets out of the way. Or if you anticipate a cow is going to kick, you make sure everyone is aware.

Sometimes the veterinarian just needs an extra trained pair of hands. For example, if a cow has a twisted uterus, we will flip them, put them down on the ground, put a board on their back, and rotate them in the opposite direction of the rotation of the uterus. You need help with that maneuver. If we find ourselves in an emergency surgery situation, I can be prepping the animal, getting the IV catheter, and getting supplies ready for the surgery while the veterinarian is talking with the client (letting them know what the surgery entails, what they may observe next, and what the outcome of the surgery continued on next page >

Sarah is restraining horse during a dental float.

Pennsylvania Veterinary Medical Association | 23

I Was Born for Large Animal Veterinary Medicine continued from page 23 may be) and getting scrubbed up themselves to perform the surgery. When we travel to an equine farm with multiple horses scheduled for routine exams, the veterinarian could conduct the full exam on the horse and give the rabies vaccine, then I could perform blood draws, give any vaccines I am licensed to administer, and all the extra steps a CVT is qualified to perform while the veterinarian moves on to the next animal. Other emergency calls are colic in horses, trouble birthing with cows, and multiple births in goats, all situations where a trained CVT can be a critical asset. If it is possible to transport the patient, we perform the surgery in the hospital suite, which is sterile and where we have a hydraulic lift.

With the puppy checks for breeders, the veterinarian gives physical exams to the puppies prior to them being sold and we provide a certificate of veterinary health, which is something we make at our hospital for the owner to give to the new family purchasing the puppy. It proves that the breeder had a veterinarian check the puppy before selling it, makes them a better breeder, and results in them getting more clients coming to them because they have that medical check that ultimately improves their reputation. Having a CVT there to hold the patient for the physical exam and/or complete the certificates while the veterinarian moves to the next patient keeps the process moving, instead of the veterinarian stopping after each patient to fill out the records or waiting to the end to fill out all the certificates and possibly not remembering something from the exam or for which puppy. This is especially efficient and effective when a breeder has multiple litters at one time that they want us to look at, and that can get busy quickly.

Challenges and Rewards

Working with animals that most people are intiminated by is a challenge AND a reward. There are not many CVTs in the LA veterinary field because it is physically demanding, especially the restraints. I’ve been stepped on. I get very dirty. I treat patients in all kinds of weather. But I am working with amazing creatures every day. I am following my passion. I also get to know our clients. If a client talks about a sick relative, I ask about them the next time I visit. That personal relationship builds trust, and they become more comfortable with me. That opens the door for educating them on their animals, how to execute a restraint safely, and how to desensitize the animal to needles like pinching them in the neck regularly so they don’t react negatively for the examination.

Communication is Key

Having good communication within the team results in our success. Each veterinarian has their own way to progress through the exam, work the room, what they like to have on hand, and what they want on the truck for every farm call day.

Once the staff learns these different preferences, everyone works more efficiently. Our veterinarians are good about teaching on the job. They don’t want you to get hurt, so they explain those life lessons that further the education received in the classroom. The flip side to that is once the veterinarians understand how to utilize an experienced, trained CVT, the hospital will benefit financially: They can treat more patients, have more income, increase the facility, and improve equipment.

Communication with our clients is equally important. We 24 | Keystone Veterinarian

work with a lot of Amish, which creates a challenge in basic communication when they rely on racing to a neighbor to make a telephone call and we often play phone tag.

Advice for Prospective Large Animal CVTs

Learn as much as you can about LA—you may be working on a camel some day, you just don’t know! When I was in school, we were taken to different farms to learn restraint techniques, but these animals were used to being handled. It is different treating injured or working animals that are not pets. Know your restraints because that is how you are most effective on farm calls. I can’t stress this enough because it is very difficult to restrain a 1500-pound Friesian horse that is scared and hurt. Invest in quality coveralls and boots—steel toed are really good EXCEPT when an animal steps directly on the steel toe and bends it down into your own foot. I have been stepped on multiple times; thankfully, I have not broken anything, but it is very painful for a long time. Always have extra clothes on hand—YOU WILL GET DIRTY. Put your hair up and out of the way because it can get pulled, or when working with the dental speculum, it can get caught in that; this also helps to just keep it clean. I am improving every single day medically and physically.

If this is a field you want to get in to, don’t back down. If you work in small animal veterinary medicine, you may be told that you will never find somewhere that you will be able to work with large animals because most of the veterinarians like to work alone. So, it is more difficult to find a job as a technician. But fight for it. Work as hard as you can to get that position. You will find it.

Goals

My dream is to become a veterinarian, but I don’t know if that is something I will be able to do just because of the cost. I am getting married this year and saving to buy a house, so maybe it is a dream for the future. A smaller goal that I have set for myself at this time is to work more with large animals than what I do now. I currently only work one day a week with the LA department and I would love to broaden that. LA is one of my main passions. I was specifically told by one technician that there is no job out there for an LA veterinary technician and that I would never get a job in that profession.

I would like this article to stimulate more CVTs to work in this field and to encourage the veterinarians that we are here to help them. We are trained for it.

About the Author: Sarah Shade, CVT, currently lives in Montandon, PA, and is saving money to buy her own home. She has 2 dogs that were rescued, their names are Oakley and Shale. She also has 2 cats, one she rescued and one is from the litter of kittens that were born in her home. Their names are Rocky and Paisley. She is engaged to be married this year in September to her fiancé Karsch. They have been together for 9 years. In her free time, Sarah loves hunting, fishing, going to tractor pulls and farm auctions, and just being outside in general. She is currently caring for 5 horses for one of her clients. Misty is the oldest and she is a Friesian crossed with a draft horse of some sort, Gracy is a miniature horse, and Gypsy, Rhianna, and Willow are all purebred Friesians. She has been caring for them for a year now and loves it. She has found a new passion for horseback riding.

5 Questions Asked of Veterinary Technician Specialists Lori Balliet, BS Biology/ Chemistry, CVT, VTS (Clinical Pathology) Specialty Field: VTS Clinical Pathology - Academy AVCPT (Past President - 2019-2021) Employer: Quakertown Veterinary Clinic (Laboratory Supervisor) and Northampton Community College (adjunct professor Vet Tech Program/Clinical Pathology Lab) 1. Make sure that you are requesting the correct test and the correct sample.

Writing down an incorrect test name or not the test you really want (“it sounded similar”) can cause delays in testing because the lab will need to contact someone to find out what the test is that is being requested. If you have the correct name, then you should be submitting the correct sample. The incorrect sample causes more delays.

2. A microscope! I love looking at slides: blood smears, urine dry slides, cytology slides, and so on. There is so much information you can gain from those slides. At Quakertown Veterinary Clinic, the lab techs are trained to examine the slides rather than having the doctors use their time to look at all the slides.

3. Get as much experience as you can. Run the lab tests if you can. If you are assisting a doctor, ask questions about the tests. If the doctor is examining slides, ask if you can take a look. Get CE that is dedicated to or contains information about clinical pathology/lab work.

4. I was the second person in the United States and Canada to earn my VTS in Clinical Pathology. There are only about a dozen people in this specialty in North America. The Academy of Veterinary Clinical Pathology Technicians (AVCPT) is a newer academy receiving its provisional status in 2012 and is just starting to increase its membership.

5. Several years ago I attended a CE about urinalysis. The doctor presenting demonstrated the technique for making a dry slide or cytology slide of the concentrated urine and then staining it with Diffquik. Identifying bacteria and differentiating epithelial cells is much easier and more accurate than using a traditional urine stain, which becomes contaminated easily.

Each person was asked the following questions: 1.

2.

3.

4.

A tip you have for veterinarians.

Favorite tool of your specialty (describe what it does please).

Advice for a colleague thinking of pursuing your field.

Feather in your cap (an acknowledgment you received, a success story you are part of, a difference you make).

5. Best trade secret you learned and from who.

Karen Becki, BS, CVT, VTS (Oncology) Specialty Field: Oncology Employer: PVSEC BluePearl

1. If referring a patient to an oncology service, one of the best things to do is to have a definitive diagnosis upon the patient’s arrival to oncology consult. This may mean that special stains, or other labs, may need to be requested from a biopsy sample prior to referral. However, it will allow the oncologist to give the owners more accurate information regarding prognosis and treatment options for their pet. (For example, histiocytic sarcomas, soft tissue sarcomas, and hemangiosarcomas all have different treatment protocols and survival rates.)

2. We use a closed-system transfer device, or CSTD, and a biological safety cabinet to draw up the chemotherapy we use to treat our patients. The CSTD replaces regular needles and syringes, allowing us to draw up the chemotherapy in a ventilated box with less risk of exposure to fumes in the rare chance there is a leak.

