FVMA Advocate Issue 3, 2022

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

Welcome to the winter edition of the FVMA Advocate.

To start, I would like to thank the Florida Veterinary Medical Association (FVMA) team and the Disaster Preparedness Committee, led by Dr. Terry Clekis. Together they coordinated veterinary volunteer efforts as well as cooperative efforts with the Florida Veterinary Corps, the Department of Agriculture and Consumer Services, State Agricultural Response Team and the University of Florida College of Veterinary Medicine for hurricane relief deployment and aid. Over 200 veterinarians signed up to volunteer and an excess of $30,000 in donations will be distributed to affected veterinarians and practices. Our friends from the Texas VMA and the College of Veterinary Medicine at Texas A&M University as well as the American Veterinary Medical Association assisted us with our relief efforts.

The holidays are approaching. Th is year, I am blessed with a two-year-old son who has fi lled our home with so much joy. For many years, this season was very difficult for me. My journey to motherhood was long and excruciatingly difficult, but love and perseverance prevailed. Often veterinary medicine was my savior. Our profession was a distraction to my fertility struggles and an emotional boost to feel needed and helpful. Whatever your journey is, our mental and emotional well-being is as important as our physical well-being. If you’re looking for help in your tool box, as a member of the FVMA, you have access to the Member Assistance Program (MAP). The MAP provides free, confidential counseling for personal and/or professional concerns. I want to say a special thank you to Dr. Phillip Richmond for his hard work in this area and leading the FVMA Professional Wellness Committee.

Although those in the recovery zone are our priority, we continue to do the work of the association. We are meeting with our legislators, presenting our language on the Veterinary Telemedicine Act and educating members of the house and senate on different options within telehealth. It is our position that for a Florida-licensed veterinarian to diagnose and prescribe via telemedicine, there needs to be a properly created veterinarian-client-patient-relationship (VCPR). Thank you to our legislative advocacy committee chair, Dr. Richard Williams, for your many years of legislative work for the FVMA. If you are interested in joining us as we meet with legislators, please sign up to be a legislative ambassador at fvma.org/fvma-advocacyambassadors.

I want to hear from you. Please reach out to me with your comments, questions and concerns at president@fvma.org

Have a blessed holiday season.

Warmest regards, Marta Lista, DVM

FVMA MISSION:

TO ADVANCE THE VETERINARY MEDICAL PROFESSION, PROMOTE ANIMAL HEALTH AND WELL-BEING, AND PROTECT PUBLIC HEALTH.

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

FVMA DISTRICTS

As a member of the FVMA, you are part of a community of nearly 5,600 veterinary professionals committed to strengthening the voice of veterinary medicine in Florida.

That community is essential in allowing us to protect and enhance the veterinary profession through legislative advocacy, charitable works, veterinary resources and membership benefits.

Some of the most valuable benefits derived from membership in the FVMA are intangible. Members receive legislative advocacy on their behalf that allows us to fight harmful laws and uplift those that seek to advance veterinary medicine.

INCREASED MEMBER BENEFITS

FVMA members have always been able to ask questions pertaining to practicing veterinary medicine, pharmacy law, and veterinary board relations. We’ve expanded legal benefits to include new areas of law such as labor and employment law and civil litigation. To take advantage of this benefit, email info@fvma.org with your inquiry and contact information.

In addition, members can now get exclusive discounts on everything from event tickets to rental cars, movie tickets, streaming services and more through Working Advantage. Visit workingadvantage.com to enroll. Click ‘Become a Member’ and use code FVMAPERKS to create your account.

NOMINATIONS ARE NOW OPEN For The FVMA 2023

The Florida Veterinary Medical Association invites you to nominate deserving candidates for the 2023 FVMA Annual Awards!

Awards in several categories will be determined by a special committee in early January 2023. Award recipients will be publicly honored during FVMA Annual Conference 2023, taking place April 20-23, 2023 in Orlando, Fla.

This is an important program for our Association, giving us the opportunity to honor outstanding members and individuals who serve our profession with distinction and contribute to the advancement of veterinary medicine in the state of Florida. We invite you to participate in this valuable program to recognize peers, colleagues and friends of the profession for their achievements and contributions.

FVMA Annual Awards also highlights exceptional service by Florida citizens who have dedicated their time, talent and services to the enhancement and protection of the veterinary profession. Awards include a “Citizen of the Year” and nominated pets can be inducted into the “Pet Hall of Fame” with a Pet Hero Award.

Nomination forms and listings of past award recipients are available at https://fvma.org/membership/awards/. Members of the FVMA are encouraged to nominate deserving colleagues and friends of veterinary medicine for an award.

Members may also call the FVMA toll-free at 800-992-3862 for assistance with their nomination.

Thank you for answering the call to honor our exemplary veterinary medical professionals and those friends of the profession who contribute so much to the promotion of animal health and well-being.

Natalie Davidson, DVM MEMBER SPOTLIGHT:

Images courtesy of Dr. Natalie Davidson.

Her dedication to end-of-life veterinary care and her participation as one of the first members of the FVMA Power of Ten is merely a window into the enthusiasm Dr. Natalie Davidson brings to veterinary medicine.

As an in-home euthanasia veterinarian, Dr. Davidson practices traditional veterinary medicine while seeing people at their most vulnerable within their homes.

“My favorite part of end-of-life care is the stories that families share with me during in-home appointments,” Dr. Davidson says. “I get to experience the love that these families feel for their pets in real time, and it can be so moving to be part of these pets' final moments.”

Dr. Davidson spends much of those appointments performing quality-of-life evaluations that include physical exams, reviews of diagnostic testing and making recommendations for further treatment, if it is the appropriate option given the pets’ and families’ circumstances.

Often, Dr. Davidson says her role is dictated by what families need most at the end of their pets’ lives, including emotional support.

“Be it silence, song, prayer or just an open ear, I am honored to help guide these families and to be part of their pet’s stories,” Dr. Davidson says.

Dr. Davidson found her path in end-of-life care upon realizing her love for older pets after spending her childhood interested in human medicine.

“I started adopting old dogs—supposedly on their last legs—

and got to see how much more love they had left to give,” Dr. Davidson says.

