FVMA Advocate Issue 1, 2023

7207 Monetary Drive

Orlando, Florida 32809

Phone – 407.851.3862

Toll-free – 800.992.3862

Fax – 407.240.3710

info@fvma.org

www.fvma.org

OFFICERS

Dr. Marta P. Lista

President

Dr. Jacqueline S. Shellow

President-elect

Dr. Alex 'Steve' Steverson

Treasurer

Dr. Mary Smart

Past President

DISTRICT REPRESENTATIVES

Dr. Julie Moodoyan

District 1–Big Bend

Dr. Thomas E. Hester

District 2–Northeast

Dr. Todd Fulton

District 3–Central

Dr. Donald S. Howell

District 4–Tampa Bay

Dr. Beth Keser

District 5–Treasure Coast

Dr. Robert L. Swinger

District 6–South Florida

Dr. Barbara Lewis

District 7–Southwest

Dr. John R. Wight

District 8–Northwest

Dr. Christine M. Storts

District 9–Space Coast

Dr. Ernest C. Godfrey

AVMA Delegate

Dr. Richard B. Williams

AVMA Alternate Delegate

Dr. Sally DeNotta

FAEP Representative to the FVMA Executive Board

President's Message

Colleagues and Friends,

Volunteering for the FVMA has been immensely rewarding and opened my eyes wide to the importance of organized veterinary medicine in our everyday livelihood.

Looking back at the last 12 months, it has been an exceptionally busy year — and at times challenging. The FVMA has shown that we have the capacity to act and address situations in a timely and constructive manner. Our association’s hurricane preparedness was tested, and our efforts provided resiliency and a commitment to caring for each other. Legislation is still unfolding as we work to preserve the VCPR, elevate our team members, and protect the profession and animals we care for. This year also brought changes to our bylaws, the formation of new committees to focus on key issues, and new administration. This issue of FVMA Advocate contains the association’s budget, demonstrating our care to being a fiscally responsible and robust organization. Support veterinary medicine in Florida by attending FVMA Annual Conference in Orlando this April 20-22. Our children can gather and play at child care and our spouses can enjoy the lazy river while we relax and learn with exceptional speakers and wet labs. This is a cutting-edge conference in our backyard!

One of the FVMA’s main challenges, I believe, is getting the message across to all Florida veterinarians that the FVMA is the only association exclusively representing the interests of veterinary professionals in Florida. If this was understood, 100% of veterinary professionals would be members. With strong membership, the ability to effectuate change would be magnified. For our organization to be truly successful, membership is key.

I encourage you to volunteer with the FVMA or your local VMA. If you are interested in volunteering, committees are a good way to start. Serving on the board of the FVMA has been one of the most valuable experiences I have had. Thank you, FVMA, for this opportunity.

Marta Lista DVM

Opinions and statements expressed in FVMA Advocate reflect the views of the contributors and do not represent the official policy of the FVMA, unless so stated. Placement of an advertisement does not represent the FVMA's endorsement of the product or service.

To advance the veterinary medical profession, promote animal health and well-being, and protect public health.

Since 1983, the ACVIM Forum has been the go-to conference for advanced, specialist-level education in veterinary internal medicine. Join us in Philadelphia for the 2023 ACVIM Forum June 15-17, or virtually from anywhere, as we celebrate four decades of bringing the veterinary community together!

FLORIDA LAWS AND RULES & DISPENSING LEGEND DRUGS RENEWAL COURSE (2022-2024)

Our updated three-part course satisfies Florida’s mandatory continuing education (CE) requirement for license renewal of no less than one hour of CE in the area of dispensing legend drugs and two hours of CE in the area of the laws and rules governing the practice of veterinary medicine.

KEY TOPICS include:

• The disciplinary process and guidelines

• Record-keeping requirements

• Appropriate drug dispensing practices

• DEA regulations

• Common causes for disciplinary action and how to avoid them

• Recent statutory, regulatory, and case law developments

Note: This course is approved by the Florida Board of Veterinary Medicine, Provider #0001682.

PRICING

FVMA members: $99.00

Non-member: $149.00

THE FVMA LAUNCHES

Two New Membership Benefits for 2023

The FVMA has long supported its members through a variety of career-enhancing and lifestylesupporting benefits. From discounted conference passes to complimentary legal consultations, FVMA membership grants veterinary professionals access to perks and resources that can boost their practice and sharpen their skills. To continue evolving with the needs of our members and profession, we are proud to introduce two new offerings to FVMA members this year.

■ Working Advantage

Your time away to recharge is just as important as your work, so we encourage you to take advantage of Working Advantage and make the most of your time off the clock. Whether resting or relaxing with a streaming service, at a movie theater, or seeking thrills at iconic theme park destinations, Working Advantage offers discounts to make it all more feasible. It’s a one-stop shop for savings on the experiences, products, and services you know and love.

Travel perks allow you to find comfort in your next adventure with flights, hotels, rental cars, and vacation package deals.

Working Advantage provides discounts on reputable, known brands including Walt Disney World Resort and Disneyland Resort, Universal Orlando Resort, Universal Studios Hollywood, SeaWorld Parks & Resorts, Sam’s Club, Cirque du Soleil, Live Nation, Samsung, Lenovo, Hertz, Wyndham Hotel Group, and more.

It’s FREE and easy to enroll:

■ Social Ordeals

Essential in our push to modernize our offerings, our members’ feedback has allowed us to introduce a benefit that can help you manage your online presence.

The powerful Social Ordeals platform excels at managing your online reputation, a common concern among members. In the internet age, 97% of consumers find local business information on the web, and around 80% trust online reviews as much as personal recommendations. Many make purchasing decisions based on their discoveries.

Social Ordeals can help you make a positive impression by showing you what people are saying about your practice online, alerting you when someone asks a question on your Google Business profile or reviews your business, and gives you the tools to quickly respond.

Social Ordeals also provides traditional digital advertising and social media management services, so you can let experts develop your online presence while you and your staff focus on taking care of patients and doing more of what you love.

The platform carries added benefits for veterinary professionals who own multiple practices by ensuring online business listings are accurate, which is essential to directing potential customers to the right place. Those who have multiple locations can quickly find the task of managing multiple online presences daunting and time consuming, so Social Ordeals provides one place to create and manage accurate business listings across the internet.

MEMBER Benefits

It even adds your business information to 300 online listings ensuring potential clients can find you no matter where they search for recommendations.

FVMA members get a free custom report card that shows you where you can make improvements to your online presence along with exclusive discounts on products and services.

■ Continue Enjoying the Benefits You Love

We’re proud to add Working Advantage and Social Ordeals to our eleven other membership benefits, including:

• Discounted conference passes

• Legal consultations

• Legislative advocacy

• FVMA Helpline

• Wellness resources

• Our publications, FVMA Advocate and The Practitioner

• Power of Ten leadership program

• Veterinary Career Center and classified advertisement discounts

• Clover Merchant Services discounts

• CareCredit discounts

• IC Systems discounts

The FVMA continues to develop membership benefits that help you focus on the things you care about the most in your profession and in your daily life.

Images courtesy of Canva.

MEMBERSHIP SPOTLIGHT: Ashley Ferrato

THE FUTURE OF VETERINARY MEDICINE

Through student engagement opportunities like the Power of Ten annual leadership program and partnerships with the University of Florida College of Veterinary Medicine (UFCVM), the FVMA has long helped nurture a bright future for young veterinary professionals. The FVMA has encountered inspiring students and professionals through these partnerships who exemplify the brilliance present in the most experienced veterinarians.

As a young professional, Ashley Ferrato has been essential to pushing veterinary medicine forward by collaborating with the FVMA since her earliest days as a pre-veterinary student.

A first-generation American from Canada, Ferrato’s life is full of blazing new trails, which is evident in her work with the FVMA. As former president of the University of Florida’s Pre-veterinary Medicine Club (UFPVMC), Ferrato secured volunteer opportunities for undergraduate students at FVMA conferences, giving students a way to engage with the profession they study.

“[I love] networking with people who constantly inspire you and share opportunities that you wouldn’t know existed otherwise,” Ferrato says.