Since chemotherapeutic medications are considered Group One Hazardous Drugs, it is of upmost importance for an oncology technician to be exposed to the least amount of drug possible when drawing up and administering chemotherapy to their patients.

3. Despite what you may think, oncology is not all doom and gloom! Yes, there are definitely sad moments when we have to help a family say goodbye to a beloved pet. Most days though, we are administering treatments to our patients so they are able to have more time and make more memories with their families.

4. In the oncology department, the technicians are the main communicators with owners during many of their pet’s appointments. A success story is when clients tell me that I have helped them to have a better experience throughout these visits. For me, the goal of oncology is not just for pets to live longer, but for pets and their families to have the best quality of life together.

5. Not a secret, but just something I learned throughout my years in oncology: Don’t be afraid to place an IV catheter in an atypical vein. If you speak to a long-time oncology technician, don’t be surprised to hear that an ear vein has been used for an IV catheter placement.

It is imperative that chemotherapy is administered through a clean-stick catheter in an unused vein. While I learned this skill in school, my original oncology skills were taught to me by some awesome technicians: Maureen, Cat, Jody, and Jess.

Amy Dowling, AAS Animal Science Specialty Field: VTS Anesthesia and Analgesia Employer: University of Pennsylvania, Matthew J. Ryan Veterinary School

1. Any patient receiving anesthesia should have a checklist of things that should be completed before their procedure. They should have full blood work. This can vary from case to case, but usually a complete blood count and a chemistry is needed.

Additional tests that may be needed could be a blood type, coagulation panel, or other metabolic screens.

It is important to obtain a full medical history. This may include records from other veterinarians or specialists who the pet has seen in the past. Look for any history of heart disease, allergies, past anesthesia records, and what medications they are taking. In some cases, the patient may need to stop some medications the day prior to anesthesia. Some medications can make it difficult to treat hypotension intraoperatively and others may prolong recovery.

A consent form should be signed and thoroughly reviewed with the owners in case complications do happen. It can be beneficial to have different consent forms for different animals. For example, it may be hard to do a full exam or get blood work on an aggressive dog, so the owner should know that higher doses of drugs may be needed.

For most surgical cases, I highly recommend having the owners give gabapentin, continued on next page > Pennsylvania Veterinary Medical Association | 25

5 Questions Asked of Veterinary Technicians Specialists continued from page 25

Each person was asked the following questions: 1. A tip you have for veterinarians.

2. Favorite tool of your specialty (describe what it does please).

3. Advice for a colleague thinking of pursuing your field.

4. Feather in your cap (an acknowledgment you received, a success story you are part of, a difference you make).

5. Best trade secret you learned and from who. trazodone, and Cerenia the night before and repeat the gabapentin and trazodone a couple hours before coming to the hospital. This reduces the amount of anesthetics that we may need for premedication and can make it a better experience for the patient and hospital staff.

2. Recently my tool of choice is the ultrasound. An ultrasound works by using a transducer to transmit sound waves into the body and record the waves that echo back. I use this as a guide for local and regional nerve blocks. By understanding anatomy, imaging of the nerves, and anatomical structures, I can deliver precise local anesthetic. This will provide optimal analgesia and decrease other anesthetics that can depress the cardiovascular and respiratory system.

3. Take pride in your career. It can be emotionally and physically draining at times, but what we do is important and life changing. There are so many opportunities to advance in this field and you are always learning. It’s very important to support your teammates and learn to have a good work-life balance.

4. I won the 2021 Award for Excellence in Veterinary Nursing Education from Harcum College. I really enjoy teaching and working with students and new technicians. After doing this for 20 years, I have learned from my mistakes and find myself advocating for new technicians so they know their worth.

5. Years ago I worked with Donna Sisak, CVT, VTS AVTAA. She was an amazing mentor to me and taught me so much. The biggest mark she left on me was to “take care of your peeps!” She taught me we have to work as a team and support each other.

We can’t take care of our patients if we don’t take care of ourselves.

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Jamie DeFazio Guiberson, CVT, BS Specialty Field: Equine Veterinary Nursing Employer: University of Pennsylvania, New Bolton Center 1. Before referring a colic, always pass a nasogastric tube (bonus points for relaying how the animal was to tube). Also, extension sets are amazing accessories to IV catheters placed in referral patients.

The extension sets let us easily check for patency and make it easier for IV fluid administration.

2. My favorite tool is the nasogastric tube!

Without this tool, so many lives would be lost to gastrointestinal rupture. As a veterinary nurse and VTS, being able to pass a nasogastric tube correctly and quickly is something I take great pride in!

My second-favorite tool is my phone with a texting app that lets me communicate patient changes and send patient photos to clinicians at any moment. This has been game changing for improving the standard of care in hospitalized patients!

3. Do it for yourself. YOU need to be invested in this journey. Also, find a mentor and someone who will be there to help and support you in your journey!

4. I was the PA Vet Tech of the Year in 2009, which really pushed me to keep doing everything I could to promote equine nursing. This year I also accepted an adjunct position at Harcum College, where I will be teaching their first class dedicated to large animal medicine! I look forward to helping the next generation of equine veterinary nurses be the best they can be.

5. This is a super tough question to answer since I learn something from our amazing faculty and staff every day! Some of the best overall lessons I’ve learned, however, are from Dr. Sue McDonnell regarding equine behavior. Through her and the semi-feral ponies that I have adopted from her program, I have learned more about patience and positive reinforcement. Sue’s teachings have helped me greatly with some of the more challenging patients we see in the hospital.

Rebekah Jakum, RVT, CVT, ARDMS/RVT (American Registry of Diagnostic Medical Sonographers – Registered Vascular Technologist) Specialty Field: Ultrasound Employer: Self Employed (Pennsylvania Mobile VUS, LLC – see below) 1. Ultrasound is an excellent, non-invasive tool that, when done by an experienced professional, can add tremendous diagnostic capabilities to a veterinary practice, providing prompt direction with cases and keeping your patients, clients and revenue inhouse.

2. My specialists. Submitting a comprehensive history and diagnostic image set allows PA Mobile’s veterinary specialists to provide referral-quality service to RDVMs. Establishing an abnormality, sampling it, and getting a diagnosis are gratifying outcomes.

3. Scan, scan, scan, and scan some more!

Actively performing studies and reviewing images are the best ways to improve.

Also, investing in a quality system and understanding the physics of ultrasound will enable setting adjustment and image optimization.

4. Being asked to scan an employee’s pet is always extremely rewarding. Our pets are truly a part of our family, and knowing my skill level is trusted is a big personal reward.

5. There are many different insights that are absorbed during the journey with ultrasound. It is difficult to narrow down one secret and one person, but I would have to say utilization of a vtrough and scanning in dorsal recumbency from a fellow RDMS. It provides a cradle that most patients acclimate to and tolerate well and allows the sonographer a more comfortable position when scanning.

Lorena Lago, BS Biology, AAS Veterinary Technology Specialty Field: Emergency and Critical Care Employer: Valley Central Veterinary Referral and Emergency Center, Whitehall, PA 1. 1. Do whatever you can to initiate stabilization before transferring a critical pet. Place an IV catheter, unblock the cat, tap the free in the chest so they can breathe better during transport, and so on. Don’t be afraid to call and speak with a specialist for guidance if needed. Post referral: Follow up on those tough cases and see if there is anything that you could learn or do to help future cases. We all have the same goal to improve patient care and outcomes.

2. 2. My favorite piece of equipment in critical care is the mechanical ventilator. It provides respiratory support for those that are unable to maintain adequate ventilation or oxygenation on their own. It helps alleviate the stress and workload for breathing in severe respiratory distress cases while treating the underlying problem.

3. 3. Never stop educating yourself on ways to raise the standard of care for your patients.

Don’t let stress and a few bad days stop you from doing what you love. Find a devoted mentor to help guide and train you to be the tech/nurse you want to be.

4. 4. I recently helped stabilize a 7-month-old, MN, Basset Hound puppy that went into cardiac arrest, was successfully revived via CPR, underwent surgery to remove its liver from his pericardium, recovered, and returned home to his wonderful family. He thanked us all with tons of kisses when he returned for his suture removal two weeks later.

5. 5. My wonderful mentor, Jennifer GradyHolmes, taught me early in my career that continued education and a willingness to teach and train others is essential to the group’s success in achieving quality patient care.

Kristine Rigler, CVT, VTS (Surgery) Specialty Field: Surgery Employer: Valley Central Veterinary Referral & Emergency Center

1. Ensure that records pertaining to the patient’s visit have been sent to the referral hospital prior to the day of the appointment. Include any radiographs, bloodwork, and aspirate/biopsy results.