She gained experience in veterinary medicine while working as a veterinary technician and, in 2016, graduated from The Ohio State University College of Veterinary Medicine. A third-year class brought light to animal hospice and palliative care with a focus on euthanasia, a seed that would reappear five years after Dr. Davidson began general practice.

“I still had a special place in my heart for euthanasia and took great pride in giving pets a gentle goodbye in their own homes,” Dr. Davidson says.

In June 2021, she founded her company, Animal Angels, which specializes in dog and cat euthanasia, pet hospice care and geriatric care. She hopes that veterinarians entering the field will develop a similar compassion for older animals.

“I hope that the fear or stigma with euthanasia as a treatment option is lost and other veterinarians become more comfortable in

providing a good death for pets in any setting,” Dr. Davidson says.

When not at work, Dr. Davidson cares for her two cats, a chocolate ball python and her Boxer-Pitbull mix, Zero. She often takes Zero on camping trips, kayaking outings and trail walks. Her hobbies include participating in her local theater group, skateboarding and playing ukulele.

Dr. Davidson is working on her acupuncture certification and plans on earning her animal hospice and palliative care (AHPC) and Companion Animal Euthanasia Training Academy (CAETA) certifications.

As a member of the FVMA Power of Ten leadership program, Dr.

Dr. Davidson is pictured skateboarding, a hobby of hers.

Dr. Davidson is pictured next to The Ohio State University College of Veterinary Medicine Academic Building. Image courtesy of Dr. Natalie Davidson.

"I am honored to help guide these families and to be part of their pet’s stories.”

Davidson has been recognized as a young trailblazer and emerging leader in veterinary medicine.

Dr. Davidson says she hopes to use her early-career learnings to grow her business.

“[It would] allow me to hire other veterinarians to be able to help more pets and their families while still keeping an optimal worklife balance,” Dr. Davidson says.

Dr. Davidson's dog, Zero, on one of their many hikes together. Image courtesy of Dr. Natalie Davidson.

Dr. Davidson (far right) pictured with the inaugural FVMA Power of Ten leadership cohort. Image courtesy of FVMA.

“I get to experience the love that these families feel for their pets in real time."

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THE COLLEGES AND AWARDEES

The FVMA Foundation is the charitable arm of the FVMA, supporting its mission with student scholarships, disaster relief aid and more. The FVMA Foundation has long been a proud supporter of the University of Florida College of Veterinary Medicine through scholarships awarded to eight of the college’s students annually.

The foundation expanded its student outreach efforts in 2010 by providing an annual scholarship of $1,000 for two Certified Veterinary Technician (CVT) students at Hillsborough Community College.

With that scholarship now going to seven additional schools, the FVMA Foundation has grown its education outreach again in 2022. We are proud to award $8,000 to 16 CVT students annually, hoping to create a strong foundation for a role crucial to veterinary medicine. This year’s recipients include: Scan the QR code

Celebrating OUR VETERINARY TECHNICIANS

Veterinary care is nearly impossible as we know it today without the work of veterinary technicians, and the Florida Veterinary Medical Association (FVMA) is as committed as ever to developing programs that can provide a long, fruitful career for our team members.

As part of our commitment, the FVMA has partnered with the Florida Veterinary Technician Association, the School of Veterinary Technology at St. Petersburg College and SPCA Tampa Bay to help save the St. Petersburg College School of Veterinary Technology Program Center. Maintaining opportunities for prospective veterinary technicians to obtain proper education is essential to further the health of the veterinary profession and, by relation, animals everywhere.

We have developed a survey to help St. Petersburg College better conceptualize the impact of its program on the careers of veterinary technicians. By taking the brief survey, practice owners and certified veterinary technicians with an associate of science degree in veterinary technology can help the FVMA work toward saving a critical veterinary facility and be entered to win a complimentary registration at a future FVMA conference of choice.

WHY JOIN THE FVMA

All veterinary technicians who join the FVMA as part of our CVT team member program will get exclusive benefits, including:

• Career networking opportunities with thousands of veterinary colleagues

• A dedicated staff of FVMA professionals committed to your success (available Monday – Friday from 8 a.m. – 5 p.m. EST)

• Discounts on world-class CE and conference registration

• Updates on the latest news and issues impacting veterinary medicine

• Legislative and regulatory advocacy

• Discounts on travel and entertainment

For more information about team member programs and applications, please visit www.fvma.org, or email us at info@fvma.org. We also can be reached by phone at 407.851.3862 or toll-free at 800.992.3862.

www.fvma.org @thefvma @the__fvma

Images courtesy of Canva

JUVENILE CANINE ORTHOPEDIC

DISEASES

Michael H. Jaffe, DVM, MS, CCRP, DACVS

Image courtesy of Canva.

Orthopedic diseases in young dogs are often difficult cases to diagnose and treat. Disorders such as hip dysplasia and patellar luxation are well documented, and most practitioners are familiar with diagnosing these. Since cranial cruciate ligament ruptures are rare in juveniles, one must consider the less common causes of lameness in puppies. There is, however, a long rule-out list of causes for non-traumatic lameness in puppies.

Elbow dysplasia is frequently difficult to diagnose. Elbow dysplasia is a broad term for several different abnormalities of the elbow that result in a subtle lameness that progresses. Most of the time, when dogs present with elbow dysplasia, they usually have only one or two of the disorders present. These components of elbow dysplasia include:

• Fragmented medial coronoid process

• Ununited anconeal process

• Osteochondritis dissecans

• Elbow incongruity

• Incomplete fusion of the medial epicondyle

Fragmented Medial Coronoid Process (FCP) is the most common manifestation seen with elbow dysplasia. FCP is a defect of the subchondral bone under the medial coronoid process that results in incomplete fusion of the bone. It has been documented that FCP has a genetic basis in some breeds, but this condition may also occur due to mechanical overloading of the coronoid process secondary to other aspects of elbow dysplasia. Trauma is an uncommon cause of FCP, but is noted to occur. Breeds of high incidence with FCP include Bernese Mountain Dogs, Labradors, Mastiff s, and other large and giant breed dogs.

