SCAV 2022 Spring Magazine

South Carolina

VETERINARIAN SPRING 2022, ISSUE 1

IN THIS ISSUE: • Asian Longhorned Tick Study in SC • Rabies Pre-Vaccinations & Titers • Esophageal Disorder Genetic Variation Identified • SEVC Offers More than 70 Topics and Six Wet Labs

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VETERINARIAN In This Issue President’s Message...................................................................................................................................... 2 Wanted: Dead or Alive................................................................................................................................. 2 Rabies Pre-exposure Vaccination and Titers........................................................................................... 3 Are there natural ways to prevent heartworms?.................................................................................. 4 AVMA Offers Resources on Harmful Algal Blooms.............................................................................. 6 Genetic Test & Dog’s Sex Predict Risk of Disease with 75% Accuracy............................................ 8 SEVC Offers Six, Hands-On Wet Labs in Myrtle Beach..................................................................... 10 Signing Bonus Versus Ownership............................................................................................................. 11 SEVC Schedule – Something for Everybody......................................................................................... 12 Advertising AVMA PLIT................................................................................................................................................. IFC Charleston Veterinary Referral.................................................................................................................. 3 Upstate Vet, Greenville................................................................................................................................. 5 Greenville Small Animal Practice For Sale............................................................................................... 6 Practice Sales Advisors................................................................................................................................ 7 American National........................................................................................................................................ 9 Simmons Classifieds..................................................................................................................................... 9 Simmons and Associates........................................................................................................... Back Cover

SAVE THE DATES June 26-29: Southeast Veterinary Conference at the Myrtle Beach Marriott November 10-13: SCAV Annual Conference at the Greenville Embassy Suites Golf Resort & Conference Center

PRESIDENT Mike Ferguson Rock Hill mikeferguson1962@gmail.com VICE PRESIDENT Lorin D. Lawrence Mt. Pleasant llawrencedvm@gmail.com TREASURER Boyd Parr Newberry bparr@clemson.edu SECRETARY Rebecca Hughes Walterboro rmhughesdvm@lowcountry.com PAST PRESIDENT Joshua Ames Duncan joshuabames@yahoo.com DISTRICT 1 Brian Leman Charleston leman.brian@gmail.com DISTRICT 2 Haley Hunt Lexington haleychunt@gmail.com DISTRICT 3 James Carter Aiken jcarterdvm@yahoo.com DISTRICT 4 Stacy Logsdon Simpsonville salogsdon@gmail.com DISTRICT 5 Daniel Knox Lancaster knoxhorse@yahoo.com DISTRICT 6 Rebecca Hughes Walterboro rmhughesdvm@lowcountry.com DISTRICT 7 Charles (Allen) Causey Florence pcausey2@sc.rr.com LARGE ANIMAL REPRESENTATIVE Patty Scharko Columbia pschark@clemson.edu SPECIALTY PRACTICE Dana Connell Greenville Dana.Connell@upstatevet.com

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AVMA DELEGATE Scott Bryant Spartanburg scottvetboy@msn.com ALTERNATE DELEGATE

Ginger Macaulay Lexington ginger@cherokeetrail.net SC STATE VETERINARIAN

Michael J. Neault Columbia mneault@clemson.edu

South Carolina Veterinarian, SPRING 2022

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President’s Message

Wanted:

I’m writing this article over a weekend in March that I believe is the last one where South Carolinians will experience below frost temperatures. It’s also the weekend when the time sprung forward, and the night skies will fill with more light to allow for those longer walks, runs and bike rides.

It won’t be too long before summer and the Southeast Veterinary Conference (SEVC) are upon us.

Dead or Alive

After two years of virtual programming, SCAV is ready to come together again. I know many of us are looking forward to being together for more than 75 hours of continuing education at the triple-A rated, ocean-front Myrtle Beach Marriott at Grande Dunes. The SEVC begins June 26 and continues through June 29. The entire veterinary team can learn from speakers who will cover oncology, emergency care, equine health, ruminant diseases, dealing with difficult clients, record keeping, controlled substances, and a whole bunch more. The schedule and hands-on labs are detailed in this publication.

This issue also includes information about harmful algal blooms. The increasing temperatures and outdoor excursions to lakes and ponds with companion animals may result in more incidents. This article along with the other resources from the AVMA may help us diagnose, manage, and treat patients who’ve encountered these harmful algal blooms.

Of course, the omnipresent heartworm disease deserves special attention because South Carolina ranks among the top five states of heartworm incidences in the US. With increased chances of pets being bitten by mosquitoes during the warm and humid Palmetto state summers, it’s important for our clients to see the statistics and know their pets could be easily affected. This issue also covers how to response to the client who asks about natural ways to prevent heartworm.

