2014 Advocate Issue 5

F V M A ADVOCATE ISSUE 5 - 2014 | www.fvma.org

Happy Holidays

Our Family to Yours!

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

PRESIDENT’S MESSAGE A

s we enjoy the holiday season, it is a great privilege to have this opportunity to offer my best wishes to all our members and their families; to our friends in industry, and to other veterinary professionals in our State and elsewhere.

The successes of this year are a great source of pride for me and the other members of your executive board, as we continue to work to provide services to our members and to improve the FVMA’s ability to continue to serve our growing membership. We are most gratified that our conferences this year all proved successful, and continue to grow in attendance and reach.

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

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

The Annual Gulf-Atlantic Veterinary Conference held in September surpassed our expectations, and as our inaugural meeting, recorded a profit in its second year. It attracted participation from near and far. Attendees came from 37 states, including Hawaii, as well as from Puerto Rico, the Virgin Islands and Canada. Our national conference is off on solid footing, and we invite you to plan on joining us at the 3rd Annual TGAVC, when we return to Boca Raton from October 29th to November 1st, next year.

Like TGAVC, we recorded great successes at the FAEP’s 10th Annual Promoting Excellence Symposium held in Hilton Head, South Carolina in October, and the Equine Foot Symposium in Orlando, in June.

As we approach the end of the year, we are busy finalizing the arrangements for our other continuing education offerings which will be held in 2015, and we encourage you to take advantage of these excellent opportunities to receive your CE and network with other veterinary professionals.

Equine practitioners are invited to Ocala, Florida, “the horse capital of the world,” for the 52nd Ocala Equine Conference from January 23rd -25th. Food animal veterinarians can look forward to the 8th Annual Dr. Harvey Rubin Memorial Food Animal Medical Conference, which takes place in Kissimmee in the early spring. (Dates will be announced shortly.) The FVMA 86 th Annual Conference is scheduled for Lake Buena Vista from April 10th to 12th; and the 2015, equineexclusive, Promoting Excellence Symposium, will be held in Naples, Florida on October 15th to 18th.

The FVMA has concentrated a large portion of its efforts toward establishing ourselves as a premier provider of top-of-the-line scientific programs for the benefit of our members and other veterinary professionals. We are proud of the confidence placed in us by those from veterinary medicine and industry, who continue to attend and support our programs.

Our focus will continue to be excellence in service and development as we go into the New Year. In relation to that, I am happy to inform you that we’ve successfully undertaken our strategic planning exercise, and I look forward to reporting fully to our membership following the Executive Board meeting in December.

Yours in service,

FVMA Staff

Sandra P. Brooks Accounting/Membership Director Kelly Callihan Director of Conference & Events Amber Coon Executive Administrative Assistant Ann Deal Director of Administration & Communications Ralph E. Huber Industry Relations Director Alssa Mathews Multimedia Art & Design Director Beni Jean Price Financial/Membership Coordinator Betsy Pynes Meetings and Events Coordinator Ann Wade Communications & Public Relations Director

2 | FVMA ADVOCATE

Donald H. Morgan, DVM

In this Issue....

4 | 6 | 8 | 10 | 12 | 15 |

In Remembrance...

ASVMAE Executive of the Year Save the Dates!

Member Spotlight UFCVM Student Mentoring Panel 52nd Annual Ocala Equine Conference

20 | Call for Nominations Reminder 22 | Collection Strategies for the

Veterinary Practice 24 | Hydrocodone Combination Products Are Now Schedule II 26 | Practice Pulse 30 | Classified Advertisements

MEMBERSHIP

ICES T O N L A W E REN

ARE IN THE MAIL

M

embership renewal notices for 2015 are in the mail.

FVMA membership expires at the end of each year. Active members of the FVMA are graduates of an AVMA-accredited college of veterinary medicine or graduates who have met the requirements of the Educational Commission of Foreign Veterinary Graduates (ECFVG).

FVMA Membership provides valuable advantages to practicing Florida vets and business owners. The association works to defend the veterinary profession, and benefits of belonging to the FVMA include:

▶ Numerous Member Support Programs that save money for both the practice owner and the associate, including lower-cost credit card processing, animal health products and services, and no-interest client payment plans.

A full listing of available programs can be viewed on FVMA’s website, at www.fvma.org. ▶ Free subscription to FVMA news magazine and information sharing through email and fax broadcasts. ▶ The FVMA Helpline at (800) 992-3862 is available to answer questions daily from 8 a.m. to 6 p.m.

▶ Defense of the livelihood of the veterinary profession though the work of the FVMA’s Legislative Committee. The Committee monitors proposed legislation that could affect the profession. The FVMA maintains a statewide network of members who contact legislators whenever necessary, to make sure members’ best interests are protected. ▶ Deployment of aggressive counter measures against proposed changes to the Veterinary Practice Act and related rules that would adversely affect the conditions under which veterinarians earn their livelihood. Toward this end, the FVMA participates in all quarterly meetings of the Board of Veterinary Medicine. ▶ The provision of affordable annual CE offerings, including the FVMA Annual Conference and GulfAtlantic Veterinary Conference, and other educational programs around the state. Conferences and other meetings also give practitioners opportunities to network professionally and socially with colleagues and the industry representatives who service the veterinary profession. ▶ Administration of the statewide certification program for veterinary technicians, and the full support of community college training programs in veterinary technology. The FVMA also offers continuing education programs to boost veterinary technicians’ skills and professionalism.

Membership Categories: Membership categories in the Florida Veterinary Medical Association are: • Regular Member • State/Federal Member (employed by a state/federal government agency) • Retired Member (65 years of age; working an average of 10 hours weekly or less at a veterinary practice; and be an FVMA member for 15 or more years) • Part-time Employed Member (work less than 20 hours weekly for an FVMA member practice; does not apply to practice owner) • Non-resident Member

Look out for your membership renewal letter in your mailbox during the month of December. Members who do not receive the dues renewal letter should call the FVMA at (800) 992-3862 for assistance in making payment by phone. Dues payments may also be made online at www.fvma.org.

www.fvma.org | 3

In Remembrance

ANTJE NEUBERT, DVM

Dr. Antje Neubert, 69, of Crystal River, passed away peacefully on Sunday, October 19, 2014. Dr. Neubert practiced small animal medicine at her clinic, Crystal River Animal Hospital, from 1975 up to the time of her death.

She was born in Witzenhausen, Germany. She graduated high school in Huntsville, Alabama and attended Auburn University to earn her Doctorate of Veterinary Medicine. She was one of three women in her graduating class of 1970.

Dr. Neubert was also an avid gardener, enjoyed cooking, spending time on the waterfront, and sharing with family and friends.

She is preceded in death by her father, Erich W. Neubert. She is survived by her mother, Margot Neubert, Huntsville, Alabama; her brothers Rolf Neubert, Scottsboro, Alabama and Dirk Neubert, Crystal River, Florida; nephew Shawn Neubert and great-nephew Braylan, Shallotte, North Carolina; companion Rex Durbin of Crystal River and good friend Sharon Worthington, of Homosassa, Florida.