This helps immensely in mapping a plan for how to best help the patient and hopefully negates the need to repeat tests that were already performed.

2. I have two favorite “toys.” Force Triad Electrocautery Unit: This electronic vesselsealing device is versatile in helping to decrease blood loss and is a major time saver in the OR. It shortens the surgical procedure and the time under anesthesia, which relieves stress for the surgeon and the nurse doing the anesthesia on a potentially high-risk patient! Hyperbaric Oxygen Chamber (HBOT): The treatment consists of 45 minutes in this pain-free chamber, which raises the plasma oxygen concentration and allows oxygen to be distributed evenly in the tissues faster than normal, thereby increasing the rate of healing. HBOT is a useful adjunct to help with wound healing and decreasing inflammation in a variety of other conditions.

3. I would recommend anyone interested in specializing in surgery (or any other

specialty) to attend national conferences or lectures targeting surgery. This will help to gain advanced knowledge in your particular area of interest, allow you to earn necessary credits, and to connect with peers who have already gone through the certification process.

4. I was the recipient of the PVMA 2012 PA Veterinary Technician of the Year Award. I was (and still am!) overwhelmingly honored and flabbergasted to have been selected to receive such a prestigious award. Success Story: A success story I was fortunate to be involved with was Figuero, a 5-year-old neighborhood stray kitty that was being fed by one family. The shed in which “Figgy” and his brother were seeking shelter in March 2021 caught fire. Unfortunately, his brother didn’t survive, but Figgy was found the following day in the garage of the family that had fed him. Figgy sustained multiple burn wounds over his body, the worst of which were 1st-2nd degree over his ear tips, the top of his head, between his shoulders, and on his paw pads. Fullthickness wounds were also sustained over his nose and muzzle, lumbosacral region, and distal limbs. Trauma to his eyes was also sustained from smoke exposure. Despite all of his injuries, he was so sweet. The family adopted Figgy and he was admitted to our surgery service for treatment.

After approximately three months of hospitalization, intensive wound care and debridement, HBOT treatments (see above!), and loving supportive care, sweet Figgy returned home for continued wound care. Five months after his trauma, Figgy came in for his final recheck. His wounds had healed, most of his fur had regrown, and he was finally able to live life e-collar free.

5. This isn’t exactly a trade secret, but something I’ve learned by listening to pet owners and coworkers over the years when admitting and discharging patients for surgery. Taking time to explain to owners the timeline for our day, educating them on any uncertainties of the procedure, and answering questions they may have prior to their pet’s admission helps to decrease their anxiety. When it comes time for pets to be returned home, spending time reviewing discharge instructions (e.g., medications and when they are due, suggestions on how to give medications) and anticipating any issues they may experience once at home, along with suggestions on how to deal with said issues, reduces stress for owners and the potential frantic phone calls after discharge. I’ve learned that time spent preemptively educating owners makes them feel prepared, empowered, and relieved, and ultimately saves us time by not having to repeatedly answer phone calls. It seems obvious, but given how hectic our schedules are lately it’s easy to rush through these processes.

Christopher Rizzo, CVT, VTS (EVN, LAIM) Specialty Field: Equine Veterinary Nursing (EVN) and Large Animal Internal Medicine (LAIM). Lead nurse of the emergency and critical care department and the neonatal intensive care unit.

Employer: University of Pennsylvania, School of Veterinary Medicine, New Bolton Center 1. Gather as much information as possible and transfer it to the receiving party. There really is no such thing as too much information. Never offer the client a price quote. This has caused much confusion and leaves everyone feeling frustrated. Allow the referral hospital to give the estimate directly to the client.

2. I absolutely love the Flexineb®. It is a portable equine nebulizer for treatment of respiratory issues in horses. It is incredibly quiet and completely self-contained. Other nebulizing instruments require you to stand with the patient for long periods of time. With this instrument, you can put it on the patient and continue doing other treatments. It works well and is efficient.

3. This is a physical and emotional job. It is not for everyone. Think carefully before deciding to pursue a career in this field. It is incredibly fun and rewarding and you never know what is going to happen at work, but it is not for everyone.

4. I have worked with a variety of species and in different environments including working at a zoo, small animal emergency and critical care hospital, and small animal orthopedic referral service in anesthesia. We once had a 1-kg kitten that coded after a bilateral femoral fracture repair. (The kitten was thrown from a moving vehicle.) There was no heartbeat, and the pupils were fixed and dilated. After immediately beginning CPR and after several rounds of epinephrine and Dopram, I administered intracardiac epinephrine and the kitten began having electrical activity on the EKG. Shortly after, it began breathing and to make a long story short, the kitten fully recovered and went on to live a normal life. I am also the 2015 recipient of the Gretchen Wolf-Swartz Award, which is presented by the New Bolton Center Veterinarians in acknowledgment of a veterinary nurse who has paid special attention to all aspects of patient care while also maintaining a professional attitude toward clients, students, and staff.

5. Another small animal trick that I use in large animal, specifically small ruminants, when performing cephalic blood draws, or catheter placement, use a Penrose drain and a hemostat as a tourniquet. This was helpful when we had a sheep that was attacked by a dog and the neck was completely ripped open, rendering the jugular veins unusable for catheter placement.

Pennsylvania Veterinary Medical Association | 27

Ouch! That Hurts!

By Robert Sullivan, VMD

Multimodal Pain Management

“He’s just getting old and slowing down, he’s not in pain.” Too often I hear these sentiments expressed from clients. I feel that pain management is all-too-often overlooked in our patients. As I work mostly with dogs and cats, I will concentrate on their needs, but we must transpose our knowledge of pain to all species.

Learning how to recognize—even anticipate—pain in our patients, how pain is transmitted, and where we can block or attenuate it with a multimodal approach will help our pets live better.

First, pain management isn’t all about medication. There are many strategies that may help. For acute injury such as postsurgery pain, cold therapy applied immediately for 10 to 15 minutes will decrease pain and inflammation. In chronic pain management, a heat pack for 10 to 15 minutes can decrease pain by increasing blood flow to the area. Avoid burns from either option by placing a dry towel between the skin and heat/cold source. Deep-tissue warming can be facilitated with massage, photobiomodulation (laser) therapy, or therapeutic ultrasound. Acupuncture has been shown to decrease pain by either blocking or freeing pain channels. Trigger point (myofascial) therapy uses needles, direct pressure, or focused laser to ease nerve spasm and thus allow tense muscles to relax. Transepidermal nerve stimulation (TENS) can aid in pain management through rapid polarization and depolarization of nerve endings. Last, pulsed electromagnetic field (PEMF) therapy using mats or devices such as the Assisi loop have helped some patients.

Before we get to treating pain, we have to recognize pain in our pets. There are numerous pain management questionnaires available for download that can be of use. We have found the Canine Brief Pain Inventory useful for dog owners. Developed at Penn, it quantitates, for you and the owner, the severity of a pet’s pain. It will help the owner to recognize that their pet IS in pain.

All of our middle-age and older patient owners get a copy before an exam.

I learned something about cats a number of years ago. Dogs and people may be from earth, but cats are from the Andromeda galaxy. Cats are not small dogs, whether it be their anatomy, physiology, or behavior, so their pain assessment and management has had to evolve from a different direction. One assessment was developed by the University of Montreal and

28 | Keystone Veterinarian

Zoetis. The Feline Grimace Scale is one way to measure pain in cats, either acute or chronic.

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage,” by the International Association for the Study of Pain, 2020. Inflammation is the body’s response to injury, and inflammation is actively required to promote healing. The problem lies in the plasma and cellular-derived mediators associated with inflammation. These mediators, which promote vasodilation, migration, and activation of pro-inflammatory cells and phagocytosis of damaged cells, are also responsible for the perception of pain. The antiinflammatories we use are directed at blocking the mediators most commonly responsible for pain such as bradykinins, prostaglandins, interleukins, leukotrienes, and tissue necrosis factor. The production of prostaglandins (PG) is inhibited by various pharmaceuticals that work on various levels of the PG pathway starting with aspirin, which works on cyclooxygenase 1 (COX-1). Unfortunately, inhibiting COX-1 also decreases the production of protective mucus in the stomach leading to ulcers.

Newer medications blocked further down the PG pathway, decreasing, but not eliminating, side effects, including COX-2, PGE2, and COX-3 inhibition.

Aside from anti-inflammatories to mitigate pain, it helps to look at the steps in the pain pathway to determine other pharmaceuticals to block pain. Pain is triggered by nociceptors, which transform the stimulus into an action potential, electrical signal using sodium channels to transmit or transduce the stimulus to the spine. Transduction can be decreased by local anesthetics such as using a line block of lidocaine along your spay incision or an intratesticular lidocaine injection prior to castration. No transduction of pain signal, no pain perception.

