Advocate Issue 3, 2021

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ADVOCAT E ISSUE 3 | 2021

PRESIDENT FAREWELL AND WELCOME

With Dr. Mary Smart and Dr. Richard Sutliff | Pg. 8

INCREASING YOUR CHEMISTRY PROFILES AND CBCS FOR CATS Gary D. Norsworthy, DVM, DABVP (Feline) | Pg. 14

HURRICANE PREPAREDNESS KIT Your 2021 Update | Pg. 20


President's Message Hello colleagues,

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

What an exciting time we are moving through! The FVMA has had some monumental victories in these past months. Legislation that would have changed how each and every one of us practices daily died in a committee in the Senate. This was not an accidental death, and was celebrated by both the FVMA and our supporting partner, the AVMA.

OFFICERS

Dr. Richard Sutliff President Dr. Marta P. Lista President-elect Dr. Donald H. Morgan Treasurer Dr. Mary Smart Past President

DISTRICT REPRESENTATIVES Dr. Scott Richardson 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. Susan M. Carastro 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

Telemedicine for animals in Florida is fully supported by the FVMA, but this year’s bills would have done away with the vital establishment of a Veterinary-Client-Patient relationship (VCPR), which is created (and maintained annually) through an in-person site visit for large animal groupings or a physical exam for the individual small animal. This has been a fundamental requirement here in Florida, even through the pandemic, and we believe it is essential for proper care for our patients. This telemedcine issue will be addressed again, and the FVMA will be providing an update on our efforts toward the start of the 2022 legislative session in Tallahassee. Also during this time, Dr. Marta Lista, our president-elect, guided a search task force and its members through reading well over 100 resumes, performing a multitude of Zoom interviews and four, final live interviews. These exemplary efforts culminated in the hiring of our new executive director. René Plasencia is the right person to lead our efforts and help navigate the future of the FVMA. The first weekend in June, we held an in-person meeting in Orlando, which (besides Annual Conference) might have been the most exciting part of this year for the FVMA Board of Directors. While a few could not attend and continued to participate on Zoom, a majority gathered and discussed, debated, proffered, lauded, laughed, and worked hard to govern in a way beneficial to the entire FVMA membership. In addition to gathering with my Florida friends and colleagues, we also hosted the AVMA leadership for a working, sit-down lunch and a social dinner over the course of the weekend. I took the opportunity to thank them for their important efforts supporting you, our members. For many, 2021 will be seen as a transition year. As we pass the midpoint, I see a very positive transition in action—sunlight gleams on the path ahead. Join our efforts to better the FVMA, and tell us how we can help you flourish in your job and your career.

Dr. Richard B. Williams AVMA Alternate Delegate Dr. Jacqueline S. Shellow FAEP Representative to the FVMA Executive Board

Richard Sutliff, DVM

Dr. Dana Nicole Zimmel Dean, Ex Officio

FVMA MISSION:

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

Opinions and statements expressed in The 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.

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Thank you FOR BEING A VALUED MEMBER Your membership entitles you to a new benefit known as the Member Assistance Program (MAP). There is no enrollment or payment required to utilize this service. We have partnered with McLaughlin Young Group, an independent provider of MAP/EAP services. The MAP offers help for personal and/or professional concerns by providing free, confidential, short-term counseling and personal consultation. Additionally, the MAP provides work-life resources for such issues as legal and financial consultations, online learning, and resources. They also host a variety of helpful seminars. MAP ALSO HAS A NETWORK OF COUNSELORS that are conveniently located. They can help you improve or resolve personal difficulties whether big or small, personal or work-related. Some examples of concerns that the MAP addresses include: • • • •

Family conflict & relationship issues Depression and anxiety Resiliency and coping skills Work-related issues

TAKE ADVANTAGE OF THIS WONDERFUL BENEFIT TODAY! DOWNLOAD THE MYGROUP APP TO GET STARTED.

• • • •

Grief and loss Alcohol or drug use Stress Legal and financial issues

CONFIDENTIALITY IS ONE OF THE MOST IMPORTANT FEATURES of the MAP. No one will know that you have used this resource unless you offer that information or unless someone’s safety is threatened. THERE IS NO COST TO YOU FOR YOUR PHONE CALLS OR FACE-TO-FACE VISITS WITH THE MAP. The FVMA covers all expenses for this program. You are eligible to use the MAP immediately. To seek assistance through the MAP, simply call 704-529-1428 or 800-633-3353. Your call is important - see how the counseling process works. Visit mygroup.com | Click on My Portal Login | Work-Life | Username: fvma2021 | Password: guest The MAP staff at McLaughlin Young is available 24 hours a day, seven days a week, ready to assist you. Appointments are available during daytime and evening hours. The MAP is not designed to evaluate fitness for duty or authorize leave of absences but will provide referrals as needed. www.fvma.org

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In Remembrance Thomas A. Krall, DVM Thomas A. Krall, DVM, passed suddenly on May 8, 2021, in Seminole, Florida. Dr. Krall was born the third oldest son on March 27, 1949. He grew up in the small northern town of Avon, Ohio. He attended The Ohio State University and graduated with a degree in veterinary medicine in 1974. Upon graduation, he entered the United States Air Force as a captain and served as the base veterinarian at the then Plattsburgh Air Force Base in New York. Both small animal medicine and St. Petersburg College (SPC) brought Dr. Krall and his wife to Florida. In the fall of 1977, he along with fellow OSU classmate, David Tollon, built and opened Oakhurst Veterinary Hospital in

Seminole, Florida, where he worked for over twenty-five years. For forty-three years, he was also a professor in the veterinary technology department at SPC. He was awarded Professor Emeritus upon retirement in July 2019. He is well-remembered for his work ethic and for impressing upon all the need to “seek the positive.” Dr. Krall was also an athlete who completed fifteen marathons and once ran a relay across the State of Florida. He never stopped studying one thing or another, read all night, enjoyed baking, and mastered his margarita recipe as well as his grill. Dr. Krall maintained a daily routine that ran like clockwork, and he seldom clocked himself out before 5 p.m. Dr. Krall and Barbara were married for over 46 years. Together they built a lifetime of memories with family and friends. He was a forever devoted and loving father to Erin and Christopher, an caring brother to Mary (Walt) Krekel, Regina (Ken) Kohl, and Teresa (Keith) Brown. He is also survived by many loving nieces and nephews. Dr. Krall is proceeded in death by his parents Joseph P. and and Regina (nee Thomas), brothers: Paul M, Joseph P. Jr, and Kevin J.

In This Issue 3 | 4 | 5 | 6 | 8 | 10 | 13 |

New Member Benefits Obituaries National Veterinary News Update Member Spotlight Past President Farewell Welcoming the Returning President NEW - FVMA Regionals Conference

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14 | Increasing Your Chemistry Profiles and CBCs for Cats 16 | University of Florida Graduates 18 | Virtual Conference Pass 20 | Hurricane Preparedness Kit 24 | How Long Will This Be Going On? 26 | Practise Pulse 28 | Classified Ads


IN OTHER

NEWS

Permanent Dean for UFCVM Appointed

FVMA executive board member Dr. Dana N. Zimmel, DVM, has been named permanent dean of the University of Florida College of Veterinary Medicine. Having served in the post on an interim basis since December 2019, she is now the college’s seventh permanent dean—and the first woman to ever hold the job. She brings with her her a vast array of leadership experience. Most recently, having served as interim dean at the college just as it entered the tumultuous COVID-19 pandemic. Dr. Zimmel also taught for many years as a clinical professor in the college’s department of large animal clinical sciences. She was the first chief of staff of the UF Veterinary Hospitals, starting in 2010, and has garnered a vast number of accolades on the way.

Guidance for Industry (GFI) #263 Finalized

FDA has finalized guidance to bring remaining approved over-the-counter medically important antimicrobial drugs used for animals under veterinary oversight. With the guidance's successful implementation, around 96% of medically important antimicrobials used in animals will be considered under veterinary oversight.

2021 Lending Rates for Agricultural Producers

Rates for 2021 have been announced. The USDA’s Farm Service Agency (FSA) loans help agricultural producers start or expand their farming operation.

Interim COVID Guidance from the CDC

"Veterinary clinics should follow the masking guidance for the general public. While veterinarians are considered clinicians, the settings in which they work are not used to treat humans with suspected or confirmed COVID-19, and instances of animal-to-human transmission appear to be very rare. Veterinary clinics should consider local transmission and vaccination rates when creating clinic policies for PPE use and interactions with clients."

Source: FVMA June/July Newsletter

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Images courtesy of Dr. Anne Moretta.

MEMBER SPOTlight: Dr. Anne MORETTA VMD, MS, CVSMT, CVA

Longtime dual FVMA/FAEP member and FAEP council member, Dr. Anne Moretta’s life has been defined by a lifelong love for horses. From pony rides to a professional show career and veterinary school, Dr. Moretta puts decades of skill and knowledge into her veterinary practice at Wellington Equine Sports Medicine. Here, she believes in a comprehensive approach to helping horses achieve their full potential: looking at the big picture, helping the whole horse, finding root causes for poor performance, and using an arsenal of remedies nearly as vast as her career experience.