ROBERT N. ROBERTS, II, DVM Dr. Robert “Rob” Norwood Roberts, II, passed away on July 5, 2014, at the age of 64. A life-long resident of Dade City, Florida, Dr. Roberts was the oldest of four siblings.

He attended Pasco High School and graduated from the University of Florida and Auburn University College of Veterinary Medicine.

As a veterinarian, Dr. Rob cared for all creatures great and small. He enjoyed being a great husband to Louse Edwards whom he married in 1970, his animals, baseball and his immediate and extended family. His obituary describes him as a “Believer, a coach, a caregiver, a listener, a motivator, and a friend to anyone fortunate enough to know him.”

Dr. Rob Roberts is survived by his wife of 44 years, Louise; his daughter Sara Louise (BJ Newcomer); sons, Rob and Will (Taryn); and grandchildren, Audrey and William; and nephew, JR Fort, who was very special to him.

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FVMA EXECUTIVE DIRECTOR NAMED

ASVMAE EXECUTIVE OF THE YEAR

T

he Florida Veterinary Medical Association’s (FVMA) Executive Director, Phil Hinkle, has been honored by the American Society of Veterinary Medical Association Executives (ASVMAE) as the 2014 recipient of the “Executive of the Year Award.” He was presented with the award at an awards luncheon which was held during the AVMA Convention in Denver, Colorado.

Witnessing the presentation of this prestigious award was FVMA President Don Morgan, DVM, who expressed great pride for this singular honor to the association. Dr. Morgan nominated the FVMA Executive Director for the award.

The ASVMAE developed the Executive of the Year Award in 1991, to recognize members of ASVMAE for outstanding contributions to the association executive profession. It is the highest honor that the ASVMAE gives one of its members who are CEOs, or staff executives of a state or allied association. It is presented to those whose accomplishments as association executives have been outstanding, and who are respected leaders of their own associations, who serve the ASVMAE, and find time to play an active role in civic and community affairs.

ASVMAE describes the award as one that “recognizes recipients who exemplify the very best in association management and continually bring credit to the profession and to the entire association community.”

Executive Director Hinkle was appointed FVMA Executive

Director in 2007, and has served the association for 28 years.

President Morgan’s letter of nomination notes the uncertain economic period during which Mr. Hinkle assumed office and lauds his leadership of a small dedicated staff to produce “a persistent growth of the association.”

Since Mr. Hinkle became Executive Director, the FVMA has realized an increase in membership of more than 27%.

In the Executive Board’s recent Strategic Planning Session, nationally recognized Facilitator, Robert Harris, described FVMA as an A+ Association because of its strong financial position, stability and membership services. The FVMA is in a very good position to expand member outreach and support as it implements its 2015-2017 Strategic Plan.

Executive of the Year

P

hilip J. Hinkle’s visionary qualities and energetic leadership of the FVMA has placed the association on a forward trajectory that will ably serve members and the veterinary profession in Florida for years to come. He has said the professional accomplishment he is most proud of, is the acquisition of the FVMA’s new corporate headquarters.

In 2012-2013, the FVMA negotiated the purchase, completed renovations, and moved into its new 13,000 square foot corporate headquarters at 7207 Monetary Drive, Orlando, Florida. Because of the strong fiscal position of FVMA, the building was purchased and renovated debt free.

Dr. Morgan describes him as a “driven executive,” but he has also found the time to devote his commendable talents to his community. His history of civic service includes serving three (3) terms as Mayor of the City of Haines City and 12 years as a city commissioner. Other positions he has held include serving as a founding member of the Haines City Economic Development Council, Community Redevelopment Agency, City Housing Authority, Chamber of Commerce Board of Directors, and the Ridge League of Cities Executive Board and Legislative Committee.

6 | FVMA ADVOCATE

abilities. His accomplishments have been outstanding. He is a respected leader of the FVMA family, and has devoted his immense talents to the well-being of our profession and the membership that we serve.”

By his words, Dr. Morgan expressed the sentiments of the broad cross-section of veterinary professionals in the State of Florida who have come to know and admire the FVMA’s Executive Director, now also ASVMAE Executive of the Year.

FVMA President-elect, Dr. Richard M. Carpenter, Executive Director Phil Hinkle, and FVMA President, Dr. Donald H. Morgan.

The FVMA has honored him with the Dedicated Distinguished Service Award in 2006, the President's Award - "Service Before Self " in 2010, and the Dedication Award, for 25 years of excellence in 2011.

He is a busy man and there's one other award he has received which may possibly be one of his most cherished --the Polk County Father of the Year-- which he received in 2005.

Elijah Cameron

Amber & Dan Cameron

Jeremiah & Ha

Philip and Janet, his wife of 31 years, are blessed and proud of their three children, Amber Cameron and husband Dan, Ashley Hinkle-Jones and her husband Charlie, and Michael Hinkle, and three wonderful grandchildren, Elijah (February 2009-April 2009), Jeremiah and Hannah Cameron.

In his letter of endorsement of the FVMA Executive Director to ASVMAE, Dr. Morgan states: “He (Phil) employs a keen ability to envision needs and possibilities, and takes the necessary actions that successfully propel his endeavors. The FVMA is grateful for his unique

Phil & Janet Hinkle On receiving the Executive of the Year Award, The FVMA Executive Director expressed sincere gratitude for the honor, and attributed the many successes at the FVMA to astute leadership of the Executive Board, the dedication of support committees and the fine work of a talented and dedicated staff, on whose behalf he accepted the Award.

nnah Cameron

Ashley & Charlie Jones

Michael Hinkle &

Cynthia Castellano s

www.fvma.org | 7

Save the Dates CE Offerings in 2015

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2015 Legislative Action Days

Schedule of Events Wednesday, March 11, 2015 2:00 p.m. – 6:00 p.m.

Legislative Workshop

7:30 p.m. – 9:30 p.m.

Group Dinner

The FVMA will host a group dinner following the Legislative Workshop. If you are traveling with a spouse or guest, they are invited to attend.

Thursday, March 12, 2015 7:00 a.m. – 8:00 a.m.

Group Breakfast 8:00 a.m. – 8:15 a.m.

Final Review of FVMA Legislative Priorities and “Charge to Delegates” 8:30 a.m.

Delegates walk to the Capitol to attend their legislative appointments The FVMA will host a group breakfast Thursday morning prior to our visit to the Capitol. Following breakfast, we will recap our legislative agenda and then head to the Capitol for our scheduled appointments.

APPOINTMENTS WITH LEGISLATORS Registration for this event is free for members, but pre-registration is required. Should you have any questions on registration, please contact the FVMA office at (800) 992-3862 .

To gain the most out of our visit to the Capitol, FVMA staff will secure appointments for you with legislators from your respective district.

These appointments are made subject to the legislators’ availabilities. Members attending Legislative Action Days for the first time will be paired with seasoned veterans to ensure you gain the most out of your Capitol visit.

We encourage all members to take the opportunity and participate in this important grassroots advocacy event!