Transmission of pain is the signal reaching the spine and traveling to the brain. Drugs that can block this signal include α-2 agonists such as using dexmedetomidine with anesthesia or local anesthesia, such as epidural nerve blocks with lidocaine.

Along the way, the pain signal can be modulated along the spine, either inhibited or enhanced. Enhancement can occur from either circulating cytokines from inflammation or from previous chronic

pain stimulus. Referred to as “wind-up” pain, nerve endings that have had continuous stimulation are sensitive to further stimulation down the road and a simple muscle spasm may ramp up to crippling pain. NSAIDS will help decrease the circling cytokines, but N-methyl-D-aspartate (NMDA) antagonists such as ketamine and amantadine will aid in desensitizing the nerve ends.

Perception of pain is the brain recognizing the stimulus and saying “OW!” Removal of pain perception is accomplished during surgery through anesthesia. Once anesthesia is removed, the perception component of pain needs to be addressed via opioids or benzodiazepines.

Other adjunct treatments for pain have been used to aid in blocking the projection of pain along the pathway. Tricyclic antidepressants, such as amitriptyline, block the reuptake of serotonin and noradrenaline. NMDA antagonists can again decrease the projection of pain and the calcium-channel modulators gabapentin and pregabalin are invaluable in a multimodal management routine.

Newer modalities are available. Owing to the macrophage’s innate role in inflammation within the synovium, SynovetinOA has been developed to provide a year’s worth of pain management in joints with osteoarthritis. A small amount of SN117 is injected intra-articularly, and the macrophages ingest the isotope and die. Other macrophages ingest the dead macrophage and so on. The isotope is present for 6 months and it takes 6 months for inflammation to build up again.

Nerve growth factor (NGF) has been shown to be an important component of osteoarthritis pain and inflammation. A monoclonal antibody has been developed to block NGF and is currently available in Europe.

By learning how to recognize pain in our patients and combining physical modalities with a knowledge of the pain pathway and how to attenuate pain transmission at each stage, we can help our pets heal with minimal pain.

About the Author: Robert Sullivan, VMD, graduated from the University of Pennsylvania School of Veterinary Medicine in 1996, then moved to and started working in Montrose, PA. In 2005, he started Southtown Veterinary Hospital, and eight years later, built the current facility, which includes rehab. In 2014, Dr. Bob completed certification in Canine Rehabilitation at the University of Tennessee. He also has special interests in internal medicine, general and orthopedic surgery, and lately, pain management.

Dr. Bob is married to Rebecca and they have two wonderful children, Alannah and Lee John. Over the years, his pets have included ferrets, fish, horses, and rodents. Currently, the Sullivans have a 12-year-old rescue dog, Hank, a Chesapeake Bay Retriever who spends most days with Dr. Bob at the office. They also have four cats: two pairs of orange siblings, Pumpkin and Blizzard, and Trick and Treat that were orphaned at 5 days old, bottle fed, and cared for by the family. When not in the office, Dr. Bob is tending to his flock of chickens, his beehives, or his garden.

Small Animal Pain Assessment Pain Management Associations International Association of Veterinary Pain Management ivapm.org Veterinary Anesthesia and Analgesia Support Group vasq.org American College of Veterinary Anesthesia and Analgesia acvaa.org

Canine Pain Assessment Canine Brief Pain Inventory scoring - bit.ly/3oHiMhO Glasgow Composite Measure Pain Scale - bit.ly/3gKxwYN Helsinki Chronic Pain Index - bit.ly/3HONJbu Colorado State University Canine Acute Pain Scale bit.ly/3BmwGey

Feline Pain Assessment Feline Grimace Scale - felinegrimacescale.com Colorado State University Feline Acute Pain Scale bit.ly/3swkYcY Feline Musculoskeletal Pain Index bit.ly/3GNtCJa

The Pain Pathway and Useful Medications Transduction Local anesthetics Opioids NSAIDS Corticosteroids

Projection NMDA antagonists Tricyclic anti-depressants Calcium-channel modulators

Transmission Local anesthetics α-2 agonists

Perception Anesthetics Opioids α-2 agonists Benzodiazepines

Modulation Local anesthetics Opioids α-2 agonists NMDA antagonists NSAIDS

Pennsylvania Veterinary Medical Association | 29

An Introduction to the Veterinary Nurse Initiative and Where It’s Heading An Interview with Pennsylvania’s Veterinary Nursing Program Directors The Veterinary Nurse Initiative (VNI) was introduced by The National Association of Veterinary Technicians in America (NAVTA) in 2017 based on the results of the 2016 NAVTA Demographics Survey.1 The initiative has four goals aimed on creating national standards for credentialing, improving public and professional recognition for this essential role in the clinic team, and improving career longevity through providing opportunities for advancement.

According to Kathy Koar, MSEd, CVT, Program Director of Harcum College Veterinary Nursing Program and Co-Chair of the PVMA’s VNI Taskforce, “There’s so much that we can do with the VNI to help the profession of veterinary medicine as a whole.”

GOALS OF THE VNI 1. Professional Standards Two of the most significant challenges faced by credentialed veterinary technicians are due to the lack of a national standard. Every state has a unique path to credentialing veterinary technicians, some of which do not require a degree or standardized examination. This makes moving from state to state particularly challenging as a license in one state may not easily transfer to a new location.

Additionally, credentialed technicians can have one of several titles, depending on where they received their degree and credentials. These currently include CVT, LVT, RVT, and LVMT. Though these credentials are equivalent, multiple acronyms increase confusion within the profession. While many terms have been proposed, the most popular choice for standardization is Registered Veterinary Nurse (RVN).

2. Public Recognition It is essential that we establish a professional identity within society. Improved public awareness and recognition of our role in the veterinary setting benefits everyone. The term veterinary technician, which has been in use for decades, remains misunderstood by the general public. The terms technician and technology are most commonly associated with information technology or service/repair in our current culture.

But everyone understands the term veterinary nurse – there is an automatic visual image of someone doing patient care, which represents the role of the majority of CVTs. Clients will process that a trained veterinary professional is taking care of their animal, which engenders both appreciation and respect.

3. Professional Recognition There is a need to clarify and standardize the scope of practice within our own profession. Credentialed veterinary nurses/

30 | Keystone Veterinarian

technicians can increase profitability for veterinary practices if they are utilized fully. Veterinary assistants have a more limited scope of practice under the law and stricter requirements for supervision. Delineating these roles will improve animal care and provide the veterinarian increased flexibility to attend to tasks specific to their role.

4. Expand Career Potential According to the 2016 NAVTA survey, 57% of respondents had changed jobs within the first 5-7 years of becoming a veterinary nurse/technician.1 Increased employment opportunities for credentialed veterinary nurses/technicians that provide the ability to grow and advance within the profession, and which provide a salary commensurate with education/licensing, will improve longevity and job satisfaction.

Recently, PVMA staff sat down with the program directors of Pennsylvania’s three veterinary nursing programs to discuss the VNI. This is what they had to say:

Kathy Koar, MSEd, CVT, Program Director of Harcum College Veterinary Nursing Program and Co-Chair of the PVMA’s VNI Taskforce

Tammy Ege, CVT, MS Assistant Professor of Veterinary Medical Technology Director of Veterinary Nursing

Kimberly Konopka, BS, AS, CVT, ESMT Program Director of the Veterinary Nursing Program Johnson College

Recently, PVMA staff sat down with the program directors of Pennsylvania’s three veterinary nursing programs to discuss the VNI. This is what they had to say: Q: Your schools all have Veterinary Nursing Programs. What prompted the change to Veterinary Nursing, and how was it received?

KOAR: It has always been my belief that real, meaningful change tends to come through academia. The VNI came to Pennsylvania in 2018 when I read an article about Purdue University changing the name of their veterinary technology program to veterinary nursing, in support of the VNI. When I saw that Purdue had done that, I thought, ‘I want to do that too!’ So we did. In January 2019, Harcum College Veterinary Technology Program became Harcum College Veterinary Nursing Program.

In the fall of 2019, we held a summit at Harcum to introduce the VNI and improve collaboration between Pennsylvania’s technician programs. We invited representation from all of the vet tech programs in Pennsylvania and New Jersey, corporate partners who supported the initiative or had interest in it, the president of NAVTA, and PVMA leadership.

KONOPKA: Of course, I left the summit with guns blazing.

This was something that I had been interested in since I had graduated from Johnson college as a nontraditional student in 2007 with a degree in veterinary technology. Since then, I always wondered why we continued to use the word technician when it is freely used for non-licensed individuals. I was able to get the approval from the powers that be at Johnson College.

