Advocate Issue 3, 2018

F V M A ADVOCATE ISSUE 3 | 2018

THE 91ST PRESIDENT OF THE FLORIDA VETERINARY MEDICAL ASSOCIATION

Marc A. Presnell, DVM

President's MESSAGE “The greatness of a nation and its moral progress can be judged by the way its animals are treated.” – Mahatma Gandhi 7 207 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. Marc A. Presnell President Dr. Michael Epperson President-Elect Dr. Donald H. Morgan Treasurer Dr. Alex M. Steverson Past President Mr. Philip J. Hinkle Executive Director

DISTRICT REPRESENTATIVES Dr. Scott Richardson District 1–Big Bend Dr. Julia Conway District 2–Northeast Dr. Todd Fulton District 3–Central Dr. Rachel Klemawesch District 4–Tampa Bay Dr. Susan M. Carastro District 5–Treasure Coast Dr. Marta P. Lista District 6–South Florida Dr. Mary Smart District 7–Southwest Dr. James M. Brechin District 8–Northwest Dr. Kelly J. Sloan-Wade District 9–Space Coast Dr. Ernest C. Godfrey AVMA Delegate Dr. Richard B. Williams AVMA Alternate Delegate Dr. Jacqueline S. Shellow FAEP Representative to the FVMA Executive Board Ex Officio Dr. James W. Lloyd, Dean UF College of Veterinary Medicine

These are exciting times to be a part of veterinary medicine and to be a part of the FVMA! In May, the FVMA was able to participate in two events at the UF College of Veterinary Medicine. President-elect Dr. Mike Epperson participated in the White Coat Ceremony for the sophomore class as they transitioned to their junior year and moved one step closer to achieving their dream of becoming veterinarians.

At the end of May, I was privileged to address the graduating Class of 2018 at the Senior Rehearsal Graduation Breakfast, and to represent the FVMA at the awards ceremony later that evening and the graduation ceremony the following afternoon. The words of the quote above by Mahatma Gandhi were given to our new colleagues with the charge to embrace this trust and stewardship that is the veterinary medical profession, along with the challenge to care for our animal world. If you have a new graduate in your community, now is the time to reach out to them. Welcome them to the profession, and invite them to be a part of your local VMA and the FVMA! In early July, the FVMA Executive Board and FVMA Foundation met for our summer quarter meeting. One of the exciting announcements to come out of that meeting is that after much planning and work, the Charlie Bild Visiting Practitioner Program is soon to be launched. This collaborative program between the FVMA and the UF CVM was created to honor the late Dr. Charles Bild, a Miami veterinarian and an FVMA past president. The FVMA named Dr. Bild Florida’s most outstanding veterinarian in 1964, and in 1972 the Association gave him its first Lifetime Award for Distinguished Service. Anyone interested in learning more about the program, including specifics about the selection process and responsibilities, should contact Marcela Brandao at mbrandao@ufl.edu. Also coming soon will be more information on the new Power of 10 program, so stay tuned.

In July, the FVMA traveled to Denver for the AVMA Annual Conference, where we met with colleagues and leaders from around the country. The FVMA is one of the most respected state VMAs in the country, and this is always a great opportunity for sharing new ideas, gaining new insights and addressing new challenges facing the veterinary profession. We listened to veterinary leaders from across the U.S. address issues, including student debt, license portability, wellness/well-being and telehealth just to name a few topics.

Looking forward, the FVMA continues to provide world class CE opportunities. In October, the Florida Association of Equine Practitioners (FAEP) will be hosting the 14th Annual Promoting Excellence Symposium (PES), and will be returning to Naples, Florida after Hurricane Irma caused a change in venue last year. This meeting draws attendees from around the world, and the FAEP has created one of the premier equine CE events available. The FVMA will also be returning to the Boca Raton Resort for the Sixth Annual Gulf-Atlantic Veterinary Conference (TGAVC). Register now to reserve your spot for this outstanding program – you don’t want to miss this year's TGAVC! Lastly, the FVMA is YOUR organization. We are here to serve you - our members and colleagues.

Let us know how we can better serve you, and join us as we work to advance the veterinary medical profession, promote animal health and well-being, and protect public health. There are many new programs and opportunities to be involved in that are on the horizon, so stay tuned!

Respectfully,

Marc Presnell, DVM

FVMA MISSION THE MISSION OF THE FLORIDA VETERINARY MEDICAL ASSOCIATION IS TO ADVANCE THE VETERINARY MEDICAL PROFESSION, PROMOTE ANIMAL HEALTH AND WELL-BEING, AND PROTECT PUBLIC HEALTH. 2 | FVMA ADVOCATE

Congratulations to the class of 2020 UF CVM White Coat Ceremony

Over the past few months, members of the FVMA Executive Board were present on behalf of the FVMA at several ceremonies celebrating the University of Florida College of Veterinary Medicine students and graduates. From FVMA hosting a rehearsal breakfast for UF CVM graduating seniors to

addressing the Class of 2020 at their White Coat Ceremony, the FVMA was honored to support the University of Florida College of Veterinary Medicine as it celebrated these professional milestones.

Read more about honored UF CVM graduates and students on pages 14-16   

In This Issue 4 | In Remembrance 6 | Member Spotlight 8 | Meet the President

by Nicole Huie, FVMA Communications

12 | Beat the Heat: Keeping Pets Cool During the Hot Summer

by Samantha Rosenthal, FVMA Communications

14 | UF CVM Class of 2018

16 | FVMA Recognizes UF CVM Students and Graduates 17 | Tips For Challenging Dental Extractions - Wade Gingerich | DVM, DAVDC 20 | Professional Liability - AVMA 22 | Practice Pulse 25 | Classified Advertisements

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In Remembrance

Dr. C. "Perry" Smith

FVMA Past President (1997) 1939-2018

With great sadness, the Florida Veterinary Medical Association mourns the loss of FVMA Past President C. "Perry" Smith, DVM, who passed away on June 23, 2018. He was 79.

Dr. Smith was a resident of Clewiston, Florida, formerly of Miami and Summerfield, Florida. Although born in Conway, South Carolina, he grew up on a farm in Dallas, Florida. He attended the University of Florida and Auburn University, where he received a Doctorate of Veterinary Medicine degree in 1964.

Immediately following graduation, Dr. Smith was drafted by the U.S. Army where he served as veterinarian at the rank of Captain. Upon his discharge, he moved to Miami, Florida where he practiced veterinary medicine for more than 40 years. As owner of Trail Animal Clinic, Inc. in Miami, he became active in both the local and state veterinary associations. He served as president and treasurer of the South Florida Veterinary Medical Association (SFVMA) where he was awarded a Lifetime Achievement Award and two Dedicated Service Awards for his numerous contributions to the association and community. In 1997, he served as president of the FVMA and later received the Distinguished Service Award in 2000. In 2008, he was honored with the FVMA's Lifetime Achievement Award, the single most prestigious award that can be given to any veterinarian in the state of Florida.

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Since his retirement, Dr. Smith owned and managed P A Smith Ranch Property, LLC, a 2,500-acre working cattle ranch in Hendry County, where 500 head of cattle reside. When he wasn’t rounding up cattle, building fences, mowing pastures, spraying Florida Holly or driving the front-end loader, he was sitting on the steps of his log cabin hand feeding the deer and wild turkey that hung out around the house. That ranch meant the world to him and until January 2018, he ran it single-handed, except during roundup time, when he brought in the “cowboys” and “cow dogs.”