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Book your room today by calling (866) 932-6282 and asking for the special FVMA room rate. www.fvma.org | 9

"Dr. K's Exotic Animal ER"…

IS DR. SUSAN KELLEHER OF DEERFIELD BEACH, FLORIDA. FVMA member, Dr. Susan Kelleher of Deerfield Beach, Florida, is the latest reality TV star. Cable TV aficionados have been excited about a new show running on Nat Geo Wild, which features “Dr. K” as she is fondly known by her colleagues and clients at her exotic animal hospital.

“Dr. K’s Exotic Animal ER” is the name of the television show, and it started a six-show run on Nat Geo on October 4, 2014.

“Anything can happen in a place that is so wild, every story is an adventure and the viewer’s imagination is allowed to run wild,” says Nat Geo Wild. All reports are that by joining the cast, Dr. K has provided some of the most riveting images of exotic animals as they are cared for by a dedicated veterinary team.

Dr. Susan Kelleher treats exotic pets along with Dr. Santiago Díaz, at Broward Avian & Exotic Animal Hospital in Deerfield Beach. Broward Avian is a full service animal hospital that takes emergency cases, and attends less urgent medical, surgical, and dental issues as well. The doctors are experienced in all types of conditions and treatments, and offer other special resources to clients that teach them to take care of their exotic pets.

Originally from Buffalo, New York, the doctor received her Bachelor’s degree with a dual major in Chemistry and Biology from Alfred University in 1990, and went on to veterinary school 10 | FVMA ADVOCATE

at the University of Tennessee College of Veterinary Medicine.

She has lived and worked in Florida since August, 1995. She lives in Loxahatchee with her family which includes a cat, an African Spur Thigh tortoise, a Macaw, and an English Budgie.

She and her husband, Greg, are proud parents of daughters Elba and Claire, and son, Myles.

The FVMA Advocate asked Dr. Kelleher to tell us how the show materialized, and describe her experience as a cable television personality.

Dr. K: (Dr. Susan Kelleher) I've been asked by many colleagues how I wound up with a show on Nat Geo Wild and what it was like filming with them and what it is like since the show premiered. Here's the story: Nat Geo Wild wanted to do a show based on avian and exotic animals in a veterinary setting. They found us via our website and contacted my office manager, Jeanine Busto. When she asked me if I was interested, I initially was vehemently against this idea. My job is stressful enough without cameras following my every move. She worked on me for a while, convincing me that it would be a great opportunity to educate people about the care that is needed and available for avian and exotic pets. After that, a team from Nat Geo Wild interviewed me and my whole staff via Skype.

before the premier on Saturday, October 4th. Suddenly I felt waves of panic. Here I was putting myself really out there for public critique essentially. (The six one-hour episodes were aired in 140 countries). Well, I talked myself into calm saying "what's done is done. I know each day I'm certainly not perfect, but I sincerely put out my best effort and I truly love my job." I will be honest and say my biggest fears were criticism from colleagues. I had no say in the editing process and didn't get to see the episodes until the day before the premier.

I was relieved that (at least in my perception) they did place the emphasis on education.

What has it been like since the show has aired? I have gotten lots of emails from people who have watched the show. I try to direct them to the websites for professional organizations where they can find an avian and exotics savvy vet close to them (AAV - Association of Avian Veterinarians, AEMV - Association of Exotic Mammal Veterinarians and ARAV - Association of Reptile and Amphibian Veterinarians).

Support from colleagues has been amazing. The biggest thrill for me was when one of my previous interns who is now a board certified avian veterinarian in Boston at Angell Memorial told me a client presented to him for help with her amazon parrot who was exhibiting signs similar to Fletcher, an amazon patient of mine who she had seen in an episode of the show. We have had a lot of new clients coming in for help after seeing the show and it refreshes me to know that I just might be able to make a difference in the care of avian and exotic pets after all.

Member Spotlight

Originally, they sent a film crew from England to film what I've now learned is called a "sizzler reel." This is an approximately 9 min video that is presented to the executives of Nat Geo Wild to say either "yeah" or "nay" to. There were two camera guys, two sound guys and a producer around us for about 2 weeks. The Nat Geo executives didn't like the sizzler and my thoughts were simply "oh well, that was a neat experience anyway and interesting to have been considered."

Shortly after that, I received a call from Guy Nickerson, president of Spectrum Productions, out of Tampa.

He told me over the phone "This is a one in a million occurrence; Nat Geo never does this....but they really liked your clinic, what you do, and the people and stories there. They just didn't like how the English crew put the first sizzler together in a very documentary-type style. Apparently English people like documentary style shows whereas Americans like "stories."

The Nat Geo executives hired his company to produce another sizzler.

Spectrum Productions then came down and produced the new sizzler which the Nat Geo executives really liked and it was a go. Shortly after that, the production crew moved into my clinic...literally. They took up consult room 4 with all their video and sound equipment. We were all hooked up with portable microphone packs clipped to the back of our pants and away we went.

Initially there were probably 8-10 additional people at the clinic and it was overwhelming. After the first 2-3 weeks, we were down to a production crew of 6. In general, they were pretty respectful about getting out of our way when things got hairy and they were very respectful of my clients and patients.

They would talk to clients ahead of time about whether or not they were ok with being filmed and if they were, they had to sign a waiver. Pets who were filmed in treatment or surgery without the owners present didn't have to have signed waivers.

We quickly got into the rhythm of filming around our daily functioning. They needed "OTFs" ("on the fly") between appointments for us to explain what was going on. They also rented space in the building across the street that they painted the same colors as my clinic. They'd take us over there for interviews.

We got into a pretty good rhythm working with the production crew but the days were longer as we had to break and explain things on camera frequently. After they got the bulk of the stories filmed, they came back to fill in explanations throughout the editing process.

They had started filming in January and didn't finish final editing until about June.

Everything in general was fine until the week

www.fvma.org  |  11

UFCVM STUDENT MENTORING PANEL Held November 12, 2014

T

he second Following Footsteps student mentoring panel at the University of Florida College of Veterinary Medicine (UFCVM) for 2014, was held successfully on Wednesday, November 12, 2014. A part of the FVMA Mentoring Program, this second panel was held under the theme, “The journey from the classroom to the exam room.” A first panel for 2014, convened on March 26, and was a tremendous success.

Hosted by the FVMA in coordination with the FVMA Student Representatives which include Geoffrey S. Landau (class of 2015), Caitlin Spindler (class of 2016), Kelsey Cox (class of 2017), and Heather Morrissey (class of 2018), Following Footsteps brings students and practicing veterinarians face-to-face for frank discussions and sharing.

The student representatives worked with Phil Hinkle, Execu‑ tive Director, in organizing the event. Executive Director Hinkle told the Advocate that these young professionals are a tremendous asset to the FVMA and the veterinary profession. “They are a very dynamic group of emerging

leaders and I’m honored to work with them,” he said.

The events are intended to assist students who are planning their future career paths to make informed decisions. The FVMA considers this activity an invaluable opportunity for students to be guided by the experience and wisdom of established practitioners, as well as recent graduates who can readily offer good advice on overcoming the challenges and uncertainties current students face as they begin their preparations to transition from the classroom to the veterinary exam room.

Dr. Bob Encinosa who headed the second panel said the November 12th event was a resounding success. “The panel's diversity was once again very helpful in that it allowed us to answer a wide range of questions, from "How do I find that first job?" to "How long should I be in a practice before it's reasonable to ask for some ownership?"” he told the Advocate.