An Early Love

“My parents told me that before I could walk, I would insist on going on every pony ride we saw,” Dr. Moretta said. “Growing up in the Northern Virginia-Maryland-D.C. area, all of my weekends revolved around riding. I was always trying different styles of riding, different breeds of horses, and every discipline I came in contact with.” When she was younger, Dr. Moretta was in the stables every day after school and later, after work. She showed every weekend in junior and working hunters and rode as a professional in the ring and hunter field through college. During her college years, she also exercised thoroughbred racehorses at Belmont racetrack.

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“I have always had a good intuition for being able to sense what is bothering a horse, and I became very good at sensing subtle problems from my time watching so many horses at the thoroughbred and standardbred tracks,” she recalled. "Some of my favorite moments have been sitting behind a horse jogging at sunrise in South Florida." After graduating college early, she stayed on to do her masters work while continuing to train horses for three-day eventing, hunting and showing on the side. During this time, she began working with an equine vet who shined a light on her future career path by suggesting she "make her avocation her full-time vocation and go to vet school." Immediately following his advice, she headed to the University of Pennsylvania for veterinary school. During her time there, she continued to, train, buy, sell, breed and ride horses as often as she could. Buying and selling helped her pay for many of her vet school expenses. At one point, even buying the Radnor Hunt Master’s horse, Cyrano. "I was never able to replace that wonderful horse and retired him to the farm in Pennsylvania where he lived to 45 and his pony companion to 42. He was a large Draft Thoroughbred cross who if he could not jump the 'trappy' fence, he would simply clear his way straight through the fence, leading the way for the rest of the hunt field! He taught me to not just hear, but to truly listen with all my senses—and to hang on..."


A Lifelong Career

Dr. Moretta's first year in practice was a dichotomy of two worlds— working with high-end stakes Thoroughbred racehorses, Amish road horses and breeding farms. Dr. Moretta’s skills were put to the test right out of veterinary school when her boss became unable to work halfway into her first year. “I basically just graduated vet school and was now doing all of the high-end lameness and breeding work alone... I was so fortunate that my veterinary school community was so supportive,” she said. “Several of my veterinary instructors at University of Pennsylvania Veterinary School would come out on weekends to the practice. They would help me do lameness checks, surgical procedures, injections, reproductive work, etc. to further my education and support my solo work in the practice until my employer was able to work again. They were pillars of selfless giving.” Following her busy first year, she went on to open her own practice in Pennsylvania, Maroche Equine Clinic, which rapidly grew thanks to a retiring veterinarian putting her name and phone number on his machine to refer his clients to her. Dr. Moretta's practice included working with Thoroughbred and Standardbred racing, all aspects of sports medicine, breeding and the yearling and racehorse sales industry. The next step was to establish Maroche Equine Consulting. Dr. Moretta used her diverse background and business skills to help her clients buy, sell and race their horses around the world. She personally bred, raised and sold over twenty Standardbred yearlings of her own at different venues over the years. Her experiences and course work/externships traveling abroad for many years introduced her to equine acupuncture and chiropractic work, where she found her niche by using eastern medicine to complement the sports medicine skillset she already employed in the US. With new knowledge and Maroche Equine Sports Medicine in Pennsylvania, she followed her sportshorse niche to work in Wellington, Florida, integrating the two practices to establish Wellington Equine Sports medicine.

"Our FAEP council members continue to be strong, motivated individuals who come from varied equine practices and backgrounds," Dr. Moretta said of the FAEP. "Our common goals focus on organizing quality educational programs for our members. I truly enjoy the team-oriented environment of our FVMA/FAEP symposiums and our participating members who support us."

A Continuing Passion

Though most of her time is now spent with clients’ horses, she still rides and raises Hanoverians and miniature spotted donkeys. Dr. Moretta continues to also make time for her larger veterinary community by serving on the FAEP executive council and as the advising veterinarian of The Practitioner, the FAEP/FVMA’s equine-exclusive veterinary publication. In this role, she helps curate content and ensures relevant articles are published. Her involvement has been invaluable to the Florida equine veterinary community and the many lives she has touched along the way. "I believe we are at crossroads in veterinary medicine," Dr. Moretta says when looking at the future. "There are many new challenges on the horizon as to how we will practice and deal with change. In particular, mental wellness is a challenge in the profession, and it is vital we do all we can to help ensure there is 'not one more vet.' As a large, diverse professional group, we all have the opportunity to support each other through effective communication, legislation and education. We need everyone to be an active participant. I strive daily to be involved and help shape future change. From participation with 4H to encouraging and mentoring veterinary students to connecting with fellow veterinarians—my door is always open. Will you accept the challenge?"

Dr. Moretta brings a special approach not only to her sports medicine and rehabilitation practice, but also to her involvement in the veterinary community. "Communication and education are paramount in veterinary medicine any level, " Dr. Moretta said. "Mentoring and encouraging college students to go to veterinary school through positive experiences, in the office or field, is important." In 2000, with great compassion, Dr. Moretta established and managed Stony Run Veterinary Center (small animal) on a neighboring property to Maroche Equine Clinic. Dr. Moretta and her late husband wanted to give a young, talented veterinarian a chance to own her own practice, which she would not have had the opportunity to do where she was working at the time. In 2006, prior to the merge with FVMA, Dr. Moretta joined the Florida Association of Equine Practitioners (FAEP). www.fvma.org

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Farewell to the past president

A conversation with Dr. mary smart Images courtesy of Dr. Mary Smart.

FVMA: Tell us what you enjoyed about your experience as FVMA

president? Dr. Smart: The experience of being FVMA president was truly amazing. I enjoyed learning about the depth and breadth of the association and meeting and working with the people that create this incredible network. I was pushed out of my comfort zone at times and learned more about my own abilities in being a more integral part of the association.

FVMA: Tell us more about the impact of COVID-19 on the

Despite her busy schedule, the FVMA was recently able to catch up with the 93rd FVMA president, Dr. Mary Smart, DVM, who has stepped down from her role as president, as is customary. Dr. Smart will continue to serve on the association’s board of governors, executive board and as the FVMA Foundation president though March 2022. Prior, Dr. Smart served five years as the District VII representative on the board. District VII encompasses the following counties in southwest Florida: Charlotte, DeSoto, Hardee, Lee, Manatee and Sarasota. She attended the University of Maryland from 1976 to 1980, where she received her BS in animal science. She continued her education at UFCVM, where she earned her DVM in 1985. Dr. Smart has worked in both large and small animal practice as an associate veterinarian, a relief veterinarian, an emergency medicine practitioner and a practice owner in Southwest Florida. She is currently employed at Westbay Animal Hospital in Bradenton, Florida. Dr. Smart is a past president of the Manatee County Veterinary Medical Society and is also a member of the AVMA. She has a soft spot for dachshunds and has two of her own (Ray and Lily) in addition to a horse named Chief.

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veterinary profession, the FVMA and its impact on your presidency. Dr. Smart: COVID-19 has been stressful on all of veterinary medicine. I think we feel that we work twice as hard to get half as much done. As president, I did not have the opportunity to interact with as many people or interact in person, as there were no conferences held during the entire year. I am thankful that the team at headquarters remained strong throughout COVID and pivoted to meet the new needs of our profession as the pandemic unfolded.

FVMA: What was most challenging about being president that

you didn’t realize until accepting the position? Dr. Smart: The most challenging parts of my presidency were the loss of Phil Hinkle and the outbreak of full pandemic mode the day after I stepped into office. Phil was a dear friend and a driving force for the FVMA; his absence was heavy on my heart. The pandemic was completely uncharted territory. We had no idea, as individuals or as veterinarians, how life would play out.

FVMA: What are some of the best experiences that stick out to

you? Dr. Smart: My best experiences revolved around the worst experiences. After Phil passed, seeing the office regroup under the strong leadership of Ann Wade and Jim Naugle was a truly incredible thing. Seeing the strength and dedication of all the staff during that time was indescribable. Seeing how the FVMA navigated the pandemic was also truly remarkable. The defeat of the telemedicine bill, through the grassroots efforts of local and national veterinarians and lobbyists, was the grand finale of best experiences of my presidency. Being part of these experiences, and feeling like I may have helped a little, was very rewarding.

FVMA: What are some issues facing the veterinary profession

right now? Dr. Smart: Some important issues for Florida veterinarians right now are wellness, proper introduction of telemedicine into our profession and engagement in organized veterinary medicine. I think all these concerns, and many other concerns, can be addressed by veterinarians becoming involved—even at just the local level. The


more we interact with each other and understand each other, and the more we bounce ideas off each other, the stronger we will become as a profession.

FVMA: Why should more veterinary professionals consider becoming members? Dr. Smart: Engagement in our profession is crucial through both the FVMA and local associations. None of us feel like we have the time to do this. But if veterinarians don’t take the time to make our profession what we want it to be, our futures will be molded in the hands of others.

FVMA: What would you say to FVMA members who haven’t

taken the time to be more involved? Dr. Smart: Involvement has many different looks. Pick one small aspect of being involved, either at the local or state level, and give it a try.

Dr. Mary Smart and family. Image courtesy of Dr. Mary Smart.

FVMA: Look 15 years down the line. Tell us how you envision

VETERINARY PRACTICE QUESTIONS

the veterinary profession in Florida in 2036? Dr. Smart: 15 years—all depends on what we make of it. If we as veterinarians control our own destiny, it will be a bright future!