This publication also highlights the four South Carolina residents at the Tuskegee University College of Veterinary Medicine who received their white coasts at the end of February. Congratulations to Allison Enfinger, Jocelyn M. McGill, Alexander J. Pierce and Bryanna G. Snipes who are class of 2023 veterinary students. South Carolina welcomes their return to the Palmetto state next year.

SCAV supports South Carolina residents with annual scholarships to the CVMs at Mississippi State, Tuskegee and the University of Georgia.

It also provides scholarships to aspiring veterinarian technicians enrolled at Piedmont, Trident, and Tri-County Technical Colleges.

Thank you for supporting SCAV. It is your continued investment in SCAV that has allowed it to flourish and advance veterinary medicine in South Carolina.

Mike Ferguson, DVM Rock Hill Animal Hospital

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South Carolina Veterinarian, SPRING 2022

Help SC Researchers Find the Asian Longhorned Tick Ticks and tick-borne disease are growing problems in South Carolina, and new tick species and new tick-borne disease pathogens have been identified. A collaborative initiative has formed between the University of South Carolina, the state entomologist, and the state veterinarian to help guide animal health and vector control response in South Carolina.

These researchers are asking veterinarians to help them identify tick species in South Carolina. Here’s how: 1.

Collect ticks you find on domestic animals or livestock.

2.

Place them in a Ziploc bag or empty pill vial.You may also request a tick collection kit.

3.

Make note of your contact information, address where tick was collected, date of collection, type of animal (or human) on which tick was found.

4.

Insert Ziploc bag or empty pill vial with notes into a padded envelope and mail to one of the two addresses: The Laboratory of Vector-borne and Zoonotic Diseases, 921 Assembly Street, Suite 417A, Columbia, SC 29201; OR SC DHEC Environmental Health Services, Farrow Road, State Park, Bldg. 5, Room 509, Columbia, SC 29203.

To request a tick collection kit or ask addition questions, please contact Dr. Melissa Nolan ( msnolan@mailbox.sc.edu), Dr. Kyndall Braumuller (kyndallb@email.sc.edu), or DHEC Entomology (vector@dhec.sc.gov).

Rabies Pre-Exposure Vaccination and Titers for Veterinary Team ​ abies exposure is an occupational hazard for veterinary professionR als, and preventive measures are necessary to protect the veterinary team.

Veterinarians and veterinary support staff are in the frequent-risk group with regard to rabies exposure and should be administered pre-exposure rabies vaccinations, according to recommendations of the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). The National Association of State Public Health Veterinarians’ Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel indicates that all team members with animal contact must be vaccinated against rabies, followed by periodic titer checks and rabies vaccine boosters, in accordance with the ACIP recommendations.

Benefits of pre-exposure rabies vaccination for the veterinary team Pre-exposure rabies vaccination does not eliminate the need for additional treatment after a rabies exposure. But it eliminates the need for post-exposure rabies immunoglobulin administration and decreases the number of post-exposure doses of vaccine needed. Preexposure prophylaxis also may provide protection if post-exposure rabies treatment is delayed or if rabies exposure is unrecognized.

The active antibody response develops in approximately 7–10 days, and detectable rabies virus neutralizing antibodies generally persist for several years. The duration of protection varies, so regular titers are necessary to assess the need for a booster vaccination. According to the ACIP guidelines: “Although virus neutralizing antibody levels might not definitively determine a person’s susceptibility or protection from a rabies virus exposure, titers in persons at risk for

exposure are used to monitor the relative rabies immune status over time. To ensure the presence of a primed immune response over time among persons at higher than normal risk for exposure, titers should be checked periodically, with booster doses administered only as needed.”

Pre-exposure rabies vaccine administration Pre-exposure rabies vaccination with either the human diploid cell vaccine (HDCV) or the purified chick embryo cell vaccine (PCEC) is administered intramuscularly in the deltoid area of the arm in a schedule of three injections, with one injection per day on days 0, 7, and 21 or 28. Failure to complete the series puts you at risk of incomplete protection if exposed to rabies.

Pre-exposure vaccination for veterinarians, veterinary technicians or others on the veterinary team can be ordered by a physician or arranged through your local or state health department. Insurance coverage varies, so ask your provider whether your policy includes coverage, either full or partial. (AVMA LIFE offers rabies vaccination benefits; see below.)

Requirements for pre-exposure rabies vaccination and titers Veterinarians and veterinary team members aren’t legally required to be vaccinated against rabies or have titers determined. Most veterinary schools require pre-exposure vaccinations prior to admission or during pre-clinical coursework, and may offer subsequent titers prior to graduation.

Continued on page 7...

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Are there natural ways to prevent heartworms?

Q A

I’d like to find a natural way to protect my pets from heartworms.

What are my options?