In further describing the event, Dr. Encinosa continued, “The panel encompassed owners of a variety of practice sizes, equine practitioners, exotic practice owners, public health veterinarians, and new graduates. There were some serious moments and some humorous ones. There were a lot of great questions from the students, and the panel did a superb job, providing a wealth of wisdom in their

Followi ng

Footste ps 12 | FVMA ADVOCATE

answers.” He concluded, “In the long run, it's so much less expensive to learn from the experience of others. For that reason alone, I know this was time very well spent by the students.”

Along with Dr. Encinosa who practices in Riverview (UFCVM 1987, small animal), the other panelists were Dr. Jenifer Chatfield, Dade City (Texas A & M 2001, public health), Dr. Russell Godfrey of Pinellas Park (UFCVM 2014, small animal), Dr. Christy Layton of Plant City (UFCVM 2001, small animal), Dr. Corey Miller of Ocala (University of Tennessee, equine-exclusive), Theresa Parrott of Davenport (UFCVM 1983, avian/exotic/wildlife), and Dr. Denise Vondrasek of Bradenton (UFCVM 1988, small animal).

FVMA thanks its members for their participation in this important program. Members’ readiness to serve in student mentoring is a distinctive demonstration of the commitment of Florida veterinarians and the FVMA to the future success of young professionals.

Distinguished Panel Jenifer Chatfield , DVM Public Health Florida Dept. of Environmental Health, H1N1 Veterinary Agriculture Liaison, Dade City Texas A&M-2001 Bob Encinosa, DVM Boyette Animal Hospital, Riverview University of Florida-1987

Small Animal

Russell Godfrey, DVM Pinellas Animal Hospital, Pinellas Park University of Florida-2014

Small Animal

Christy Layton, DVM Small Animal Timberlane Pet Hospital & Resort, Plant City University of Florida-2001 Corey Miller, DVM, MS, DACT Equine-Exclusive Equine Medical Center of Ocala, Ocala University of Tennessee-1994 Theresa Parrott, DVM Avian/Exotic/Wildlife St Charles Veterinary Hospital, Davenport University of Florida-1983 Denise Vondrasek, DVM DeSoto Animal Clinic, Bradenton University of Florida-1988

Small Animal

www.fvma.org | 13

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®

For more information, visit FAEP on the web at www.faep.net

A-Glance All Lectures held at the Hilton Ocala

Continental Breakfast 7:45 a.m. - 8:30 a.m.

Registration Desk Opens at 7:30 a.m.

Case-Based Management of Wounds of the Body, Limbs and Hoof Regions - Part 1 Ted Stashak, DVM, MS, DACVS

s a t u r da y - J an u a r y 2 4

W. Rich Redding, DVM, MS, DACVS 8:50 a.m. 9:40 a.m.

Understanding the Use of Diagnostic Imaging in the Performance Horse: The Relationship Between Radiology, Ultrasonography and MRI W. Rich Redding, DVM, MS, DACVS

11:00 a.m. 11:50 a.m.

Equine Rectal Exam: What am I Really Feeling?

A Laparoscopic Perspective

Case-Based Management of Wounds of the Body, Limbs and Hoof Regions - Part 3

Eric Mueller, DVM, PhD, DACVS

Ted Stashak, DVM, MS, DACVS

Interactive Colic Case Presentations and Practitioner Discussions

Case-Based Management of Wounds of the Body, Limbs and Hoof Regions - Part 4

Eric Mueller, DVM, PhD, DACVS

Ted Stashak, DVM, MS, DACVS

11:50 a.m. - 1:35 p.m. Lunch 1:35 p.m. 2:25 p.m.

2:25 p.m. 3:15 p.m.

Ted Stashak, DVM, MS, DACVS

9:20 a.m. 10:10 a.m.

10:10 a.m. - 10:40 a.m. Break - Visit The Exhibit Hall

9:40 a.m. - 10:10 a.m. Break - Visit The Exhibit Hall 10:10 a.m. 11:00 a.m.

Case-Based Management of Wounds of the Body, Limbs and Hoof Regions - Part 2

8:30 a.m. 9:20 a.m.

10:40 a.m. 11:30 a.m.

11:30 a.m. 12:20 p.m.

suN day-January 25

8:00 a.m. 8:50 a.m.

The Ever Changing Lameness Exam in the Horse: A Better Understanding (or not) of Diagnostic Analgesia and New Tools Available to Interpret Lameness

Managing Infertility in the Problem Mare

Conference Host Hotel

Karen Wolfsdorf, DVM, DACT Suppression of Undesirable Behavior in the Performance Horse

Karen Wolfsdorf, DVM, DACT 3:15 p.m. - 3:45 p.m. Break - Visit The Exhibit Hall

3:45 p.m. 4:35 p.m.

Update on Infections Caused by R. equi

4:35 p.m. 5:25 p.m.

Lower Respiratory Tract Disorders of the Older Foal

Steeve Giguère, DVM, PhD, DACVIM Steeve Giguère, DVM, PhD, DACVIM 5:25 p.m. - 6:55 p.m. Reception & Dinner

6:55 p.m. 8:35 p.m.

My Equine Behavior Bucket List: Important Concepts of Horse Behavior with Everyday Relevance to Horse Owners and Veterinarians

Special Saturday Night Keynote

Saturday, January 24 6:55 p.m. - 8:35 p.m.

My Equine Behavior Bucket List:

Sue McDonnell MS, PhD

Sue McDonnell, MS, PhD, CAAB

Important Concepts of Horse Behavior with Everyday Relevance to Horse Owners & Veterinarians

Hilton Ocala

3600 SW 36th Ave., Ocala, FL 34474 www.hiltonocala.com | Toll Free:(877) 602-4023 Telephone: (352) 854-1400 | Fax: (352) 854-4010

4

 Mail:

Easy Ways To Register Register Today and Save!

After January 16th add $50 Per Registrant.  Online:

FAEP/FVMA www.fvma.org 7207 Monetary Dr. info@fvma.org Orlando, FL 32809

 Phone:

 Fax:

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

(407) 240-3710

nd

52

annual ocala equine conference REGISTRATION

HOST Hotel Information

A Proud Tradition of Quality Equine Practitioner Education

January 23-25, 2015 • Ocala, Florida

PRE-REGISTRATION DEADLINE January 16, 2015 Personal Information Name Starting at

Address only

City

State

Zip

Phone

Fax

Per day

Conference HOST Hotel Hilton Ocala

Email College Year of Graduation

3600 SW 36th Ave. Ocala, FL 34474 www.hiltonocala.com Toll Free: (877) 602-4023 Telephone: (352) 854-1400 Fax: (352) 854-4010

Business/Clinic/School

One registration per form. Please duplicate this form for additional registrants.

Membership q My FAEP/FVMA Membership is current q Yes, I would like to take advantage of the FAEP/FVMA joint membership special offer and register for the 52nd Annual Ocala Equine Conference as a member!