Ultimately, we completed our name change in July of 2021.

EGE: With Wilson College, three of us attended the Harcum College summit. We came back and surveyed our students. The majority, if not all, of our students at that time were in favor of the name change. We were in the midst of a curriculum overhaul in general, so it was a perfect time to throw the name change in with it. Our administration was supportive and the name change went through easily.

Q: What advantages does a degree in veterinary nursing give to your students?

EGE: The veterinary nursing degree gives the students a more relatable degree name which helps the community better understand what our profession entails and hopefully, encourages them to be open to a variety of career options.

We also hope by discussing their degree and the VNI with our students it will encourage them to be active in our profession and advocate for change.

KONOPKA: A student will say, ‘I’m going to become a veterinary technician.’ People will smile and ask, ‘what do you do with that?’ They think that [vet techs] work on the blood machines and x-ray equipment that veterinarians use, and that we don’t actually work with animals.

I think the word technician is utilized across so many different industries that it leads to confusion. The minute you say the word ‘nurse’ to someone, whether it’s human or animal, they can understand what it is that we do.

Q: How do you see the VNI impacting the future of veterinary medicine?

KONOPKA: Veterinary nurses are underappreciated, underpaid, and overworked. They can’t maintain that level for an extended period of time. I’m hoping [the VNI] not only helps the general public to understand what we do, but also helps the veterinary nurses to get the recognition that they deserve. Hopefully that will strengthen their career lifespan.

Not even all veterinarians know what a veterinary technician is licensed to do. Veterinary nurses are underutilized in the profession. A 2019 article in Today’s Veterinary Business looked at the financial opportunities in the profession related to the utilization of veterinary nurses.2 According to the article, if a veterinarian places their own catheter 100% of their time, their lost potential revenue from not using a licensed nurse is over $352,000. On average, for every single credentialed veterinary nurse that a practice has, they have potential revenue increases of over $200,000 per year.

Hopefully, listening to numbers like that and seeing numbers like that, veterinarians might step back, and utilize their nurses better and realize the potential income for their practice. And maybe it will have a trickle-down effect in the pay scale.

Q: Where does the VNI stand nationally and in Pennsylvania?

KOAR: NAVTA continues to support and promote the VNI. Change needs to happen at the state level due to the variety of paths to licensure nationally. NAVTA is supporting state efforts for title production and standardization of licensing, however the state chooses to approach these issues.

Here in Pennsylvania, we have an appropriate licensing process.

What we need now is to standardize and protect the term veterinary nurse. Right now, anyone who isn’t a veterinarian in the practice can be referred to as a technician. But veterinary nurses deserve recognition for their education and licensure, which is why it is important to clarify terminology and reserve the term ‘veterinary nurse’ for those who are licensed.

There have been important initiatives and statements at the national level that have come recently. In December, NAVTA issued a press release regarding the use of veterinary nurse as a job title.3 If an employer is advertising for the position ‘veterinary nurse,’ it should be clearly stated that all applicants hold a CVT/RVT/LVT/LVMT. Q: How does PVMA support the VNI? KOAR: PVMA has been 100% supportive of where we are in Pennsylvania. After the Harcum College Summit, the PVMA Board of Trustee’s Veterinary Support Staff At-Large Member, Nicholas Rivituso, CVT, VTS (ECC), sent out a survey to the membership of PVMA. The results were published in the Keystone Veterinarian magazine, Spring 2020. There was overwhelming support of the VNI across the board. Depending on the question, between 76-95% of the respondents were in support of the VNI. That spring, the PVMA Board voted to put out a statement in favor of the VNI in Pennsylvania. continued on next page > Pennsylvania Veterinary Medical Association | 31

An Introduction to the Veterinary Nurse Initiative continued from page 31 Right now, in the state of Pennsylvania, there are 7 fully accredited AVMA-veterinary technology/nursing programs.

Three of them are now veterinary nursing programs. So, we’re as close as we are going to get to a 50/50 split of veterinary nursing and veterinary technology programs. Three of our four oldest, most established programs are awarding degrees in veterinary nursing. It’s time that the state board recognize the term veterinary nurse.

Q: How can Pennsylvania veterinary professionals get involved and stay up to date on the status of the VNI? KOAR: The PVMA has a VNI Committee that is co-chaired by Nicholas Rivituso and myself. There is a group on the PVMA member portal for the VNI, and the committee has a Facebook group that is open to all PA veterinary professionals, called Pennsylvania VNI Task Force, where interested professionals can receive updates.

We need the support of a large number of veterinary nurses in this state who want to politely have conversations with others in the profession as well as the legislature of why the VNI is important. We’re here to talk to people who have concerns. We can show them the benefits for the entire profession.

Q: What comes next for the VNI, and how long do you foresee this taking?

32 | Keystone Veterinarian

KONOPKA: I still think there needs to be a lot of informational and educational sessions that need to be provided to individuals in the human nursing profession, because I think that’s where the majority of our pushback is coming from. And I think that’s because they too, just like the general public, don’t really know what it is that we do. I feel as though once they are informed of what it is that we do, the fact that we have to go to an accredited program, and the fact that we have to sit for a national board exam, and the fact that we need to continue with continuing education credits. I think once they understand that, they are a little less ‘prickly’ about sharing the word nurse.

KOAR: Change takes time. It’s my plan to work on it until the change happens. I know this is what’s in the best interest of my students and the profession.

EGE: We are looking at a long term change, so, unfortunately, it won’t happen overnight. However, with each graduating class, we are instilling the importance of our profession and the VNI so they can be our future campaign leaders.

References: 1 NAVTA 2016 Demographics Survey Results. Available at bit.ly/36sURfY. Accessed February 15, 2022.

2 Walsh S. A recipe for success. Today’s Veterinary Business April 2020. Available at bit.ly/3wiKyp. Accessed February 12, 2022.

Practice Pearls

By PVMA Partner, FocusHRO

Employment Practice Liability Important Coverage for Veterinarians

By PVMA Partner, FocusHRO Your practice may have never experienced a fire, but you have your building insured in case it ever would, right? Did you know that businesses are three times more likely to be sued by an employee than experience a fire? Yet many owners don’t consider purchasing an Employment Practice Liability Insurance (EPLI) policy to provide themselves with the correct coverage for those issues—or they mistakenly believe that their current policy provides it. Many veterinarian practices might believe that the size of their staff is too small, too much like family, or that the cost for coverage is too high. But the truth is, the cost of not having coverage could be even higher; out-of-court costs average $75,000, and the average jury award hits $217,000 if you go to court and lose.

EPLI protects you and your practice when employment claims occur. Policies cover defense costs associated with allegations of discrimination (age, sex, race, religion, and disability), sexual harassment, wrongful termination, or wrongful discipline.

Veterinary hospital practice owners are vulnerable from the prehiring process through the exit interview, even if the employee was never hired, or only at the company a matter of days. Even if allegations are groundless or fraudulent, coverage will protect you from monetary damages that could seriously threaten the ongoing viability of your practice. Your owners, directors, managers, doctors, and technicians all receive protection.

Facts 1.

2.

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Three out of five employers will have an EPL claim in the next five years.

No veterinary practice, large or small, is immune to EPL claims.

30% of all EPL claims are against employers with less than 50 employees.

Employment-related lawsuits can come from your employees, clients, vendors, and/or independent contractors.

Every practice owner should consider adding EPLI to their insurance and risk management portfolio.

Statistics indicate that owners are more likely to have an employment practice claim than a general liability or property loss claim. And EPLI claim rates have been climbing from recent societal issues—gender pay gap, #MeToo, racial and social injustice movements, COVID-19, and more. For many practices, EPLI claims are not a matter of “if” but “when.” So, even though you may have never dealt with an employment issue and your current policy may include EPL items, it’s important to review your coverages and purchase the right policies—just “in case of fire.”

PVMA preferred partner FocusHRO is ready to help do just that: checking your current lines of coverage, adding employment practice liability or other liability, and workers’ compensation coverages you might need. Their team is ready to help take these necessary steps off your already long to-do list and bring you peace of mind and potential savings.

Visit FocusHRO.com/PVMA or call Tara Schlyfestone at 717.980.3330 extension 109.

About FocusHRO: Your PVMA Membership gives you and your practice access to FocusHRO’s best programs and pricing. They’ve created “Business in a Box,” which takes the guess work out of running your veterinary practice and lets FocusHRO handle all your insurance, HR/compliance, accounting, and web/IT needs. These services help keep your veterinary practice running smoothly. Visit FocusHRO.com/PVMA or call 717.980.3330 to get more information.