Ferrato was essential in building collaboration opportunities between the FVMA and UFCVM students. Her efforts allowed FVMA representatives to visit campus and share the importance of organized veterinary medicine with undergraduate students. Ferrato also introduced the FVMA to its first UFPVMC summer intern, Sydney Utzig, in 2022.

“I have enjoyed getting to know my colleagues and the faculty, and the administrative staff have been supportive. It really feels

like we’re all in it together,” Ferrato says.

In 2022, Ferrato graduated cum laude with a bachelor’s degree in animal sciences and a minor in zoology/animal biology. She is a UFCVM DVM candidate and serves as FVMA Student Representative for her cohort.

“My goal as a student rep is to have every student know what the FVMA is and how the FVMA supports them in their careers, during and after school,” Ferrato says.

Ferrato has been a life-long animal lover outside of the classroom too with five horses, a dog, and two cats. The ability to assist pets was an early motivator for her getting involved in veterinary medicine.

“[I want to] truly enjoy work and help people and their pets,” Ferrato says.

Though she expects to graduate in 2026, Ferrato is already looking toward her profession’s future.

“I see veterinary medicine becoming more modern and inclusive,” Ferrato says. “I hope to continue to see improvements in worklife balance and increased appreciation for veterinarians.”

Discomfort and pain associated with dental and oral disease is often difficult to assess in veterinary patients. A conscious oral exam presents a diagnostic challenge, as dogs and cats rarely show obvious signs of dental illness. Intraoral radiographs provide the clinician with important information to obtain a diagnosis and begin planning for treatment of oral pathology not visible during direct examination.

Interpretation of dental radiographs is like the evaluation of full-body radiographs. Start by scanning the complete image for quality, positioning, and overall impression. Note any abnormalities, including anatomical structures that are not present or appear abnormal. This includes fractures, missing teeth, and areas of osseous lucency. Next, evaluate each tooth beginning with the crown and continuing with the root, periodontal ligament space, pulp chamber/root canals, and surrounding bone (cancellous and cortical).

Bear in mind, a radiograph is a two-dimensional image of a three-dimensional structure, which means the image shows multiple overlapping layers stacked upon each other. The resulting summation effect is the result of this stacking. Radiodense structures (crowns, roots, and cortical bone) will add to the radiopacity of the image, making the image appear lighter. Radiolucent structures (pulp chambers and root canals) will subtract, making their anatomy appear darker.

Determining the depth or location of a specific structure within the two-dimensional radiograph can be challenging. Additional views taken by changing the angle of the X-ray beam can help determine which structure is closer to the film or sensor.

PERIODONTAL DISEASES

Identifying the alveolar margin (alveolar crest), the cementoenamel junction (CEJ), and the lamina dura is important in the radiographic evaluation of periodontal disease. The lamina dura is a radiographically visible, thin radiopaque line that represents a layer of compact bone lining the alveolus. It appears dense and uniform in the younger animal, becoming ill-defined in the aged patient or in various disease states. The lamina dura is separated from the root by a radiolucent line, which represents the periodontal ligament space.

Periodontal disease can be classified from stages 1 to 4 based on the severity of radiographic and clinical findings. The toothsupporting bone height in periodontal disease decreases as inflammation and infection increases and bone is resorbed. Around 40% of the bone’s thickness must be destroyed before it is detected radiographically. Distribution of bone loss is classified as either localized or generalized, depending on the number of areas affected. Specific areas of bone loss may be classified as horizontal (perpendicular to the tooth) or vertical (angular along the side of the root).

Figure 1: Periodontal anatomy. Image courtesy of Dr. Jan Bellows.

Figure 2: Vertical bone loss typical in moderate periodontal disease. Image courtesy of Dr. Jan Bellows.

STAGES OF PERIODONTAL DISEASE

Stage 1 - Gingivitis

Occurs when the gingiva appears inflamed. There is no periodontal support loss or radiographic change.

Stage 2 - Early Periodontitis

Occurs when attachment loss is less than 25%, as measured from the cementoenamel junction to the apex. Clinically, early periodontitis is typified by pocket formation or gingival recession. Radiographically, stage 2 disease appears as blunting (rounding) of the alveolar margin in addition to bone loss. There may also appear to be a loss of continuity of the lamina dura at the level of the alveolar margin.

Stage

3 - Moderate Periodontitis

This is diagnosed when 25-50% of attachment loss occurs. The direction of bone loss may be horizontal or vertical (angular).

Alveolar bone expansion clinically appears as bulging alveoli around one or both maxillary and/or mandibular canines. Radiographically, this lesion appears as bone loss around the root and expansile alveolar bone growth.

Stage

4 - Advanced Periodontal Disease

This is typified by deep pockets and/or marked gingival recession, tooth mobility, gingival bleeding, and purulent discharge. Attachment loss is greater than 50% of the root length.

Furcation involvement and exposure results from bone loss at the root junction of multi-rooted teeth. It is sometimes difficult to determine radiographically whether the interradicular space is involved unless there is a radiolucent area in the region of the furcation. Lack of radiographically detectable furcation involvement is not confirmation of the absence of periodontal destruction. Advanced furcation through-and-through exposures, where both cortical plates are resorbed, are easily recognized on radiographs.

Figure 3: Early and moderate periodontal diseases. Image courtesy of Dr. Jan Bellows.

Figure 4: Furcation exposure consistent with advanced periodontal disease.

Image courtesy of Dr. Jan Bellows.

Figure 5A: Bilateral canine alveolar bone expansion. Figure 5B: Intraoral radiograph consistent with bone expansion. Image courtesy of Dr. Jan Bellows.

Tooth extrusion (also called super-eruption) occurs when one or more of the intact canine teeth appear longer than normal. Radiographically, the affected teeth have marked loss of periodontal support. Hypercementosis appears as excessive deposition of cementum, usually at the apical third of the root in response to chronic inflammation or abnormal occlusal forces. Ankylosis is the union of cementum with the alveolar bone through destruction of the periodontal ligament. The tooth root becomes fused to the alveolar wall. Radiographically, there will be little or no periodontal ligament space.

ENDODONTIC DISEASES

Intraoral radiography is essential for evaluation of endodontic disease. Diagnostic images of the teeth and tissues around the roots help to define the extent of endodontic disease and prognosis for the tooth. The radiograph of an endodontically affected tooth is examined for the following:

• Apical closure, which is necessary for conventional root canal therapy.

• Tooth fracture with and without pulpal exposure.

• Abnormalities in the root canal, such as obstruction, resorption, or enlarged canal(s) compared to adjacent teeth.

• Periapical pathology, such as widened periodontal ligament space at the tooth's apex and circumscribed alveolar bone resorption. In the early stages of endodontic disease, bony changes are not radiographically present. As the infection progresses, a homogeneous radiolucency at the apex or a dark halo in the periapical tissues becomes apparent, typical of an infection. A sharply outlined circumscribed radiolucent area is commonly caused by a periapical cyst, which usually arises from preexisting granulomas.

Figure 6: Right maxillary second incisor enlarged root canal and periapical lucency consistent with endodontic disease.

Image courtesy of Dr. Jan Bellows.

Figure 7A: Fractured left mandibular canine with pulp exposure and periapical lucency. Figure 7B: Periapical lucencies surrounding the three roots of the right maxillary fourth premolar. Figure 7C: Pulp exposure and periapical lucencies consistent with apical granulomas affecting a dog’s left mandibular first molar. Image courtesy of Dr. Jan Bellows.

These radiograph abnormalities should not be confused with chevron signs or chevron effects. To differentiate this artifact from true endodontic pathology, evaluate the periodontal ligament space and lamina dura around the root apex. Generally, periapical lesions of endodontic origin will appear more circular on radiographs compared with chevron-shaped lucencies. Additionally, there should be a visible loss of the radiolucent continuity of the periodontal ligament space and radiodensity of the dura with endodontic disease.