I qualify for the following Membership Category (please check one) q Regular Member $255.00 q Recent Graduate (within last 2 years) $141.00

To Ensure Your Accommodations,

q State/Federal Employee $141.00 qPart-Time Employed $141.00 q Non-FL Resident $104.00

Conference Registration

A

New FAEP/FVMA Member Fee

$

FAEP/FVMA Member On or Before January 16 q $395.00 After January 16 q $445.00 To register at the discounted member rate, your 2014 FAEP/FVMA dues must be current!

$

Non-Member

On or Before January 16 q $595.00 After January 16 q $645.00

$

Student Registration – Currently enrolled in an AVMA-Accredited Veterinary College. q $95.00 School Attending ____________________________________________________________________________________

$

Spouse/Guest Registration – Spouse registration only allows entrance to the Exhibit hall and social events. Spouses who wish to attend C.E. sessions must pay full registration fees.

Spouse/Guest Name _____________________________________________________________________ q $95.00

$

B Conference Wet Lab

Registration Fee

$

Comprehensive Imaging Wet Lab q Wet Lab Only–$795 q Wet Lab with Conf. Reg.–$595 $ This lab will be held at Peterson & Smith Equine Hospital. (Lunch & Transportation will be provided)

C

Friday, January 23, Wet Lab Fee

$

Payment Information Make checks payable to the FAEP/FVMA (U.S. Funds drawn on U.S. Banks)

Total Registration Fee

A

B

$109

C

$

q Check Enclosed Charge my credit card q VISA q MC q AMEX q DISCOVER Credit Card # Exp. Date Name on Card Signature

■ Reserve Your Room Today!

Request Ocala Equine Conference Special Room Rate of $109 plus tax per night.

■ $5 breakfast buffet

■ Special Room Rate Ends January 18, 2015 ■ Reserve Your Room Today!

Call Group Reservations Department, (877) 602-4023

USE CODE "OEC" to make your reservation

It’s a soft chew.

Kills both fleas and ticks.

It’s prescription only.

Now a pprov to kill m ed ore ticks!

NexGardTM (afoxolaner) is the protection you asked for, and patients will beg for.

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

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

TM

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

CAL L

NOMINA T

r e ind

m e r

Less than a month remains for nominations to be submitted for the 2015 FVMA Annual Awards. Members of the FVMA and the leadership of district associations are encouraged to nominate deserving veterinary professionals and citizens who should be honored for their contributions to organized veterinary medicine, and for their service to the veterinary profession. December 26, 2014, is the submission deadline.

The Annual Awards Committee sent out its call for nominations in October. The committee of five FVMA past presidents, chaired by Immediate Past President Jerry Rayburn, DVM, will name the 2015 recipients no later than January 10, 2015. The annual awards will then be presented in a gala ceremony during the 86th FVMA Annual Conference which takes place from April 9 to the 12, 2015.

The annual awards honor veterinarians, team members and citizens in our state who have gone above and beyond to further the profession of veterinary medicine in Florida.

Nomination forms for the different award categories are downloadable from the FVMA website, www.FVMA.org.

Nominating procedures are detailed on each form. Each nomination must be accompanied by a high resolution photograph of the nominee, and a separate form must be received for each nomination at: FVMA Awards Committee, 7207 Monetary Drive, Orlando, FL 32809. Nominations may also be faxed to (407) 240-3710, or emailed to ann.wade@fvma.org.

20  |  FVMA ADVOCATE

NS IO

R O F

Nominations Deadline

FOR THE 2015 FVMA ANNUAL AWARDS NOMINATION DEADLINE

December 26, 2014

Award categories in the 2015 FVMA Annual Awards are:

Gold Star Awards

To be awarded to members who have contributed much of their time and energy to the association and/or local association for the advancement of veterinary medicine and the profession.

In any given year, no more than two percent of the total membership may be awarded a Gold Star. To be eligible for this award, the nominee must have been an active member of the association for at least the past three years.

Veterinarian of the Year

To be awarded to a member for distinguished and unselfish, dedicated service to the association for the advancement of veterinary medicine and the profession. To be eligible for this award, a nominee must have been an active member of the association for at least the past 10 years.

Lifetime Achievement Award

To be awarded to a senior active or retired member who has made outstanding contributions to the association and veterinary medicine. To be eligible for this award, a nominee must have been an active or retired member of the association for the last 30 consecutive years and must be at least 65 years old. In exceptional cases, the service requirement may be reduced to 25 years.

Distinguished Service Award

To be awarded for exceptional achievements and contributions by a member towards the advancement of veterinary medicine and the profession. To qualify, a member must demonstrate that he/she has been fully dedicated to veterinary medicine and given time and energy beyond reasonable expectations. To be eligible for this award, a nominee must have been an active member of the association for at least the past 15 years.

Citizen of the Year

This award is to be awarded to any non-veterinarian who has made an outstanding contribution to the advancement of the association and veterinary medicine.

Certified Veterinary Technician and Team Member of the Year

These two awards recognize the many outstanding contributions made by Certified Veterinary Technicians (CVT) or any other special team member to the overall success of the veterinary practice operated or staffed by an FVMA-member veterinarian.

The criteria for nomination requires that the individual be a fulltime employee of an FVMA-member practice for a minimum of 3 years and demonstrate the following: • CARING -- Provides animal health care services in a compassionate and clinically appropriate manner.

• COMMITMENT -- Works in support of the employing veterinarian to achieve a high level of client satisfaction and established annual performance goals of the veterinary practice.

• LEADERSHIP -- Assumes a leadership role in creating and maintaining an efficient and highly motivated animal health care services delivery team among all employees.

• EDUCATION -- Regularly strives to further develop his/her knowledge and skills by participating in continuing education seminars, formal study at a junior college or university, or by undertaking self-directed study through journals, online programs, etc.

Pet Hero There will be one inductee selected for one of the following categories: 1. HERO -Pets who have unselfishly saved or preserved human life (non-professional).

2. COMPANION -Pets who have provided a benefit and contributed to the quality of life of their human companions.

3. PROFESSIONAL -Specialty trained as a physically challenged person's assistance animal or used in law enforcement.

Requirements for Nomination Individual FVMA members or organizations having an FVMA-member endorsement may submit nominations.

Each nomination must be a living, domestic animal that exemplifies the affection, loyalty, security and value of the human-animal bond.

The owner/caretaker must sign the completed nomination form and the release form.

Include comments by the nominating veterinarian and others describing why the animal should be awarded.

www.fvma.org | 21

COLLECTION STRATEGIES FOR THE VETERINARY PRACTICE Nice People Can Collect

Can “Nice People” Collect Delinquent Accounts?

If you’re like most people, collecting past due accounts doesn’t rate that high on your fun meter. In fact, it’s probably just another one of the hats you have to wear that doesn’t fit well and probably makes you uncomfortable. Right?

You’re not alone. That’s why we’ve compiled some proven, easy to use collection tips into this handy article. Keep it nearby and refer to it often and in no time, you will improve your cash flow and collect more of your past due accounts.

When invoices, statements and letters go unanswered, it’s time to pick up the phone. It’s the best collection tool in your arsenal because it offers convenient, timely, and cost effective two way communication. But to win on the telephone it’s essential that you be prepared to handle customers who often have their own arsenal of stall tactics and excuses to avoid paying creditors.