This is a valid question and one veterinarians frequently hear. Certainly, drug-free strategies can help reduce the risk of heartworm transmission to a dog or cat. Because heartworms are spread by mosquitoes, keeping pets indoors overnight and avoiding walks at dusk or dawn when mosquitoes may be feeding can help prevent exposure to mosquitoes that could be carrying heartworms. Eliminating standing water close to your home that could serve as mosquito breeding grounds is also recommended.

Finally, natural repellents such as Neem oil and CedarCide may help diminish the chances that pets will be bitten by infected mosquitoes; however, Neem oil products should be used with caution in cats.

Unfortunately, mosquito control is not enough.

While the risk of heartworm exposure can be reduced with these strategies, it can’t be eliminated.

To give pets the best chance of being protected, the American Heartworm Society recommends yearround use of U.S. Food and Drug Administration (FDA)-approved heartworm preventives.

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South Carolina Veterinarian, SPRING 2022

Here’s why: • It only takes one bite from an infected mosquito to transmit heartworms to a dog or cat.

• Ensuring that your pet is never bitten by a mosquito is virtually impossible. Dogs need exercise—plus most go outside for bathroom breaks.

• Indoor cats aren’t completely shielded either.

In fact, a heartworm study showed that 1 in 4 cats infected were indoor cats. Why? Mosquitoes can sneak inside and often lurk in doorways and breezeways. Once indoors, mosquitoes see your pet as the source of a tasty blood meal.

To give pets the best chance of being protected, the American Heartworm Society recommends year-round use of U.S. Food and Drug Administration (FDA)-approved heartworm preventives. While you may have seen websites that promote nosodes and herbal preventives, none of these products has been proven or FDA-approved to prevent heartworms in pets—nor do respected alternative-therapy veterinarians endorse their use.

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AVMA Offers Resources on Harmful Algal Blooms Harmful algal blooms (HABs) can affect all living organisms. HABs are found in both freshwater and marine environments and are caused by a variety of toxin-producing microalgae, including prokaryotic bluegreen algae (also known as cyanobacteria) and eukaryotic microalgae.

The toxins produced by HABs vary depending on the organisms.

Toxicosis can result in acute or chronic disease in most vertebrates, depending on the type of toxin and amount of toxin absorbed.

The microalgae that create HABs are impacted by environmental changes. Changes in our environment and our way of life have increased the frequency of HABs and have brought a new focus to their impacts on animal populations.

Cyanobacteria Cyanobacteria, a type of microalgae, are ancient photosynthetic freshwater prokaryotic organisms found worldwide. These organisms can proliferate in a body of water under specific environmental conditions, such as warm water temperatures and availability of phosphorus and nitrogen. These proliferations are termed harmful algal blooms (HABs).

At least 95 cyanobacteria species have the potential to produce toxins, and cyanobacterial toxicosis has been documented in humans, companion animals, livestock, and wildlife. Cyanobacteria produce several types of toxins that can cause clinical diseases including respiratory, gastrointestinal, dermatological, and neurologic disease. In some circumstances, they can result in sudden death.

Red tide Red tide, or marine HABs, are caused by several species of dinoflagellate or phytoplankton. These are single-celled organisms and can be found at different light levels of the water column. Most species photosynthesize, but many can live in deeper or murkier water levels if the nitrogen and phosphorous levels are high.

The blooms are affected by changes in mixing and temperature that occur with climate change and create environments that are more beneficial to the toxic species. These organisms have been known to travel on large vessels, allowing for migration into different hemispheres where the species they contact have a lower tolerance to their toxins due to lack of previous exposure.

RED TIDE TOXINS Brevotoxins: Neurological shellfish poisoning (NSP) Saxitoxins and their derivatives: Paralytic shellfish poisoning (PSP) Domoic acid: Amnesic shellfish poisoning (ASP) Okadaic acid: Diarrhetic shellfish poisoning (DSP) Ciguatoxin: Ciguatera poisoning How can a diagnosis be made?

ANIMAL’S HISTORY

CYANOBACTERIAL TOXINS Hepatotoxins

Several questions should be asked to determine if the animal’s history points to a potential exposure:

cylindrospermopsin, microcystins, nodularins

•

Has your sick animal been in or near a water source?

These toxins damage the liver, leading to depression, loss of appetite, vomiting, diarrhea, abdominal tenderness, and jaundice minutes to days after exposure.

•

Was that water source discolored?

•

Did you notice any green mats on the surface?

•

Has the water been tested for HABs?

•

Is the physical exam consistent with any particular HAB toxin?

Neurotoxins anatoxin-a, anatoxin-a(s), saxitoxins These are nicotinic agonists that cause disruption of nerve cell communication. They can lead to paralysis of the respiratory system. Most cases of neurotoxin ingestion result in death within one hour.

Dermatotoxins aplysiatoxin, lyngbyatoxin-a These cause irritation to the skin and also can irritate the respiratory airways if inhaled. This leads to coughing and wheezing.