“Dr. Perry,” as he was called, will be greatly missed by his family and friends. He is survived by his wife of 54 years, Adele E. Smith, and his son, Perry F. Smith, DVM (wife, Jill), his brother, Frank Smith and his grandchildren, Hayley and Madison Lemery (17), daughters of Kay Smith Lemery (deceased), Cole Smith (14) and Jacob Smith (13), sons of Perry and Jill Smith. His animal family include his dog Tramp, his cat Kitty Kitty, his horses Cowboy and Calvin, and Bambi the pet deer.

Dr. Ignatius Adams Retired veterinarian Dr. Ignatius “Iggie” Adams, 89, passed away on June 16, 2018. He served the Miami community for more than 40 years and was recognized for opening the first veterinary emergency clinic in Miami. At the same time, he served as the head veterinarian for the Hialeah race track.

Dr. Adams also served as the president of the Miami Veterinary Association and was an FVMA member since 1996. Dr. Adams was granted honor roll status by the AVMA House of Delegates in September 2000 at its annual meeting. He was a graduate of the University of Pennsylvania Veterinary Medical School.

Aside from veterinary medicine, he also loved traveling the world with his wife and fishing. He was married to Carol Adams for more than 60 years.

He’s survived by his three children, Joy A. Ray, Carol A. Pawley, and Egan Adams; seven grandchildren Ashlee, C.C., Dobbs, Clayton, Devon, Jade, and Jake; and four great grandchildren Cannon, Camden, Henry and Graham.

Dr. Fayez Michael Dr. Fayez Michael, 69, passed away on May 21, 2018 in Miami. He served Miami-Dade County as a veterinarian for more than 35 years. Dr. Michael was an alumnus of the School of Veterinary Medicine at Cairo University.

He practiced as an emergency veterinarian for five years in Miami-Dade prior to opening his own practice in 1987 – Michael Animal Hospital. Dr. Michael was an FVMA member since 1997, and he also was a member of both the AVMA and SFVMA. As an active FVMA member, he attended multiple FVMA Annual Conferences and also participated in a Closing the Gap Forum at a previous Annual Conference. He also attended the Gulf-Atlantic Veterinary Conference and South Florida Regional Veterinary Conference multiple times. He was truly a lifelong learner of the veterinary profession.

Dr. Michael was also a proud husband to his wife Dr. Sonia Victor Michael, and a father to his two sons Drs. Paul Michael and Peter Michael.

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MEMBER SPOTLIGHT CLINICAL BEHAVIORIST RECEIVES AWARD FROM ALMA MATER Photo courtesy of Valentine Becker

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r. Terry Curtis, who is an FVMA member and a clinical behaviorist at the University of Florida College of Veterinary Medicine, will be receiving the 2018 Professional Achievement Award from her alma mater Keuka College. This award is one of five awards that will be presented to accomplished alumni.

“This professional achievement award validates my passionate commitment of over 20 years to education and service,” said Dr. Curtis. “I am very humbled and appreciative.”

She graduated from Keuka College in 1980 and will be receiving the award due to her achievements in the field of veterinary medicine. Dr. Curtis has spoken at a handful of FVMA conferences on the topic of behavioral medicine in small animals.

She also does house calls to help pets and their owners overcome behavioral issues like anxiety, and she teaches classes at the University of Florida College of Veterinary Medicine.

Dr. Curtis has been published more than 34 times, lectured on five different continents, and she is featured often in print media and on television shows like the “Today Show” where she talks about animal behavior.

Dr. Curtis will be presented with the award at the Alumni Association Breakfast Meeting on Saturday, September 22 during Keuke College’s Green and Gold Celebration Weekend.

Photo courtesy of Air Animal Pet Movers

FVMA LIFETIME MEMBER RECEIVES INTERNATIONAL INDUSTRY AWARD Isabel Cudel of EuRA Southern Region noted that both Dr. Woolf and Linda were lucky to have each other as life partners as well as business partners. Michelle Bramstoft of EuRA Northern Region said at the meeting that “loving, loyal and longevity” were the three words she could think of when describing Dr. Woolf and Linda.

Air Animal Pet Movers founders (right center) Dr. Walter Woolf and his wife Linda receive the Exceptional Partnership Award at EuRA’s Relocation Conference in Croatia.

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he European Relocation Association’s (EuRA) Executive Group presented Air Animal Pet Movers founders Dr. Walter Woolf, who is an FVMA Lifetime member, and his wife Linda with the Exceptional Partnership Award during this year’s EuRA Relocation Conference. The award was presented to Dr. Woolf and his wife for their commitment and loyalty to the organization and to each other.

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“Air Animal joined EuRA in 2008 and we regularly participate in their information-sharing conferences.” said Dr. Walter Woolf of Tampa. “Funny story - we had no idea we were being recognized, and we chose to sit in one of the side banquet rooms with EuRA friends so we could talk more easily. When they called our name, we didn’t hear it! Linda and I were floored to be recognized for partnering with EuRA to promote the welfare of animals as they relocate. We were also recognized as both business partners and partners in life.”

Based in Tampa, Air Animal Pet Movers has helped relocate more than 100,000 pets across the world. Air Animal Pet Movers is an appointed and endorsed International Air Transport Association (IATA) air cargo sales agency working with all airlines that move animals, ensuring all their clients are provided with the best in animal care and transportation.

Are you a member with news to share?

Please email info@fvma.org for consideration in an upcoming issue.

MEET THE PRESIDENT MARC A. PRESNELL, DVM

FVMA President | 2018-2019

By Nicole Huie, FVMA Communications

A CONVERSATION WITH

FVMA President Dr. Marc A. Presnell Santa Fe Animal Hospital | Lakeland, FL Marc Presnell, DVM, was installed as president of the FVMA for the year 2018-2019 at a ceremony held in Tampa, Florida on April 6, 2018. He succeeded Dr. Alex M. “Steve” Steverson, who now serves on the FVMA Executive Board as immediate past president.

Dr. Presnell served on the FVMA Executive Board as the District 3 Representative for five years, and was on the FVMA Budget and Finance Committee for eight years. An alumnus of the University of Florida College of Veterinary Medicine, Dr. Presnell also served two terms as president of Ridge Veterinary Medical Society. His practice, Santa Fe Animal Hospital, was named “Small Business of the Month” by the Lakeland Chamber of Commerce in December 2016.

The FVMA was able to sit down with the newly installed president to talk about building upon FVMA’s current successes, leaving his mark during his term as president and looking toward the future of veterinary medicine in Florida.

GOALS AND OBJECTIVES FVMA Advocate:

What are your goals as president of the FVMA?

President:

The FVMA Executive Board established its strategic plan in 2015 and will be meeting again soon to update the plan which will address new opportunities and challenges and to sharpen the vision of our organization. I look forward to working with our outstanding executive board in this process.

A one year term passes quickly, so I have tried to set small, but attainable, goals for my term. In order to ensure the strength and vitality of the veterinary profession for the future, I will commit to working with the dedicated FVMA staff to complete the launch of the Power of 10 program. This new program will train the next generation of leaders of our profession and find new ways to fulfill our sworn veterinary oath. I believe this is critical for the future of veterinary medicine in Florida. I ask all practitioners and practice owners to find, nominate and

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support our young practitioners who will lead the profession into the future.