FVMA: What was it like balancing the presidency with your

job as a veterinarian? Dr. Smart: Balancing the presidency and my job was difficult. But this year was like no other, so it may be an unfair comparison. I feel very fortunate to have had so much support from my employer, Dr. Sheila Scroggins, my co-workers at Westbay Animal Hospital, my family, and all the staff and board/committee members of the FVMA. They all made this year possible.

FVMA: What impacts did COVID-19 have on your work/

workplace? Dr. Smart: COVID-19 affected my workplace the same way it affected every one of my colleagues in their workplaces. Uncertainty, worry and stress ran high this year. We all had challenges as we continued to provide our patients with compassionate and exemplary care. But we have forged ahead despite these challenges, and continue our work as, hopefully, this pandemic dwindles.

FVMA: What advice would you give to those in the field right

now? Dr. Smart: My advice is stay strong! This too will pass! Lean on your friends, colleagues, and team members for support and allow them to lean on you.

FVMA: What advice do you have for veterinary school

graduates in 2021? Dr. Smart: I advise all new graduates to shop for an outstanding mentor. You have worked very hard and deserve that guidance as you segway into practice. Be patient with yourself and those you work with—the art of practice takes time to learn, and there will be stumbling blocks along the way—and that is okay. Just keep moving forward.

FVMA: Why should more people attend conferences hosted by the FVMA? Dr. Smart: FVMA conferences speak for themselves. They provide incredible CE and give an opportunity to network with veterinarians from all over the US.

FVMA: What are you most looking forward to in life, work

Dr. Mary Smart and family. Image courtesy of Dr. Mary Smart.

and with FVMA? Dr. Smart: My “bucket list” of things I look forward to are spending time with my family in Maryland, Colorado, and Florida, continuing to work as a small animal practitioner in this incredible profession that I love, and continuing to serve our profession. WWW.FVMA.ORG | THE FVMA | @FLORIDAVMA | www.fvma.org @thefvma @the__fvma

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WELCOMING the returning president

A conversation with Dr. Richard Sutliff FVMA: Tell us about your experience so far with the FVMA.

Dr. Sutliff: I have been a member since I was a student at the University of Florida (UF) in the late 1990’s. Sadly, I am not sure I understood what “organized veterinary medicine” was upon the completion of my formal training. Once I was established in Jacksonville, Dr. Russ Snyder came to my clinic and informed me that I would be attending a local association meeting that week. Once I became involved on the local level and served in JVMS leadership, I was offered the opportunity to serve on the FVMA board and serve the veterinarians of the entire state. Over my years as the District 2 Representative and my previous three years in leadership, I was able to learn about the issues that affect our entire profession. During those years, I also saw how difficult it is to actually move issues in a positive direction in a timely manner.

FVMA: What made you interested in accepting the Dr. Richard Sutliff, DVM, was installed as the 94th president of the FVMA in March of this year. Unlike previous years, there was no pomp or an Annual Awards Ceremony. There was no FVMA Annual Conference or any of the usual flair. Like so many other firsts over the past year, for the first time in FVMA history, a previous president was returning to the helm—and he did so quietly. The business-minded new president slid into the old role with ease, welcoming René Plasencia as the new executive director while presiding over numerous important meetings. While the circumstances are new, the stresses of leadership are old hat to this seasoned pro. Dr. Sutliff obtained professional experience in numerous roles and decided to pursue his DVM. After a few years of associate practice, Dr. Sutliff purchased Scott Mill Animal Hospital in 2003, which he operated for many years with his wife, Kay. He became active in organized veterinary medicine in 2004, serving as secretary of the Jacksonville Veterinary Medical Society (JVMS) for two years. He then served as vice president from 2007-2008, then as president in 2008. Veterinarians in Northeast Florida selected him to serve as the District 2 Representative on the FVMA Executive Board in 2010. Dr. Sutliff served a year as president-elect of the FVMA in 2015, president in 2016 and past president in 2017.

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responsibilities of FVMA president for a second term? Dr. Sutliff: I was honored that the current board believed I could once again help guide our association. The past year had placed many challenges in the path of veterinarians in our state. With the pandemic affecting the workloads of our members' businesses and their employees' lives, as well as the loss of my dear friend Phillip Hinkle, I saw a unique situation where I could again offer some stability and historical insight as the FVMA navigated 2021.

FVMA: Tell us a little bit more about the unique

circumstances leading to this second term. Dr. Sutliff: Subsequent to my previous time in FVMA leadership, I sold my practice to my young associate Dr. Zack Moore. This transaction was the culmination of a long relationship dating back to Dr. Moore’s undergraduate summer employment in my kennels and treatment area of the clinic. The time was right for the passing of the ownership torch, and he is gracious enough to allow me to continue working a few days a week. This opened some time in my schedule, and I am excited to apply that time to this organization.

FVMA: What are some of the best experiences that stick out

to you when talking about your past involvement with the FVMA? Dr. Sutliff: There was always a pride in serving my colleagues in Florida. Seeing The Gulf Atlantic Veterinary Conference (TGAVC) move from being an idea to the awesome conference it has become is one. Passing legislation to exclude our prescription pet foods from state sales tax gave me insight into


FVMA: What are some current issues faced by Florida

veterinarians, and what do you recommend is done about it? Dr. Sutliff: We need to see that the future of our passion is being slowly chipped away by individuals and corporations who do not ultimately have the veterinarian, client nor patient as their primary focus. We need the newest members of this hallowed profession, including our youngest colleagues, to become aware of the long term risks and educate them about how being a member and participating in organized veterinary medicine is not only about working for the entire industry's future, but also directly working for their own individual future.

FVMA: What would you say to FVMA members who haven’t taken the time to be more involved? Dr. Sutliff: This is your future. Help shape it to be the one you want and not the one someone else shapes it to be!

Dr. Sutliff and his family Image courtesy of Dr. Richard Sutliff.

VETERINARY PRACTICE QUESTIONS

how things operate in our legislative process. Meeting all the members who serve and have served on the FVMA Board.

FVMA: What are your thoughts on the impact of COVID-19

on the veterinary profession and the FVMA? How well do you think we’re handling it? Dr. Sutliff: I see COVID-19’s impact on organized veterinary medicine as slightly different than the effect it has had on our practitioners in the field. The year seems to have increased the case load at the clinics our members are employed within. There were positives in the work flow as having curbside service and restricted work areas allowed for some more focused work to occur. The greatest downside to this work model was the opportunity lost for educating our patient’s owners. As far as COVID and organized veterinary medicine, it has caused us to have to be nimble and reactive to the daily changes in our state and nation. With the appropriate barriers to social and in-person educational interactions early in the pandemic much of our direct membership support was tested, and important changes were implemented as we leveraged our financial and intellectual resources at the FVMA. Now as we again return to healthy in-person interactions, there are long term changes in our association and in our world that will continue to offer opportunities to mature and stabilize the veterinary profession.

FVMA: What made you want to become a veterinarian?

Dr. Sutliff: My formal undergraduate focus was in organic chemistry and I did spend time in a major petrochemical company’s lab. After realizing the research lab was not something I wanted to spend a career in, my life and relationships led me to Kentucky and specifically the area of equine business. In a large change of focus, I worked in an equine and farm insurance agency for eight years and oversaw the care of many broodmares on a relative’s farm. Eventually, situations change, and I moved to Jacksonville, Florida, to help my sister and her husband start a new company. Eventually, my wife convinced me to return to school and pursue my dream of a medical career. Animal health was my interest so after spending some time working and taking additional classes at University of North Florida, I applied to UF and was accepted into the College of Veterinary Medicine when I was 36 years old.

FVMA: What excites you the most about this second term?

Do you have any goals for this year? Dr. Sutliff: I am excited to see the FVMA grow with our new opportunities and also to see long term projects that I was involved with many years ago come to fruition. This year, I look forward to bringing quality CE to our members in additional areas of the state, making it more accessible. This provides a direct benefit to our patients in Florida. Dr. Sutliff gives presentation at the 2021 Annual Conference. Image by the FVMA.

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FVMA: Tell us about your history in the veterinary field.

Dr. Sutliff: Following graduation, my wife’s Naval career moved us to North Chicago, Illinois. I ultimately took a position at Lake County Animal Emergency serving over 60 day-practices in the area. Not what I thought would be my path, but probably the best place I could have spent those formative years. I was exposed to more unusual medical situations and performed dozens of emergency surgeries that actually taught me what I actually did know… It allowed me to realize how well UF had actually trained my thought patterns and my skills. Upon our return to Jacksonville, I purchased a small animal practice and ran it as a solo practice for 13 years, eventually expanding it to a two-and-a-half doctor practice.

FVMA: What advice do you have for veterinary school

graduates in 2021? Dr. Sutliff: Work some shifts at your local ER. You will be exposed to more cases that you need to see in a shorter amount of time, and this will solidify your understanding of just how well prepared you actually are to practice.

RAPID FIRE QUESTIONS FVMA: Any pets currently at home?

Dr. Sutliff: One bottle raised, diabetic cat that is the only animal never allowed to enter my clinic due to his attitude outside the house.

FVMA: What are some milestones you look back on fondly as FVMA: A fact about yourself that may surprise people: a practicing veterinarian? Dr. Sutliff: Performing 20 GDV surgeries in 24 months while early in my career at the emergency clinic. I have now seen three additional in private practice in the past 20 years. Otherwise, being chosen to participate in leadership of my local veterinary society and eventually the FVMA.

Dr. Sutliff: I am actually a slight introvert.