TOOTH RESORPTION

External root resorption generally results from unknown stimuli. The cause of internal resorption is unknown, but trauma or pulpitis from anachoresis — bacteria gaining access to the injured pulp through vascular channels — are believed to be contributing factors. It can be difficult to determine whether a lesion is due to internal or external resorption. If a normalappearing root canal is visualized radiographically, the lesion is considered external in origin. Radiographically, external resorption appears as radiolucent defects on any area of the root surface.

External tooth resorption is classified anatomically as:

• Stage 1 (TR1)

Mild dental hard tissue loss (cementum or cementum and enamel).

• Stage 2 (TR2)

Moderate dental hard tissue loss (cementum or cementum and enamel with loss of dentin that does not extend to the pulp cavity).

• Stage 3 (TR3)

Deep dental hard tissue loss (cementum or cementum and enamel with loss of dentin that extends to the pulp cavity); most of the tooth retains its integrity.

• Stage 4 (TR4)

Extensive dental hard tissue loss (cementum or cementum and enamel with loss of dentin that extends to the pulp cavity); most of the tooth has lost its integrity.

Ȇ TR4A - Crown and root are equally affected.

Ȇ TR4B - Crown is more severely affected than the root.

Ȇ TR4C - Root is more severely affected than the crown.

Figure 8: Cheveron sign apparent on right maxillary canine apex radiograph.

Image courtesy of Dr. Jan Bellows.

Figure 9A: Stage 2 external root resorption affecting a cat’s right mandibular canine. Image courtesy of Dr. Jan Bellows.

Figure 9B: Stage 3 external root resorption affecting a cat’s left maxillary canine tooth. Image courtesy of Dr. Jan Bellows.

Remnants of dental hard tissue are visible only as irregular radiopacities, and gingival covering is complete.

In addition to the above classifications, it is helpful to examine the radiographic appearances of tooth resorption in order to create a treatment plan (extraction vs. crown removal and gingival closure):

A focal or multifocal radiolucency is present in the tooth with otherwise normal radiopacity and normal periodontal ligament space.

There is narrowing or disappearance of the periodontal ligament space in at least some areas and decreased radiopacity of part of the tooth.

Figure 9C: Stage 4 C external root resorption affecting the apex of a dog’s right mandibular canine tooth. Image courtesy of Dr. Jan Bellows.

• Stage 5 (TR5)

• Type 1

Figure 10A: Type 1 tooth resorption affecting a right maxillary canine tooth. Note the observable periodontal ligament space-extraction indicated.

Image courtesy of Dr. Jan Bellows.

• Type 2

Figure 10B: Type 2 tooth resorption affecting both mandibular canines. Note the decreased opacity and lack of observable periodontal ligament space – crown removal and gingival closure indicated.

Image courtesy of Dr. Jan Bellows.

• Type 3

SW Forida Coast 1.25 Dr. grossed $1.26M in 2021, very nice location, well equipped, Prx and RE available SOLD!!

SW Florida Coast- Solo Dr. small animal in a great location just minutes from the Gulf. Beautiful 5000 Sq ft. custom built hospital , 4 exam rooms, 2022 just over $1M. Owner willing to stay on for the right buyer.

N.E Florida- Solo Dr. now, but has been a multi Dr. practice in recent history. $1M gross in 2022. 3500 Sq. ft. custom built hospital with 4 ex am rooms , turnkey operation.

S.E. Florida- 1.5 Dr. prac tice in a lease space. 202 2 gross of $1. 24 M, very profitable, 2 exam rooms with an option for a 3rd , well established with an experienced and efficient staff.

S.E. Florida- ! Dr. small animal Practice that has served the area for over 30 years. Great location in Palm Beach County. Lease s pace with 2 exam rooms and room for a 3rd. 2022 gross was $1.1M. Priced right, with an after debt income of about $242K.

JAN BELLOWS

DVM, DAVDC, DABVP

Dr. Bellows received his undergraduate training at the University of Florida and his DVM from Auburn University. After completing a small animal internship at The Animal Medical Center, he returned to South Florida where he still practices companion animal medicine surgery and dentistry at ALL PETS DENTAL, in Weston, FL. He is certified by the Board of Veterinary Practitioners (canine and feline) since 1986 and American Veterinary Dental College (AVDC) since 1990. He was president of the AVDC from 2012-2014 and is currently president of the Foundation for Veterinary Dentistry.

Dr. Bellows’ veterinary dentistry accomplishments include authoring five dental texts: The Practice of Veterinary Dentistry …. A team effort (1999), Small Animal Dental Equipment, Materials, and Techniques (2005, second edition 2019), and Feline Dentistry (2010, second edition 2022). He is a frequent contributor to DVM Newsmagazine and a charter consultant of Veterinary Information Network’s (VIN) dental board since 1993. He was also chosen as one of the dental experts to formulate AAHA’s three Small Animal Dental Guidelines published in 2005 and updated in 2013 and 2019.

Features of both type 1 and type 2 are present in the same tooth. A tooth with this appearance has areas of normal, narrow, or lost periodontal ligament space, and there is focal or multifocal radiolucency in the tooth and decreased radiopacity in other areas of the tooth.

Figure 10C: Type 3 tooth resorption affecting the left maxillary third premolar. Note type 1 tooth resorption affecting the mesial root and type 2 tooth resorption affecting the distal root-removal of the distal root indicated.

Image courtesy of Dr. Jan Bellows.

Paul A. May, DVM

Dr. Paul A. May, known as one of Bradenton’s most beloved veterinarians, passed away on January 3, 2023, at the age of 84. Dr. May grew up in Remington, IN, where he spent time working on farms and developed a love for animals and agriculture, which resulted in him majoring in agriculture and graduating with his doctorate in veterinary medicine from Purdue University. He moved to Florida in 1967 and practiced in both Sarasota and Manatee County, where he worked at Bishop Animal Shelter and owned Manatee Veterinary Clinic for over 40 years. Dr. May was an active deacon at West Bradenton Baptist Church, taught college and career Sunday school, and took care of babies in the nursery. His hobbies included fishing, reading, and spending time with his family. Another favorite hobby was participating in field trials at the Babcock-Webb preserve in Punta Gorda, FL, where he had many dear friends who shared his love of dogs and horses.

He was preceded in death by his wife of 57 years, Jean Meadows. He is survived by his three daughters and sons-in-laws (Page and Tony England, Julie and Richard Williams, and Sarah and Jeff Berry) as well as six grandchildren and one great-grandson.

Florida Practices for Sale

4.5 days a

Saturday per month, located between Lakeland and Tampa, $850K Gross. PRX Only (FL33V) FL, Titusville, East Coast: Open 4 days a week. Solo Doctor. 2940SF freestanding facility located on .60 acre. 3 exam rooms. Abaxis in -house blood machines. Revenues of $850K+. Buyer’s after debt income ≈$210K. PRX & RE (FL40T)

FL, Palm Beach County: Solo, DVM, $1.6M+ Gross, 5 -day work week, 2142SF Free-standing facility. PRX & RE (FL53L)

FL, New Listing! West Coast, Clearwater: Sugary sand & emerald waters, Solo doctor practice with real estate. PRX & RE (FL55C)

RAW DIETS Facts and Misconceptions

Ed Carlson, CVT, VTS (Nutrition) Director of Veterinary Nursing Education VetBloom

RAW, BARF, FREEZE-DRIED, AND FROZEN DIETS

Commercial raw diets are available in many forms with frozen and freeze-dried being the most common. These are often marketed as complete while others are intended to be fed with additional supplements.

The internet is also full of recipes for Bones and Raw Food or Biologically Appropriate Raw Food (BARF) homemade diets. Many of these diets advocate a formula of 60% raw meaty bones with the remainder of the diet consisting of green vegetables, eggs, milk, brewer’s yeast, muscle and organ meats, yogurt, and sometimes grain and legumes. Meals are not expected to be balanced, but rather, in theory, are to be balanced overall by varying the ingredients from one meal to the other.

Articles explaining “how to feed raw” quite often advocate feeding muscle meats, organ meats, bones, and fish, with or without vegetables, fruits, grains, herbs, vitamins, and supplements. While some dedicated pet owners will follow these instructions in order to provide this “over time balanced approach” many others, however well-intended, will not. Many owners will begin to make substitutions or not continue to dedicate the time and effort this feeding method may require.