The FVMA currently offers world-class continuing education in an accessible and learning-friendly environment. To better serve our members working in all disciplines throughout the state, whether practitioner or team member, I will work with the FVMA to continue to develop and launch regional conferences. This ensures that our colleagues and team members – whether in The Keys or in the Panhandle – will have equal access and opportunity to fulfill their pledged obligation to continually improve their professional knowledge and competence.

Finally, I will work with the FVMA to develop a memberaccessible resource center that will help provide aid in managing financial, professional and personal challenges, which will enhance the well-being of all its members and thereby more effectively ensure the fulfillment of our mission.

FVMA Advocate:

Describe your overall vision for the future of the Association.

President: I envision the FVMA continuing to strengthen its position as the voice of veterinary medicine in the state of Florida.

President:

The recent appearance and elimination of screwworm in Florida should remind all of us of the critical role Florida veterinarians play. We must remain vigilant concerning emerging animal diseases because Florida remains a vulnerable port of entry.

FVMA Advocate:

What does that mean for the FVMA and its members?

Currently, the model of delivery of veterinary services is undergoing change as technology and corporate practices both evolve, and outside influences continue to attempt to enter the field of delivering veterinary services. We are going to have to think outside the box as we consider some of the following: how the profession will embrace telehealth, how the profession will redefine the roles of the veterinary team, how the profession will provide services to areas that currently do not have access to veterinary care, how the profession will meet the need for rural animal veterinarians, and how the profession will nurture the well-being and health of veterinary professionals and the veterinary team.

President:

Being the voice of veterinary medicine in Florida means that whenever the public or private sectors think about animal care, animal health, food safety or the preservation of our wildlife resources, they think of the FVMA as the organization that either has the answers or is developing the answers to these issues. It means strengthening our partnership with the University of Florida College of Veterinary Medicine (UF CVM). All of our members need to seize the opportunity to guide the development of civic policies that affect our profession and our ability to fulfill our veterinary oath. As members, we cannot just sit on the sidelines and watch. When called upon to serve in our local communities whether that’s through collaborative work with the UF CVM or to serve on a broader statewide platform, we embrace the opportunities.

We have had remarkable examples from many colleagues in the past who helped shape the profession of today, and I hope we can honor their examples by doing the same for those who come after us.

FVMA Advocate:

How long have you been involved with the FVMA? President: I became actively involved with the FVMA and my local VMA in 1996 when I returned to Lakeland, Florida.

The current opioid crisis will, for the short term, also alter how our profession delivers care, and it will alter regulations that affect our practitioners no matter which veterinary discipline you are involved in. These challenges may seem overwhelming and can significantly change the landscape of veterinary medicine, but effort, diligence and thoughtful solutions can help make the profession even better.

FVMA Advocate:

What are your ideas about addressing those issues?

President:

We have to be tough minded as we make decisions in each of these areas. We do not want to seek the easy or quick answers, but the best answers for the animal world and for the profession. We need to collaborate with our colleges, legislators, industry partners, other state VMAs, the AVMA and even international organized veterinary medicine as some of these issues, like telehealth, extend beyond our state and national borders.

FVMA Advocate:

What is your philosophy about service, specifically in organized veterinary medicine?

President: I believe that all of us owe a tremendous debt to others — whether it’s those who inspired us, educated us, mentored us, financed us or developed the profession for us. Because of this debt, I believe service is simply a part of who we are. Others have given for me, and now I have the opportunity to give for others.

In organized veterinary medicine, this means we have had many colleagues who have made sacrifices to help shape our profession and organization. We enjoy great respect as a profession, and the FVMA is respected nationally. It should just be a part of our professional lives to care for not just our patients and clients, but also our staff, colleagues, future colleagues and our profession by serving through our local VMAs, the FVMA and the AVMA.

FVMA Advocate:

After your tenure as president, will you remain active in organized veterinary medicine?

President: I certainly hope to stay an active member in organized veterinary medicine as long as my services are needed and beneficial.

FVMA Advocate:

What message would you like to leave the membership?

President:

FVMA Advocate:

What would you consider to be important issues for Florida veterinarians? Why are they important?

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We are a part of one of the best professions in the world, and the FVMA is one of the best state veterinary organizations in the country. Be proud of the profession, be proud of your FVMA and be dedicated to making both better — the best is yet to come.

PRACTICING AS A VETERINARIAN  THEFVMA |

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PRACTICING AS A VETERINARIAN President:

FVMA Advocate:

While in Georgia, Dr. Larry Corry taught me the importance of being involved in organized veterinary medicine. When I returned to Lakeland, I became involved in the local Ridge Veterinary Medical Society (RVMS). We had great examples in Drs. Wade Gardner, Bill Jackson, Geoff Gardner and Jerry Rayburn in serving the veterinary profession. I have served on the executive council of the RVMS starting in 2005, where I held the position of RVMS president twice and secretary once.

Look 15 years down the road and tell us how you envision the veterinary profession in Florida at that time.

President: The practice of veterinary medicine has changed immensely since I graduated 32 years ago and will continue to change.

This is necessary and good even though change may make us uncomfortable at times. I still believe, though, our profession will always boil down to some simple things like listening to the patient, being compassionate and caring for each other.

FVMA Advocate:

FVMA Advocate:

Do you have any special anecdotes about your practice? Any milestone stories you would like to share about your work as a veterinarian?

President: I am sure that every practitioner has some story from their practice that stands out. I will only say that one of the pleasures of veterinary medicine is that it is never boring. You never know what will come through the door — whether it is the client wearing nothing but a children’s swimming pool, a “miniature” 200-pound pig that has to be moved out of the house, or a camel who relishes trying to bite its handler’s foot off. You have to keep a sense of adventure and a sense of humor.

Describe your history as a veterinarian.

President: I graduated from the University of Florida College of Veterinary Medicine in 1986. After graduation, I entered a mixed animal practice in Cumming, Georgia, then later entered a primarily small animal practice to allow more time for some of the responsibilities I had outside of practice. I returned to Florida and worked as an associate and was mentored by Dr. Gary Bowen in Orlando before returning home in 1996 when I purchased Santa Fe Animal Hospital.

FVMA Advocate:

FVMA Advocate:

What inspired you to become a veterinarian?

President: Like any child, I had many ideas about a career. After coming to the realization that I would never play professional football, I decided to become a veterinarian when I was in the ninth grade.

I felt it was a great combination of my love of animals, science and the outdoors. I looked forward to making farm calls and helping families, whether that meant helping their pets or their livestock. I will always be grateful to Dr. N.L. Black for his help in making this dream a reality.

Do you participate in any community programs and entities outside of veterinary medicine?

President: I currently serve as a board member of Parker Street Ministries in Lakeland, Florida and have been involved with Parker Street for the past seven years. I have primarily worked in the academic enrichment program, an after school program helping students by offering tutoring and homework assistance, and helping students to prepare for college or post-high school career opportunities. I am also very involved in our church where I have served as the education coordinator, a teacher for 20 years, with our mission teams to Honduras, and as an elder for the past 11 years.

FVMA Advocate:

Describe your involvement in organized veterinary medicine at the local level.