FVMA: If I weren’t a veterinarian, I would probably be a: Dr. Sutliff: A USCG certified captain.

FVMA: A good book or podcast you’ve been into lately:

Dr. Sutliff: Recently been reading biographies about Winston

FVMA: How long did it take you after graduating to be truly Churchill and Bob Dylan. comfortable as a practicing veterinarian? Dr. Sutliff: About three months. The wonderful thing that built my confidence was the time spent in emergency practice. I was presented with patients, some who had life-threatening situations, and many did very well. Sadly, after two years of ER practice I had to do my first health spay in a four-pound yorkie… (there goes the comfort level).

Dr. Sutliff and his wife out for a hike Image courtesy of Dr. Richard Sutliff.

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FVMA: Tell us about your family:

Dr. Sutliff: Wife: Kay (US Navy Retired), my rock. Daughter: Alicia (married in 2019 and expecting my first grandson in September). Son: Blake (graduated with his electrical engineering degree and married in 2019).

Dr. Sutliff and his wife at their daughter's wedding. Image courtesy of Dr. Richard Sutliff.


just for you

Regionals SHERATON PANAMA CI TY PANAMA CI TY BEACH, FLORI DA

NOVEMBER 11-14, 2021


Necessity is the Mother of Invention nine otitis

Image courtesy of Shutterstock.

Increasing Your Chemistry Profiles and CBCs for Cats Gary D. Norsworthy, DVM, DABVP (Feline) INTRODUCTION I purchased Abaxis (now Zoetis Diagnostics) chemistry and hematology machinesa for my practice over 10 years ago, because I wanted quick answers on my sick patients. Although I loved the service of my commercial lab, I felt that waiting until tomorrow or the next day for results was highly detrimental to many of my patients. These machines seemed like the perfect answer. I could get a comprehensive 14-test chemistry profile and a CBC in about 15 minutes. However, in order to do that I needed blood in a lithium heparin (LH) tube (green top) and blood in an EDTA tube (purple top). I do most of my blood collection in the presence of my clients, and I found that jugular blood collection was a very poor client relation event. To make it worse, I usually had to shave hair over the jugular vein, which left an obvious reminder of the unpleasant event for over two months. Therefore, I decided to use the medial saphenous vein. It is easily accessible, shaving hair is usually not needed (and when it is needed, the site of largely out of sight), and the vein is large enough to patiently collect 1-2 ml of whole blood in many to most cats.

PROBLEM/SOLUTION #1

I soon discovered that clotting of blood in the syringe was a serious problem for many to most cats. Before appropriate portions of the blood could be transferred to the LH tube and 14  | FVMA Advocate

the EDTA tube, clots would often form making the samples unusable. My perfect solution to the rapid-result problem was in serious jeopardy. The LH tubes contain a small bead that is to aid in mixing the blood and the anticoagulant. However, it has enough LH adhered to it to anticoagulate the blood. I decided to put the bead in the syringe so the blood is immediately anticoagulated when it enters the syringe. No matter how slow the blood draw, the sample is unclotted and ready to put in the chemistry machine.

PROBLEM #2

Since my entire blood sample has been anticoagulated with LH, it is not usable in the hematology machine, at least according to the manufacturer.

PROBLEM #3

Although many cats have medial saphenous veins that flow well, some do not. In some cats, collecting more than 0.5 ml of blood is not possible. The hematology machine calls for 1.3 ml of blood for proper processing.

SOLUTIONS TO #2 AND #3

An internist at Texas A&M, a clinical pathologist, and I decided to see if blood briefly exposed to LH and transferred to an EDTA tube would produce equivalent CBC results to whole blood


Figure 1: The bead from the LH tube is placed in a 3-cc syringe that is used for the blood draw. Image courtesy of Dr. Gary Norsworthy

Figure 2: When blood is collected from the medial saphenous vein, it immediately contacts the LH that is coated on the bead and does not clot. Image courtesy of Dr. Gary Norsworthy

transferred directly to an EDTA tube. Further, we also wanted to see if a sample size of 0.5 ml and 1.3 ml would give statistically equal results. The results were recently published in the Journal of Feline Medicine and Surgery.1

cat. Jumping across species lines carries significant room for error. Another way to state that is “cats are not small dogs.”2

We collected blood from the jugular vein using a dry syringe. A portion was transferred to a LH tube, and a second portion was transferred to an EDTA tube. Two portions of the blood in the LH tube were then transferred to EDTA tubes (LH-EDTA sample). One sample size was 1.3 ml, and the other sample size was 0.5 ml. Another portion of the jugular sample was transferred to two EDTA tubes. One sample size was 1.3 ml, and the other sample size was 0.5 ml. This gave us two EDTA samples and two LH-EDTA samples. Each sample was run through the hematology machine three times, and the average was computed.

RESULTS

We showed that sample sizes (0.5 ml vs. 1.3 ml) did not affect the CBC results, with one notable exception. We also showed that brief exposure of blood to LH and then transferred to EDTA also did not affect the CBC results, with one notable exception. The notable exception was the platelet count. That analyte varied inconsistently when the sample was exposed to LH. Fortunately, cats very rarely have platelet disorders, so that is more of a theoretical problem than a realistic one. Another notable finding was the lack of effect of LH on leukocyte morphology. In spite of a long-held belief that LH is detrimental to leukocyte morphology, our clinical pathologist could not tell the difference when he was read realistic smears without knowing which group they were in. NOTE: The study that concluded that LH is detrimental to leukocyte morphology looked at several species, but it did not include the

APPLICATION

I put the LH bead in a dry syringe attached to a 25 ga. needle (Figure 1). I collect 1.0 to 1.5 ml of blood from the medial saphenous vein (Figure 2). About 0.25 ml is used to fill a chemistry rotor, and the rest is placed in an EDTA tube made for the hematology machine. Within 15 minutes from the blood draw, I have both chemistry profile and CBC results. Because of this technique, we perform blood tests on over 50% of the cats that we see. We average 337 chemistry profiles and 139 CBCs per month in our three-doctor feline practice. Imagine what this technique could do for your practice.

References: 1. Norsworthy, GD, Cook, AK, Lanier, CJ. Impact of preheparinization

and sample volume on routine hematology findings in healthy cats. J Fel Med Surg. 2021;23(2); 79-85. 2. Harenberg J, Malsch R, Piazolo L, et al. Preferential binding of heparin to granulocytes of various species. Am J Vet Res 1996; 57: 1016-1020 access the horizontal ear canal.

Gary D. Norsworthy, DVM, DABVP (Feline) Dr. Gary D. Norsworthy has been in private practice for 47 years, including 22 in feline-only practice. He is the owner of Alamo Feline Health Center in San Antonio, Texas, where he practices fulltime. In addition to practice, he lectures frequently on feline diseases and is the editor and major author of seven feline textbooks. He is a charter diplomate of the American Board of Veterinary Practitioners in the Feline Practice Category and an adjunct professor at the College of Veterinary Medicine, Mississippi State University, and the Western University of Health Sciences.

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VIRTUAL PASS The FVMA is offering a virtual pass for those who wish to participate in many of this year's FVMA Annual Conference sessions remotely. The virtual conference pass provides up to 184 CE hours for veterinarians and up to 110 CE hours for technicians, with special discounts for FVMA members and affiliate members. Edwin Bayo's Floida Laws and Rules Governing the Practice of Veterinary Medicine and Dispensing Legend Drugs are included with the virtual pass. These courses satisfy Florida's mandatory 3-hour course requirement. The pass will see 17 topics covered by 25 different speakers who spoke live at the FVMA's 2021 Annual Conference. The pass will also be made available to every inperson conference attendee, so those who make it to our conference can catch up on the sessions they missed or brush up on information from their favorites. Regardless of whether you obtain a virtual-only pass or get a pass included with your conference registration, all virtual sessions will be available anytime, anywhere until October 10, 2021. No matter who you are or how you choose to attend our conference, we're thrilled to make earning your continuing education as accessible as possible.

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ANNUAL CONFERENCE SESSIONS AVAILABLE virtually FROM JULY 13 TO OCTOBER 10. Those interested in a virtual-only pass can register at cvent.me/7koPR9 while those who obtained one as part of their attendance received additional communication following the conclusion of the in-person portion of the conference.


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hurricane preparedness kit 2021 FOR VETERINARIANS AND VETERINARY PRACTICES

Another hurricane season has arrived. While hurricanes have gotten larger and deadlier in recent years, last year's storm fears were eclipsed by the raging COVID-19 pandemic. This year marks a return to rainy rituals and serves as a reminder of the importance of preparation. It's vital to stock up and be aware of potential storms that may head Florida's way. During uncertain times, remain prepared for, not scared of, what lies ahead. Your clients choose to bring animals into their homes, and these animals cannot fend for themselves when huge storms approach. The following tools will help pet owners and veterinary practices prepare for major storms.

ADVICE TO PASS ALONG TO YOUR CLIENTS

While many clients will have previously weathered hurricanes with their pets, some may be first-time pet owners or may have just moved to an area with hurricanes. Remind your clients that pets should be kept inside during the storm and indoor accommodations made for them to ‘go potty.’ It is also important to make sure the client knows that if they choose to evacuate, the pet should go with them. If it’s not safe for the pet owner, it’s not safe for their pets. As hurricanes approach, and chaos ensues, consider emailing your clients with the following recommendations.