Advocates of raw feeding often compare domesticated dogs to wolves while claiming this diet is more natural and healthier. However, a 2013 study (Axelsson, et al.) identified mutations in key genes found in dogs and provided functional support for increased starch digestion in dogs relative to wolves. These results indicate that novel adaptations allowing the early ancestors of modern dogs to thrive on a diet rich in starch, relative to the carnivorous diet of wolves, constituted a crucial step in the early domestication of dogs.

Some benefits of raw feeding cited by individuals and companies promoting raw diets are:

• Healthier skin and shinier coat

• Fewer allergy-related issues

• Cleaner teeth and healthy gums

Claiming raw meat and bones do not allow for plaque to build up

• Raw bones provide a source of calcium and roughage for cleaning the teeth and gums naturally

• Dogs stay lean and strong

Ȇ Lean dogs live longer, have a stronger immune system, and have lower blood pressure

• Improved muscle strength and stability

• Lower risk of cancer

• Better digestion and improved stool quality

• Better eye health

These claims are anecdotal and unsubstantiated by evidencebased studies or research.

HEALTH CONCERNS ASSOCIATED WITH FEEDING RAW DIETS

Various studies have linked pathogenic bacteria such as Salmonella spp., Listeria monocytogenes, Campylobacter spp., Clostridium spp., and Escherichia coli with raw diets. Salmonella infections being the most frequently documented (Carter &Quinn, 2000; Cobb & Stavisky, 2013; Finley et al., 2007; Joffe & Schlesinger, 2002; Leonard et al., 2011; Morley et al., 2006; Shimi & Barin, 1977). Clinical signs of salmonellosis, an infection with salmonella bacteria, may include abortion, anorexia, conjunctivitis, gastroenteritis, hematochezia, and death (Carter & Quinn, 2000; Cobb & Stavisky, 2013). Healthy pets may not show clinical signs of illness when ingesting these bacteria; however, the immunocompromised, the very young, and the very old are at significant risk.

Pets fed raw diets may also contract zoonotic parasitic diseases, such as toxoplasmosis and echinococcosis (Araujo et al., 1975; Elmore et al., 2010; Jokelainen et al., 2012; Moro & Schantz, 2009; Schwabe et al., 1972; Strohmeyer et al., 2006).

Bacterial pathogens can also be spread during food handling and through environmental contamination stemming from animals fed a raw diet (FDA, 2016; Finley et al., 2007; Freeman et al., 2013; Freeman, Janecko & Weese, 2013; Joffe & Schlesinger, 2002; Lenz et al., 2009; Leonard et al., 2011; Morley et al., 2006; Nemser et al., 2014; Strohmeyer et al., 2006). The pathogens found in raw meat also pose significant health risks to young children, the elderly, and immunocompromised people. It is therefore extremely important for anyone preparing these diets to practice proper hand washing and to ensure that all utensils, bowls, and surfaces used for the preparation of raw pet food diets are properly cleaned and disinfected.

CLIENT COMMUNICATION AND EDUCATION

An important role of veterinary healthcare team members is to educate clients. This is especially important when it comes to nutrition! Studies show that pet owners and dog breeders consider veterinarians as their primary source for information regarding their pet's nutrition and healthcare (Connolly, Heinze & Freeman, 2014; Freeman, Janecko & Weese, 2013; Kienzle, Bergler & Mandernach, 1998; Laflamme et al., 2008; Michel et al., 2008). However, less than 50% of dog breeders ask their veterinarian for nutritional guidance. Pet owners that feed their

animals noncommercial diets are also less likely to trust their veterinarian will provide sound nutritional advice (Connolly, Heinze & Freeman, 2014).

What if the diet a client is feeding is not complete and balanced? Or, what if you do not agree with the type of diet a client has chosen to feed? How can you explain your concerns and educate a client that their perceptions are incorrect?

Here are some strategies that you can use:

• Listen to the client’s reasons for feeding the diet in question and their concerns with other diet options.

• Ask open-ended questions to ensure you understand their viewpoint. Be careful not to sound or appear judgmental.

• Avoid making disapproving comments, using a negative tone of voice, facial expressions, and body language. If you are perceived as judgmental, condescending, closedminded, or unwilling to listen and consider their point of view or beliefs, clients are likely to become defensive or simply unwilling to listen to your advice.

• Gently point out any misconceptions or false information offering references to the correct information.

• Some owners turn to alternative diets out of concern that their pet will not eat more conventional diet options. These owners may express concerns about their pet not eating as well as the cause for not wanting to change diets.

• Some owners will not be interested in hearing your advice. Others may listen and perhaps discuss or debate the issue with you, but may not be willing to make any change to their feeding practices. Be respectful and do not take it personally. Making a nutritional recommendation does not ensure that the owner will follow your recommendation.

• As with any medical advice, document the patient’s nutritional history and your nutritional recommendation in the patient record.

NUTRITIONAL RECOMMENDATION

Remember to make a nutritional recommendation for every patient, every time they present to your hospital. Consider the patient’s age, weight, body condition and muscle condition scores, life stage, lifestyle, and any health issues. Recommend the diet you believe is the best for that particular patient but remember you may also need to consider the owner’s perception of what is the best diet for their pet.

When you have done your best to educate your client but they insist on feeding a diet you do not think is best, consider if there is a way to improve the patient’s diet. Perhaps the client would agree to have a veterinary nutritionist evaluate the

diet. If the diet is not nutritionally balanced, you may suggest improvements. If they are feeding a grain-free diet that does not contain highly digestible ingredients, perhaps you can help them find one that does. If corn-free is all the client will consider, research the available options and recommend the one you believe is best suited for your patient. Suggest or provide a referral to a veterinary nutritionist for the client that wants to prepare a home-cooked diet or a raw diet.

Remember the goal of a nutritional recommendation is to provide the patient with the best possible diet. If the client is not willing to follow your recommendation, what recommendations can you make to improve the patient’s diet? Be a nutritional advocate for your patients!

REFERENCES

Axelsson, E., Ratnakumar, A., Arendt, M.-L., Maqbool, K., Webster, M. T., Perloski, M., Liberg, O., Arnemo, J. M., Hedhammar, Å., & Lindblad-Toh, K. (2013). The genomic signature of dog domestication reveals adaptation to a starchrich diet. Nature, 495(7441), 360–364. https://doi.org/10.1038/ nature11837

Araujo et al. (1975) Araujo FP, Schwabe CW, Sawyer JC, Davis WG. Hydatid disease transmission in California. A study of the Basque connection. American Journal of Epidemiology. 1975;102:291–302. Elmore et al. (2010) Elmore SA, Jones JL, Conrad PA, Patton S, Lindsay DS, Dubey JP. Toxoplasma gondii: epidemiology, feline clinical aspects, and prevention. Trends in Parasitology. 2010;26:190–196. doi: 10.1016/j. pt.2010.01.009.

Carter & Quinn (2000) Carter ME, Quinn PJ. Salmonella infections in dogs and cats. In: Wray C, Wray A, editors. Salmonella in domestic animals. CAB International; Wallingford: 2000. pp. 231–244.

Case LP, et al., Canine and Feline Nutrition 3rd edition, 2011 Cobb & Stavisky (2013) Cobb MA, Stavisky J. Salmonella in dogs and cats. In: Barrow PA, Methner U, editors. Salmonella in domestic animals. CABI; Wallingford: 2013. pp. 318–336.

Connolly, Heinze & Freeman (2014) Connolly KM, Heinze CR, Freeman LM. Feeding practices of dog breeders in the United States and Canada. Journal of the American Veterinary Medical Association. 2014;245:669–676. doi: 10.2460/ javma.245.6.669.

FDA (2016) FDA Get the facts! Raw pet food diets can be dangerous to you and your pet. 2016. [07 October 2016].

Finley et al. (2007) Finley R, Ribble C, Aramini J, Vandermeer M, Popa M, Litman M, Reid-Smith R. The risk of salmonellae shedding by dogs fed Salmonella-contaminated commercial raw

food diets. The Canadian Veterinary Journal. 2007;48:69–75.