Patients with FCP often initially demonstrate a vague, nonspecific lameness that may be partial to non-weight bearing. Th is lameness may be confused with trauma since these are usually young, active puppies. Oftentimes, one leg is more clinically affected, although the disease is frequently bilateral, so both elbows need to be carefully evaluated during a clinical exam and with imaging. Radiographs in early cases are frequently normal, which adds to the challenge in diagnosing this. A combination of CT and arthroscopy is often necessary to confi rm the presence of an FCP when clinical index of suspicion for this is high. Treatment of FCP involves arthroscopic or open removal of the fragment and debridement of the subchondral bone defect to allow fibrocartilage ingrowth. Prognosis for this condition is good, however, long-term secondary osteoarthritis will still be present and will need to be medically managed lifelong.

Osteochondritis Dissecans (OCD) is a failure of normal endochondral ossification of the cartilage that results in

Lameness in young dogs can sometimes be confusing and difficult to diagnose. By performing a good orthopedic exam coupled with highquality imaging, a diagnosis and treatment plan can be determined. Image courtesy of Dr. Michael Jaff e.

thickening and separation of cartilage from the underlying subchondral bone. Typically, a flap of cartilage forms and may break free, resulting in a free floating joint mouse. OCD is diagnosed most frequently in the shoulder originating from the proximal humerus and from elbow at the distal humeral condyle. Other sites of OCD less commonly seen are in the stifle, tarsus and hip. Patients usually present with a mild to severe partial to non-weight bearing lameness that worsens with activity. Stiff ness after rest is usually noted as well. Its onset is usually between four to seven months of age, and OCD is frequently diagnosed between six to eight months of age. Since this condition often occurs bilaterally (~50-90% of cases) and is most common in large and giant breed dogs, careful evaluation of both limbs must be performed even when the patient is clinically lame in only one limb. Like FCP, OCD has a strong genetic basis. As such, breeding of patients diagnosed with OCD should be strongly discouraged. Diagnosis is based on clinical exam fi ndings of pain on manipulation of one or bilateral joints, index of suspicion based on breed and radiographic fi ndings of abnormal joint surfaces. Arthroscopic removal of the

damaged cartilage/joint mouse should be performed. Once the cartilage flaps are removed, the subchondral bone is debrided. Aftercare involves six weeks of activity restrictions. Like FCP, there is a high likelihood that patients treated for OCD will develop secondary arthritis, which will require lifelong medical management.

Panosteitis is an inflammatory condition of the endosteum of long-bones. Any breed can be affected, but there seems to be a higher prevalence in large breed dogs, although there is no identified genetic component. German Shepherd Dogs are over-represented, and male dogs are most common. Although this is most often seen in young dogs, it is not unusual for older dogs to also be affected. In general, the etiology of panosteitis is unknown. Panosteitis is characterized by a chronic, shifting lameness that typically is self-limiting and eventually resolves on its own. Despite this, the lameness can take up to 12-18 months for full resolution of signs. Radiographic demonstration of lesions is inconsistent and only appears in advanced cases. Radiographic signs include demonstration of a hazy appearance of the medullary canal of bone often centered around the location of the nutrient foramen with a thickening of the endosteum. Physical exam findings frequently include lameness, mild muscle atrophy and pain on palpation of longbones centered over the location of the panosteitis lesion. Conservative management with limited activity, NSAID’s and pain medications are the current treatment of choice until signs resolve.

Angular Limb Deformities are progressive limb growth changes as a puppy advances in age. These are very frustrating to

diagnose because they may be initiated by what may seem like mild trauma that initially demonstrates little to no radiographic changes. The most common limb affected by angular growth deformities is the forelimb, which occurs secondary to a Salter 5 distal ulnar growth plate injury. However, angular growth changes may occur in any bone due to a variety of factors. The distal ulnar growth plate accounts for ~85% of ulnar growth. Damage to the germinal cells of the growth plate may arrest further ulnar growth. However, the radius will continue to grow, resulting in disparity of the length of the two bones and subsequent angular changes.

Angular changes of the forelimb, causing a valgus (most commonly) or varus deformity, develop slowly as the puppy grows. Curvature of the bone and rotational abnormalities of the paw may progress concurrently, resulting in progressive pain and lameness. Although the carpal changes are most obvious, secondary elbow incongruity develops as well, resulting in even more pain as the radial head growth plate continues its normal growth. Radiographic changes will demonstrate several abnormalities including carpal valgus, curvature of the radius, rotational abnormalities of the paw and elbow incongruity. Surgical correction as early as possible is warranted to attempt to mitigate these changes. Ulnar and radial corrective osteotomies may be indicated, and these surgeries may need to be staged to correct the limb until skeletal maturity. Prognosis for these cases is guarded as long-term arthritic changes at both the carpus and elbow may be a limiting factor. In general, the earlier in life that these are corrected, the better the prognosis. Splinting patients instead of surgery in an attempt to straighten the bone does not work in these cases.

Growth plate injuries in puppies are a common cause of angular limb deformities. Note the cranialcaudal bowing of the forelimb and external rotation of the paw in this seven-month-old puppy who had a Salter-Harris 5 injury of his distal ulnar growth plate.

Image courtesy of Dr. Michael Jaffe.

Carpal hyperextension injuries are one of the many common causes of lameness in puppies. These injuries are due to forelimb flexor muscle and tendon weakness from being housed on hard surfaces. Treating these cases with exercise and a high-quality diet instead of splinting will usually result in a good outcome.

Image courtesy of Dr. Michael Jaff e.

There are numerous other causes for lameness noted in juvenile dogs including trauma and other congenital and infectious causes. The most important thing for veterinarians and owners to remember is that early diagnosis and treatment to alleviate long-term problems will offer the best prognosis.

MICHAEL H. JAFFE DVM, MS, CCRP, DACVS

Dr. Michael Jaffe is a graduate of the University of Missouri College of Veterinary Medicine. He completed a one-year companion animal internship and a three-year small animal surgery residency at Louisiana State University, where he also received his master's degree. Dr. Jaffe is currently an associate professor and service chief of small animal surgery at Mississippi State University CVM. Dr. Jaffe became a diplomate of the American College of Veterinary Surgeons in 2002 and a certified canine rehabilitation practitioner in 2017.