Getting prepared…

Pre-call planning starts with changing your attitude and then following four steps before each call.

Change your attitude

Your customer received a service and is better for it. Now, as the provider of that service – you deserve to be paid. Remember, the first call is not your first contact. The consumer has had many chances to pay: at the time of service, at the first invoice and at reminder notices. So be firm and confident in your tone, not condescending or judgmental.

Four Steps for success…

1. Gather facts – you must know exactly how much is owed, for what service(s) and for how long the debt has been owed.

Knowing your facts establishes your credibility, so consumers are less likely to argue.

2. Review history – has the individual owed you money before?

What were their objections? Have precedents been set by previous deals? A thorough review helps you uncover potential problems

22 | FVMA ADVOCATE

or opportunities for holding people to their promises.

3. Decide in advance – are you willing to accept less than full payment? How much less, and under what conditions?

Experienced late paying consumers try to make deals. Be prepared for their offers and know how you will respond… any hesitation on your part during the negotiations can weaken your position and put the consumer in control.

4. Put time on your side – the best chance to catch most people at home is 4:00 to 8:00 p.m., Sunday through Friday. On Saturdays, try between 8:00 and 10:00 a.m.

Phone Skills: Be better than the consumer

Make the most of your call with these tips.

1. Confirm that you are speaking to the correct person, at the correct address. If anyone else answers, do not share the purpose of the call with them and ask to speak to the proper person.

2. Identify yourself to them by giving your name, title and the name of your business.

3. Ask for payment in full! Example: “Mr./Mrs. Consumer, your account with us is seriously overdue. Will you mail your $500 check today, or will you drive by our office with your check today?”

4. WAIT for their response. Up to this point you’ve done all the talking. A timely pause puts the burden on the other end. The longer the silence lasts, the more pressure builds on them. Do not break the silence!

5. Listen and note any clues to help you obtain payment in full.

Remember your pre-call planning and use it to motivate them.

6. Find the solution by asking questions and using information provided by the consumer and the facts you gathered for your pre-call plan.

7. Close the deal! Be sure that you and the consumer agree on a method and date of payment. Ask them to write down your name, address, phone number and what he/she has promised to do. Ask them to repeat it. Make notes of your conversation and repeat them and record it in the consumer’s file.

“Prizes” for non-payment

If your patient says he/she won’t pay, you need to adopt a new strategy. For starters, don’t argue with them. Let them think they have won. Then list off their “prizes” for non-payment:

the advantage goes to them. When consumers yell -- speak firmly but drop your voice enough to make them strain to hear you. When they use unacceptable language, tell them to speak civilly.

Don’t get mad – get paid!

When consumers fail to respond to your statements and letters, or are “unavailable” when you try to reach them by phone, remember, this is a common and deliberate tactic. And if it works (meaning you settle for it), they will give you more of it. Getting the silent treatment simply means the consumer believes you’ll go away if they ignore you. More than likely, any time you put into collecting these accounts will be wasted. Turn these people over for collection.

• Interest charges • No future services • Forwarding the account to a collection agency • Reporting to a credit bureau which will limit their credit capacity in the future.

It’s important that they understand that even if they get YOU off the phone and temporarily off their back, the collection process doesn’t stop and won’t until the debt is satisfied.

Offer them the opportunity to forego these “prizes” by ensuring their payment is received within 10 days.

Consumer Psychology 101

The following tips will help you understand what goes on in the minds of those who owe money and help you recover more from those who can and will pay as well as identify those who will only pay following professional or extraordinary attention.

Know the difference between a lie and a fib!

When consumers give you a tall tale along with a payment, it’s a fib, and fibs are good. People tell fibs to save face. Wise creditors accept such fibs as a way of preserving the payer’s selfesteem. But, when consumers give you a tall tale instead of a payment -- it’s a lie! And that’s bad, because effective two-way communications cannot exist in the absence of truth. When you catch a consumer in an outright lie, you are dealing with a consumer that needs to be confronted with real consequences.

We’d suggest this type of consumer go to collection.

Don’t reward consumers who use bullying tactics!

Consumers will sometimes do “whatever it takes” to discourage your collection efforts. Sometimes “whatever it takes” comes in the form of intimidation. You know that intimidation was used on you whenever you find yourself putting off contacting certain consumers because you feel threatened or uncomfortable. Don’t be intimidated, remember your facts, remember you deserve to be paid, stand your ground and refuse to be intimidated.

Stay in your comfort zone when talking to consumers!

Consumers who raise their voice or use unacceptable language are inviting you to give them a taste of their own medicine. If you walk into this trap,

Resolving accounts is more important than collecting money!

A collector’s most important job is to resolve as many accounts as possible -- quickly. Resolving is the process of putting each debt into the right box. So perhaps the most important tip to help you collect more of your past due accounts can be summed up with a simple, “One, Two, Three.” Each one of your slowpaying customers needs to be assigned to one of three boxes.

Box #1: Consumers who clearly can and will pay with reasonable efforts stay in the office to be worked by internal staff.

Box #2: Consumers who clearly can’t pay are placed in a forgiven, or write-off status for no further action.

Box #3: Consumers who clearly can pay, but just prefer not to, must be outsourced to professionals.

Once a customer demonstrates that they are slow-paying and at risk of becoming non-paying, it’s important that you attempt to put them in a box by assigning then to one of the above categories as quickly as possible and take the prescribed action. If you’re having trouble figuring out which box to put certain clients into – consider seeking outside assistance from a professional collection agency who specializes in understanding veterinary collections from tip to tail.

Isolating accounts in these three categories helps you focus your collection energy for the greatest return. When you run into accounts that require collection services, turn to the experts at Veterinary Collect powered by IC System.

Call us toll–free at 1-800-279-3511 For more great (free) tips on how to train YOUR front office staff to collect more money, check out our on-demand Webinar series on our BrightTalk channel. Here you’ll find simple yet effective tactics which will quickly ensure your staff is doing everything possible to turn slow-payers into current, fully-paid and happy returning clients.

Or visit us online at veterinarycollect.com to learn more.

You’ll quickly discover how easy and efficient it is to turn over an account to IC System. And you’ll gain the peace of mind that comes from knowing the job is in the hands of experts.

www.fvma.org | 23

HYDROCODONE COMBINATION PRODUCTS ARE NOW SCHEDULE II

On August 22, the U. S. Drug Enforcement Administration (DEA) published a Final Rule moving Hydrocodone Combination Products (HCPs) from Schedule III to the more-restrictive Schedule II. This Final Rule imposes the regulatory controls and sanctions applicable to Schedule II substances on those who handle or propose to handle HCPs. The new DEA requirements for HCPs became effective on October 6.

How the Final Rule Affects Veterinarians

HCPs are now considered as Schedule IIs in Florida, even though they may still be listed in Chapter 893 as a Schedule III. Florida Veterinarians who treat patients with HCPs must be registered with the DEA to handle Schedule II substances, and will be required to follow all other Schedule II requirements, which include: ■ Use of Form 222 to order HCPs. ■ Secure storage of Form 222.