Freeman et al. (2013) Freeman LM, Chandler ML, Hamper BA, Weeth LP. Current knowledge about the risks and benefits of raw meat-based diets for dogs and cats. Journal of the American Veterinary Medical Association. 2013;243:1549–1558.

Freeman, Janecko & Weese (2013) Freeman LM, Janecko N, Weese JS. Nutritional and microbial analysis of bully sticks and survey of opinions about pet treats. The Canadian Veterinary Journal. 2013;54:50–54.

Hand, et. Aal, Small Animal Clinical Nutrition, 5th edition

Joffe & Schlesinger (2002) Joffe DJ, Schlesinger DP. Preliminary assessment of the risk of Salmonella infection in dogs fed raw chicken diets. The Canadian Veterinary Journal. 2002;43:441–442.

Jokelainen et al. (2012) Jokelainen P, Simola O, Rantanen E, Nareaho A, Lohi H, Sukura A. Feline toxoplasmosis in Finland: cross-sectional epidemiological study and case series study. Journal of Veterinary Diagnostic Investigation. 2012;24:1115–1124. doi: 10.1177/1040638712461787.

Kienzle, Bergler & Mandernach (1998) Kienzle E, Bergler R, Mandernach A. A comparison of the feeding behavior and the human–animal relationship in owners of normal and obese dogs. The Journal of Nutrition. 1998;128:2779S–2782S.

Laflamme et al. (2008) Laflamme DP, Abood SK, Fascetti AJ, Fleeman LM, Freeman LM, Michel KE, Bauer C, Kemp BL, Doren JR, Willoughby KN. Pet feeding practices of dog and cat owners in the United States and Australia. Journal of the American Veterinary Medical Association. 2008;232:687–694. doi: 10.2460/javma.232.5.687.

Lenz et al. (2009) Lenz J, Joffe D, Kauffman M, Zhang Y, LeJeune J. Perceptions, practices, and consequences associated with foodborne pathogens and the feeding of raw meat to dogs. The Canadian Veterinary Journal. 2009;50:637–643.

Leonard et al. (2011) Leonard EK, Pearl DL, Finley RL, Janecko N, Peregrine AS, Reid-Smith RJ, Weese JS. Evaluation of pet-related management factors and the risk of Salmonella spp. carriage in pet dogs from volunteer households in Ontario (2005–2006) Zoonoses and Public Health. 2011;58:140–149. doi: 10.1111/j.1863-2378.2009.01320.x.

Michel et al. (2008) Michel KE, Willoughby KN, Abood SK, Fascetti AJ, Fleeman LM, Freeman LM, Laflamme DP, Bauer C, Kemp BL, Doren JR. Attitudes of pet owners toward pet foods and feeding management of cats and dogs. Journal of the American Veterinary Medical Association. 2008;233:1699–1703. doi: 10.2460/javma.233.11.1699.

Morgan SK, Willis S, Shepherd ML. Survey of owner motivations and veterinary input of owners feeding diets containing raw animal products. PeerJ. 2017 Mar 2;5:e3031. doi: 10.7717/ peerj.3031. PMID: 28265510; PMCID: PMC5337082.

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Shimi & Barin (1977) Shimi A, Barin A. Salmonella in cats. Journal of Comparative Pathology. 1977;87:315–318. doi: 10.1016/0021-9975(77)90020-2.

Strohmeyer et al. (2006) Strohmeyer RA, Morley PS, Hyatt DR, Dargatz DA, Scorza AV, Lappin MR. Evaluation of bacterial and protozoal contamination of commercially available raw meat diets for dogs. Journal of the American Veterinary Medical Association. 2006;228:537–542. doi: 10.2460/javma.228.4.537.

ED CARLSON, CVT, VTS (Nutrition)

Ed Carlson is the director of Veterinary Nursing Education for VetBloom. He is the treasurer of the New Hampshire Veterinary Technician Association and the secretary of the Massachusetts Veterinary Technician Association. Ed has served on multiple National Association of Veterinary Technicians in America (NAVTA) committees and was the 2021 NAVTA President. He obtained a VTS (Nutrition) in 2014 and lectures frequently at local, regional, national, and international veterinary conferences on a variety of topics. Ed also received the NAVTA Technician of the Year award in 2019.

SIGNIA BY HILTON ORLANDO BONNET CREEK APRIL 20-22, 2023 | ORLANDO, FLORIDA

Continuing education

FOR EVERY MEMBER OF THE VETERINARY CARE TEAM!

FVMA Annual Conference returns this April 20-22, 2023, for its 94th year! Our flagship event gives you access to an outstanding scientific program coupled with unique social and networking activities that will make for an unforgettable weekend of enrichment, exchange, and enjoyment.

With over 250 hours of continuing education sessions and 13 hands-on wet labs, FVMA Annual Conference is your chance to sharpen your skills and empower every member of the veterinary care team.

WET LAB & SESSION TOPICS INCLUDE:

ƒ Anesthesia/Pain Control

ƒ Avian/Exotic

ƒ Cardiology

ƒ Dentistry

ƒ Dermatology

ƒ Endocrinology

ƒ Gastroenterology

ƒ Infectious Diseases

ƒ Internal Medicine

ƒ Nutrition

CONTINUING EDUCATION HOURS:

More than 250 CE hours

ƒ Oncology

ƒ Practice Management

ƒ Urology

ƒ and more!

ƒ 13 hands-on wet labs

ƒ Maximum of 24 CE hours for veterinarians

ƒ Maximum of 16 CE hours for veterinary technicians

ƒ AAVSB RACE, Provider #50-27127: Program #20-990988

ƒ Florida Board of Veterinary Medicine DBPR FVMA Provider #0001682

ƒ Sponsor of Continuing Education in New York State

Thank you TO OUR EDUCATIONAL PARTNERS & SPONSORS

2023 SPEAKERS

Wet Lab Instructors

JAN BELLOWS

DVM, DAVDC, DABVP

All Pets Dental

• Specialty: Dentistry

RALPH HARVEY

DVM, MS, DACVAA

Chair, Veterinary Advisory Board; BioTraceIT Corporation

• Specialty: Anesthesia/Pain Control

PETER HELMER

DVM, DABVP (Avian Practice)

BluePearl Veterinary Partners

• Specialty: Avian/Exotic

GARY OSWALD

DVM, MS, DACVIM (Internal Medicine)

Tampa Bay Veterinary Specialists

• Specialty: Internal Medicine

DARCY ADIN

DVM, DACVIM (Cardiology)

• Specialty: Cardiology

RICK ALLEMAN

DVM, PhD, DABVP, DACVP

• Specialty: Infectious Diseases

MELYSSA ALLEN

MA, CHWC, DACLM

• Specialty: Wellness

SERGE CHALHOUB

BSc, DVM, DACVIM (SAIM)

• Specialty: Ultrasound

KRISTIN A. COLEMAN

DVM, MS, DACVS

• Specialty: Surgery

ERIC D. GARCIA

Digital Strategist

• Specialty: Practice Management

LAWRENCE GARCIA

MS, DVM

• Specialty: Shelter Medicine

ADAM HONECKMAN

DACVIM (Internal Medicine)

• Specialty: Internal Medicine

ED CARLSON

CVT, VTS (Nutrition)

• Specialty: Nutrition

HOWARD B. SEIM III

DVM, DACVS

Small Animal Surgery Faculty at Colorado State University

• Specialty: Surgery

ROBERT SWINGER

DVM, DACVO

Veterinary Ophthalmologist, Owner/Medical Directory Animal Eye Guys of South Florida

• Specialty: Ophthalmology

JACQUELINE WHITTEMORE

DVM, PhD, DACVIM (SAIM)

Associate Professor of Medicine University of Tennessee, College of Veterinary Medicine

• Specialty: Gastroenterology

SHELLY OLIN

DVM, DACVIM, SAIM

• Specialty: Endocrinology

JEANNE PERRONE

MS, CVT, VTS (Dentistry)

• Specialty: Dentistry

JASON PIEPER

DVM, MS, DACVD

• Specialty: Dermatology

ANDREW SPECHT

DVM, DACVIM (SAIM)

• Specialty: Urology

WET LABS

Reserve your seat for one of our 13 hands-on wet labs.