LAD 2023 Legislative Action Days

HOW YOU CAN HELP US:

Introducing Our New Advocacy Program

Every year, legislation is voted upon that has the potential to impact the veterinary profession we love so dearly.

Whether successfully allowing veterinarians to dispense compounded medications without limitation to their patients’ owners or caregivers or preventing the passage of legislation that would have allowed non-economic damages against a veterinarian for the loss of a pet, we have been key contributors to ensuring veterinary medicine is protected.

Our new program, which labels you an FVMA Advocacy Ambassador, lets you do just that.

You'll be needed to combat telemedicine legislature that harms veterinary professionals as we remain adamant in developing a system that protects you with the same vigor you use everyday to care for and defend your patients and clients.

Our new program will join initiatives like the FVMA PAC and Legislative Action Days (LAD) to provide a wealth of legislative initiatives to help us protect your profession.

We will always fight for veterinary-related legislation that's good for you and your patients, but when we fight with you beside us, we are at our strongest. That's why we've launched our new ambassador program.

Indicating your interest as an FVMA Advocacy Ambassador allows us to provide you with opportunities like meeting with legislators, visiting with your district representatives to discuss legislative topics, virtual legislative strategy meetings and exclusive communication on FVMA legislative maneuvers. You may see additional, hands-on opportunities during LAD and will get to choose when and how you fight for veterinary medicine.

With the form below, you can indicate your interest in becoming an FVMA Advocacy Ambassador. If selected, you will be part of key FVMA initiatives and opportunities to fight for the prosperity of veterinary medicine.

Please scan the QR code below and take a moment to express your commitment to bettering veterinary medicine.

HOW ARE YOU REALLY? Burnout in Veterinary Medicine

by Katie Pearce, FVMA Senior Creative Lead

In 2019, the Florida Veterinary Medical Association (FVMA) began a substantial well-being campaign. With multiple studies reporting alarming statistics regarding depression, anxiety, burnout, compassion fatigue and suicidal thoughts/actions for veterinarians and veterinary professionals, the industry and the FVMA homed in on this issue. Since then, we have created and added to our well-being committee, put wellness continuing education (CE) at the forefront of our conferences, launched a Membership Assistance Program (MAP), ran numerous well-being articles and more – all with the goal of improving our members’ wellness and well-being as well as continuing to normalize discussions around mental health. One of the bigger challenges the profession faces is is workplace burnout and its compounding nature.

Workplace burnout is not confi ned to veterinary medicine, it’s a larger phenomenon that's not unique to health care fields. It can be found everywhere from law enforcement to teachers. However, there are unique and compounding factors in the veterinary working environment where long working hours, animal death, unexpected patient outcomes, client complaints and more are repeatedly encountered, making recovering from workplace burnout a challenge for any individual. In a field where student debt is a growing issue, burnout also carries a fi nancial toll.

Costs of Burnout

According to research from the Cornell Center for Veterinary Business and Entrepreneurship, workplace burnout is costing the veterinary industry two billion dollars a year.

The World Health Organization (WHO) defi nes workplace burnout as a syndrome "resulting from chronic workplace stress that has not been successfully managed." Those experiencing burnout may feel depleted energy levels, high exhaustion and

job cynicism. These symptoms can lead to poor performance, missing days, looking for new jobs or retiring early. In both human and veterinary medicine, burnout can lead to increased medical errors.

Published in the journal Frontiers in Veterinary Science in February of this year, the two-billion-dollar figure (almost 4% of the industry’s value) comes from "The Economic Cost of Burnout in Veterinary Medicine". Significantly, the cost includes both veterinarians and technicians, with each accounting for approximately one billion dollars lost per group.

A now oft-quoted statistic is ‘one in six veterinarians consider suicide,’ which notably leaves out other veterinary professionals like technicians who are similarly dealing with a challenging workplace. Cyberbullying, ethical and moral dilemmas, and education-related debt are among the factors that affect the mental health of those in veterinary professions, according to the nonprofit organization Not One More Vet (NOMV).

Whilst it can be easy to fi xate on these bleak statistics, much is being done within the veterinary community to remedy this situation – including right here at the FVMA.

Images courtesy of Canva

Solutions

Having a mental illness does not make you weak or a lesser person. It is a condition that forms in one of the most complex and misunderstood parts of the body – the brain. We could all benefit from having more compassion for each other and accept mental health as a common ailment of life that should be treated – not neglected. Taking time for yourself, instituting destressing activities, setting aside time for breaks, showing appreciation for staff, limiting new clients, and continuing to engage in wellness conversations and CE are just some of the key ways you can combat burnout and mental illness stigma.

“When we have wellness and well-being in conjunction with this career, it makes us love being a veterinarian again,” says FVMA Wellness and Well-being Committee Chair, Dr. Philip Richmond.

The use of research and open discussions on a national and state level at many conferences and meetings has helped veterinary students and practicing veterinarians to be more open about their experiences. As we continue to fight stigma, increase awareness and offer new benefits, we ask that you consider yourself and your colleagues with the kindness and compassion you offer your patients and clients. Th is profession is both challenging and rewarding – but you are doing a good job! Don’t neglect your own health. We hope you will prioritize attending wellness CE at conferences and keep discussions open in your offices.

If you or someone you know is suicidal or in emotional distress, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Trained crisis workers are available to talk 24 hours a day, seven days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. Please also utilize our MAP services and attend our wellness CE sessions. Other resources are available from the American Veterinary Medical Association (AVMA) and NOMV.

“When we have wellness and well-being in conjunction with this career, it makes us love being a veterinarian again.”

BEHIND THE FVMA’S

Hurricane Ian relief efforts

Hurricane Ian uprooted many across Florida and left them without basic necessities, impacting animals, their owners and the veterinary professionals who help care for them. The Florida Veterinary Medical Association (FVMA) and its partners spent the week after the storm bringing boots-on-the-ground and financial aid to affected regions to help treat animals and support veterinarians.