KEEP YOUR PET IN DISASTER-READY CONDITION

• Ensure all of your pets’ collars and tags have up-to-date contact information. ▶ Microchipping a pet is one of the best ways to find them again should they become lost. • Have proper equipment for pets to ride in the car with you (this is especially important for cats or exotics, who may not leave your house often).

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• Pet carriers are needed at many shelters and can serve as a safe space for a nervous pet. They are highly recommended when transporting your pet. The pet carrier should be the correct size (the pet should be able to stand, turn around and lay down comfortably). Be sure to label the carrier with your pet's name, breed, sex, date of birth, your current address and contact numbers, and any important medical information. • Collar or harness with ID tag, rabies tag and a leash. ▶ Carry at least one slip leash. A simple slip-type webbing or nylon leash will ensure you have a way to restrain a dog (or even a cat) in the event they slip out of their collar or harness.

WHAT TO INCLUDE IN YOUR PET'S DISASTER KIT • At least three days to two weeks’ worth of food and water specifically for your pet stored in sealed containers. ▶ If your pet’s regular diet includes canned food, remember to have a manual can opener with you. ▶ Don’t forget bowls to serve your pet’s meals • At least two weeks’ worth of any medication they require in a sealed, airtight container. • Important documents such as any registration information, adoption papers and vaccination documents. Photocopied records of your rabies certificate, vaccinations and medical summaries should be stored in a waterproof container. • A first aid kit particularly for your pet. May include bandage rolls, tape and scissors; antibiotic ointment; flea and tick prevention; latex gloves, isopropyl alcohol and saline solution. A pet first aid reference book is a good idea too. • Hygiene and grooming supplies. Any sanitation items and products you need to clean and clean up after your pet. Consider pet litter and litter box if appropriate, newspapers, paper towels, plastic trash bags and household chlorine bleach.


• A picture of you and your pet together will help you document ownership and allow others to assist you in the event you become separated. If it is a printed photo, consider noting the pet's species, breed, age, sex, color and distinguishing characteristics on the back of the photo. • Familiar items, such as treats, toys and bedding can help reduce stress for your pet. Toys will also help keep your pet occupied.

ASK, DON’T ASSUME

Be sure to secure accommodations for your pet before the storm. Every time a hurricane approaches, false information circulates on social media. A common myth is that there are laws requiring all hotels to allow pets in their rooms during an evacuation notice. This statement is not true and can put you in a tough spot if all other pet-friendly hotels in your area are already booked. Ask ahead of time if the location you plan to evacuate to is comfortable with every pet you will be bringing when you arrive there. There are also plenty of websites where you can verify if a hotel or shelter will be pet-friendly.

For more information, visit CDC.gov and search “Pet Safety in Emergencies.” Whether you plan to evacuate or ride out the storm, every effective disaster plan for veterinary practices and clinics consists of seven basic parts. All seven of these will be critical to the success of your company during a major storm. • Emergency relocation of boarded and hospitalized animals • Backups of medical records • Continuity of operations • Building and personnel security • Fire prevention • Chemical spill prevention • Insurance coverage/legal issues Be sure to hand out your completed hurricane plan in advance, so you aren’t trying to create and disseminate a plan at the last minute.

EMERGENCY RELOCATION OF BOARDED & HOSPITALIZED ANIMALS

• Make sure leashes, carriers and other species-specific supplies are brought along. • Plan for appropriate, pre-arranged animal transportation along with a temporary animal holding location. ▶ Include a 24-hour client contact list, which can also be accessed off-site. • Inform staff, clients and legal counsel of your planning processes for these animals.

MEDICAL RECORD BACKUP

• Keep medical records and digital copies of important documents backed up on an off-site computer.

CONTINUITY OF OPERATIONS

• Have alternative power sources to avoid issues, should the power go out for an extended period of time. ▶ If you purchase backup generators, make sure staff is well-versed in the maintenance and operation of them.

• Compile a seven-day supply of food and water for staff and patients, along with any medications that might be needed for this seven-day period. • Write down a list of contacts that can be used throughout the duration of the emergency operations period, should any challenges arise.

BUILDING & PERSONNEL SECURITY

Your local fire department is a great resource for inspections and evacuation drills. Each municipality has specific instructions in the event of an impending disaster. • Outline all preferred means of reporting emergencies, as well as the main point of contact in such emergencies. • Establish an office phone tree and pre-plan opportunities for conference calls with anyone who will be off-site during the storm. • Secure your practice to prevent any crime, such as theft and looting

FIRE PREVENTION

• Identify any/all fire hazards in the workplace. • Go over proper handling and storage procedures with the rest of the staff. • Appoint employees who will be responsible for maintaining this equipment.

CHEMICAL SPILL PREVENTION

• Create a plan to address appropriate responses to all foreseeable emergencies, which may include hazardous chemical spills. ▶ Employees will need to be trained on the proper equipment required to respond to these issues, should they arise. ▶ Each Florida county’s extension service has information on how to respond to chemical disasters, which was provided by the University of Florida’s Institute of Food and Agricultural Services (UF/IFAS).

INSURANCE COVERAGE & LEGAL ISSUES

• Make sure your insurance is up to date. ▶ Speak to your agent ahead of time, preferably before the impending disaster. ▶ AVMA PLIT’s insurance carriers accept claims from uninsured customers in affected areas. ▶ If you are insured through AVMA PLIT and you need to file a claim, you can find filing information at avmaplit.com. This site also offers additional resources to assist with commercial damage assessments, reestablishing security after a natural disaster, and minimizing interruptions for your business. AVMA LIFE will sometimes extend the grace period for premium payments for an additional 60 days following a natural disaster. If you are insured through AVMA LIFE and have questions or need assistance, call 800.621.6360 or visit avmalife.org.

POST-DISASTER RESOURCES FVMA FOUNDATION ASSISTANCE Any FVMA member who assists in rescue, relief and recovery

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PET LOSS SUPPORT YOUR CUSTOMERS DESERVE

efforts during a natural disaster is encouraged to apply for reimbursement through the FVMA Foundation. Member veterinarians who provide emergency boarding to animals may also be eligible. Any members who are facing an unreimbursed loss as a result of a storm may also be considered for FVMA grant assistance. For more information, contact the FVMA at 800.992.3862 or visit www.fvma.org/disaster-relief.

ADDITIONAL GRANT AND REIMBURSEMENT ASSISTANCE

AVMA member veterinarians participating in rescue and emergency care related to a natural disaster may apply for reimbursement through their charity, the American Veterinary Medical Foundation (AVMF). For more information visit www.avmf.org and search “disaster reimbursement grants.”

FEMA AID

Those impacted by damage from these disasters can also apply for FEMA aid. There are specific loan programs for businesses and private non-profit organizations, as well as homeowners and renters in affected counties. To learn more, visit www.fema. gov or www.disasterassistance.gov. The IRS offers tax relief to areas designated by FEMA as qualifying for either individual or public assistance. The IRS has a declaration permitting a postponement of certain deadlines for taxpayers who have a business in, or live in, disaster areas. If you receive a late filing or late payment penalty notice from the IRS, call the telephone number on the notice in order to abate the penalty. The IRS will also waive any usual fees and expedite requests for copies of previously filed tax returns for those who were affected. Affected taxpayers in a federally declared disaster area also have the option of claiming disaster-related casualty losses on their federal income tax return. You may also deduct personal property losses that were not previously covered by insurance or other reimbursements.

Your clients depend on you to help guide them throughout their pet’s lives – as well as at the end of it. As a Paws & Remember provider, you benefit from our specialized staff training, quality education material, dignified cremation services, and memorial items that are tailored to the needs of the pet owner and their pet. These resources will help your clients cope with their loss and remember their beloved companions in a way that is meaningful to them. Contact us for more information about how we can help you create a more personal memory for your clients.

BUSINESS RELOCATION REMINDER

If your practice suffers damage from a storm and you need to relocate, contact the Florida Department of Business and Professional Regulation to apply for a new establishment license for the new location. For more details, visit the Florida DBPR website at www.myfloridalicense.com. 22  | FVMA Advocate

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Dr. Alexis Polles, MD The title phrase no longer takes us to first remembering the 1974 Ace song with a similar title, (“How long has this been going on,” Five-A-Side, 1974), but rather to the ongoing experiences related to the COVID pandemic. Are you at risk, even post-pandemic? As the global crisis abates, many sources, including the Centers for Disease Control (CDC. org) and the American Veterinary Medicine Association (AVMA. org) emphasize that the risk of the physical and emotional stress of the pandemic will not soon disappear in the rearview mirror as you “drive on” with your life. Unfortunately, the results, sometimes catastrophic, of burnout, stress, anxiety, depression and addiction are not new to veterinary professionals. This article will focus on veterinary medical doctors, but much of it also applies to other veterinary professionals.

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STRESS AND BURNOUT

There are distinctions between stress and burnout. With chronic stress, emotions may be over-reactive, resulting in a sense of urgency and hyperactivity with a loss of energy over time. Anxiety disorders are a result, and there may be physical damage associated with those disorders, such as development or worsening of hypertension. Burnout, on the other hand, produces feelings of helplessness and hopelessness, along with a loss of motivation, ideals and sense of efficacy. This leads to detachment, numbing, depression and even thoughts of suicide. The damage is mostly emotional. Both stress and burnout can produce sleep problems and heightened perfectionism. Shockingly, 85% of veterinarians surveyed at the 2018 AVMA meeting endorsed having “stress and burnout” (Am Vet News, 10/11/18). Contributors to these conditions include intensive use of technology, regulatory and competency maintenance requirements, social media attacks


from patient owners, and, for most, running a business. COVID has exponentially increased the stress of the business aspects of practice with changing guidelines regarding practice settings and employee protection requirements.