Open to veterinarians and technicians, our labs are your chance to get hands-on training from experts. You will get ample opportunity to learn and practice your skills while coached through the procedures by our esteemed instructors.

Seats are limited to ensure you receive personalized instruction. Our wet labs are suitable for all experience levels, whether you want to learn something new or hone your skills with the best in the field. This is a can’t miss opportunity to learn from the best and elevate your practice!

Featured WET LABS

BACKYARD CHICKEN MEDICINE (FOR DVMS & TECHS)

Lead instructors: PETER HELMER, DVM, DABVP-Avian Practice & BRIGETTA ALLEN HUGES, DVM, MAM, DACPV

April 21, 2023 | 1:30 p.m. – 6 p.m.

8 CE CREDITS: Topics include regulations and reportable diseases, handling and management, anatomy, and diagnostics. Resources for physical exams, history taking, and treatment will be covered.

OPHTHALMIC SURGERY (FOR DVMS)

Lead instructor: ROBERT SWINGER, DVM, DACVO

April 20, 2023 | 8:00 am - 1:00 p.m.

5 CE CREDITS: Improve your proficiency in performing practical eyelid and orbital surgeries while gaining an appreciation for the skill level required for most corneal and conjunctival procedures.

SURGERY WET LABS

• Soft Tissue Surgery Boot Camp - DVM only | 8 CE credits - SOLD OUT!

• Advanced Soft Tissue Surgery - DVM only | 8 CE credits

DENTISTRY WET LABS

• Canine Extraction Techniques - DVM only | 4 CE credits

• Feline Extraction Techniques - DVM only | 4 CE credits

• Advanced Extraction Techniques - DVM only | 4 CE credits

• Dental Nerve Blocks Cleaning, Probing, & Charting - Tech only | 4 CE credits

• Dental Radiology Positioning Techniques - Tech only | 4 CE credits

ULTRASOUND WET LABS

• Basic Small Animal Abdominal Ultrasound - DVM only | 8 CE credits - SOLD OUT!

• Advanced Small Animal Abdominal Ultrasound - DVM only | 8 CE credits

• Ultrasound for Technicians - Tech only | 4 CE credits

• Veterinary Point-of-Care Ultrasound for Everyday Practice - DVM only | 8 CE credits

VENUE & DISCOUNTS

SIGNIA BY HILTON ORLANDO BONNET CREEK

14100 Bonnet Creek Resort Lane, Orlando, Fla. 32821

An Official Walt Disney World® Hotel, Signia is a newly renovated resort with a blend of inspired hospitality and exceptional amenities. Our host hotel is primed to offer you a great conference and a memorable family vacation destination.

Our room block at Signia is almost SOLD OUT! If you need assistance booking at an alternate hotel, please contact meetings@fvma.org.

CHILD CARE SERVICES

Provided by Kiddie Corp

DISCOUNTED DISNEY TICKETS

Walt Disney World Resort®

Busy parents can get their CE while the kids enjoy their own program. Discounted daycare services are available April 21-22 at the Signia by Hilton Orlando Bonnet Creek for children from six months of age through 12. Register early as availability is limited!

TICKETS STARTING AT $78.87

FVMA Annual Conference attendees have access to special theme park tickets up to seven days before, during, and after the event! Meet, relax, and unwind with everything Walt Disney World Resort has to offer.

Special Discounted Rate: $12.00/HOUR SCAN

OUR POSITION ON Veterinary Telemedicine

The FVMA is confident veterinary telemedicine legislation will be voted upon during Florida’s legislative session this year. We have long supported veterinary telehealth legislature that provides protections for the veterinarian-client-patient relationship (VCPR) and are committed to nurturing opportunities that properly protect animals, their owners, and the veterinarians who support them.

WHAT IS VETERINARY TELEMEDICINE?

Telehealth is a loose, catch-all term that encompasses a significant number of concepts when discussing electronic veterinary care in Florida and the United States. The term describes a large umbrella of healthcare modalities that all use electronic devices to connect healthcare providers with clients/patients.

Telemedicine has been the focus of legislation in recent years, as it concerns the act of a Florida-licensed veterinarian exchanging medical information electronically to improve a patient’s clinical health status. This includes diagnosing and subsequently prescribing legend drugs or controlled substances strictly by telecommunications or audio/visual means.

Other forms of telemedicine include teleadvice and teletetriage. Teleadvice concerns discussions between a veterinary professional and an animal owner about general care, such as providing advice on heartworm prevention, proper hygiene, and dietary practices. This information is not specific to a patient's unique health status.

Teletriage concerns a veterinary professional answering a call from an animal owner regarding immediate steps to take during an emergency. It generally includes short-term, lifesaving care that is generally followed by directions to go to the closest veterinary care facility for further treatment.

The FVMA supports teleadvice and teletriage — which do not require a VCPR — when appropriate and supports telemedicine under the proper establishment of a VCPR.

WHY IS THE VCPR IMPORTANT?

Used appropriately, telemedicine can enhance accessibility and ongoing veterinary care. However, establishing the VCPR is fundamental to ensuring telemedicine can work as designed.

Unlike when humans participate in telemedicine, animals cannot verbally communicate with their healthcare providers. A veterinary professional’s best way of providing accurate care is through a physical examination, which would give the treating professional some familiarity with the pet’s true baseline condition. Thus, maintaining the VCPR through a periodic, in-person visit with a veterinary professional is essential to establishing a proper understanding of the animal’s health.

Without the initial in‐person examination required to establish a VCPR, the risks of misdiagnosis, failure or delay in conducting appropriate diagnostics, and ineffective treatment increase and can lead to poor clinical outcomes.

As a member of the American Veterinary Association’s (AVMA) Telehealth Coalition, we believe that a VCPR that meets the requirements defined under Florida’s Veterinary Practice Act

Image courtesy of Canva.

FVMA Communications Team Florida Veterinary Medical Association

must be in effect for a veterinarian to diagnose and treat an animal and/or to prescribe or dispense medications in the State of Florida.

A VCPR that meets federal requirements established by the Food and Drug Administration (FDA) must also be in effect to use FDA‐approved animal drugs in any manner that differs from their approved labeling, any FDA‐approved human drugs (including over‐the‐counter medications), compounded drugs, authorize a Veterinary Feed Directive (VFD), and use certain USDA‐approved biologics. A federal VCPR cannot be established through telemedicine and explicitly requires an inperson animal examination and/or visit to the premises where the animal(s) are kept.1

The FDA also requires an in‐person examination or timely visits to the premise where animals are kept for common activities because this degree of oversight is necessary to ensure that medications, including antimicrobials and controlled substances, are used judiciously and to protect the quality and safety of the nation’s food supply. This further highlights the value and importance of establishing a VCPR via inperson examination. Veterinary telemedicine is most effective and safest for patients, clients, and veterinarians/veterinary practices when used to maintain a VCPR that has already been established via an in‐person examination. We support the recommendation of the AVMA that a VCPR should not be established via electronic means, and telemedicine should only be conducted within an existing VCPR.

WHAT IS OUR SOLUTION?

We are introducing our own bill — the Veterinary Telemedicine Act — to lawfully permit the practice of veterinary telemedicine with the establishment of a VCPR. The Veterinary Telemedicine Act will provide the following:

• Define the veterinary “patient” to include herds, groups, or collections of animals.

• Define veterinary telemedicine as the practice of veterinary medicine via telecommunications and audio/ visual technology within the confines of a properly established VCPR.

• Define and implement a properly created VCPR, which is imperative to ensure:

Ȇ There is an understanding of the ongoing care or status of the patient.

Ȇ There is an understanding of the ability of the owner or caretaker to properly complete treatment of the patient.

Ȇ These understandings help prevent the overprescribing, incorrect prescribing, or diversion of

medications that would place the patient, humans, and the environment at risk.

Veterinary patients are protected from misdiagnosis and non-effective or harmful treatments. No veterinarian has ever been taught or trained to diagnose solely from a picture/video with a layperson’s description.