Veterinary Corps volunteers. In times of crisis, the State of Florida uses the database of volunteers to dispatch disastertrained veterinarians to impacted areas.

FVMA Disaster Preparedness Committee Chair, Dr. Terry Clekis, helped delegate and organize volunteers and supplies. With the assistance of Dr. Clekis, the Florida Veterinary Corps deployed 86 individuals across impacted regions. The Florida Veterinary Technician Association provided veterinary technicians across the same regions to support animals and veterinarians.

“I was struck by the amount of help veterinarians and those associated with the industry offered,” Dr. Clekis says. “It was almost hard to delegate due to the volume of support we received.”

The FVMA, in partnership with UFCVM, facilitated volunteers for its Veterinary Emergency Treatment Service (VETS) Team, a 12-person group of faculty veterinarians, technical staff and students deployed by the FDACS to support natural disaster recovery. Stationed at the Terry Park Sports Complex in Fort Meyers, Fla., for 10 days, 16 volunteer veterinarians joined the VETS team and provided support to over 400 animals including dogs, cats, rabbits, bearded dragons, a potbellied pig and a goat.

“We would like to express our sincerest gratitude to all who donated supplies and their time in support of the University of Florida VETS Team’s mission to help animals and people impacted by Hurricane Ian,” says Dr. Lawrence Garcia, the VETS Team medical director.

Earlier this year, the FVMA, alongside the Florida Department of Agriculture and Consumer Services (FDACS) and the University of Florida College of Veterinary Medicine (UFCVM), redeveloped a new system to organize and recruit Florida

The FVMA also coordinated volunteer assistance for Humane Society International, which provided veterinary care for a total of 881 patients at the Mid County Regional Library parking lot

Image courtesy of Dr. Terry Clekis .

Hurricane relief volunteers taking a break at an improvised care center set up by SART.

Displaced by Hurricane Ian, patients seek veterinary attention at makeshift care centers.

in Charlotte County.

“The support from the Florida veterinary community was truly remarkable, and we hope that we were able to successfully provide the interim veterinary care that was needed until normal veterinary services resume in the county,” says Dr. Katherine Polak, vice president of companion animals and engagement at Humane Society International.

In addition to these efforts, FVMA staff called each FVMA member in heavily impacted regions to discern aid needs and discuss support opportunities.

“The FVMA headquarters acted as a data collection center to find out which of our members needed help. We then sent this information to the Veterinary Corps members, who acted quickly in assisting with urgent issues that were reported. I am proud of the staff for coming together at a time when so many of our members needed help,” says FVMA Executive Director, Jim Naugle. “It was a rewarding experience for all of us.”

The FVMA also established the FVMA Foundation Hurricane Ian Relief & Recovery Fund within 24 hours of the storm’s landfall. Powered by $20,000 in donations, the fund is dedicated to assisting veterinarians who incurred out-of-pocket expenses due to storm-induced clinic damage or from providing medical care, food, or shelter to animals affected by the storm. All Florida veterinarians can apply for Hurricane Ian aid, and those able to can donate by scanning the attached QR code below.

Photos of Hurricane Ian damaged areas as well as veterinary volunteers and their hurricane-impacted patients.

Dr. Terry Clekis (left) assisting with a medical procedure on hurricanedisplaced patient.

PRACTICE Pulse

QUESTION: Our practice was wondering if there is any liability associated with sending clients home to administer sub-Q fluids to their cats with CKD. When this is needed, we teach the clients how to give the fluids and we ask them to return used needles, IV sets and fluid bags to us for disposal. Occasionally we will instruct a client on how to give sub-Q injections to their pets. This might, of course, include insulin but also may include injectable antibiotics when necessary. Is there any problem with doing this, and is it considered a standard of care when deemed necessary for a patient? Any advice or thoughts on this issue will be much appreciated.

A: Open ended questions like this regarding liability are not easy to answer. If you train the client well and there is no problem, there is no possible liability. Some clients must provide fluids, insulin and other medications to their pets on an ongoing basis, and they are presumably taught how to do so by their veterinarian. If you train the client correctly and provide written instructions with pictures, which I assume you can get on the internet, you will be in the most defensible posture.

QUESTION: I have maintained a DEA license while working as an employee at my clinic, but the clinic has been sold, and I no longer wish to maintain my license. The new business will take over drugs and dispensing. What do I need to do to surrender my DEA license and the inventory?

A: Both the DEA and the State of Florida have rules that must be followed for the sale of a pharmacy. Although these instructions do not specifically relate to the sale of a veterinary practice and its drug inventory, the instructions must be followed.

According to the Code of Federal Regulations, § 21 CFR 1301.52(d)(e).:

(d) Any registrant desiring to discontinue business activities altogether or with respect to controlled substance (by transferring such business activities to another person) shall submit in person or by registered or certified mail, return receipt requested, to the Special Agent in Charge in his/her area, at least 14 days in advance of the date of the proposed transfer (unless the Special Agent in Charge waives this time limitation in individual instances), the following information:

(1) The name, address, registration number, and authorized business activity of the registrant discontinuing the business (registrant-transferor);

(2) The name, address, registration number, and authorized business activity of the person acquiring the business (registrant-transferee);

(3) Whether the business activities will be continued at the location registered by the person discontinuing business, or moved to another location (if the latter, the address of the new location should be listed);

(4) Whether the registrant-transferor has a quota to manufacture or procure any controlled substance listed in Schedule I or II (if so, the basic class or class of the substance should be indicated); and

(5) The date on which the transfer of controlled substances will occur.

(e) Unless the registrant-transferor is informed by the Special Agent in Charge, before the date on which the transfer was stated to occur, that the transfer may not occur, the registranttransferor may distribute (without being registered to distribute) controlled substances in his/her possession to the registrant-transferee in accordance with the following:

(1) On the date of transfer of the controlled substances, a complete inventory of all controlled substances being transferred shall be taken in accordance with § 1304.11 of this chapter. This inventory shall serve as the final inventory of the registrant-transferor and the initial inventory of the registrant-transferee, and a copy of the inventory shall be included in the records of each person. It shall not be necessary to file a copy of the inventory with the Administration unless requested by the Special Agent in Charge. Transfers of any substances listed in Schedule I or II shall require the use of order forms in accordance with part 1305 of this chapter.