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South Carolina Veterinarian, SPRING 2022

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Titers and booster vaccinations The ACIP recommends titers every two years to assess protective immunity, with a single-injection booster vaccination recommended if the titer level is below 1:5 serum dilution (0.1-0.2 IU/mL). The World Health Organization’s (WHO) rabies titer cutoff is higher; WHO recommends that a single booster rabies vaccination be given when the titer drops below 0.5 IU/mL by the RFFIT. That said, there is no established “protective titer,” and post-exposure prophylaxis is still necessary after known exposure.

According to the Kansas State Veterinary Diagnostic Laboratory, titer levels or IU/mL values equal to or above 0.5 IU/mL (~1:50), provide evidence of a robust immune response after rabies vaccination.

Although the presence of antibodies after vaccination is important, a specific level above 0.5 IU/mL does not give complete assurance of protection against the disease in every individual because there are other immunological factors involved in the protection from rabies infection. However, an overview of rabies challenge studies indicates rabies virus neutralizing antibody (RVNA) levels equal to or above 0.5 IU/mL provide at least equal assurance of protection as does current vaccination status.

Two laboratories in the United States perform the ACIP-recommended Rapid Fluorescent Foci Inhibition Test (RFFIT), which measures the ability of RVNA to prevent the rabies virus from invading cells.

•

Kansas State University (https://ksvdl.org/laboratories/rabieslaboratory/)- Titer testing at KSU may also be requested through Quest Labs as Rabies Vaccine Response End Point Titer (order # 5789)

•

Atlanta Health Associates (http://atlantahealth.net/)

Although ACIP guidelines recommend that booster vaccination should be based on the results of the RFFIT, the test is not mandated, and some veterinarians may opt for the booster instead of the titer.

AVMA LIFE offers rabies vaccination benefits AVMA LIFE includes rabies vaccination coverage with its Member Basic Protection Package for veterinarians and with the Student Basic Protection Package for veterinary students. Up to $600 will be paid for a series of rabies prophylaxis given to a member veterinarian or an eligible dependent either before or after rabies exposure; the student plan provides a benefit up to $300. Rabies titers also are covered under both the member and student plans. AVMA Life also sponsors the Wellness Booth at the AVMA Convention annually, offering $50 rabies titers for veterinarians, dependents, team members, and veterinary students.

Coverage of rabies pre-exposure vaccinations for veterinary technicians and other staff To our knowledge, the veterinary practice is not required to pay for rabies vaccination for veterinary staff. However, practice owners should consult state regulations to determine their obligations and should weigh the benefits of providing the vaccination to their employees. Note that the cost of post-exposure rabies prophylaxis can easily reach into the thousands, and may involve workers compensation claims. Providing pre-exposure rabies vaccination could not only provide protection for staff, but could reduce overall costs associated with rabies exposure. If you offer medical benefits to your staff, check with your health insurance carrier to make sure this is a covered benefit. https://www.avma.org/resources-tools/one-health/rabies-pre-exposure-vaccination-and-titers-veterinarians

South Carolina Veterinarian, SPRING 2022

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Genetic Test & Dog’s Sex Predict Risk of Disease with 75% Accuracy This article was reprinted with permission from Clemson University’s College of Science Clemson University researchers have discovered a genetic variation associated with an often-deadly esophageal disorder frequently found in German shepherd dogs.

German shepherds are predisposed to congenital idiopathic megaesophagus (CIM), an inherited disorder where a puppy develops an enlarged esophagus that fails to move Leigh Anne Clark food into their stomachs. Puppies with the condition regurgitate their food and fail to thrive, often leading to euthanasia.

While German shepherds have the highest incidence of the disease, other breeds are susceptible, too, including Labrador retrievers, Great Danes, dachshunds and miniature schnauzers. Researchers do not yet know if the same genetic variation is involved in disease development in other breeds.

Researcher Leigh Anne Clark, an associate professor in the Department of Genetics and Biochemistry, and her collaborators developed a genetic test for the disease that German shepherd dog breeders can use to reduce the risk that puppies in future litters will develop the disease.

The journal PLOS Genetics published the findings on March 10.

CIM is often discovered when the puppies are weaned from the mother’s milk to solid foods at about four weeks of age.

The study also revealed that male puppies are twice as likely to be affected by the disorder than females. The researchers suspect that higher estrogen levels allow food to pass to the stomach more effectively, thereby protecting against disease development.

“What they’ve found in people is that estrogen has the effect of relaxing the sphincter that connects the esophagus to the stomach.

By having more estrogen, the smooth muscle there is naturally more likely to open. This increases the motility of food into the stomach,” Bell said. “In dogs with megaesophagus disease, a drug called sildenafil has shown good results. What it does is to relax the sphincter that connects the esophagus and stomach.”