Pennsylvania Veterinary Medical Association | 33

MEMBER NEWS Obituaries In memory of...

the AHS and lectured on his hybridizing program. He expressed his pride in local culture with daylily names such as “Rutchin” and “Ferhoodled.”

The son of Maurice Groff Herr and Anna Martha Greider Herr of Refton, PA, he was predeceased by a brother, Dr. Harold Greider Herr. He is survived by his wife of 59 years, Dr. Patricia Louise Thomson Herr; a son, Roger Allan, and partner Vincent Fiorenti, Brooklyn, NY; two daughters, Martha Anne, wife of James A. (excerpt from lancasteronline.com) Brown, Linglestown, PA, and Elizabeth (Beth) Louise, wife of William B. Collier III, Marietta, GA. He is also survived by a sister, Dr. Donald M. Herr, 83, of Mary Jane Graybill, Stevens, PA; and two grandchildren, Carolyn Lancaster, passed away on Sunday, Elizabeth Brown and Aaron James Brown.

December 12, 2021 at home.

Born in Refton, PA, he completed Don was a 70-year member of Covenant United Methodist West Lampeter High School in Church. He was proud of being a 9th generation Lancaster 1955. He graduated from Franklin Countian and a direct descendent of the early Lancaster County & Marshall College in 1959 and settler Hans Herr. from the New York State College of Veterinary Medicine (Cornell) in 1963.

Dr. Donald Herr

He and his wife founded the Manheim Pike Veterinary Hospital in 1964. He was a pioneer in advanced veterinary dentistry.

Dr. Herr was a trustee and member of the Board of Governors of the Pennsylvania Veterinary Medical Association, receiving the PVMA Award of Merit in 1982. He was a past Vice-President of the PVMA, and a founding member and PVMA liaison to the Veterinary Technicians and Assistants Association of Pennsylvania, of which he was a founding member.

He was a lecturer, author, researcher, guest curator and collector of 18th and 19th century American pewter and Pennsylvania German Decorative Arts. Don was past President of the Pewter Collectors’ Club of America, president of the MidAtlantic Regional Group. He was a member of the Collections Committee of the Lancaster County Historical Society and held memberships in the Landis Valley Museum Associates, Heritage Center Museum of Lancaster County, Lancaster Mennonite Historical Society, the Hans Herr Foundation, the Pennsylvania German Society, Winterthur Museum Associates and the Museum of American Folk Art. He was a nationally known hybridizer of Hemerocallis (daylilies) and received numerous awards, including the Bertrand Farr Silver Medal for “outstanding results in the field of daylily hybridizing” from the American Hemerocallis Society (AHS). Don was an accredited garden and exhibition judge, a life member of

34 | Keystone Veterinarian

Dr. Thomas L. Kowachick

(excerpt from kelchnerfuneralhome.com) Dr. Thomas “Tom” L. Kowalchick, beloved husband, father, grandpa, brother, uncle, and friend, died tragically on February 16, 2022, at the Berwick Hospital. He was 78.

Born May 15, 1943, in Berwick, he was the son of the late Stanley and Betty (Smith) Kowalchick.

Tom was preceded in death by his beloved and devoted wife of 53 years, Sharon K. Kowalchick.

He graduated from Berwick High School in 1961. He earned a Bachelor of Science degree from Pennsylvania State University.

Tom was awarded a doctorate from University of Pennsylvania’s School of Veterinary Medicine in 1969. Tom felt honored to faithfully serve the United States in two branches of the Military. First, he was a member of the U.S. Naval Reserve and he was honorably discharged as a hospital corpsman.

Following his graduation from veterinary school, he served in the Army Veterinary Corps and he was stationed with his family in Ft. Lewis, Washington. After distinguished service, he was honorably discharged having attained the rank of Captain.

Tom’s compassion and commitment to his life’s work and calling as a veterinarian was inspiring and spanned over five decades. Following veterinary work in Philadelphia and Maryland, he returned to Berwick to fulfill his greatest dream of starting his own animal hospital. In 1974, he worked together with his father, brother and friends to build his hospital from the ground up. Tom and his wife launched and established his veterinary practice, North Berwick Animal Hospital. It was here throughout his noteworthy career that he exemplified his philosophy that pets are not just animals, they are true family members.

He was well-known and loved for his willingness to provide care anytime and anywhere. He prioritized providing compassionate care and was honored to serve his clients and community. He was thought of by many as an advocate and true friend.

Through his practice, he also mentored and supported many young learners and aspiring veterinarians as well as many enthusiastic employees. Tom was a skilled and intuitive teacher. He was also a role-model for providing a welcoming, loving environment to help serve clients during difficult times.

Tom’s humor and wit were legendary. He was a fantastic storyteller and could regale friends and family with his comedic delivery and impeccable timing. He was always ready to share a joke, loved to entertain and was a generous host. He loved spending time at “The Cabin” on Fishing Creek, cheering on Penn State (“We Are…..!!”), and taking a break to visit and enjoy family time in Cape May, N.J. Tom’s family loves him dearly for his kindness, generosity and compassion. We are extremely proud and grateful to have him as our father and grandfather. The legacy he leaves us is one of love, strength, and steadfastness. Our father lived an exemplary life. He is the person we aspire to be. Tom Kowalchick was a great man.

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In addition to his dear wife and beloved parents, Tom was also preceded in death by his father-in-law, Carl E. Whitmire and mother-in-law, Thelma (Molyneux) Whitmire.

Tom is survived by his three children: Leigh Ann Kowalchick, of Harrison N.Y., and her boyfriend, John C. Mann, of Riverdale, N.Y.; Tracy L. Kowalchick, of Perkasie, and her boyfriend, Harry D. Yanoshak, of Hatboro; Thomas S. Kowalchick and his wife, Shayla, of Berwick; and three grandsons: Mitchell S. Kowalchick and his fiancée, Amber Coolbaugh, of Scranton; and Asher and Griffin Porphy, of Harrison, N.Y. Tom is also survived by a brother, Stanley J. Kowalchick and his wife, Mary, of Millheim; brother-in-law, Carl E. Whitmire, Jr. and his wife, Judy, of Berwick; four nieces and a nephew: Debra (Whitmire) Yachimowski, Jayne (Whitmire) Burke, Michael Whitmire and Jennifer (Kowalchick) Claus; and his best friends Peter Marycz and his wife, Denise, of Sugarloaf.

Pennsylvania Veterinary Medical Association | 31

Classifie d Ads VETERINARIANS Camboro Veterinary Hospital | Full Time / Edinboro, PA Managing Veterinarian / Medical Director opening at Camboro Veterinary Hospital located near Erie, PA. We are looking for an experienced Veterinarian who is a good communicator, a team player who enjoys collaboration and contributing to the growth of our team through sharing knowledge and teaching. This is both a clinical and non-clinical position some of which involves surgery, dentistry, providing excellent medical leadership, creating an environment of teamwork, managing Associate veterinarians and assuring regulatory compliance relating to the practice of veterinary medicine. We are a team of 5 FT and 2 PT veterinarians.

Progressive clinic with lots to offer. Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.Dowhaniuk@nva.com.

Lewisburg Vet Hospital | Full Time / Lewisburg, PA Our small animal practice is located in the beautiful town of Lewisburg, Pennsylvania, home of the prestigious Bucknell University. We have the tools you need to practice, an excellent support staff whom we cherish and all the standard perks of the job. Last year our 3 associate veterinarians grossed an averaged $186,000 and that is working 4-5 days a week, no weekends, no on-call, no overnight. Consider scheduling an interview with us, all expenses paid, so we can tell you what’s in it for you. We look forward to hearing from you! Contact: Please call Kim at 570.523.3640 and/or email lvh@dejazzd.com.

Countryside Animal Clinic | Full Time / Mechanicsburg, PA Countryside Animal Clinic in Mechanicsburg, PA is seeking a veterinarian. Located on 11 beautiful acres, our work environment is upbeat & enjoyable. We are a busy, family-oriented one doctor practice, rapidly growing into two doctors. My staff is great and our team is highly reviewed by our clients. If you desire a good work-life balance, we are a great fit! Our practice has digital x-ray, in-house Abaxis lab, Ultrasound, & is well-versed in dentistry & most surgeries.

36 | Keystone Veterinarian 28

Mentoring is available if desired. Most weekends and evenings off unless you want the opportunity to see emergencies.

Check out our website! Contact: Please call Amanda at 717.697.6747 and/or email at krusenvet@gmail.com.

Troy Veterinary Clinic | Full Time / Troy, PA Mixed animal practice, located in the beautiful northern tier of Pennsylvania, seeking a small animal practitioner for full time employment. Our recently remodeled facility is equipped with all the necessary work space and diagnostic tools to provide quality services to our clientele. Our team strives to work together and promote a cohesive, family friendly attitude.