(2) On the date of transfer of the controlled substances, all records required to be kept by the registrant-transferor with reference to the controlled substances being transferred, under part 1304 of this chapter, shall be transferred to the registrant-transferee. Responsibility for the accuracy of records prior to the date of transfer remains with the transferor, but responsibility for custody and maintenance shall be upon the transferee.

This means that at least 14 days prior to the transfer of the business, a certified letter containing the information on (d)1-5 must be sent to the local DEA Special Agent in charge. On the day of the transfer, a complete inventory of controlled substances must be taken, and that inventory must have the same information as an initial or biennial inventory.

According to the Code of Federal Regulations, Inventory requirements § 21 CFR 1304.11(e)(1)(iii), this must include:

(A) The name of the substance;

(B) Each finished form of the substance (e.g., 10-milligram tablet or 10-milligram concentration per fluid ounce or milliliter);

(C) The number of units or volume of each finished form in each commercial container (e.g., 100-tablet bottle or 3-milliliter vial); and

(D) The number of commercial containers of each such finished form (e.g. four 100-tablet bottles or six 3-milliliter vials).

If there are Schedule II drugs in the inventory, you must use DEA Form 222 to document the transfer from the seller to the buyer. With the transfer of controlled substances, the seller must transfer all records they were required to maintain to the buyer. This includes invoices and shipping documents for the

HAVE A QUESTION? THE FVMA CAN HELP.

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.

controlled substances received when they were purchased, biennial inventory, and records of drugs dispensed. It is highly recommended that the seller maintain copies of such records for at least two years.

QUESTION: Our head doctor is leaving the practice at the end of the month, and we need some clarification regarding how to handle prescriptions and follow-up care for his patients. What is our responsibility towards patients we have not examined if the owners call requesting medication? My understanding was that since I have not seen that patient, and the medication is not a refill, I would need to examine the patient before prescribing.

A: The responsibility for patients of the practice the individual veterinarian has not examined is a complicated question. There is no one answer because it depends on the circumstances and the veterinarian’s professional judgment.

According to the Florida Department of Business and Professional Regulation, § 474.214(y).:

(y) Using the privilege of ordering, prescribing, or making available medicinal drugs or drugs as defined in chapter 465, or controlled substances as defined in chapter 893, for use other than for the specific treatment of animal patients for which there is a documented veterinarian / client / patient relationship. Pursuant thereto, the veterinarian shall:

1. Have sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal, which means that the veterinarian is personally acquainted with the keeping and caring of the animal and has recently seen the animal or has made medically appropriate and timely visits to the premises where the animal is kept.

2. Be available or provide for followup care and treatment in case of adverse reactions or failure of the regimen of therapy.

3. Maintain records which document patient visits, diagnosis, treatment, and other relevant information required under this chapter.

The first question is whether there is a documented veterinarianclient-patient relationship (VCPR), and I believe there is one in these circumstances. Even though the associate veterinarian has not personally examined the patient, their colleague has, and the animal is a patient of the practice. This means the associate veterinarian has access to the patient’s medical records.

The second question is whether the associate veterinarian has sufficient knowledge of the patient to initiate a general or preliminary diagnosis of the medical condition. That knowledge comes from examining the patient and from what the owner says. I believe the associate veterinarian can be considered to be personally acquainted with the caring of the patient by virtue

of access to the medical records.

Taking everything into consideration, it is my opinion that providing an existing patient of the practice with a prescription or medication (non-controlled substance) that is reasonable based on the history provided by the owner, and after reviewing the patient records, is not a violation. Once again, it is very fact specific.

On the human side of things, physicians covering for another physician’s patients can call in a prescription for a patient they did not personally examine under similar circumstances. It depends on the condition, the medication and the physician’s professional judgment.

QUESTION: We have treated a client’s pet numerous times for moderate to severe allergic reactions. The dog appears to be hypersensitive to everything and has even had reactions after walks. We don't know if this will get better with time, or potentially progress to more dramatic or life-threatening situations. The client has asked us to dispense an EpiPen – is there a legal concern with dispensing this drug?

A: There are some regulatory and civil liability concerns. Using an EpiPen intended for human usage may have some contraindications, because the dose is designed for a humansized mammal. However, there are EpiPens available for dogs and cats.

I strongly recommend that the veterinarian consider prescribing veterinary-grade EpiPens rather than prescribing an EpiPen intended for human use. Although such off-label use may be acceptable from an FDA/Board of Veterinary Medicine standpoint, the veterinarian may be incurring some liability in the event of an overdose.

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

CLASSIFIED ADVERTISEMENTS

VETERINARIANS WANTED

VETERINARIAN POSITION AT JUNGLELIFE ANIMAL HOSPITAL– HIALEAH, FL: Full-time position available. We are a Small Animal, Exotics, and Birds Private practice. Salary, terms of employment, work schedule and future long-term potential are negotiable. Call Dr. Diaz at (305) 887-2342 or e-mail diazdvm@yahoo.com for more information. We are a full hospital service practice.