• Allow veterinarians practicing veterinary telemedicine to legally prescribe legend drugs and controlled substances.

• Allows for proper referral to specialists employing audio/visual technology to practice under the referring veterinarians VCPR, with prescribing being completed by the referring veterinarian (behavior medicine, hospice care, etc.).

• The Board of Veterinary Medicine retains full authority over those practicing veterinary telemedicine in our state, protecting the public and their animals.

• Allows Municipal Animal Control Authorities to vaccinate dogs, cats, and ferrets for rabies under the indirect supervision of veterinarians via telemedicine.

Research and conversations with all affected parties has led to proposed legislation we believe can serve as equal protection for pets, owners, and veterinarians alike.

OUR GRASSROOTS EFFORTS

Our work in fulfilling our mission through legislative advocacy doesn’t end with any singular bill. Every year, legislation is voted upon that has the potential to impact the veterinary profession we love so dearly. That is why we created the FVMA Advocacy Ambassador program, which joins initiatives like the FVMA PAC and Legislative Action Days in providing you with a wealth of opportunities to choose how you fight for veterinary medicine.

Whether you join the FVMA Advocacy Ambassador program, donate to the PAC, or join us at the next Legislative Action Days, we invite you to fight for the prosperity of veterinary medicine alongside us.

1The FDA temporarily suspended enforcement of some federal veterinarian-client-patient relationship (VCPR) requirements, namely the requirement for an in-person animal examination and/or visit to the premises where the animal(s) are kept during the COVID-19 outbreak. This suspension was nullified Feb. 21, 2023.

EMOTIONAL INTELLIGENCE Starts With You

When we think about emotions at work, most people think they need to be left at the door. There is simply no space for feelings when we are working with a team tirelessly for many hours, often without a break. No, definitely no feelings. But who are we kidding? You can’t just leave your emotions at the door any more than you can leave your left foot at the door, so we must find a way to deal with them.

That’s where emotional intelligence comes in. This is your ability to recognize, understand, and manage your emotions as well as those of others to create strong relationships. As much as we feel influenced by, and sometimes even victims of the emotions of others, emotional intelligence is an internal job. We are responsible for how we feel and how we respond, and the first step in doing so is recognizing we’re feeling something. Sounds simple, right?

Emotional intelligence is made up of four domains: selfawareness, self-management, social awareness, and relationship management. Self-awareness is the ability to recognize and understand your feelings and emotions as they happen and predict how they affect your performance. After working with thousands of individuals through our emotional intelligence workshops and e-courses, we’ve found that self-awareness is most often the place where people in our industry struggle. It’s critical to build in this area because the remaining domains rely heavily on a person’s ability to be self-aware. Without an understanding of our emotions, we can’t manage them (self-management), recognize, and respond appropriately to the emotions of others (social awareness), or build strong relationships (relationship management). For this article, we’ll be focusing solely on the first two domains.

Self-awareness is made up of three competencies: selfconfidence, self-assessment, and emotional awareness. Selfawareness is about knowing who you are. Self-confidence comes from your values, having a vision of where you’re heading, and a deep commitment to staying true to yourself.  Self-assessment is taking that awareness piece and seeing if others see you in the same way. Essentially, a self-aware person will have a small gap between how they see themselves and how others perceive them, and feedback should not be surprising. Finally, we have emotional awareness: your ability to know when you’re having a feeling, properly label it, and predict its impact. For many, this is the competency where the work starts.

To become more self-aware, we need to recognize our internal cues. These are your thoughts, body sensations, and emotions. When your fifth emergency walks into the practice, what is that

Image courtesy of Canva.

Image courtesy of Canva.

Rachel Teichberg | CVPM, CVBL, CCFP Veterinary Growth Partners

inner voice saying? Maybe something like, “Are you kidding me? We can’t handle another emergency today!” What is your body doing? Maybe your heart is beating a little faster, or your head suddenly starts to hurt. Maybe you notice that you’re clenching your fists. These are your indicators. Now, it’s time to label the emotion. Could you be stressed, overwhelmed, uneasy, worried, anxious, afraid, or annoyed?

Once you recognize the emotions, you can move into the second domain of self-management. This is your ability to choose your response. That’s right, you get to choose! Do you often feel like you’ve made a conscious choice about handling your feelings, or do you typically feel swept away by an emotion, without any control? It’s important to clarify that self-management is not pretending your emotions don’t exist or shoving them down. This is about making a conscious choice in the moment about how you need to process or express what you’re feeling.

To go back to the emergency walk-in example, maybe your initial gut response was to throw your head back and scream at the ceiling. By tuning into your emotional intelligence, you can recognize the feelings and choose a different path, like taking a few deep breaths or telling the team you need to take a minute outside. That's the magic of emotional intelligence because, too often, we don't choose; we just react, and there can be serious consequences for those actions.

This is one of the many reasons why emotional intelligence is an important leadership skill. Great leaders work through emotions and drive the collective emotions of the group in a positive direction. Within a team, the leader (even if it is an emerging leader) has the power to sway everyone’s emotions and can clear or cause toxicity. You simply can’t lead teams without acknowledging and addressing emotions. As Brené Brown said, “Leaders must either invest a reasonable amount of time attending to fears and feelings or squander an unreasonable amount of time trying to manage ineffective and unproductive behavior.”1

If you’re ready to start working on your emotional intelligence, here are a few simple places to start:

• Determine your starting point with an emotional intelligence assessment by attending a workshop or looking into other options online.

• Establish your core values.

• Develop your emotional language. Google ‘The Feelings Wheel’ and print it out so you can better identify what is going on inside of you. Using the right language is critical to best address the feeling and connect with others through the social awareness domain.

• Meditate. Find time to slow down and practice turning down the volume of your inner voice.

• Get curious about what’s happening inside of you. Ask questions like: Why did I react that way? Why am I sweating uncontrollably? Why am I crying for ‘no reason’?

It’s okay to not be great at this right away. In fact, it would be surprising if you were! However, we need to reflect and learn from our mistakes or missteps. Ask yourself what you could have done differently, or what emotional signal — be it a thought or body sensation—you may have missed. Let your team know you’re working on your emotional intelligence and ask for feedback. Improving your emotional intelligence will take time and patience, but starting with just one small thing can make a huge impact.

REFERENCES

1Brown, Brené. (2018). Dare to lead: brave work, tough conversations, whole hearts. Random House.

CVPM, CVBL, CCFP

Rachel Teichberg is the head of Learning and Development at Veterinary Growth Partners. As a content creator, consultant, and speaker, she creates and delivers interactive leadership training programs that support veterinary practices to establish or sustain highly productive teams. She is a certified trainer in emotional intelligence, workplace conflict resolution, and QPR. Visit vgpvet.com for more information.

Image courtesy of Canva.

RACHEL TEICHBERG

FVMA 2023 ANNUAL OPERATING BUDGET Approved

AnnualBudget

The FVMA Executive Board approved the association's 2023 operating budget in November 2022. This budget reflects the FVMA’s commitment to advancing strategic goals and broadening the delivery of high-quality services to the diverse veterinary professional community of our state.

Our focus is on enhancing our continuing education services and expanding membership benefits, offering a wealth of tangible and intangible resources. At the same time, we are steadfast in our goal to expand our grassroots advocacy efforts and position the association as the leading voice of veterinary medicine in Florida, furthering our mission to empower, support, and provide valuable resources to the entire veterinary community.

We are equally committed to exercising sound stewardship of FVMA membership fiscal resources. We understand the importance of having a strong financial foundation and are dedicated to preserving the stability and success of our organization.

The FVMA has the fiscal resources, experienced leadership, and dedicated professional staff to responsibly expand and enhance our membership services, programs, and outreach. It's an all-encompassing effort to continue to serve our membership well, protecting and advancing the veterinary profession in Florida. The 2023 budget equips the FVMA to perform efficiently in all areas of operation and carry out all its important functions.

Let us be inspired by the FVMA’s mission statement: to advance the veterinary medical profession, promote animal health and well-being, and protect public health.