Sildenafil is the generic name for the active ingredient in Viagra. Clark said sildenafil increases the percentage of dogs that outgrow the disease and no longer have to use a high chair when eating.

Genetic test The MCHR2 variant, along with the dog’s sex, can predict whether a dog will develop a megaesophagus with 75 percent accuracy. Owners can swab their dog’s gums and submit the sample to genetic testing companies to learn which variant(s) their dog inherited.

The test is a tool breeders can use to reduce disease incidence while preserving genetic diversity.

“One thing I stress with any disease in any breed is don’t make a problem where there isn’t one. If you’ve been breeding German shepherds for 20 years and you’ve never bred a megaesophagus puppy, then don’t use this test,” she said. “But if you’re a breeder and you’ve had megaesophagus puppies, you may benefit from the test.”

Gravity doesn’t help “They don’t have swallowing activity. When the puppies swallow food, it just sits in their esophagus and doesn’t trigger those sequential contractions that normally occur to help push the food into the stomach,” said Sarah Bell, a graduate research assistant in genetics and the first author of the study. “Because a dog’s esophagus is horizontal instead of vertical like ours, gravity doesn’t aid the transportation of food into the stomach.”

“ “

Because a dog’s esophagus is horizontal instead of vertical like ours, gravity doesn’t aid the transportation of food into the stomach.

To get food and water in their stomachs, puppies with megaesophagus must eat and drink while sitting upright in a dog highchair and remain there for up to 30 minutes afterward. Some will outgrow the condition, but many require lifelong symptomatic management with upright feedings, small liquid meals multiple times a day, gelatin cubes, and drug therapies.

In the study, Clark and Bell performed a genome-wide scan to identify genes associated with the disorder. The scan revealed an association on canine chromosome 12 and a variant within melanin-concentrating hormone receptor 2 (MCHR2), which affects appetite, weight and how food moves through the gastrointestinal tract. Clark and her team believe that an imbalance of melanin-concentrating hormones plays a role in CIM.

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South Carolina Veterinarian, SPRING 2022

This work was supported in part by funding from the Collie Health Foundation, the American Kennel Club Canine Health Foundation, the Upright Canine Brigade, the Orthopedic Foundation for Animals and the National Institute of General Medical Sciences of the National Institutes of Health.

The College of Science pursues excellence in scientific discovery, learning and engagement that is both locally relevant and globally impactful.The life, physical and mathematical sciences converge to tackle some of tomorrow’s scientific challenges, and our faculty are preparing the next generation of leading scientists.The College of Science offers high-impact transformational experiences such as research, internships and study abroad to help prepare our graduates for top industries, graduate programs and health professions. clemson.edu/science

Puppy with congenital idiopathic mega esophagus must eat and drink while sitting upright in a high chair.

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SEVC OFFERS SIX, HANDS-ON WET LABS IN MYRTLE BEACH Sunday, June 26 1-4 pm Back-yard Poultry Lab: Using live birds, this lab will show how to restrain various types of birds to conduct exams, draw blood, sedate and more. Sarah Scott, DVM will lead this lab.

Monday, June 27 8-11:50 am Radiographic Position Dental Lab will cover intra-oral dental radiography techniques and how to obtain diagnostic dental radiographs. The bisecting angle and parallel technique will be discussed as well as correcting skewed angles. Katherine Queck, DVM, FAVD, DAVDC, is the presenter. This lab is sponsored by The Carolinas Animal Hospital & Dental Clinic.Veterinarians and technicians may attend and are encouraged to attend the lectures covering positioning and interpretation that are scheduled on June 26.

1-4:30 pm Basic Abdominal Ultrasound Lab will cover basics of fast, hepatic, splenic and GI ultrasound. Rudy Rivas, DVM, DACVR will lead this lab that is sponsored by CVETS (Columbia Veterinary Emergency & Trauma Specialists). Equipment Sponsor is Universal Imaging.

Tuesday, June 28 8-11:50 am Soft Tissue Surgery Wet Lab: Veterinarians will learn Incisional gastropexy, liver biopsy techniques, aural hematoma repair, and episioplasty. Mandy Wallace, DVM, MS, DACVS-SA will lead this lab that is sponsored by Steris.

1:15-4:30 pm Dental Extractions Lab: Veterinarians will learn and practice simple and complex extractions on feline and canine specimens. Katherine Queck, DVM, FAVD, DAVDC, is the presenter. This lab is sponsored by The Carolinas Animal Hospital & Dental Clinic.Veterinarians are encouraged to attend the extraction lectures scheduled Tuesday morning.

Wednesday, June 29 7:30-11:00 am Wound Management Surgical Wet Lab: Veterinarians will learn techniques for closing wounds under tension, subdermal plexus flaps (rotation flaps/ advancement flaps), axial pattern flap development, appropriate drain placement, tie over bandage placement. Mandy Wallace, DVM, MS, DACVS-SA will lead this lab that is sponsored by Steris.