ASSOCIATE VETERINARIAN(S) WANTED – NAPLES, FL: Quality of life, quality of practice, what more could an associate want? Well, how about mentorship, teamwork, and even eventual ownership? Gulfshore Animal Hospital has all of these to offer to the veterinary associate fortunate enough to join our 4-doctor practice. We have been a top ranking AAHA practice since 1996. Our clientele demands excellent veterinary care and personalized professional service, and our team delivers. Learn all the skills you will ever need from the combined 70 plus years of experience of our 2 doctor owners. Enjoy the satisfaction and fulfillment that true team comradery can bestow in a practice. And lastly, after ensuring Gulfshore Animal Hospital is the right fit for you, realize the sense of achievement and independence that potential practice ownership can confer. Naples is ranked among the top most desirable beach destinations in the US; a great place to visit, but an even greater place to work and live. If this sounds like an inviting offer, it is! We can promise you that the visit alone to our beautiful town will be well worth it. Applicants must have a passion for surgery and be proficient in routine dental and surgical procedures. Please email your resume to drdave@gulfshoreanimalhospital.com

ASSOCIATE VETERINARIAN WANTED – PORT CHARLOTTE, FL: Loving Paws Animal Hospital is an independently owned small animal hospital located in Port Charlotte, Florida. We are looking to add on our first associate veterinarian. Operating hours are Monday-Friday 8am to 5pm, so no weekend or overnight emergencies. We are a small close-knit team that enjoys working together. We have digital x-ray, in house Idexx Lab machines including a Sedivue, use of SignalPet (artificial intelligence report for radiographs), electrocautery, Cryopen, laser therapy and recently added on an ultrasound machine. We also offer integrative medicine and grooming services. The clinic has a designated euthanasia/ comfort room and a feline exam room. All exam rooms are fully equipped. We are looking for a like-minded individual that is passionate about veterinary medicine and wants to grow with us and be part of the team. We can modify working hours depending on your desires. Full or part time is considered along with new graduates. Salary is dependent on desired hours and experience. This is an opportunity to practice medicine how you would like and grow your career as we are a rapidly expanding clinic.

VETERINARIAN(S) WANTED – BRADENTON, FL: Banfield Pet Hospital is seeking Veterinarians in Bradenton! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

VETERINARIAN(S) WANTED – FT. LAUDERDALE, FL: Banfield Pet Hospital is seeking Veterinarians in Ft. Lauderdale! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

VETERINARIAN(S) WANTED – JACKSONVILLE, FL: Banfield Pet Hospital is seeking Veterinarians in Jacksonville! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

VETERINARIAN(S) WANTED – LAUDERHILL, FL: Banfield Pet Hospital is seeking Veterinarians in Lauderhill! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth

opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

VETERINARIAN(S) WANTED – MIAMI, FL: Banfield Pet Hospital is seeking Veterinarians in Miami! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

VETERINARIAN(S) WANTED – SAVANNAH, GA: Banfield Pet Hospital is seeking Veterinarians in Savannah, GA! Are you looking for industry leading compensation and benefits, cooperative and collaborative teams, comprehensive coaching and mentorship, and tremendous growth opportunities? Look no further, because Banfield Pet Hospital is hiring! Contact Eric.Miller@banfield.com to learn more or check out our website: https://jobs.banfield.com.

ASSOCIATE VETERINARIAN-MERRITT ISLAND, FL: Associate Veterinarians – COME GROW WITH US! A privately owned network of three veterinary hospitals on Florida’s Space Coast. We are looking to expand our staff with a full-time associate at our newly renovated 8000 sq. ft. hospital on Merritt Island. Island Animal Hospitals are AHAA accredited with locations also in Viera and Cocoa Beach. Island Animal Hospitals focus on high quality preventative medicine and surgery with compassionate care and education. Our progressive hospitals are equipped with the latest in technology, including advanced dentistry, radiology, echocardiograms, rehabilitative services, and surgery. We are also fully equipped for laparoscopic procedures and endoscopy. We are seeking energetic, self-motivated, enthusiastic veterinarians that strive to provide high quality medicine in a warm and compassionate environment. Applicants must possess good communication skills and a desire to foster a lasting relationship with our hospital and patients. Compensation package is competitive, and benefits include four weeks paid vacation, health, dental and vision insurance, continuing education allowance, membership dues, and many others. Please send resume with cover letter highlighting your interests to Myvet@IslandAnimal.com N OTES: Additional Salary Information: Salary based on experience

ASSOCIATE VETERINARIAN WANTED– KISSIMMEE, FL: Osceola Animal Emergency is seeking an associate veterinarian for a small animal exclusive practice in Kissimmee, Florida. We are a well-established busy practice that offers complete medical & surgical services for dogs and cats. Our hospital has Abaxis lab equipment, digital radiology, Vimago CT, cold laser therapy, a fully stocked pharmacy, oxygen generator and central oxygen system, ICU, and a large surgical suite. We offer a very competitive salary, PTO, benefits, CE, and a 401k. Part time is also available if the candidate is interested.We do not have overnight doctors’ hours. Currently we are open daytime only, 7 days a week. Call 407-9104771. Ask for our hospital manager.

REGIONAL MEDICAL ADVISOR–BOCA RATON, FL: Are you a veterinarian who is looking for a career path towards leadership and professional growth? Do you enjoy mentoring young DVMs and creating hospital protocols that improve processes and decrease stress? Are you a big picture thinker who cares about every individual on your team? If so, we would love to work with you. Also searching for RMAs in Greater Atlanta / Greater Philadelphia / Greater Raleigh / Eastern Coastal Florida / + more As a Regional Medical Advisor your knowledge of Best Practices and continuing education will be never-ending. You are the type of doctor who is extremely forward-thinking and comfortable providing pro-tips and feedback to increase the competency of everyone around you. If a problem arises, you seek first to understand and you work compassionately together to elevate your teammates. You are instrumental in keeping your hospitals AAHA-accredited and you hold yourself and your team to high standards. Hospital environment, culture, and employee feedback reviews will all be KPIs (Key Performance Indicators). This is a role that is equal parts clinical, administrative, and leadership centric. Your focus on providing outstanding medical care as well as business and people development will all be of equal importance. Building and developing teams, mentorship of young veterinarians and technicians, and maintaining excellent relationships in your region will

be crucial. As a veterinary medicine thought-leader, we will look to you to help us create your full job description and make it your own. We hire great people, support them thoroughly, and allow them to show us what amazing looks like. If this job description describes you and inspires you, let’s have a conversation about what we can build together. Our current business model has us looking for top-tier DVMs like you to become owners (or partial owners) of the practices they oversee. More information can be found here: https://www.petsmart.com/veterinary-ownership.html or please reach us at vetoWnership@petsmart.com

PRACTICE/EQUIPMENT FOR SALE/LEASE

EMERGENCY VETERINARY PRACTICE FOR SALE– MIAMI, FL: Retiring veterinarian is selling small profi table after-hours emergency veterinary practice. Location is leased in highly desired Miami area for nearly 20 years. High visibility from very busy road in high traffic shopping center across from a popular mall. Extremely close and accessible from major highways. Clinic is around 1,400 square feet including: reception area, waiting area, bathroom, 2 exam rooms, 1 surgical suite, lab area, treatment area, oxygen chamber, hospitalization cages in all sizes and digital radiograph room. Purchase will include all equipment and medicines. Also includes doctor’s office that fi ts a bed and a full bathroom with shower for the doctor’s private use. Great untapped potential for growth. Possibility for regular or specialist practice during daytime or even a 24-hour ER. Asking $350,000. Contact Julia@miamipetemergency.com for more information.