Salary negotiable based on experience.

Other benefits include assistance with relocation expenses, 3% matching simple IRA retirement plan, health insurance benefits, CE allowance, assistance with organization dues and opportunities for productivity bonuses. Contact: Please call Seanna or Marsha at 570.673.3181 or email marosanelli@gmail.com.

Banfield Pet Hospital | Full Time / Mechanicsville, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Banfield Pet Hospital | Full Time / Fairless Hills, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Banfield Pet Hospital | Full Time / Springfield, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Banfield Pet Hospital | Full Time / Christiana, DE Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Banfield Pet Hospital | Full Time / South Philly, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Banfield Pet Hospital | Full Time / Caste Village, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact: Jackie.Griffith@banfield.com today to learn more.

Interested in placing a classified ad? Visit PaVMA.org/Classified-Ads for information on all classified ad placement opportunities.

Banfield Pet Hospital | Full Time / Parma, OH Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities?

Look no further, because Banfield Pet Hospital is hiring! Contact: Gregory.Spunt@ banfield.com today to learn more.

Banfield Pet Hospital | Full Time / Pittsburgh, PA Banfield Pet Hospital is seeking Veterinarians! Sign-on bonus available at select locations! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities?

Look no further, because Banfield Pet Hospital is hiring! Contact: Gregory.Spunt@ banfield.com today to learn more.

North Versailles Veterinary Care | Full Time / North Versailles, PA North Versailles Veterinary Care located in North Versailles, Pennsylvania is a fullservice animal hospital that welcomes both emergency treatment cases as well as pet patients in need of routine medical, surgical, and dental care. We are looking for an enthusiastic and passionate Veterinarian to help us continue to grow. Relief, PT, FT, and Managing opportunities available.

North Versailles Veterinary Care stays on top of the latest advances in veterinarian technology and above all, remembers that all animals and pets need to be treated with loving care in every check-up, procedure, or surgery. All levels of experience welcome to apply! Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Holiday Park Animal Hospital | Full Time / Pittsburgh, PA Holiday Park Animal Hospital located on the Golden Mile Highway is a full-service animal hospital providing comprehensive healthcare services. Our facility includes inhouse testing for accurate diagnosis, digital x-ray, ultrasound, surgical suite, dental suite, pharmacy, and more. We are looking for an

enthusiastic and passionate Veterinarian to help us continue to grow. Our ideal candidate has strong communication skills, is team-oriented, and excited to help our vibrant practices excel in our community.

If you want a place where your passion and skills are valued, where your feedback, input, and ideas are heard, then apply today! Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Pittsburgh Premier Veterinary Care | Full Time / Pittsburgh, PA Pittsburgh Premier Veterinary Care & Rehabilitation is located on Frankstown Road in Pittsburgh. We are a full-service veterinary and rehabilitation hospital that welcomes dogs and cats but open to exotics as well. Holistic and alternative wellness options welcome. As a Veterinarian at our hospital you will be responsible for routine exams to sick visits to physical therapy.

Hours are 9-5pm or 9-6pm; 40 hours per week. No weekends or on call. Limited ER. Equipment includes under water treadmill, digital x-ray, ultrasound and many therapeutic options including cold laser, PRP, Fitness, Electro, and Hirudotherapy.

Excellent benefits and extra incentives.

All levels of experience welcome to apply!

Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Blair Animal Hospital | Full Time / Altoona, PA Our hospital in beautiful central Pennsylvania is looking to add another part or full time veterinarian. We are currently comprised of two full-time veterinarians and one part-time veterinarian, along with an amazing support staff. Blair Animal Hospital is a cat and dog exclusive hospital, but our clientele and team would be happy to open our doors to exotics and/or pocket pets if there is an interest in this area. We look forward to mentoring a new graduate or learning from an experienced applicant that is looking to work within a team to care for our patients and clientele.

Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Keysville Mobile Vet Services, LLC | Part Time / Southern PA/North Central MD Tired of the frantic pace of vet hospital work? Frustrated by communication barriers created by COVID but here to stay? Our family friendly mobile practice is seeking a 3 day/week associate with MD and PA licenses to provide personalized, in-home care for cats and dogs and their people. Utilizing vet assistants & remote CSS’s, we currently service Carroll & Frederick Counties from a home office in Keymar, MD. We are adding a second van and team to expand into Southern PA this spring. Buy in potential.

Contact: Please call email cc@keysvillemobilevet.com or call 443.974.4348.

Best Friends Animal Hospital | Full Time / Chambersburg, PA Best Friends Animal Hospital is seeking a veterinarian to join our small animal practice. We are committed to your learning and growth as well as providing mentorship. Someone with an interest to learn alternative medicines or exotics on their own is encouraged to apply. The ideal candidate for this role would be able to perform surgery, evaluate emergent patients, perform annual examinations, order appropriate tests and provide a diagnosis and treatment plan. We offer a 3–4-day flexible schedule with one rotating Saturday per month and limited on call hours. This position is 30 hours per week. Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Camboro Veterinary Hospital | Full Time / Edinboro, PA Camboro Veterinary Hospital located near Erie, PA is seeking an Associate Veterinarian to join our practice. Part-time or Full-time hours available. Our 7,000 square foot modern hospital provides primary, referral and limited emergency services. There are 6 modern exam rooms, a large hospital waiting and reception area, retail and pet discharge areas all for the convenience of our clients, and much more! Generous Signing Bonus. Formal Mentorship Program Available. Excellent benefits and incentives.

Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com. continued on next page >

Pennsylvania Veterinary Medical Association | 37

clas sifie d ads continued from page 37 Confederate Woods Veterinary Hospital | Full Time / Gettysburg, PA Confederate Woods Veterinary Hospital in Gettysburg, PA, is an AAHA-accredited hospital seeking a Veterinarian. We focus on work, life, and family balance, with no on-call duties and after-hours emergencies are referred to a local ER. Your day-to-day will include; well and non-well case workups, spay/neuters, dentistry, appointments, and general practice. We are technician driven with a 3:1 tech to doctor ratio, leaving you free to practice and treat with the full support of our sophisticated in-house lab, digital dental radiography, ultrasound, laser therapy, and acupuncture.

Our doctors are always looking for more ways in which to serve their community.

Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.

Dowhaniuk@nva.com.

Londonderry Animal Hospital | Full OR Part Time / Middletown, PA Londonderry Animal Hospital celebrated its 50th anniversary in 2019 and is seeking two full- or equivalent part-time companion animal veterinarians. We are privately owned and looking for long-term associates who want to establish roots in the community. Future practice ownership is a possibility. Our stand-alone facility was recently renovated. The practice utilizes electronic record keeping with integrated in-house laboratory equipment and digital radiology. We provide comprehensive wellness care and client education, along with general surgical and dental services.

We encourage the development of your special interests. The area boasts great schools, lots of outdoor activity opportunities. Contact: Direct inquiries to gwbook@londonderryvet.com.

Hidden Valley Animal Clinic | Full Time / McMurray, PA Hidden Valley Animal Clinic is a privately owned, well-established small animal clinic located in the South Hills of Pittsburgh. We have been serving the community since 1981. We are currently seeking a full-time Associate Licensed Veterinarian for our busy eight doctor practice. The philosophy of our practice is to allow a good work life balance. Associate Veterinarians work approximately 35 hours a week with 1 week day off, 1-3 Saturdays per month, and no after hour emergencies. Benefits include matching 401K and paid healthcare, vacation, professional fees, and continuing 38 | Keystone Veterinarian

education. Practice hours are Monday & Thursday 8am-7pm, Tuesday, Wednesday, Friday 8am-5pm, and Saturday 8am-1pm.

Our schedule allows our associates to pursue outside interests and hobbies!

We utilize digital and dental radiography, ultrasound, and Idexx in-house laboratory equipment. We encourage professional growth and want our doctors to pursue special interests! We are looking for a personable, energetic and client oriented veterinarian to join our team. Our large practice allows for guidance and training of newer graduates. We accept all levels of experience to apply! Contact: Please email your resume to hiddenvalley@hvemac. com.

National Veterinary Associates | Full Time / South and Central Pennsylvania RELIEF VETERINARIAN needed for our GP small animal hospitals in Southern and Central Pennsylvania. Southern locations are Chambersburg, Gettysburg, York, Dover and Mount Joy. Central locations include State College, Williamsport and Altoona. This role can be as part-time or as full-time as you want. Compensation is negotiable. This is an ideal opportunity for an experienced doctor who seeks the flexibility, balance, and earning potential of relief work with the consistency and stability of working for one amazing company. Services include preventative wellness, urgent care, dentistry, surgery, laser therapy, and much more! Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.Dowhaniuk@nva.com.