■ When prescribing, provide a written prescription, with zero refills. In a short term emergency, a prescription for a 72-hour supply may be given by fax or phone.

■ Maintaining detailed records in a physical file for Schedule II, separate from Schedule III-IV records.

■ Keeping accurate and detailed inventory records for HCPs and other Schedule II substances.

■ Schedule II prescriptions are treated differently than Schedule III-IV. Schedule IIs cannot be called or faxed in; they must be in writing, and they cannot authorize refills.

■ Each written prescription prescribed by a practitioner in Florida for a controlled substance listed in Schedule II must include both a written and a numerical notation of the quantity of the controlled substance prescribed, and a notation of the date in numerical, month/day/year format, or with the abbreviated month written out, or the month written out in whole. ***Please note that the DEA Final Rule provides for hydrocodone Schedule III prescriptions that prescribed refills before October 6. Refills prescribed before October 6, are allowed to be filled as long as they are dispensed before April 8, 2015. Thereafter, refills will not be allowed because all hydrocodone products will be Schedule II (and therefore ineligible for prescription refills).

FURTHER DETAILS AND A LINK TO FLORIDA BOARD OF PHARMACY FREQUENTLY ASKED QUESTIONS ON DEA FINAL RULE ON THE RESCHEDULING OF HYDROCODONE COMBINATION PRODUCTS (HCPs) TO SCHEDULE II ARE BELOW. The Pertinent Parts of Florida Statute 893.04 on Prescribing & Dispensing Schedule II Substances 893.04 (1)(f) A prescription for a controlled substance listed in Schedule II may be dispensed only upon a written prescription of a practitioner, except that in an emergency situation, as defined by regulation of the Department of Health, such controlled substance may be dispensed upon oral prescription but is limited to a 72-hour supply. A prescription for a controlled substance listed in Schedule II may not be refilled.

(2)(a) A pharmacist may not dispense a controlled substance listed in Schedule II, Schedule III, or Schedule IV to any patient or 24 | FVMA ADVOCATE

patient’s agent without first determining, in the exercise of her or his professional judgment, that the order is valid. The pharmacist may dispense the controlled substance, in the exercise of her or his professional judgment, when the pharmacist or pharmacist’s agent has obtained satisfactory patient information from the patient or the patient’s agent. (b) Any pharmacist who dispenses by mail a controlled substance listed in Schedule II, Schedule III, or Schedule IV is exempt from the requirement to obtain suitable identification for the prescription dispensed by mail if the pharmacist has obtained the patient’s identification through the patient’s prescription benefit plan. (d) Each written prescription prescribed by a practitioner in this state for a controlled substance listed in Schedule II, Schedule III, or Schedule IV must include both a written and a numerical notation of the quantity of the controlled substance prescribed and a notation of the date in numerical, month/day/year format, or with the abbreviated month written out, or the month written out in whole. A pharmacist may, upon verification by the prescriber, document any information required by this paragraph. If the prescriber is not available to verify a prescription, the pharmacist may dispense the controlled substance but may insist that the person to whom the controlled substance is dispensed provide valid photographic identification. If a prescription includes a numerical notation of the quantity of the controlled substance or date, but does not include the quantity or date written out in textual format, the pharmacist may dispense the controlled substance without verification by the prescriber of the quantity or date if the pharmacy previously dispensed another prescription for the person to whom the prescription was written. (f) A pharmacist may not knowingly fill a prescription that has been forged for a controlled substance listed in Schedule II, Schedule III, or Schedule IV. LINK - Florida Board of Pharmacy FAQs on DEA Rescheduling of HCPs http://floridaspharmacy.gov/latest-news/faqs-regarding-the-dea-rescheduling-of-hydrocodone-combination-products-hcps/ LINK – Florida Statute Chapter 893.04 Pharmacist and practitioner. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/Sections/0893.04.html LINK – DEA Practitioner’s Manual An Informational Outline of the Controlled Substances Act http://www.gpo.gov/fdsys/pkg/FR-2014-08-22/pdf/2014-19922.pdf LINK – The full text of the DEA’s Final Rule, Schedules of Controlled Substances: Rescheduling of Hydrocodone Combination Products From Schedule III to Schedule II, may be found at the following link. http://www.gpo.gov/fdsys/pkg/FR-2014-08-22/pdf/2014-19922.pdf

CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.

Description: NEXGARD™ (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5[3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl.

Indications: NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of Black-legged tick (Ixodes scapularis), American Dog tick (Dermacentor variabilis), and Lone Star tick (Amblyomma americanum) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month.

Dosage and Administration: NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg).

Dosing Schedule: Body Weight 4.0 to 10.0 lbs.

10.1 to 24.0 lbs.

24.1 to 60.0 lbs.

60.1 to 121.0 lbs.

Over 121.0 lbs.

Afoxolaner Per Chewable (mg)

Precautions: The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated.

Use with caution in dogs with a history of seizures (see Adverse Reactions).

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

Table 1: Dogs With Adverse Reactions.

Treatment Group Afoxolaner

Chewables Administered

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

NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If it is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration, redose with another full dose. If a dose is missed, administer NEXGARD and resume a monthly dosing schedule.

Flea Treatment and Prevention: Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly treatment with NEXGARD should continue the entire year without interruption.

To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product.

Tick Treatment and Control: Treatment with NEXGARD may begin at any time of the year (see Effectiveness).

Contraindications: There are no known contraindications for the use of NEXGARD. Warnings: Not for use in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a physician immediately.

Oral active control

N1

% (n=415)

N2

% (n=200)

Vomiting (with and without blood)

17

4.1

25

12.5

Dry/Flaky Skin

13

3.1

2

1.0

Diarrhea (with and without blood)

13

3.1

7

3.5

Lethargy

7

1.7

4

2.0

Anorexia

5

1.2

9

4.5

Number of dogs in the afoxolaner treatment group with the identified abnormality.

Number of dogs in the control group with the identified abnormality.

In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the first dose and on the same day after receiving the second dose of NEXGARD. This dog experienced a third seizure one week after receiving the third dose. The dog remained enrolled and completed the study. Another dog with a history of seizures had a seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study. A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study.

To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at 1-888-637-4251 or www.merial.com/ nexgard. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at http://www.fda.gov/ AnimalVeterinary/SafetyHealth.

Mode of Action: Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA), thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes.

Prolonged afoxolaner-induced hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines. The selective toxicity of afoxolaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors.

1 2

Effectiveness: In a well-controlled laboratory study, NEXGARD began to kill fleas four hours after initial administration and demonstrated >99% effectiveness at eight hours.

In a separate well-controlled laboratory study, NEXGARD demonstrated 100% effectiveness against adult fleas 24 hours post-infestation for 35 days, and was ≥ 93% effective at 12 hours post-infestation through Day 21, and on Day 35. On Day 28, NEXGARD was 81.1% effective 12 hours post-infestation. Dogs in both the treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment (0-11 eggs and 1-17 eggs in the NEXGARD treated dogs, and 4-90 eggs and 0-118 eggs in the control dogs, at 12- and 24hours, respectively). At subsequent evaluations post-infestation, fleas from dogs in the treated group were essentially unable to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs).

In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively.