If you have any questions regarding the 2023 fiscal operating budget, please direct them to me or FVMA Executive Director Jim Naugle.

Thank you for the opportunity to serve this great profession.

Respectfully,

Steve Steverson, DVM Treasurer

PRACTICE Pulse

QUESTION: We received a visit from our local county animal control officer, who requested a monthly copy of our clients’ rabies certificates. These contain personal information, and as a private company, we are not comfortable with disclosing it without our clients’ consent. Is this something we can decline?

A: Paragraph (3) of the applicable Florida Statutes requires that the veterinarian provide the owner and the animal control authority with a rabies vaccination certificate:

According to Florida Statute 828.30 Rabies vaccination of dogs, cats, and ferrets.—

(1) All dogs, cats, and ferrets 4 months of age or older must be vaccinated by a licensed veterinarian against rabies with a vaccine that is licensed by the United States Department of Agriculture for use in those species. The owner of every dog, cat, and ferret shall have the animal revaccinated 12 months after the initial vaccination. Thereafter, the interval between vaccinations shall conform to the vaccine manufacturer’s directions. The cost of vaccination must be borne by the animal’s owner. Evidence of circulating rabies virus neutralizing antibodies shall not be used as a substitute for current vaccination in managing rabies exposure or determining the need for booster vaccinations.

(2) A dog, cat, or ferret is exempt from vaccination against rabies if a licensed veterinarian has examined the animal and has certified in writing that at the time vaccination would endanger the animal’s health because of its age, infirmity, disability, illness, or other medical considerations. An exempt animal must be vaccinated against rabies as soon as its health permits.

(3) Upon vaccination against rabies, the licensed veterinarian shall provide the animal’s owner and the animal control authority with a rabies vaccination certificate. Each animal control authority and veterinarian shall use the “Rabies Vaccination Certificate” of the National Association of State Public Health Veterinarians (NASPHV) or an equivalent form approved by the local government that contains all the information required by the NASPHV Rabies Vaccination Certificate. The veterinarian who administers the rabies vaccine to an animal as required under this section may affix his or her signature stamp in lieu of an actual signature.

QUESTION: We had a client take a written Rx filled out on a security Rx — and a DEA number to a pharmacy. They were told that it is now required to send by e-script only. Is this exclusive to certain pharmacies, or does it apply state- or county-wide?

A: The pharmacist is wrong. The e-prescribing law is in Chapter 456 of the Florida Statues, which applies to “health care practitioners” as defined in Chapter 456:

(4) “Health care practitioner” means any person licensed under chapter 457; chapter 458; chapter 459; chapter 460; chapter 461; chapter 462; chapter 463; chapter 464; chapter 465; chapter 466; chapter 467; part I, part II, part III, part V, part X, part XIII, or part XIV of chapter 468; chapter 478; chapter 480; part II or part III of chapter 483; chapter 484; chapter 486; chapter 490; chapter 491.

Veterinarians are licensed under Chapter 474 of the Florida Statutes and are not on that list.

QUESTION: Is a VCPR required to deliver prescription diets to a client, or can we do so via telecommunications?

A: Because prescription diets are not prescription items in a strictly legal sense, a VCPR is not required. Nevertheless, these diets are specifically formulated to aid in the management of illness or disease in an animal that presumably has been diagnosed as needing such (or deriving some benefit from such).

A veterinarian may incur some liability by selling these without a VCPR because, when sold by a veterinarian, a consumer may be under the impression that the veterinarian is recommending it or somehow agreeing with the diagnosis made by another veterinarian. This is why we recommend that the veterinarian selling these to a consumer without having established a VCPR ask the consumer information about who diagnosed the animal as needing it, making a note of that information somewhere, and maybe even calling or emailing the original veterinarian to confirm.

In addition, although these prescription diets are not prescription items in a strictly legal sense, they are specifically formulated to aid in the management of illness or disease of a diagnosed health disorder in an animal. The State of Florida Department of Revenue calls them “therapeutic veterinary diets” and grants them a salestax exemption.

Veterinarians may incur some unintended liability if they sell these to anyone. The reason is that these are intended to address/ manage specific conditions, so an argument can be made that if you as a veterinarian sell one of these to someone you do not have a VCPR, how do you know the animal has the condition that requires or supports the therapeutic diet?

We understand that some veterinary retailers ask for a “prescription” before selling these. It may be a similar risk management issue for them.

Although the chance of incurring trouble for selling to anyone may be small, it is not impossible, so some due diligence may be appropriate.

One of the benefits of an FVMA membership is our helpline (800-992-3862), which is available to members Monday through Friday from 8 a.m.-5 p.m. Our helpline also provides insight to the FVMA staff of the challenges and concerns of our members. In this feature, we will highlight topics from the questions we received in preceding weeks as a part of an effort to keep our members up to date on current concerns, as well as regulatory and legislative changes.

QUESTION: I bought a clinic in partnership with someone who is not a veterinarian. My partner, with one of the clinic’s certified technicians, is making medical decisions without my approval. Many of these decisions are medically debatable and some of them are totally wrong, such as a veterinary technician consulting and recommending medical treatments without the intervention of a licensed veterinarian. What can I do?

A: You need to consult with an attorney and may end up having to dissolve the partnership. Because you are the “responsible veterinarian” for the clinic, any problems that occur as a result of poor medical decisions may become your responsibility.

QUESTION: We recently had a question arise about the health certificate for the sale of a dog/cat in Florida. There is a breeder located in Florida who sold puppies to an individual located out-ofstate. Do we need to have a health certificate for the sale of a dog/cat in Florida for this transaction as the point-of-sale is in Florida? Or is this not needed as the puppy was not bought by an individual located in Florida?

A: The requirement for the health certificate is not tied to the state of residence of the buyer. It is required for each dog offered for sale within the state. Even if the seller is advertising on the internet, the sale occurs within the state because the transfer of possession occurs in Florida.

QUESTION: I am assuming the responsibility of the DEA in a clinic. I was taught that phenobarbital needs to be dispensed in 30-day intervals with multiple refills; however, they are currently being dispensed in 90 and even 120-day intervals. Which dispensing method is correct, or is there an in-between?

A: Phenobarbital is a Schedule IV Controlled Substance. As such, a prescriber can issue a 30-day prescription with a maximum of five refills, totaling 180 days. Dispensing a 90-day supply or even a 120-day supply is not prohibited.

According to the 2022 Florida Statutes, § 893.04(g).:

(g) A prescription for a controlled substance listed in Schedule III, Schedule IV, or Schedule V may not be filled or refilled more than five times within a period of 6 months after the date on which the prescription was written unless the prescription is renewed by a practitioner.

As a matter of due diligence and care, I would recommend dispensing no more than a 90-day supply.

QUESTION: Our main veterinarian is retiring, and we need some guidance on how to handle prescriptions for his patients. My previous understanding was that we as associates can refill prescriptions on long-term medications that he has previously prescribed, such as Thyro-tabs and Vetmedin, even if we have not directly examined the patient. Is that correct?

Associates can refill prescriptions for patients of the practice they have not personally examined so long as they have access to the patient records and can confirm that the medication is appropriate for the condition diagnosed and that any necessary testing/ bloodwork is current.

END NOTE: The ultimate responsibility in the practice of veterinary medicine lies with the licensed veterinarian. Professional discretion must always be exercised.

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PRACTICE FOR SALE/LEASE

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PRACTICE FOR SALE – SARASOTA, FLA.: Storefront practice for sale. Solo veterinarian retiring. Low overhead; low stress. Fantastic clients. Gross $300,000 +. Recently upgraded interior. Fully computerized. Asking $200,000 obo. Contact Lee at (941) 914-3239

SOLO PRACTICE RETIRING: An independent building, 2,000 sq ft, (lease or buy) & a satellite clinic (leasehold) in Tampa Bay. No ER & low overhead. Gross $470,000 ++. Asking $340,000 (negotiable & owner financing). Only serious buyer. Email to lovevet1234@gmail.com

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ARIZONA

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ORLANDO Area - Well-established practice grossing approximately $800K Upstairs apartment allows for additional income!

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MICHIGAN

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