BALANCING A BUSY SCHEDULE FVMA Advocate:

Tell us about your family and hobbies.

President: My wife Terri and I met at the University of Florida, and we have been married for 31 years. We have three children: Colin, who graduated from Pepperdine University; Aubrey, who graduated from Duke University; and Chase, who is currently finishing college at Florida Southern College. When I am not working, I enjoy reading, music, hiking, kayaking, fishing, or just about anything outdoors or that allows me to spend time with family.

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FVMA Advocate:

How are your extra duties as president impacting your veterinary practice?

President: It is still early in my term, so I am not feeling much impact yet. The FVMA staff are excellent at preparing me for my responsibilities.

I have also had many FVMA members offer to help share the load as we carry out the FVMA mission. I do anticipate being away from the office more than I typically am this upcoming year.

FVMA Advocate:

Any advice on balancing private life with the responsibilities of a veterinary medicine career?

President: I was counseled early in my veterinary career by a seasoned practitioner with the following words: “Do you know what your clients are going to say when they call your practice the day after you die? They will say, I am so sorry to hear that...who do you recommend?” Veterinary medicine is a consuming career and we enter it because we want to help others and their animals, but each practitioner must determine their own boundaries that will allow them to be whole and maintain their well-being. Never be afraid to ask for advice or help. I have always felt it is hard to be well at work if you are not well outside the practice, and it is an everchanging balancing act that requires constant attention just as our practices require constant evaluation, adjustment and new goals.

Dr. Presnell with his children Colin, Aubrey and Chase, and wife Terri.

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Photo credit: www.123rf.com/profile_sam74100

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BEAT THE HEAT

KEEPING PETS COOL DURING THE HOT SUMMER

By Samantha Rosenthal, FVMA Communications Every year, hundreds of pets die from heat stroke after being left in unattended vehicles.

With high temperatures and humidity, Florida’s summers can be brutal, threatening animals of all sizes.

With summer underway, we are breaking down the facts about protecting pets from the summer heat and are offering some recommendations on how to best treat animal patients who are suffering from heatrelated ailments. We also have some helpful tips that you can share with pet owners about how to care for their pets during Florida’s hot summer months.

HEAT-RELATED AILMENTS IN PETS

When it comes to the higher temperatures during the summertime, there are many things to consider concerning animal safety and the many factors that can contribute to heat exhaustion or heat stroke.

The American Animal Hospital Association provides a list of signs to be aware of that could indicate a pet is overheating. Those signs include: • excessive panting and drooling • difficulty breathing • increased heart rate • mild weakness • stupor or actually collapsing • seizures • bloody diarrhea • vomiting FVMA President Dr. Marc Presnell, who operates Santa Fe Animal Hospital in Lakeland, Florida, says that veterinarians across the state need to be diligent in reminding clients and the community about this issue. While the media often focuses on dogs being left in cars, heat exhaustion can occur under many circumstances; for example, pets can even suffer from heat stress while walking on hot pavement or concrete.

“When people are walking their animals on hot concrete or asphalt, those animals are much closer to that hot surface,” Dr. Presnell explains. “They’re getting a lot more of that radiant heat off of the ground. We might think it’s tolerable and yet the pet is absorbing a lot more heat.”

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Dr. Presnell also recalls an incident of a dog that was at daycare and was accidently left outside in the play yard without shade or water, and it suffered from heat stroke due to this. Another innocent danger is when a pet owner takes its dog to a public space to play, like a beach. They can easily get overheated from running around and playing with other dogs, and should be offered frequent water breaks and cooled with misters or cool water rinses.

Many large animals that are kept outside, like horses and farm animals, are also susceptible to heat exhaustion due to high temperatures, lack of adequate shade and sometimes lack of good ventilation in barns. While Dr. Presnell says there is a difference between an animal being overheated versus if they are actually experiencing heat stroke, both situations are approached in similar ways on how to initially try to cool the animal down.

TIPS FOR KEEPING PETS COOL

If an animal exhibits any of the signs that indicate its overheating, it is best to get them into a cooler temperature area, either a shaded area or preferably indoors where there’s air conditioning.

“If they’re alert and responsive enough, you may be able to get them to drink,” says Dr. Presnell. “Sometimes the animal is not in a condition where they are able to drink immediately or they are not responsive enough, and you may have to deal with other complications that arise.”

Owners may also place a wet cloth on the animal's neck, armpits and behind their hind legs. Do not provide the animal with water

that is too cold as it may quickly drop their internal temperature and send them into shock. If symptoms worsen or the pet doesn't seem to be responding, owners should contact their local veterinarian or an emergency veterinarian.

“If a pet’s body temperature has gotten really high, they may be having some clotting disorders you’ll have to manage,” Dr. Presnell explains. “They may be having profuse diarrhea and other organ systems may be affected. I’ve seen cardiac arrhythmias – irregular heartbeats – that develop, and so each of those complications have to be addressed as they develop.”

Clients should always be advised that it’s better to be proactive than reactive. Make sure pet owners always have water with them when they will be outside for extended periods of time, especially if the pet is engaging in physical activity because this allows for evaporative cooling.

KNOW THE LAW

During the 2016 Florida Legislature, a bill was passed that created immunity for individuals for property damage caused when attempting to rescue a domestic animal from a vehicle.

“I think the law is a great law. I’m really happy that it passed. It certainly enables people to do what’s right for the pet and save them rather than worrying about the consequences if they were to break into someone’s vehicle,” says FVMA Animal Welfare Committee Chair Dr. Christy Layton, chief of staff at Timberlane Pet Hospital & Resort in Plant City, Florida.

In order to ensure immunity, the law states an individual must go through the following checklist before attempting to break into a vehicle: • Determine if the vehicle is locked and there’s no other way to gain access inside without help, or that the animal isn’t able to get free on its own.

• Have good reasoning to believe that entry into the vehicle is necessary due to the animal being in imminent danger.

• Contact a law enforcement agency or 911 prior to entering the vehicle.

• Only use necessary force needed to gain entry into the vehicle to remove the animal from harm.

• Stay with the animal in a safe location, near the vehicle if possible, until law enforcement or first responders arrive.

This same law applies to minors and elderly/disabled adults. The law also clarifies that a “domestic animal” is either a dog, cat or other domesticated animal that can be considered a household pet. For further information about the state law, visit http://www. leg.state.fl.us/statutes/.

In addition to the state law, there are many county animal ordinances or codes that state leaving your animal inside a vehicle is unlawful, where many consider it animal cruelty and have ways to file formal complaints. Some counties even have

committees that make recommendations to county-elected officials on animal-related policies and issues. Dr. Layton is on the Hillsborough County’s Animal Advisory Committee. She says getting involved within your communities — whether through local government or veterinary medical societies — is a great way to help educate the general public on animal welfare issues.

She is also on the FVMA Legislative Committee and encourages members to become involved to learn more about the FVMA’s role in animal welfare advocacy.

“The Florida Veterinary Medical Association is an amazing source of information for things like this and also a great group to learn from on how the whole legislative process works,” Dr. Layton says. “If they get involved in the FVMA, and participate in things like Legislative Days, it’s certainly an eye-opening experience to see the things that we, as veterinarians, can actually do to help craft laws to aid the animals in our state to become healthier and also to have less issues with animal cruelty.”