CONSEQUENCES

The consequences of untreated emotional distress can be devastating, including the development of substance use disorders, diminished patient care that may include medical errors and reduced patient (owner) satisfaction, suicidal ideation, and leaving the profession (Shanafelt, et al, “Changes in Burnout and Satisfaction with Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clin Proc. 2019 Sep;94(9):1681-1694). The rate of suicide in veterinarians may be higher than in physicians and dentists, and 1-1.5% of veterinarians have attempted suicide since graduation (“When Caring Hurts: Dealing with Depression in Veterinary Medicine,” Today’s Vet Nurse, Jan/Feb, 2017). In terms of means, they are readily available, and veterinarians more often use lethal euthanizing agents from their practice to attempt and complete suicide. The drug most often used is pentobarbital, typically at their home (Witte, et al, “Suicides and Deaths of Undetermined Intent Among Veterinary Professionals from 2003-2014,” JAVMA, 255(5), pp. 595-608, 9/1/19). Both suicide and burnout in healthcare professionals are associated with substance use and substance use disorders. This is not surprising, since people take drugs, including alcohol, for similar reasons, i.e., to feel good (euphoria), to feel better (reducing or relieving feelings of anxiety, stress, and depression), for actual or perceived improvement of performance, and for curiosity or to fit in (sense of belonging). Because prolonged stress, such as that of the pandemic, can have emotional consequences that do not show up for months or years, learning how to take care of yourself has never been more important. The proliferation of tools on organizational websites and in the general media, such as online mental healthcare services and wellness apps, makes reaching out much easier than in the past. However, healthcare professionals tend to think, “I can handle this myself.” Thus, watching out for one another is something we must all commit to doing. Engaging in or encouraging colleagues to engage with the FVMA’s Professional Wellness and Well-being Committee and programs is one great way to start. For those who need it, the Professionals Resource Network, which has acted as the Consultant to the Board of Veterinary Medicine on matters of potentially impairing mental health, addiction and physical/cognitive conditions since 1982, can provide non-disciplinary access to services that evaluate, treat and monitor the safe practice of veterinary medicine for the professional and the public. When it comes to taking care of lives, your own is the priority. Whether it is the result of early traumatic experience, training, work stress, personal loss or the pandemic, veterinarians are at risk for emotional distress and its sequelae. It should not be borne in silence or solitude. Please, reach out.

A message from the FVMA office The increasingly debilitating effects of stress and burnout, as outlined by Dr. Alexis Polles, continue to wreak havoc in the veterinary field. Access to licensed professionals is an essential part of treating the seemingly endless cycle of frustration, which is why we've launched our Membership Assistance Program (MAP). Through our new program, our members will have access to personal and professional help at no cost. To learn more about the program, please email info@fvma.org We believe that through the advice of experts such as Dr. Polles, our new MAP program and our continued efforts to educate, we can help better the mental health of those in the veterinary profession.

Dr. Alexis Polles, MD Dr. Polles is a fellow of the American Psychiatric Association and a diplomate of the American Board of Addiction Medicine. For more than 30 years, her practice has been devoted to treating healthcare professionals with addiction and co-occurring disorders at all levels of care, specializing in the treatment of trauma and addiction. Dr. Polles graduated from the Tulane University School of Medicine, completed a residency in emergency medicine at LSU Charity Hospital and a residency in psychiatry at the University of Mississippi Medical Center. She serves on the Board of Directors of the Federation of State Physician Health Programs and is currently a member at large of the Board of the Florida Society of Addiction Medicine. She joined the Florida Professionals Resource Network as medical director and CEO in January of 2017.

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@thefvma |  25


Practice Pulse QUESTION: I am a Florida-licensed doctor of oriental medicine/ acupuncture physician and a Florida-licensed massage therapist hoping you can clear up the issue of non-DVM supervised massage of horses in Florida. I see LMT peers on social media discussing their working with horses, and I have been under the impression that only DVMs and staff can provide equine care in Florida. One of these LMTs posted that she could massage horses by F.S. 641: Animal Service Providers; that it provides that chapter 474, F.S., re veterinary medical practice, does not apply to a part-time worker or independent contractor who is hired by an owner to provide certain services. On reading the law, I see it exempts a person hired on a part-time or temporary basis, or an independent contractor, hired by an owner to assist with herd management and animal husbandry tasks for herd and flock animals from the definition for unlicensed practice of veterinary medicine. I'm not sure how equine massage or acupuncture, etc. would be considered as animal husbandry and hope you might provide some clarification on if this ruling indeed allows other healthcare providers to work with horses without DVM supervision.

A: You have asked about the exemption which was codified in statute as:

(5)(a) Any person, or the person’s regular employee, administering to the ills or injuries of her or his own animals, including, but not limited to, castration, spaying, and dehorning of herd animals, unless title is transferred or employment provided for the purpose of circumventing this law. 1This exemption does not apply to any person licensed as a veterinarian in another state or foreign jurisdiction and practicing temporarily in this state. However, only a veterinarian may immunize or treat an animal for diseases that are communicable to humans and that are of public health significance. (b)  A person hired on a part-time or temporary basis, or as an independent contractor, by an owner to assist with herd management and animal husbandry tasks for herd and flock animals, including castration, dehorning, parasite control, and debeaking, or a person hired on a part-time or temporary basis, or as an independent contractor, by an owner to provide farriery and manual hand floating of teeth on equines. This exemption does not apply to any person who has been convicted of a violation of chapter 828 that relates to animal cruelty or a similar offense in another jurisdiction. The exemption (a) does not apply as you are not a regular employee. The exemption under (b) applies to herd management and animal husbandry tasks (there are examples of what those are) and farriery and hand floating of teeth on horses. If there was a “massage” exemption, it would have been included with the specific examples of farriery and floating teeth.

26  |  FVMA Advocate

For a massage therapist to provide service to an animal, the therapist needs to have a relationship with a veterinarian who authorizes such procedures on his/her client, and a report provided to the veterinarian by the therapist. In such a case, the LMT would be acting as a veterinary technician under general supervision. Without the authorization of a veterinarian, the therapist would be engaged in unlicensed activity.

QUESTION: Our clinic has had a change of responsible veterinarian. What action is required? A: The permit holder of the clinic has 10 days to notify the Board in writing of the name of the new responsible veterinarian. It is the duty of the licensed veterinarian named on the premise permit to return the permit to the Department when he or she ceases to be the responsible veterinarian for that location.

No fee is charged for the change of responsible veterinarian, and you should complete and submit form VM 13 to make the change to the new responsible veterinarian.

QUESTION: I was curious if our state practice act allows technicians to give a microchip outside of a VCPR. I couldn’t find the information online in the practice act info. A: Microchipping is the practice of veterinary medicine and only a licensed veterinarian in the State of Florida can microchip. A technician engages in “unlicensed activity” if he/she microchips an animal. The below along with other useful information related to Florida Statute 474, Veterinary Practice Act, may be found on the website of the Department of Business and Professional Regulation (DBPR). What services require a State of Florida license? Veterinary Medicine Veterinary Medicine means diagnosing the medical condition of animals and prescribing, dispensing or administering drugs, medicine, or treatment of whatever nature for the prevention, cure or relief of a wound, fracture, bodily injury, or disease thereof; performing any manual procedure for the diagnosis of or treatment for pregnancy or fertility or infertility of animals; or representing oneself by the use of a title, or undertaking, offering, or hold oneself out, as performing any of these functions. The term also includes the determination of the health, fitness, or soundness of an animal. These items are offered as examples of services you do need to hire a person with a Florida license and services you do not need to hire a person with a Florida license. The list is not all inclusive. If you have specific questions, please contact the department at 850.487.1395 or review the


GOT 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.

rules for the profession at www.myfloridalicense.com. You should also check with your county or city to learn whether or not a local business tax receipt or certificate of competency is required for services that do not require a state license. Please visit our Unlicensed Activity page to learn more about how you can help us combat Unlicensed Activity.

You must submit a letter of request and a fee of $25.00 to: Department of Business and Professional Regulation Board of Veterinary Medicine 2601 Blair Stone Road Tallahassee, Florida 32399-0783. Allow 30-45 days to process your written request.

Needs a License

Does Not Need a License

Treatment or diagnosis of an animal.

Treating the ills or injuries of animals you own.

Immunization or treatment of diseases of animals that are communicable (can be transferred) to humans.

Grooming or boarding unless performed at a veterinary clinic.

Microchipping.

Farriery and manual hand floating of teeth on equines (horses) if hired by an owner. Examples of farriering include equine hoof care, the trimming and balancing of a horse's hoof and the placing of shoes to the horse's foot.

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

Dispensing of drugs to animals.

QUESTION: I have someone who is applying for a position in my clinic. They are a licensed veterinarian from outside the country but not in Florida or the United States. Because there is no valid license, I know I'm limited in how I would be able to utilize their skills, however, am I able to utilize this person as a certified technician?

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A: The foreign veterinarian can work as a technician within your

clinic. As a reminder, they would need to work under a licensed veterinarian's supervision and any issues that arise through that practice would be under that supervising veterinarian's license.