THANK YOU TO SEVC SPEAKER AND EQUIPMENT SPONSORS: CHI UNIVERSITY CLEMSON LIVESTOCK POULTRY HEALTH CVETS (COLUMBIA VETERINARY EMERGENCY TRAUMA & SPECIALTY) ENCORE EPICUR PHARMA GET MOTIVETED

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South Carolina Veterinarian, SPRING 2022

JUROX STERIS THE CAROLINAS ANIMAL HOSPITAL & DENTAL CLINIC T&L VETERINARY BUSINESS CONSULTING UNIVERSAL IMAGING ZOETIS

Signing Bonus Versus Ownership Doyle Watson, DVM Simmons & Associates Southeast, Inc. You have been offered a $200,000 bonus to sign a four-year employment agreement with a corporation at a nearby practice to your current place of employment. The practice is growing, and you would be an additional veterinarian to the handful already employed with the corporation. There is a nice six-digit salary ($125K) in addition to production bonuses and the signing bonus. However, you have been pondering the idea of ownership yourself and don’t want to wait four years to do so. But the $200K bonus surely could help make that ponder become a reality by reducing debt and providing a respectable down payment, so let’s peel this banana.

It is highly unlikely that the bonus will come as one advance payment.

It will likely be earned and paid over the employment period. While that is no problem if you have no desire to leave during that time, what if you come upon a practice purchase opportunity you want to pursue? In the event you leave prior to fulfilling the four year commitment, there will most likely be a requirement to repay the portion already received (claw back clause). Additionally, this may be a small point, but what might be the attitude among existing employees, especially associate doctors, who have been in the practice a period of years and here comes an outsider riding on the back of a huge bonus.

They didn’t get one. Why should you?

Nevertheless, over the four year period you have earned $500,000 for being a doctor and have what’s left of a $200K bonus after taxes and debt reduction. Let’s compare that to the four year future benefit of purchasing a practice. Let’s just say that the practice grosses $1,200,000, is priced as such, and has cash flow of 30% ---$360K (reasonable). You had no down payment so borrowed the entire purchase price from a commercial lender (yes, 100% financing). If the purchase was in early 2022, your annual debt service on $1.2M would be approximately $142,000, leaving you a personal after-debt income of approximately $218,000, or $872K in four years. Additionally, you have built some net worth by the reduced mortgage balance and your practice has hopefully increased in value and continues to do so. Of course, the $142K debt service becomes personal income after the ten-year loan is retired.

This article is not to say that one should not accept a signing bonus.

However, it does mean to say that one should be mindful of the commitment that may in time preclude taking advantage of another opportunity. Not that it’s a bad thing to make commitments, that’s typically considered an honorable thing to do. But just explore and remain aware of possible consequences.

That said, practice ownership is not for the faint of heart. There are many demands on your time and patience, and many folks today enjoy the simple pleasure of veterinary medicine and worry-free evenings and weekends. These are big life decisions not to be taken lightly. As an associate veterinarian today, fortunately you have choices that many before you did not.

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Upgrade equipment.

Remove non-functional equipment.

NC, near Winston Salem & Greensboro: $767K+ Gross. Solo DVM, Doctor works 4 days a week with no emergencies & no weekends. PRX & RE (NC20Y)

Update facility.

GA, Johns Creek: 2 DVM SA, $1.4M+ gross, growing. Solid staff.

Young city 22 mi from Atl. - built by the people, for the people; schools with highest avg test scores in state. PRX ONLY (GA56J)

Call us!

For other listings nationwide, add yourself to Practice Watch from our website.

800.333.1984 | southeast@simmonsinc.com | simmonsinc.com

South Carolina Veterinarian, SPRING 2022

11

Southeast Veterinary Conference

SEVC SCHEDULE – SOMETHING FOR EVERYBODY

Audience: (A): All / (V): Veterinarians / (VT): Veterinary Technicians / Practice Managers (PM)

8 – 8:50 am •

Small Ruminant (goats and sheep) Parasite Control, Jennifer Halleran (V)

Sunday, June 26 (4 CE Available)

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Fluid Therapy, Samantha Sedgwick (CVETS) (V)

9:00 am Registration

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How to Integrate TCVM into General Practice: Acupuncture Basics, Part 1, Tami Shearer (Chi. Univ.) (V)

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Corporate Veterinary Medicine: Is Winter Coming?, Tim Loonam (Encore) (A)

11:00 am Exhibitor Move-in 1-4:00 pm Backyard Poultry Lab, Sarah Scott, DVM 12:30-1:20 pm •