EDUCATIONAL RESOURCES ON PET HEAT SAFETY

Dr. Presnell says the key to ensuring your clients are aware of the seriousness of pet heat safety is through education, whether that be public service announcements (PSA) or advertising in magazines. Client education forms and flyers are available for download on the AVMA website that can be made available to clients to spread awareness and education on the topic.

He also stresses that accidents can occur, which veterinarians need to understand. Because many people lead busy lives, veterinarians need to do their best to get the word out to always check your car prior to leaving it and to realize how fast temperatures can rise in a vehicle. Another thing he stresses is that veterinarians also need to realize that while their job is to save animals lives, not all lives can always be saved. While this is hard for many veterinarians to accept, Dr. Presnell says that veterinarians can only provide the best care possible for each patient, and sometimes that might not be enough to save them which is why educating clients on pet heat safety is so important.

Dr. Layton suggests veterinarians push sending out PSAs during the summer months in order to make clients aware of the issue.

Some creative ways can include sending out a notification reminder if your hospital or clinic has a smartphone app or even tagging a friendly reminder onto the bottom of invoices during this time of year. Other communication methods include sending out email messages to clients or posting information onto social media. If any veterinarians are comfortable writing articles and/ or talking on the news, she highly encourages these individuals to pursue these PSA efforts, allowing for more people to realize that even if their dog is healthy heat can still affect them.

“Veterinarians know about the issue,” Dr. Presnell says. “Our job is to educate the public about it and to address not only the things that we think of first, like animals being left in cars, but also to think outside of that to those animals that could be exposed to other heat situations.”

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W E L C O M E T o T h e

P R o F E S S i o n

FVMA AWARDS TWO SCHOLARSHIPS AT WHITE COAT CEREMONY

This year, 113 sophomores were coated during the ceremony, each presented with professional white clinic lab coats at the Phillips Center at the University of Florida.

The FVMA also gave each student FVMA-branded scrubs as a congratulatory gift from the Association for having successfully completed their pre-clinical training.

Malachai Schang (left) and Laura Martin (right) receive the Sophomore Champion of Veterinary Medicine Scholarships.

Photo Credit: UF Photography

The FVMA presented two FVMA Foundation scholarships to sophomore veterinary scholars Laura Martin and Malachai Schang on May 11, 2018, during the UF CVM’s White Coat Ceremony. Each student received a $1,500 check along with a commemorative plaque, which were presented by the 2018 FVMA Champion of Veterinary Medicine Dr. Richard Sutliff who is an FVMA past president. FVMA President-elect Dr. Michael Epperson also addressed the students.

FVMA HOSTS REHEARSAL BREAKFAST FOR UF CVM ’18 GRADS The FVMA hosted a Rehearsal Breakfast on the morning of May 25, 2018, for graduating UF College of Veterinary Medicine seniors. The Class of 2018 enjoyed a delicious breakfast at the Banfield Small Animal Hospital at UF. FVMA President Dr. Marc Presnell addressed the Class of 2018 and FVMA Executive Director Philip Hinkle, Dr. Richard Carpenter, who is an FVMA past president, and many UF dignitaries were present at the Rehearsal Breakfast to make this a special occasion.

As new graduates, the new DVMs receive complimentary membership to the FVMA for 2018 and reduced registration to FVMA continuing education conferences for the next two years. The FVMA presented each student with a gift of a specially prepared jump drive containing useful professional resources.

Executive Director Phil Hinkle also presented the FVMA Class of 2018 student representative Dr. Heather Morrissey with an award of recognition in appreciation for her years of work and dedication representing the Association on campus.

Photo Credit: UF Photography

FVMA PRESENTS SCHOLARSHIP AWARDS AT SENIOR BANQUET & AWARDS CEREMONY The FVMA presented three scholarship awards during the UF College of Veterinary Medicine Senior Banquet & Awards Ceremony on the evening of Friday, May 25, 2018. FVMA President Dr. Marc Presnell presented each recipient with their scholarship award.

Dr. Marc Presnell (left) presents Bryan Allen (right) with the Charlie Bild Clinical Proficiency Award Scholarship.

Dr. Marc Presnell (center) presents Necia Godzisz (left) and Heather Morrissey (right) with the Champion of Veterinary Medicine Scholarships.

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Drs. Necia Godzisz and Heather Morrissey were presented with the Champion of Veterinary Medicine Scholarship, and Dr. Bryan Allen was presented with the Charlie Bild Clinical Proficiency Award Scholarship. The Champion of Veterinary Medicine scholars are senior students selected for their exceptional academic achievements, along with possessing outstanding leadership and communication skills. Each recipient received a $1,500 scholarship and plaque from the FVMA Foundation. The Charlie Bild Clinical Proficiency Award Scholarship is named in honor of the late Dr. Charles Everett Bild, who was known internationally for his clinical research of cancer and cardiovascular disease. The selected recipient is a senior student who demonstrates outstanding clinical proficiency with both large and small animals, and they’re presented with a $1,000 scholarship and plaque.

The FAEP Scholarship was presented to Dr. Heather Morrissey, who will pursue a career in equine medicine post-graduation. The selected recipient demonstrates high ethical standards, solid communication and a strong desire to serve horses and people. Dr. Morrissey received a $1,000 scholarship and plaque.

TIPS FOR CHALLENGING DENTAL EXTRACTIONS WADE GINGERICH | DVM, DAVDC It has been said that dental extractions can be awfully simple or simply awful. I can’t find a better description for the experiences I have encountered while performing dental extractions over the past 15 years. Some teeth with severe periodontal disease can be removed in seconds. In other cases, dental extractions present major surgical challenges with risks of severe complications and consuming considerable time. In this article, I will discuss some techniques and equipment that can help you get through the more difficult extractions with fewer complications and greater efficiency.

Which dental extractions are the most challenging? This may depend on the person you ask. In my experience, mandibular canine and first molar teeth, any tooth with ankylosis and tooth resorption frequently present the greatest challenge. Mandibular first molar and canine teeth have large roots that are surrounded by a decreased density of bone, resulting in an elevated risk of iatrogenic mandibular factures. Removal of alveolar bone for an open extraction technique is somewhat limited in the mandible because of the location of neurovascular structures and excessive removal can lead to significant hemorrhage and weakening of the mandibular bone. In large breed dogs, the risk of mandibular fracture is lower, but the forces required to elevate these large roots from the dense mandibular bone are significant and can lead to operator fatigue.

Ankylosis is a pathological phenomenon where the periodontal ligament is obliterated and the tooth root fuses with the alveolar bone. Tooth resorption is another pathologic condition, often occurring with ankylosis (Figure 1), and it results in significant weakening of roots and replacement of portions of the root with bone. Tooth resorption and ankylosis are extremely common in dogs and cats, affecting more than 50 percent of both species as they age.