QUESTION: I need a letter of good standing for my license sent to another state. What do I do? A: You can verify your license to another state instantly by using

DBPR’s Online Services. Create an online account or login to your existing account at www.myfloridalicense.com. Select “Request License Certification” from the License Menu. Complete the online application and pay the $25 fee by credit card or electronic check. A copy of your license record will be created and emailed directly to the State Board selected during the transaction. Certain jurisdictions are not set up to receive verifications electronically; in those cases, the verification will be mailed within 10 business days. If you need to send certification of your license to multiple states, you will repeat the instructions above and pay the required $25 application fee for each request. Jurisdictions outside the United States may not be found in the online drop down menu, and in that case you should do the following:

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CLASSIFIED ADVERTISEMENTS VETERINARIANS WANTED

VETERINARIAN WANTED – ST. PETERSBURG, FL: We are hiring a fulltime veterinarian for our low-cost, full-service clinic. We have digital x-ray and digital dental x-ray equipment. Each client room has it’s own computer so you may look at client records and show client’s x-rays. We have one fulltime vet and two part-time vets. We would like to add an additional vet so that we may increase the number of patients seen and surgeries performed. You must be licensed in the state of Florida. Must have or be able to obtain DEA license. Our address is 1900 34th St S, St Petersburg FL 33711. Our hours are 8-5, Monday thru Friday. We are open ½ day on Saturdays, but you will not be expected to work Saturday unless filling in for our Saturday vet for vacation. New graduates are welcome to apply. We have PTO, paid CE, paid health insurance, and we pay for your license renewal. For more information, please contact Scott Daly at 727.385.8025 or by email at scott@petpalanimalshelter.com. (3/21 / #50474) VETERINARIANS WANTED – ORLANDO, FL: Banfield Pet Hospital is hiring Orlando Florida! Are you looking to flourish in an environment that emphasizes personal and professional growth? Do you believe in practicing high quality, solutionoriented medicine? Does the thought of being supported by a team of dedicated professionals and given the freedom to practice at the top of your license excite you? Do you want to push yourself, take the lead on growing your career, and have the opportunity to affect change at the hospital level and beyond? If you answered “yes!” to any of the above, we want to talk to you today! Whether you’re an experienced doctor looking for your next adventure, a new graduate seeking to find the perfect fit as you begin your career, or you’re anywhere else along your veterinary journey, the opportunity to grow with Banfield has never been better. Offering structured mentorship, outstanding benefits, powerful scheduling flexibility, and a dedicated focus on the health and wellbeing of our team, Banfield is committed to your success! Sound good? Let’s chat! Reach out to Miranda.Adams-Ford@banfield.com to learn more about how you can #bhere and #bhappy Your dream job is waiting, why are you? (3/21 / #50354) VETERINARY ASSISTING INSTRUCTOR – PORT CHARLOTTE, ORLANDO, AUBURNDALE, SANFORD, BRANDON AND FORT MYERS, FL: Southern Technical College is seeking full time instructors for its Veterinary Assisting diploma program in Florida. STC is hiring at the following campuses: Port Charlotte, Orlando, Auburndale, Sanford, Brandon and Fort Myers. Curriculum is provided. Qualified candidates will either hold a Doctor of Veterinary Medicine degree or be a certified Veterinary Technician, and have at least three years of work experience in the field. Teaching experience is not required, but is preferred. Email resume to Csukloff@southerntech.edu to learn more about the position. (3/21 / #50332) VETERINARIAN RESIDENT WANTED – CLEARWATER AND WESLEY CHAPEL, FL: The Pet Dentist at Tampa Bay—Clearwater and Wesley Chapel, FL: The Pet Dentist at Tampa Bay is seeking a full time resident for its AVDC approved residency program, beginning in 2022. With two locations in the Tampa Bay area, our practice offers mentorship from two board-certified veterinary dentists. Our practice on the west coast of Florida continues to grow thanks to over 20 years of relationships with local general practitioners and specialists. Our offices have great support staff including certified veterinary technicians and receptionists. The caseload is diverse and includes all aspects of veterinary dentistry and oral surgery. Practice locations are recently renovated and offer state-of-the-art equipment. Applicants are required to have completed a one-year internship or equivalent experience in private small animal practice. We offer a competitive salary and benefits package and a 5-day work week. A letter of intent, curriculum vitae, and three references should be sent via email to thepetdentist@gmail.com. For more information about the program, contact Dr. Chris Smithson or Dr. Michael Peak, phone: 813.406.4800. (3/21 / #592) VETERINARIAN WANTED – KISSIMMEE, FL: Associate veterinarian needed for a full-service animal hospital in Kissimmee, Florida. Osceola Animal Emergency has an immediate opening for a full time (40 hours per week) veterinarian. We are currently open 6 days per week. Salary to start $140,000/yr. plus all licenses paid for, and continuing education.

28  | FVMA Advocate

Signing bonus available as well. We are fully equipped and utilize Cornerstone veterinary software system, Fovea digital radiology, ultrasound, Vimago CT machine, video endoscopy, Abaxis bloodwork machines, and perform all types of soft tissue and orthopedic surgery. An interest in surgery is preferred. Contact Joe Mata (manager) or James Barnett (chief veterinarian) at the hospital. 407.910.4771. We can also be contacted at our email dolphinvet@gmail.com. For more information, please contact Dr. James Barnett at 407.765.9152. (3/21 / #26792) VETERINARIAN WANTED - HERNANDO COUNTY, FL: Hernando County Animal Services is looking for our next great Veterinarian! We employee one Veterinarian; therefore, the clinic will be yours to make your own. The County offers competitive pay, great benefits and State Retirement. We have a very busy shelter but manage to maintain a 90% save rate. Our county is diverse offering many great communities, anything from a busy city environment to rural farmland and State Forests. Please apply at: https://www.hernandocounty.us/departments/departmentsf-m/human-resources/employment. For any questions please contact Shelter Manager. (3/21 / #4223) VETERINARIANS WANTED – TALLAHASSEE, FL: Capital Veterinary Specialists is a growing multidisciplinary specialty hospital located in Tallahassee Florida and is seeking veterinarians for our Urgent Care service. Our current team includes two internal medicine specialists, two board certified surgeons, a critical care specialist, a part time dermatologist, an ophthalmologist, four urgent care DVMs and two rotating interns. We have over 70 support staff members who work closely with our specialty team, facilitating the daily workflow of the hospital. Our hospital spans a 2-acre campus and offers 11,000 square feet of specialty medicine and urgent care facilities including 8 patient exam rooms, two operating room suites, internal medicine procedures suite, ultrasound suite, radiology suite, on site CT, on site underwater treadmill, centralized ICU, large spacious treatment room, and off-site MRI. All advanced diagnostic equipment and imaging capabilities are available, and we practice on the forefront of specialty medicine. Our specialists work cohesively together and enjoy a friendly, laid back environment. Compensation package includes competitive and negotiable base salary, commission-based bonus structure, health and retirement benefits, paid CE, paid vacation and much more. Please call or email Kevin Drygas at 352.258.5891 or kevind33@aol.com and check us out on the web: www.capvetspecialists.com. (3/21 / #48) VETERINARIAN WANTED – HUMANE SOCIETY ORLANDO, FL: Hiring two Florida licensed veterinarians. Salary is 140 K for a 40-hour week. It is possible to work 4 days per week. Ask about student loan forgiveness via the Public Service Loan Forgiveness Program. For more information please call 407.482.1955. (Issue 3, 21 / #28095) ASSOCIATE VETERINARIANS WANTED! WITH A $10K SIGNING BONUS – TITUSVILLE, FL: SPCA of Brevard Wellness Clinic – Titusville, FL If you are motivated, compassionate and eager to give back to the community, WE WANT YOU! The SPCA of Brevard has been established in our community since 1979 and we are committed to our 35,000+ loyal clients. We provide the highest quality medical care with empathy and compassion. Our facility is currently home to 2 full-time veterinarians and we are looking to expand into a 4-doctor practice. We have a highly qualified support team and a full service, well equipped facility including digital radiology, in-house bloodwork and urinalysis and dental capabilities. Our office is a fast-paced environment, and is an excellent learning environment with great mentorship available. As the leading non-profit animal welfare organization in this area, spaying/neutering is paramount to our mission so surgical skills are required for this position. We offer a very competitive salary, vacation/personal time, 401k, health insurance options, dental, vision and life policies, continuing education allowance and an incentive program. There are No On-Call responsibilities. AND... We are offering a $10K signing bonus!