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An Introduction to Controlled Substances and DEA Regulations and Why Controlled Substances Are one of the Veterinarians Biggest Risk, Jan Woods (Epicur Pharma) (A) Radiographic Positioning for Dental Radiographs, Suzanne Edwards (The Carolinas Animal Hospital & Dental Clinic) (VT,V)

1:30-2:20 pm •

DEA Regulatory Requirements When Ordering, Receiving, Storing, Recordkeeping, Logging, Dispensing…, Jan Woods (Epicur Pharma) (A)

9:00-9:50 am •

Small Ruminant Dermatology, Jennifer Halleran (V)

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Immune Mediate Hemolytic Anemia, Tracy Schlicksup (CVETS) (V)

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How to Integrate TCVM into General Practice: Acupuncture Basics, Part 2, Tami Shearer (Chi. Univ.) (V)

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When Tacos and Doughnuts Stop Working: Creating a Positive Practice Culture, Tracy Sheffield (T&L Veterinary Business Consulting) (A)

10:00-10:50 am

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Pre-Referral Management of Oncologic Patients, Dana Connell (V)

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Selecting the Best Antimicrobials for SR Cases, Jennifer Halleran (V)

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Interpretation of Dental Radiographs, Suzanne Edwards (The Carolinas Animal Hospital & Dental Clinic) (VT)

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The Diagnostic Approach to the Pruritic Dog, Fiona Bateman (Zoetis) (V)

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Dealing with Difficult Clients, Tracy Sheffield (T&L Veterinary Business Consulting) (A)

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Capnography and Anesthetic Ventilators, Tim Loonam (Encore) (VT)

2:30-3:20 pm

11:00-11:50 am

Recognizing and Handling Staff and Client Addiction and What the DEA Says the Veterinarian Must Do About It, Jan Woods (Epicur Pharma) (A)

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Overview of Camelid Medicine, Jennifer Halleran (V)

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The Diagnostic Approach to the Pruritic Cat, Fiona Bateman (Zoetis) (V)

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Immune Mediate Hemolytic Anemia, Tracy Schlicksup (CVETS) (VT)

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The Workplace Environment: The Overlooked Profit Center, Tracy Sheffield (T&L Veterinary Business Consulting) (A)

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Dealing with Difficult Clients cont., Tracy Sheffield (T&L Veterinary Business Consulting) (A)

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Nonulcerative Corneal Disease of Small Animals, Hannah Visser (V)

•

3:30-4:20 pm •

Proactively Preparing for a DEA Audit and How to Handle a DEA Audit When the DEA Knocks on Your Door! Jan Woods (Epicur Pharma) (A)

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Small Animal Ophthalmic Emergencies, Hannah Visser (V)

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Fluid Therapy, Samantha Sedgwick (CVETS) (VT)

12:00 – 1:00 pm

Lunch & Learn – ECG Interpretation, Rebecca Kennerly (CVETS) (A)

1:00- 1:30 pm

Dessert in Exhibit Hall

1:00-2:20 pm •

Clemson, Livestock, Poultry Updates, Michael Neault (CLPH) (V)

4:30-5:30 pm Grand Opening Reception in Exhibit Hall

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Case Studies of Common Ophthalmological Issues, Hannah Visser (V)

Monday, June 27 (7 CE)

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Case Discussions in Dermatology, Fiona Bateman (Zoetis) (V)

7:00 am Registration/Exhibit Hall Open/Breakfast in Exhibit Hall

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Bullet Proof Medical Records, Part 1, Jerry Alan Greene (A)

8:00- 11:50 am Radiographic Position Dental Lab, Katherine

Queck, (The Carolinas Animal Hospital & Dental Clinic) (V,VT)

12

South Carolina Veterinarian, SPRING 2022

2:30-3:20 pm •

Lowcountry Zoo at Brookgreen Gardens, Andrea DeMuth and Patricia Scharko (A)

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Otitis - Treatment Tips and Tricks, Fiona Bateman (Zoetis) (V)

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Who Goes First: Triage in Challenging Times, Tracy Schlicksup (CVETS) (VT)

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Bullet Proof Medical Records, Part 2, Jerry Alan Greene (A)

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4:00-9:00 pm Offsite: Brookgreen Gardens Walking Tour, Creek Excursion, Dinner,

Transportation to and from.