Figure 2 - Shown in the photo from left to right are the following tungsten carbide FG burs: 701L, 330, ½ standard length round, and ½ surgical length round The traditional technique for extraction of a tooth includes the use of dental luxators and elevators to tear and/or fatigue the periodontal ligament. When ankylosis and tooth resorption are present, it’s impossible for these instruments to function as they are intended. Using excessive forces to extract large roots or those with ankylosis and tooth resorption can lead to fractured tooth roots; mandibular fractures; and penetration of the instrument into the nasal cavity, orbit or mandibular canal resulting in serious complications. An alternative to this traditional extraction technique is to use dental burs or periotomes to recreate the periodontal ligament space when tooth resorption and ankylosis are present. These instruments can also excise the periodontal ligament and expand the periodontal ligament space to reduce the amount of force necessary to elevate large roots. Since most veterinarians probably don’t have access to a periotome, I will focus on the use of dental burs that can be used with high-speed dental units now present in most veterinary hospitals.

Figure 1 - Radiograph of tooth 409 in a dog. Tooth resorption and ankylosis are present along the mesial aspect of the mesial root (blue arrows).

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The most commonly used dental burs for extraction procedures are friction grip (FG)-style burs that are used in air-driven, highspeed dental handpieces. These burs have cutting surfaces that

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Figure 3 - Demonstration of the moat technique using a surgical length ½ round bur in a dog.

are made with either tungsten carbide blades or diamond grit.

Diamond grit burs are utilized for alveoplasty during and after extractions and can be autoclaved for use in multiple patients.

Tungsten carbide burs are used to cut bone and teeth and are intended for single-patient use as they tend to dull easily. Many shapes and sizes of carbide cutting burs are available, but most veterinarians prefer the 701L (L stands for the extended length of cutting blades) for sectioning teeth and at times removing alveolar bone. Although the 701L may be the most efficient bur at sectioning large teeth, it is a relatively large bur that greatly increases the risk of iatrogenic trauma to surrounding tissue. A much smaller but very efficient cutting bur is the pear-shaped 330. This small bur is still efficient for sectioning large teeth but it allows for finer detail in bone removal and greatly reduces the risk of iatrogenic trauma to surrounding tissue. I use the 330 bur exclusively for sectioning teeth and buccal alveolar bone removal in dogs weighing less than 20 pounds and all cats.

Another style of carbide cutting bur is the round bur, which is available in a range of sizes. During dental extractions, the round bur is most useful for removal of alveolar bone as it is not efficient at sectioning teeth. Typical round bur sizes used in veterinary medicine are sizes 2 and 4; however, the round bur is also available in extremely small ¼ and ½ sizes and extended surgical length shanks (25 millimeters total length versus 19 millimeters standard length). It is the size ¼ and ½ round bur that has proven useful for facilitating the extraction of large teeth and those with tooth resorption and ankylosis. An additional use for this bur is the removal of retained tooth roots.

Figure 4 - Preoperative radiograph of 407 and 408 in a dog. Both teeth show radiographic evidence of tooth resorption and ankylosis.

Figure 5 - Intraoperative photograph of the moat technique to extract 407 and 408 in a dog.

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The technique for utilizing these small round burs to facilitate difficult extractions is referred to as “creating a moat” and is illustrated in Figure 3. In this technique, these small round burs are used to excise the periodontal ligament or separate tooth root from bone when ankylosis is present. Depending on the length of the root, either a standard or surgical length bur is chosen. I prefer using the size ½ for this technique because it has slightly greater cutting efficiency than the ¼ yet maintains a low risk for iatrogenic trauma to periodontal tissues and neurovascular structures. For this technique to be successful, the bur must be maintained in a parallel direction with the length of the root and used 360 degrees around the root, slowly working toward the apex until the root becomes mobile. If mobility is not achieved, a dental elevator may be used to elevate the root in some cases but this increases the risk for root fractures. If a root fracture occurs, the small round bur is used again in the same fashion until all root fragments have been removed. Beginning this procedure by amputating the crown and elevating soft tissue away from the tooth to be extracted will both help to increase visibility of the root and facilitate the process (Figures 3-5).

These small round burs are also useful for removal of root tips using the same technique described above. The surgical length bur is helpful for longer roots and in larger patients. Caution needs to be exercised because using these small inefficient burs can place excessive forces on high-speed handpiece turbines and use of them may result in replacement of turbines more frequently. Also, when these burs are cutting bone in the depths

of the alveolus, water irrigation may not reach the cutting surface of the bur and thermal damage to the bone may result. Although this result is a minor complication, attention to when it is happening is important so that bone cutting can be slowed or the angle of the bur can be adjusted. Use of magnification loupes and a portable light source are highly recommended to help avoid complications and increase success of the procedure.

The most common complications encountered when utilizing the moat technique will be hemorrhage and iatrogenic damage to tissues adjacent to the teeth. Careful angulation and depth control of the bur will help to prevent these complications in most cases.

If major hemorrhage occurs, firm pressure with a gauze sponge or hemostatic material should control the bleeding within three to five minutes. Closure of the wound may be required for longterm control of hemorrhage as well.

Although some dental extractions may be simple and require minimal skill, it doesn’t mean the task should be given to nonveterinarian staff members. Having non-veterinary staff members perform dental extractions puts the supervising veterinarian’s license at risk. According to Florida Statute 474.202, the practice of veterinary medicine includes dentistry and the treatment of disease. According to Florida Statute 474.213, only a veterinarian with a valid Florida license should practice veterinary medicine.

Practices that allow non-veterinarian staff members to perform dental extractions should reconsider the benefits versus the potential implications of doing so.

The No. 1 priority when faced with a challenging dental extraction should be to first do no harm. This is part of the oath that all veterinarians take prior to receiving a DVM degree.

No veterinarian should ever feel forced to perform a dental extraction procedure that is outside of his/her comfort or skill level. Consultation with a veterinary dentist — providing dental radiographs and photos is very helpful — may reveal alternative treatments to extraction of a diseased tooth. Pet owners should also be provided with the option to see a veterinary dentist for challenging dental extractions when the risk of complications may be reduced.

References

1. DuPont, GA., DeBowes, LJ. Atlas of Dental Radiography in Dogs and Cats. Saunders Elsevier: St. Louis, 2009 2. Niemiec, B. Small animal dental, oral and maxillofacial disease: a color handbook. Manson/Veterinary Press: London, 2010 3. Tutt, C., Deeprose, J., Crossley, D. BSVA Manual of Small Animal Dentistry, 3rd ed. British Small Animal Veterinary Association: Gloucester, 2007 4. Verstraete, FJ., Lommer, MJ. Oral and Maxillofacial Surgery in Dogs and Cats, 1st ed. Saunders Elsevier: 2012 5. Peralta, S., Verstraete, FJ., Kass, PH. Radiographic evaluation of the types of tooth resorption in dogs. AJVR 2010; 71: 784-793

Dr. Wade Gingerich is a contributing author and a presenter at FVMA conferences.

AIR TRAVEL WITH EMOTIONAL SUPPORT As the use of emotional support animals (ESAs) has become more common, businesses of all kinds are beginning to create more policies and guidelines around their use. In particular, several airlines have updated their requirements for travelers with ESAs. These policies and requirements can differ markedly between airlines.

Following a recent policy change by United Airlines, AVMA worked with AVMA PLIT and reached out to United to discuss concerns with the new Veterinary Health Form they required a veterinarian to complete.

AVMA's Response to the United Airline Policy Change In February, United Airlines announced an update to its policies for customers traveling with an emotional support animal or a psychiatric service animal. The policy required United customers to provide "a veterinary health form documenting the health and vaccination records for the animal as well as confirming that the animal has been trained to behave properly in a public setting."