Collectively, the data from the three studies (two laboratory and one field) demonstrate that NEXGARD kills fleas before they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations.

In well-controlled laboratory studies, NEXGARD demonstrated >94% effectiveness against Dermacentor variabilis and Ixodes scapularis, 48 hours post-infestation, and against Amblyomma americanum 72 hours post-infestation, for 30 days.

Animal Safety: In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment.

In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of NEXGARD with other medications.

Storage Information: Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F).

How Supplied: NEXGARD is available in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each chewable size is available in color-coded packages of 1, 3 or 6 beef-flavored chewables.

NADA 141-406, Approved by FDA Marketed by: Frontline Vet Labs™, a Division of Merial Limited.

Duluth, GA 30096-4640 USA Made in Brazil.

1050-4493-02 Rev. 4/2014

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

PRACTICE PULSE Got a question? The FVMA can help.

One of the benefits of membership in the FVMA is our Helpline, (800) 992-3862, available to members daily, Monday to Friday, 8:00 am to 6:00 pm.

Our Helpline also provides insight to the FVMA staff, of the challenges and concerns of our members.

In this feature we will highlight topics from the questions we received in preceding weeks, in an effort to keep our members up-to-date on current concerns as well as regulatory and legislative changes.

Question:

Question:

Are veterinarians required to place lot numbers on the labels of all prescribed medications?

Is it OK for a veterinarian to call in a prescription for Tramadol (category IV controlled drug) to a human pharmacy that is located in another state for a patient that is residing in that state for a month? This client travels between her home in Florida and a home in the other state with her pets. Further, could calling in the prescription be considered practicing medicine in a state the veterinarian is not licensed to practice in?

A: Veterinarians (or a pharmacist) are not required to include a lot number on the label of a dispensed drug. Florida Administrative Code (F.A.C.) 61N-1.006 rule is applicable to repackaged or multiple unit pre-packaged drug products.

Repackagers are companies that buy drugs in bulk and subdivide them into smaller containers (i.e. a drum of 10,000 pills and produce 100 ct. bottles). This rule is not applicable to a container being dispensed by a veterinarian.

The applicable rule for veterinarians is F.A.C. 61G1815.002(2)(a)5.i.

The rule requires veterinarians to list the name of the drug, strength, quantity, expiration date, instructions for use, name and species of the animal, name of the owner, and the name, address and phone # of the prescribing vet. No lot number is required.

The applicable rule for pharmacies is F.A.C. 64B16-28.108.

Note that the lot number is not required when the pharmacy dispenses to the patient. The lot number is only required for repackaged or multi-unit prepackaged drugs, which is consistent with the 61N-1.006 rule.

Question: Can the Coggins test be administered by a veterinary assistant?

A: Yes it can, but only under the direct supervision of a veterinarian.

26 | FVMA ADVOCATE

A: You will see below, that Florida recognizes the validity of prescriptions issued by doctors in other states, so long as the pharmacist determines that the order is valid and necessary for the treatment of a chronic or recurrent illness. The definitions in other states are fairly similar to Florida's. In this scenario, the veterinarian is transmitting a prescription to the pharmacy in the other state for one of his patients of record, owned by a client that spends time in Florida and the other state. It is recommended that whomever calls the prescription should offer to provide whatever documentation the pharmacy in the other state may require for them to ascertain that it is a valid prescription, such as a copy of portions of the patient record showing the justification.

Florida Statute 893.02 “Prescription” includes any order for drugs or medicinal supplies written or transmitted by any means of communication by a duly licensed practitioner authorized by the laws of the state to prescribe such drugs or medicinal supplies and intended to be dispensed by a pharmacist. The term also includes an orally transmitted order by the lawfully designated agent of such practitioner. The term also includes an order written or transmitted by a practitioner licensed to practice in a jurisdiction other than this state, but only if the pharmacist called upon to dispense such order determines, in the exercise of her or his professional judgment, that the order is valid and necessary for the treatment of a chronic or recurrent illness.

Question: I have an animal’s cremated remains in my clinic after he died under my care and the owner verbally authorized its cremation. We have not heard from the owner since the animal passed away. How long do I have to keep the cremated remains?

A: These cases are problematic in many respects. First, many times the owner of the pet has an outstanding bill that the Veterinarian would like to be paid, and the owner is trying to avoid. In the case of living pets, Florida law provides for a veterinarian to maintain a lien on the pet if the owner doesn’t pay the amount. In a case such as this, the pet is deceased and has no value, so the lien law is ineffective.

In this case, the only other law that the Vet may rely upon is the abandonment statute which allows a Vet to turn over an abandoned animal to the local humane society or shelter upon 10 days written notice to the owner. The abandonment law does not delineate between living and deceased pets. To be safe, the veterinarian should send an abandonment letter to the owner and then after ten days contact the local shelter or humane society to see if they will dispose of the animal or if they will give permission to dispose of the body on their behalf. In order to follow the letter of the law, the animal simply needs to be treated (dead or alive) as abandoned.

A draft abandonment letter is reproduced below. Be sure to send the letter by certified mail and keep all documents in your patient/client file. In the eyes of the Board of Veterinary Medicine, if it isn’t in the medical record, it did not happen.

Date:

Please Govern Yourself Accordingly,

To: Name Address

City, State Zip VIA: United States Postal Service RE: Patient/Pet Name NOTICE OF INTENT TO INSTITUTE ABANDONMENT PROCEEDINGS

your animal, and that our establishment intends to institute abandonment procedures as permitted by Florida law. Section 705.19, Florida Statutes, which states: “(1) Any animal placed in the custody of a licensed veterinarian or bona fide boarding kennel for treatment, boarding, or other care, which shall be abandoned by its owner or agent for a period of more than 10 days after written notice is given to the owner or the owner’s agent at her or his last known address may be turned over to the custody of the nearest humane society or dog pound in the area for disposal as such custodian may deem proper.

(2) The giving of notice to the owner or the agent of the owner, of such animal by the licensed veterinarian or kennel operator as provided in subsection (1) shall relieve the veterinarian or kennel operator and any custodian to whom such animal has been given of any further liability for disposal. Such procedure by a licensed veterinarian shall not constitute grounds for disciplinary procedure under Chapter 474.

(3) For the purpose of this section, the term “abandonment” means to forsake entirely or to neglect or refuse to provide or perform the legal obligations for care and support of an animal by its owner or agent. Such abandonment shall constitute the relinquishment of all rights and claim by the owner to such animal.”

In order to avoid such procedures, you must immediately remove your pet from our establishment or make other written arrangements for your pet’s care, prior to the above-stated ten-day period. Please be aware that failure to remedy the abandonment status of your pet within the stated time frame constitutes the relinquishment of all rights and claims to your pet, and permits the receiving facility to dispose of your pet “as such custodian may deem proper.” In addition, you will be responsible for any and all charges incurred for your pet’s care up to that time, regardless of outcome.

(Signature of Responsible Vet or Agent) (Name of Responsible Vet or Agent) (NAME OF ANIMAL HOSPITAL)

ANIMAL

Dear Mr. and Mrs. (CLIENT), Please accept this letter as Final Notice that our veterinary establishment believes that you have abandoned

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