SE Flor id a -Currently solo Dr. grossed $1.5M in 2021, upscale lease s pace w/5 exam rooms, SOLD!!

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

Greater Orlando area- Solo Dr. grossed $925K in 2021, well established, well equipped, Prx. and RE av ailable. SOLD!!

SW Florida Coast- Solo Dr. small animal in a great location just minutes from the Gulf. Beautiful 5000 Sq ft. custom built hospital, grossing $1M. Owner willing to s tay on.

Central Fl. -Equine Pr actice Unique Opportunity 1 Dr. Hospital barn, treatment area, surgical suite, equipped truc k s 2021 gross $690K Could easily convert facility to s mall animal clinic.

PARK, FL: WINTER PARK 436 PET DOC HOSPITAL LLC is for sale with owner financing. Ask about a $50,000 to $250,000 bonus or more by working this clinic until it sells with an annual salary of $166,400 during the employment agreement, or can purchase the clinic with a large discount; 407-529-5651 ask for Winthrop. Florida Veterinary License with a good background check.

PRACTICE AND EQUIPMENT FOR SALE—WINTER

MY LAB GAMMA ULTRASOUND FOR SALE– PEMBROKE PINES, FL: My Lab Gamma Ultrasound System for Sale Model # 230097 Purchased 2018, in Great Condition Includes Roll Stand and Frame 14k OBO Located in Pembroke Pines, Florida Buyer pays shipping and insurance Contact drferberah@gmail.com for more information.

N.E Florida- Solo Dr. now, but has been a multi Dr. practice in recent history. on pace for $1M gross in 2022. 3500 Sq. ft. c ustom built hospital with 4 exam rooms , turnkey operation.

S.E. Florida- 1.5 Dr. prac tice in a lease space. 2021 gross of $1.3M, v ery profitable, 2 exam rooms, well established.

In Remembrance

Gary A. Carrier, DVM

Dr. Carrier (Missouri ’72), 73, Panama City, Fla., passed away April 22, 2022. Following graduation, he served in the Air Force Veterinary Corps for two years at Moody Air Force Base in Valdosta, Ga. Dr. Carrier subsequently worked at Pasadena Veterinary Hospital in St. Petersburg, Fla. He later established Baywood Veterinary Hospital in Cape Coral, Fla., where he practiced small animal medicine until retirement in 2013.

Dr. Carrier is survived by his wife, Rebecca; a daughter and a son; five grandchildren; and a brother.

James G. Fish, DVM

Dr. Fish, 92, Jacksonville, Fla., passed away July 13, 2022. Following graduation from Texas A&M in 1954, he served in the army. Dr. Fish subsequently practiced small animal medicine at San Juan Animal Hospital in Jacksonville for more than 40 years.

His wife, Janet; three children; two grandchildren and two great-grandchildren survive him.

Jennifer B. Davis, DVM

Dr. Davis, 44, Jacksonville, Fla., passed away April 16, 2022. She practiced small animal medicine at San Jose-Beauclerc Animal Hospital in Jacksonville. Dr. Davis graduated from Auburn in 2009 and previously worked at Deerwood Animal Clinic and Briarcliff Animal Hospital in Jacksonville. She was president of the Jacksonville Veterinary Medical Society and was a member of the American Association of Feline Practitioners and the FVMA. Dr. Davis was active with the Golden Retriever Emergency Assistance Team Rescue of northeast Florida.

Dr. Davis was predeceased by her father, and survived by her mother, Jeanette Phillips; her brother, Todd; sister-in-law, Abby; and multiple nephews

Earnest E. Seiler Jr., DVM

Dr. Seiler, 87, Fort Lauderdale, Fla., passed away June 2, 2022. Following graduation from Colorado State in 1964, he practiced in Orlando, Fla. In 1967, Dr. Seiler established Seiler Animal Hospital in Fort Lauderdale. He also founded the Pet Emergency Center in Fort Lauderdale and owned Broward Pet Cemetery and Crematory in Plantation, Fla. Dr. Seiler was a lifelong member of the FVMA and served on several of its committees. He was also a past president of the Executives’ Association of Fort Lauderdale.

Dr. Seiler is survived by his wife, Nancy; three daughters and two sons; 17 grandchildren; and a great-grandchild.

Image courtesy of Canva

FL, West Coast, South of Tampa SA Solo Practice Grossing $1.2M+ Located in a Lease Facility in a Busy Plaza. ADI $316K. PRX Only (FL25S)

FL, West Coast Area SA Solo DVM, +/-3500SF Lease Facility, Open 4.5 days a week plus 1 Saturday per month, located between Lakeland and Tampa, $850K Gross. PRX Only (FL33V)

FL, Titusville, East Coast Open Mon-Fri. Solo DVM. +/-2940SF free-standing facility, +/-.60 acre housing 3 exam rooms with Abaxis in-house blood machines. Revenues of $850K+. Buyer’s after debt income ≈$180K. PRX & RE (FL40T)

FL, NEW LISTING! West of Jacksonville 100% SA, Solo DVM, $1M Gross. Freestanding facility. Information forthcoming. PRX & RE (FL95J)

FL, NEW LISTING! Palm Beach County Solo DVM, 1.6M+ Gross, 5-day work week. +/-2142SF Free-standing Facility. PRX & RE (FL53L)

FL, NEW LISTING! West Coast Solo DVM, well-established, Practice is 5 minutes from the beach. Information forthcoming.

& RE (FL48S)