Following the policy change, AVMA contacted United to express concerns over the new form and discuss revisions to the policy. On March 2, details of the discussed revisions were posted on the AVMA@work blog: The AVMA reviewed United’s Veterinary Health Form, which the airline said would take effect March 1, and recognized that the information it requested might not position United to make good decisions that would appropriately support the health and welfare of their animal and human passengers. The statements on the form also created potential liability risks for veterinarians attesting to them.

We know that our members want to do the right thing for patients and clients, while also being responsive to other service providers who depend on your expert recommendations. We’re pleased that United wanted to collaborate with us on improvements to its veterinary health form.

United has since updated the form for emotional support animals on their website, utilizing the alternate language developed collaboratively by the AVMA and AVMA PLIT. AVMA is also contacting other major US airlines to represent veterinarians' interests in regards to this type of documentation.

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AVMA compiled resources related to service, emotional support and therapy animals, including definitions, guidelines, and other reports available on their website.

Links to thoswe resources and other references in this article are available at avmaplit.com/ESA.

What should you do?

While PLIT is glad United was willing to discuss its ESA requirements with AVMA and update the form, other airlines may not take that approach. At some point, it is likely that a client will request documentation for an ESA to fly with them. Since airline ESA policies can differ or change, you should consider the following before signing off on statements or documents that may put you and your practice at risk: •

Read the forms thoroughly. You are not required to sign documentation or make a statement about a patient’s behavior (in an airport, on an airplane, or anywhere else) outside the scope of your treatment of that animal. Doing so can open you to potential liabilities and lawsuits from the airline or passengers if a crew member or passenger is injured, or if your patient’s behavior causes a disruption in service (ie. if the plane is delayed, has to return to the gate, or is diverted).

•

Limit your statements. Only factual information should be referenced (eg. vaccinations administered).

Statements regarding the client’s need for an ESA should only be made by the client or the client’s physician. Remember, you are not obligated to complete the form or certification. You should never speculate about a patient’s behavior outside of your interactions with the animal. Statements about the patient’s training or demeanor outside the practice should only be made by the owner.

If you have any questions or concerns regarding a client’s request, call us at 800-228-PLIT (7548), option 2, or email us at info@avmaplit.com.

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PRACTICE GOT A QUESTION? THE FVMA CAN HELP. One of the benefits of membership in the FVMA is our Helpline, (800) 992-3862, available to members daily, Monday to Friday, 8:00 am to 6:00 pm.

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

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

QUESTION:

I have a question regarding weather I can or can't buy the drug Naloxone (opioid reversal) for our local beach police. We are the hospital that helps their police dog with his medical needs. They asked me if we could order this drug for them in case their dog has an emergency while working in the field. I don't know what the protocol is for this.

A: A veterinarian that works with canines that may be at risk for an opioid overdose due to sniffing a small amount of fentanyl (or other similar opiod) is authorized to purchase and store naloxone for that use. A Florida statute (see below) was recently amended to allow many health care providers acting in good faith and exercising reasonable care to dispense or administer naloxone. Although this statute may technically not cover veterinarians (because they do not fit the technical definition of “health care practitioner”) the statute evidences a clear legislative intent that naloxone be readily available to treat “patients” who may be experiencing an opioid overdose.

In addition, Naloxone is no longer a controlled substance.

Taking all of these factors into consideration, it is my opinion that a veterinarian that routinely takes care of drug-sniffing canines is authorized to purchase, store and even make available naloxone to law enforcement personnel who may be faced with an emergency with a drug-sniffing canine.

381.887 Emergency treatment for suspected opioid overdose.— (1) As used in this section, the term: (a) “Administer” or “administration” means to introduce an emergency opioid antagonist into the body of a person. (b) “Authorized health care practitioner” means a licensed practitioner authorized by the laws of this state to prescribe drugs. (c) “Caregiver” means a family member, friend, or person in a position to have recurring contact with a person at risk of experiencing an opioid overdose. (d) “Emergency opioid antagonist” means naloxone hydrochloride or any similarly acting drug that blocks the

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effects of opioids administered from outside the body and that is approved by the United States Food and Drug Administration for the treatment of an opioid overdose. (e) “Patient” means a person at risk of experiencing an opioid overdose.

(2) The purpose of this section is to provide for the prescription of an emergency opioid antagonist to patients and caregivers and to encourage the prescription of emergency opioid antagonists by authorized health care practitioners.

(3) An authorized health care practitioner may prescribe and dispense an emergency opioid antagonist to a patient or caregiver for use in accordance with this section, and pharmacists may dispense an emergency opioid antagonist pursuant to such a prescription or pursuant to a non-patientspecific standing order for an autoinjection delivery system or intranasal application delivery system, which must be appropriately labeled with instructions for use. Such patient or caregiver is authorized to store and possess approved emergency opioid antagonists and, in an emergency situation when a physician is not immediately available, administer the emergency opioid antagonist to a person believed in good faith to be experiencing an opioid overdose, regardless of whether that person has a prescription for an emergency opioid antagonist.

(4) The following persons are authorized to possess, store, and administer emergency opioid antagonists as clinically indicated: (a) Emergency responders, including, but not limited to, law enforcement officers, paramedics, and emergency medical technicians. (b) Crime laboratory personnel for the statewide criminal analysis laboratory system as described in s. 943.32, including, but not limited to, analysts, evidence intake personnel, and their supervisors.

(5) A person, including, but not limited to, an authorized health care practitioner, a dispensing health care practitioner, or a pharmacist, who possesses, administers, prescribes,

dispenses, or stores an approved emergency opioid antagonist in compliance with this section and s. 768.13 is afforded the civil liability immunity protections provided under s. 768.13.

(6)(a) An authorized health care practitioner, acting in good faith and exercising reasonable care, is not subject to discipline or other adverse action under any professional licensure statute or rule and is immune from any civil or criminal liability as a result of prescribing an emergency opioid antagonist in accordance with this section. (b) A dispensing health care practitioner or pharmacist, acting in good faith and exercising reasonable care, is not subject to discipline or other adverse action under any professional licensure statute or rule and is immune from any civil or criminal liability as a result of dispensing an emergency opioid antagonist in accordance with this section.

(7) This section does not limit any existing immunities for emergency responders or other persons which are provided under this chapter or any other applicable provision of law.

This section does not create a duty or standard of care for a person to prescribe or administer an emergency opioid antagonist.

History.—s. 2, ch. 2015-123; s. 1, ch. 2016-145; s. 1, ch. 2017-107.

QUESTION:

I am a receptionist at a cat only facility. We have a client that owes us money. We had set up a "payment plan" with the owner as her cat presented with pyometra, a raging infection, and needed some expensive medical treatment. Long story short, the client canceled the credit card we had on file so her last remaining payments are still outstanding. She says she is going to pay us, "when her tax refund comes in," but I'm not hopeful. She mentioned she will be going to another clinic, as it is cheaper, for medical treatment for her cat. I know we cannot hold records due to a bad debt, but does it break confidentiality if we tell the NEW veterinarian/clinic that the client has a bad debt with us? Is it ethical to let the new clinic, who might call us for previous records, that their "new" client has a bad debt with us? We haven't run into this situation previously, so we wanted to check with the FVMA regarding this issue. Thanks in advance for all that you do.

seem to be no tangible benefit to the veterinarian, other than "getting even." It will not get the vet paid any sooner. If you share that information with the other vet, and the other vet requires a deposit or otherwise lets the client know that the client's reputation has been shared, the client may file a complaint with the Board (not likely to prevail, but costly to the vet); or take to social media to spread bad gossip about the vet.