Who Goes First: Triage in Challenging Times, Tracy Schlicksup (CVETS) (V)

•

Pet Birds: Common Presentations and How to Manage Them, Jose Biascoechea (V)

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Don’t Sweat the Small Stuff: When Not to Panic During Anesthesia, Elizabeth Martinez (Jurox) (V)

(A): All / (V): Veterinarians / (VT): Veterinary Technicians / Practice Managers (PM) Tuesday, June 28 (7 CE) 7:00 am Registration/Exhibit Hall Open/Breakfast in Exhibit Hall 7:00 – 7:50am

Christian Veterinary Mission Fellowship

8-11:50 am Soft Tissue Surgery Wetlab, Mandy Wallace (Steris) (V) 8:00-8:50 am •

Equine, Reid Hanson (V)

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When to Extract, Katherine Queck (The Carolinas Animal Hospital & Dental Clinic) (V)

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An Evidence Based Comparison: Alfaxalone & Propofol, Amanda Calla (Jurox) (V)

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Diabetes Demystified, Tim Loonam (Encore) (V,VT)

9:00-9:50 am •

Equine cont., Reid Hanson (V)

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Extraction Techniques, Katherine Queck (The Carolinas Animal Hospital & Dental Clinic) (V)

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Balancing Anesthesia and Common Co-Morbidities, Elizabeth Martinez (Jurox) (V)

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What a Practice Manager Can Do for Your Practice, Tracy Sheffield (T&L Veterinary Business Consulting) (A)

10:00-10:50 am

2:15-3:05 pm •

Module #35 Bovine Tuberculosis, Ronald Southerland (V)

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Seizures and Status Epilepticus, William Draper (V)

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Reptiles: Common Presentations and How to Manage Them, Jose Biascoechea (V)

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Optimizing Anesthetic Recovery, Elizabeth Martinez (Jurox) (V) Reception in Exhibit Hall – Games – Prizes

3:15-4:15 pm

Wednesday, June 29 (4 CE) 7:00-7:30 am

Breakfast

7:30 – 11:00am

Wound Management Surgical WetLab, Mandy Wallace (Steris) (V)

7:30-8:20 am •

Practical Use of Mindfulness: Improve Performance, Enjoy More, & Stress Less, Quincey Hawley & Renee Machel (Get MotiVETed) (A)

•

Updates in Veterinary Neurology, William Draper (V)

•

Small Mammals, the Carnivores and Omnivores: Common Presentations and How to Manage Them, Stephanie Munyon (V)

•

Effective Communication Skills of Common Small Animal Diseases, Michelle Mayers (VT)

8:30-9:20 am

•

Equine cont., Reid Hanson (V)

•

Managing Otitis Externa, Science or Art?, Cindy Bauer (V)

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Pathology for Dentistry, Katherine Queck (The Carolinas Animal Hospital & Dental Clinic) (V)

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Case-based Video Review of Diagnosis and Management of Common Neurologic Diseases, William Draper (V)

•

How to Integrate TCVM into General Practice: Herbals and Tui-na, Part 3, Tami Shearer (Chi. Univ.) (V)

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Small Mammals, the Herbivores: Common Presentations and How to Manage Them, Stephanie Munyon (V)

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Vomiting & Diarrhea, Tim Loonam (Encore) (V,VT)

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Improving the Anesthetic Experience During Dental Procedures, Suzanne Edwards (The Carolinas Animal Hospital & Dental Clinic) (VT)

11:00-11:50 am •

Equine cont., Reid Hanson (V)

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Is the Lameness Neurologic or Orthopedic, William Draper (V)

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How to Integrate TCVM into General Practice: Case Studies and Review, Tami Shearer (Chi. Univ.) (V)

11:55 am – 12:50 pm Lunch and Learn – The Veterinary

Wellbeing Choice: How to Prioritize, Cultivate, and Maintain Wellbeing,

Quincey Hawley & Renee Machel (Get MotiVETed) (A)

•

How to Get the Best Outcome with Atopy Patients, Cindy Bauer (V)

•

Dental Instruments & Appropriate Use, Suzanne Edwards (The Carolinas Animal Hospital & Dental Clinic) (VT)

•

A 5-Step Formula for Creating a Life and Veterinary Career You Love, Quincey Hawley & Renee Machel (Get MotiVETed) (A)

10:30-11:30 am •

1:15-4:30 pm Dental Extractions Lab, Katherine

Queck (The Carolinas Animal Hospital & Dental Clinic) (V)

Diagnosing and Managing Common and Uncommon Dermatology Cases: A Case Review, Cindy Bauer (V)

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Advice from a Practice Owner: Creative Ways to Increase Value, Michelle Mayers (A)

1:15-2:05 pm

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Progressive Veterinary Leadership: Placing Individual and Team Wellbeing at the Forefront, Quincey Hawley & Renee Machel (Get MotiVETed) (A)

12:50-1:10 pm

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Dessert in Exhibit Hall

9:30-10:20 am

Module #19 Animal Health Emergency Response, Ronald Southerland (V)

South Carolina Veterinarian, SPRING 2022

13

South Carolina Association of Veterinarians PO Box 11766 Columbia, SC 29211

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Valuations are essential for assessing your practice financial health and determining your path to higher practice value.

They're an excellent tool to help you stay on target with your goals.

Contact Simmons today to get started on your valuation!

800.333.1984 or Southeast@SimmonsInc.com

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