National Veterinary Associates | Full OR Part Time / Pittsburgh, PA We are looking for a RELIEF VETERINARIAN for our GP small animal hospitals in the Pittsburgh Pennsylvania area. Our locations are diverse and situated in rural, suburban or urban areas. They range anywhere from 2-5 vets with excellent technician support. We provide a variety of services depending on the hospital which include rehabilitation, wellness, surgery, diagnostics and treatment, and dental services. Limited daytime emergency at most of our practices although one does offer more emergency shifts, including evening/weekend hours if interested. We treat mainly dogs and cats. Pay rate and hours negotiable. Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.Dowhaniuk@nva.com.

East End Veterinary Medical Centre | Full Time / Pittsburgh, PA Associate Vet opening at our practice in Pittsburgh, PA. Enjoy a great work/ life balance. Our office is collaborative hosting weekly and monthly meetings, but our culture is what we’re most proud of.

East End Veterinary Medical Centre is a professional practice with a tight knit team and because of this we have experienced growth ever year. 3-Vet practice with plans of expansion. Wellness, surgery (including ortho if you want), diagnostics and treatment, and dental services. Dog and cat exclusive. No on call. Closed on most national holidays. Limited ER. Competitive salary and bonus program. Excellent benefits and incentives. Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.Dowhaniuk@nva.com.

Dover Area Animal Hospital | Full Time / Dover, PA Dover Area Animal Hospital in South Central PA located Northwest of York is seeking an Associate Veterinarian. We are currently a 7-doctor practice with a recently expanded and upgraded hospital.

We are a high-volume busy clinic with experienced veterinarians who are willing to teach and mentor new graduates. Our hospital includes surgical and cold laser, digital x-ray, ultrasound, paperless records, and boarding and grooming facilities. You can expect a diverse medical and surgical caseload in a laid-back atmosphere. We are offering competitive salaries and flexible work hours with a full benefits package and potential sign-on bonus (minimum $10,000). Contact: Please call Kelli Dowhaniuk at 818.309.3709 and/or email Kelli.Dowhaniuk@nva.com.

Cummings Veterinary Hospital | Full OR Part Time / Easton, PA We are a five-doctor, companion animal, AAHA accredited practice, looking for an energetic certified veterinary technician to join our team. We have 8 exam rooms, a very large 4 table treatment room, complete in-house laboratory, a dental suite, soft tissue surgical suite, orthopedic suite, an ultrasound room and separate dog and cat kennel areas. We pride ourselves on cleanliness and providing great all-around service for clients and patients alike. We are centrally located in the Lehigh Valley, close to Routes 22, 33, and 78. We offer competitive benefits which include a pet discount

program. Pay is commensurate with experience. Contact: Please call Joanne at 610.923.0393 and/or email joanne@ cummingsveterinaryhospital.com.

Animal Wellness Clinic | Full Time or Part Time / Biglerville, PA Career Opportunity in Adams County! Four day work week! Associate Veterinarian needed for AAHA accredited small animal privately owned practice. The Animal Wellness Clinic offers a convenient location and competitive benefits package. Contact: Call Dr. Flake at 717.337.2785 FMI. Animal Wellness Clinic | Full Time or Part Time / Biglerville, PA Urgent Care Veterinarian – The Animal Wellness Clinic is an AAHA accredited Small Animal Veterinary Clinic conveniently located 8 miles west of Gettysburg along Route 30. Seeking an Associate Veterinarian to provide Urgent Care. Prefer Full-time but Part-time will be considered. Hours and salary negotiable. Competitive benefits package available. Contact: Call Dr. Flake at 717.337.2785 or email weluvpets@ embarqmail.com for more information or to apply.

Butler Veterinary Associates and Emergency Center | Part Time or Full Time / Butler, PA We are looking to add another relief, PT or FT Veterinarian to our team who has a special interest in Emergency Medicine.

Our GP/ER large group practice is located just north of Pittsburgh and sees many unique cases, so you’ll never be bored!

We’re flexible in hours, days, and even offer mentorship on the ER side. No over nights! Offering: Sign-on bonus, retention bonus, relocation assistance and student loan assistance. Contact: Learn more at butlervet.com or email Kelli.Dowhaniuk@ nva.com for more details!

Animal Medical Hospital of State College | Full Time / State College, PA Animal Medical Hospital of State College located in State College, Pennsylvania is looking for an energetic and team-oriented veterinarian to join our team! Offering a $35,000 sign-on bonus! We provide primary veterinary care, including wellness care, general surgery, orthopedic surgery, ultrasound, dentistry, and oral surgery to small animals. Our facility includes 4 exam rooms, treatment area, surgery suite, inhouse lab equipment, digital dental, and

a complete pharmacy, to name a few.

Benefits include a competitive salary, full health benefits, 401K with match, CE allowance and days, paid time off, and licensing/professional dues to name a few.

Contact: If you’re interested in learning more reach out to Kelli.Dowhaniuk@nva. com or click here!

The Animal Hospital on the Golden Strip | Full Time / Williamsport, PA The Animal Hospital on the Golden Strip in Williamsport, Pennsylvania is hiring a diligent and driven Managing Veterinarian/ Medical Director. Guaranteed $125,000 salary + $25,000 Signing Bonus! You will be responsible for providing medical leadership for a team of collaborative veterinarians and crafting an environment that fosters teamwork and quality medicine. You will also partner with the Hospital Manager to ensure the success and growth of the hospital and work with Divisional Leadership to accomplish hospital goals. Contact: If you’re interested in learning more reach out to Kelli.

Dowhaniuk@nva.com or click here! practices/Equipment For sale

Bedford, PA 2021 F-250 STX 6.2L gas, extended cab, 4709 miles, New bowie platinum 8 unit.

Ceramic coated bumper to bumper, tinted windows, sprayed in bed liner, undercoated, mud flaps, front seat covers and floor mats. $65,000 obo. Contact: Call 814.381.1905.

South Central, PA Established two doctor practice (canine, feline) in South Central PA. Growing population with multiple doctor potential, if one desires. Attention Medical Directors: Want to work similar hours/responsibilities and earn 3-4 times your current salary?

Practice the way you want to and earn what you deserve. Pleasant, conscientious, and reliable staff. Updated IT, digital radiography (human grade) and in-house laboratory machines. Business and freestanding real estate for sale. Average Gross Revenue over 3 years: 1.4 million (2021, 2020, 2019).

Owner ready to ride off into the sunset.

Contact: Inquiries to vetsale22@gmail. com. Please no corporate inquiries.

East of Pittsburgh, PA PRACTICE FOR SALE – Small animal practice east of Pittsburgh grossing over $550K. Nice, well-equipped practice. Practice and

real estate offered at $499K. (PA-6050).

Call for more information. Contact: Dr. Kurt Liljeberg of Total Practice Solutions Group at 440.933.4522 or kurt@tpsgsales.com.

Various Locations, PA BUYING OR SELLING A PRACTICE – Buying or selling a veterinary practice? Confused about corporate consolidators? Count on the experience of Total Practice Solutions Group. Contact Dr. Kurt Liljeberg for a free consultation! Contact: Call 440.933.4522 or kurt@tpsgsales.com. relief veterinarians

David J. Henzler, DVM, PhD | Dauphin, Lebanon, Berks, Schuylkill, Lancaster, Lehigh, and York Counties RELIEF VETERINARIAN with 15 years of clinical practice experience, including 3.5 years as a full-time 24-hour emergency doctor. PhD in Veterinary Science.

Serving small animal and exotic practices in Dauphin, Lebanon, Berks, Schuylkill, Lancaster, Lehigh and York counties.

Available anywhere in Pennsylvania for oneweek or longer periods to cover vacations, illness, maternity and other needs.

Energetic with a professional appearance and excellent communication skills.

Integrous, dependable and detailed. “I treat your practice like my own!” Contact: Call 717.341.4357 or email henzlerdvmphd@ aol.com.

Jacqueline Burke, VMD | Berks and Bucks Counties 1987 Penn grad seeks part-time employment within 30 to 45 minutes of the Pottstown/Quakertown area. Special interests in surgery, diagnostic imaging, exotics. Professional, reliable, neat appearance. Contact: Phone 610.754.1155 or email jacquib1018@gmail.com.

Relief or Part-time Veterinarian Needed | Elkton, MD Seeking relief vet for Elkton, MD, easy commute from PA or DE, excellent compensation and work environment. No after 6 hours. Contact: email neah1771@ comcast.net.

Relief Veterinarian Job Opportunity | Bensalem, PA Regulatory Relief Vets needed for Parx Racetrack. Please call for more info if interested. Contact: Phone 609.314.0136.

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