New Graduates welcome! DVM license, DEA license, surgical skills, and the desire to grow with us. NOTES: 3 openings. (3/21 / #50384)

PART-TIME VETERINARIAN WANTED – STATESBORO, GA:

Practice high-quality medicine, your way! Seeking full-time or parttime companion animal veterinarians for our brand-new Vetco Total Care hospital in Statesboro, GA. Veterinarian Hospital Medical Leader and Exotic/Companion Animal Veterinarian positions available! We offer relocation assistance. Our general practice hospitals have four exam rooms, large treatment area, in-house lab and diagnostics, full surgical suite, digital x-ray suite and digital dental x-ray. Excellent full-time benefits/incentives include: Competitive Salary plus Bonus (with no negative accrual), Open Time Off, $3500 CE Allowance, Paid Parental Leave. Full-time roles are Signing Bonus Eligible! Email: Lindsay.Cropper@Petco.com or call/text: 858.692.8904. Petco is an Equal Opportunity Employer. (3/21 / #50795) VETERINARIAN WANTED – DEERFIELD BEACH, FL: SEEKING VETERINARIAN FOR EMERGENCY CLINIC IN DEERFIELD BEACH -130K AVERAGE COMPENSATION FOR 4 SHIFTS A WEEK * Full time and/or part time is available. * Must be licensed in the state of Florida. * Minimum of 1-year experience preferred. * Comfortable performing surgeries. * Professional comportment and appearance, with excellent interpersonal skills and a positive, friendly attitude. * The ability to make decisions and communicate clearly and effectively with clients and fellow team members. * Respect for and willingness to work with clients and their pets. * A commitment to practicing the highest standard of medicine upholding the veterinary code of ethics. * Manages times and tasks appropriately. Our Clinic Provides: * Excellent compensation Candidate must be able to work nights and some weekends. For more information please contact Rodolfo Padilla at rpadilla@aec-d.com or by phone at 954.235.1121. (3/21 / #4449) VETERINARIAN WANTED – NAPLES, FL: FULL TIME VETERINARIAN in beautiful Naples, Florida. Town and Country Animal Hospital is dedicated to our small animal patients and is looking to expand our AAHA accredited 2-doctor practice. The practice employs a full complement of in-house state-of-the-art diagnostics, as well as digital and laser technologies. Our practice focuses on preventative care, houses a dedicated surgery suite and emphasizes canine and feline dentistry . Our board certified Theriogenologist Dr. Carver-Raffa offers a full array of reproductive services. We offer a fixed salary, an alternating 4 to 4 ½-day work week, an annual bonus participation plan, a generous package of paid personal benefits, CE opportunities and a progressive environment for longterm professional growth and mentorship. Salary based on experience (85,000.00 +). Please visit our website (www.mynaplesvet.com) for further information about out practice. Email your resume in confidence to: employment@mynaplesvet.com. (Issue 3/21 / #598) VETERINARIAN WANTED – WEST PALM BEACH, FL: Clear Lake Animal Hospital is seeking a part-time or full-time associate veterinarian for our busy and growing small animal hospital in West Palm Beach, FL. Our hours are Monday-Friday 8-5 and Saturday 8-12 with no on-call hours. Our practice is paperless and equipped with state-of-the-art equipment such as digital radiographs, dental radiographs, in house lab blood machines, and Class IV Therapeutic Laser. The ideal candidate we are looking for has experience, is a team player, outgoing and compassionate with our clients and patients, motivated and has excellent communication skills. Please email clearlakeanimalhospital@gmail.com for more information. (Issue 3, 21 / #28300) VETERINARIAN WANTED – MANDARIN, FL: San Jose Beauclerc Animal Hospital is currently seeking to hire a full time veterinarian to join our family in the beautifully historic district of Mandarin, Florida. Close to beaches, the St. Johns River, town center shopping, private schools, etc. Our hospital comes well equipped with digital radiology, full in-house diagnostic laboratory, digital dental x-rays, grooming, boarding and much more. Salary is competitive. Benefits include vacation pay along with health, continuing education, retirement contribution with a matching opportunity, and LTD/ STD. We also offer payment

for local and state association memberships. Cobra and Dental are available, if desired, at a small fee. Mentorship is available.For more information, please contact www.sjbahanimalhealth@aol.com (Issue 3, 21 / #4223)

RELIEF VETERINARIAN

RELIEF VETERINARIAN: "Got to get away? "VetRxRelief , 40 years experience small animal Veterinarian. Please call 321.508.3879 or Vetgator@gmail.com. (3/21 / #2187)

PRACTICE FOR SALE/LEASE

PRACTICE FOR SALE – MELBOURNE, FL Turnkey, fully equipped hospital , Space Coast, close to beach, marina, and shopping. Equipment also for sale separately. Call 321.508.3879 or VetGator@gmail.com. (Issue 3/21 / #2187) PRACTICE FOR SALE - SW BROWARD COUNTY: Small animal clinic located in affluent SW Broward County; FL. Practice has been in current location for over 20 years. 1200 sf. 2 exam rooms, 1 surgical room, grooming room, treatment room and kennel room. Pictures available. Please contract Stuart M. Auerbach, DDS Henry Schein Professional Practice Transitions. Stuart.Auerbach@henryschein.com Cell: 954.298.4575. (3/21 / #18359)

EQUIPMENT FOR SALE/LEASE

EQUIPMENT FOR SALE – KISSIMMEE, FL: Clinic closing, equipment for sale: Revo Square Digital X-ray, Inovadent Dental machine, Samsung blood analyzer, SS cages and tables, Sevoflurane anesthesia, autoclave, other items such as surgical instruments, centrifuge, cold laser, etc. Location: Kissimmee, FL. For more information, please call 407.744.3800. (321 / #8337) X-RAY SYSTEMS FOR SALE - FLORIDA: DIGITAL AND STANDARD X-RAY SYSTEMS, FLORIDA X-RAY SALES FOR MORE INFORMATION, PLEASE CONTACT FRANK BYKOWSKI AT 941.637.0614. (Issue 3, 21 / #26934)

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FLORIDA’S LEADING ONCOLOGY PRACTICE HOPE, CARE, AND OPTIMAL OUTCOMES

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30  | FVMA Advocate


Practices for Sale NEW LISTING! West Coast FL: Lee County: SA, 1.25 DVM Prx. $1M+ 2020 gross. 4,000 SF building on app. 1 acre w/ 3 exam rooms. RE included. (FL25F) NEW LISTING! FL, Palm Beach County: SA, Solo Dr. Prx. Leased facility. (FL30W) GA, South Atlanta Area: Solo SA Prx w/RE, Approx 2,217SF efficient facility. Open 4.5 days a week + ½ day Saturday. Well Equipped. PRX & RE. (GA48C) NEW LISTING – NC, Appalachian Mountains: Solo Doctor, 100% SA w/ increasing revenues. Convenient to Charlotte, Winston-Salem, and Greensboro. Home to more than several dozen commercial wine producers, surrounded by the largest concentration of vineyards, wineries and tasting rooms in NC. Real Estate included (NC20Y) NEW LISTING! NC, Crystal Coast Area: Located near the Neuse River area, only 30 miles from Atlantic Beach. SA, Solo DVM. $900K+ 2020 gross. +/- 2 acres included. (NC32N) NC, Piedmont/Triad/Growing Area: AAHA Certified, SA 1.25 Dr. Prx., +/-3000SF spacious facility. Only open 4.5 days a week. Well Equipped. PRX & RE $625K. (NC15B) 1610 Frederica Road, Saint Simons Island, GA 31522 Toll Free: (800) 333-1984 | www.simmonsinc.com Email: southeast@simmonsinc.com Licensed in Florida, Georgia, North Carolina, South Carolina and South Carolina Real Estate Broker

Veterinary Practice Sales, Acquisitions & Valuations

MIAMI-DADE COUNTY: Prime location! Leased facility + mobile unit. Option to buy real estate available. (Listing Code: FL105) PALM BEACH COUNTY: Prime location on ocean with a dock! $618K gross and $120K after-debt income. Real estate included. Huge growth potential! (Listing Code: FL107)

Practices for Sale North Central FL – 1+ Dr. 2020 gross ~$800k, free standing clinic w/ 2 exam rooms, in-house lab, digital x-ray, great staff. Equine Practice-Brevard Co.- Rare opportunity to buy a turnkey Equine practice on the central east coast. 1 to 1.5 Dr. 2020 gross $678K. Barn, stalls, treatment area, paddocks, office. Motivated owner...any offer will be considered. S.E. Florida-Solo Dr. Prx with huge growth in 2020... $657K..Lease space in high growth area west of the Turnpike. 2 exam rooms, digital x-ray, in-house lab, great clientele. Owner is ready to retire. Coastal Panhandle- Solo Dr. grossing $1.1M, 2200 sq. ft., 2 exam rooms, tenured staff, after debt income ~$190K. Just minutes to the beach. New-SE Florida-Mobile Equine Practice- Rare opportunity to buy a well established and very profitable Equine practice in the Miami area. Solo Dr. grossing $745K. All the bells and whistles you need with a substantial after debt income. Owner financing! New-West Coast north of Tampa- Solid solo Dr. Practice grossed almost $1.2mm in 2020. lease space w/3 exam rooms, well equipped, experienced staff, very profitable.

When Selling or Buying a Veterinary Practice... Call on

Practice Sales Buyer Representation Associate Buy-Ins Exit Strategies Appraisals Richard Alker, DVM Florida Representative

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WHEN IT COMES TO SELLING YOUR PRACTICE, GETTING THE BEST PRICE IS JUST THE FIRST STEP. PROTECTING YOUR LEGACY SHOULD GUIDE THE JOURNEY. Your practice is worth more than just a building with equipment. Its value includes your dedicated team, carefully crafted culture, and personal commitment to pets and their families. That is why we approach selling your practice with the goal of ensuring you receive a maximum return and that your legacy continues. Whether you’re considering a private or corporate sale, partner with the experts to navigate the process.

42 Years | 3,200 Sales Transactions | 12,000 Practices Appraised

Call us today at 800.333.1984 for a complimentary and confidential conversation.

Learn more at simmonsinc.com


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