If the new vet is a friend of the first vet, then sharing a warning verbally over the phone is not a bad idea; however the vet him/herself must be making that decision. Staff should be instructed that ANY gossip about a client should not be shared with staff of another clinic.

QUESTION:

My wife is vet and we are wishing to move to Florida. Searching for information we saw that if she will be under supervision of a certified veterinarian, she doesn´t need be licensed to get a work visa. Do you know if this is true?

A: You may get information about working in Florida as a vet or veterinary team member from the Board of Veterinary Medicine at the Department of Business and Professional Regulation. The Board of Veterinary Medicine is the regulator of the practice of veterinary medicine in Florida - www. myfloridalicense.com. Call 850.487.1395 to speak to a customer service agent, or write: Board of Veterinary Medicine Florida Department of Business and Professional Regulation 2601 Blair Stone Road Tallahassee, FL 32399

A: There is no easy answer to this question, and each situation is different. Generally speaking, the fact that a client owes you money and has become a bad debt is not a confidential matter. The things to keep in mind are: what is the benefit to the veterinarian? What is the risk? There would

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

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digital X-ray, ultrasound, laser plus a superb team. Must be an excellent communicator, work independently, be able to perform medical and surgical appointments. WI license attainable with open book and $50.

Northcountryvetclinic.com, Dr. Lynda Ludwig, 715.661.0178.

(3/18; ID#40368) VETERINARIAN WANTED – JACKSONVILLE, FL: Jacksonville, Florida small animal hospital seeking full or part time veterinarian with a minimum of 3 years’ experience to join our team in a well-established clinic. We have a loyal long-term clientele who wish the best care for their furry family members. We have in house IDEXX diagnostic lab as well as the ability to refer to outside lab. The position requires some surgery, compassionate care, good communication skills and the ability to work well with others. Congenial support staff. Salary negotiable based on hours, skills and experience. Contact Deloris Stamm at deloris@paradiseoga.com or call 904.294.8384 to discuss your goals and to set an interview. (3/18; ID#40490) VETERINARIAN WANTED – SPRING HILL, FL: Animal Emergency of Hernando is seeking Emergency Veterinarians. We are located in Spring Hill on the west coast of Florida with easy access to several larger metropolitan cities. We have access to many beaches and wildlife preserves. Spring Hill is a growing city with numerous veterinary clinics/hospitals which refer to our facility for after hour care. We provide emergency/trauma care with exceptional customer service. Excellent communication skills with clients and our referral practices are a must. Our standards are high both medically and professionally. Our support staff is highly skilled and self-motivating.

We place great emphasis on balancing professionalism and maintaining an enjoyable place to work. We offer in-house lab tests (Idexx Procyte, Catalyst DX, Snap reader), Digital X-Ray, K Laser, EKG and Vital scan. We offer competitive salary and excellent benefits. Benefits include IRA, health insurance, vacation, CE allowance, dues and more. Relocation/sign on bonus incentives. Full time /Part time Contact Debbie at 352.279.1522 or email resume to aeoh3496@yahoo.com (3/18; ID#27547) VETERINARIAN WANTED – BROWARD COUNTY, FL: The Humane Society of Broward County is seeking a full time Veterinarian.

Join an experienced team and provide exceptional care to animals from the community and shelter. Frequent medical and surgical care includes spay/neuter, vaccine and heartworm treatment. The position includes comprehensive benefits and vacation. Send resume to jobs@hsbroward.com or visit www.humanebroward.com for more information. (3/18; ID#40487) VETERINARIAN WANTED – TAMPA, FL: Why vacation when you could live in paradise? Animal Doctors of South Tampa is a busy small animal practice looking to add on a 4th full time veterinarian in the heart of South Tampa. Our hospital has modern in-house lab machines, digital radiography, and ultrasound as well as all other basic equipment. We have an excellent reputation within the community, and are privileged to serve clients who truly value the human animal bond.

Outside of the office, South Tampa could not be a more desirable place to live. From unique restaurants and bars, to sporting events, beaches, arts and other entertainment, we have it all. Please send any questions or resumes todr.chadhall@gmail.com. New grads are preferred but all experience levels are welcome! (3/18: ID#12123) VETERINARIAN WANTED – WINTER HAVEN, FL: Exciting opportunity for an associate veterinarian to join a progressive three doctor small animal hospital. No emergency or call required. Salary commensurate with experience and a competitive wage with bonus potential available. Benefit package, including signing bonus and relocation also available.

Practice is primarily dogs and cats, with some birds and exotics. New graduates welcome to apply.

Located in the center of the State of Florida, Winter Haven offers yearround recreational opportunities such as boating, fishing, golfing or tennis. Winter Haven is situated around 50 lakes with 24 of the lakes

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connected via canals. Winter Haven is known as “The Chain of Lakes City”. The area also offers great schooling and provides a safe, friendly, family environment. Winter Haven is close to both Orlando and Tampa’s metropolitan area and only 90 minutes to the beautiful white sandy beaches of the Gulf of Mexico or the Atlantic Ocean. Winter Haven is also home to LEGOLAND Florida and is within minutes to the beautiful Historic Bok Tower Gardens and the Water Ski Hall of Fame. To learn more about Dunham Animal Hospital, view the web site at www.dunhamanimalhospital.com The site will provide some additional information and history of the Hospitals nearly 40 years of operation. Apply to: Dunham Animal Hospital, 3201 Recker Highway Winter Haven, Florida 33880 Phone: 863-293-0850 Email: sdunham1@gmail.com (3/18: ID#7375) VETERINARIAN WANTED – TALLAHASSEE, FL: Bradfordville Animal Hospital is seeking a full-time associate. We are a busy AAHA accredited small animal veterinary hospital in the Tallahassee, FL area with an emphasis on progressive medicine, diagnostics and surgery. We enjoy a small-town atmosphere and feel strongly about fostering our client and patient relationships. We are currently operating as a 4-doctor practice but are growing and in need of another associate veterinarian. We enjoy practicing and helping each other professionally and would expect the same in a new associate. There is an excellent opportunity for mentorship. We have a phenomenal support staff that allows us to perform only veterinary duties.

Our clinic is extremely well-equipped with Sound Eklin digital radiography, a new Sound ultrasound unit, full in-house diagnostics, radiocautery surgical unit, Surgivet monitoring, pin and bone plate surgery sets. We utilize electronic medical records on Avimark software. Our clinic is open MondayFriday, and ½ day on Saturday. We refer after hours emergencies to the local emergency clinic. Salary will be very competitive with an attractive benefit package and long-term employment for the right person. Please email resumes to drsteve@bradfordvilleanimalhospital.com.

(3/18; #4244) VETERINARIAN WANTED - NEW SMYRNA BEACH, FLORIDA: Glencoe Veterinary Hospital, located in New Smyrna Beach, FL is looking for an Associate Veterinarian to join the practice!

We are looking for someone who genuinely loves what they do and are eager to grow with us! We are an exceptional one doctor practice that has been servicing the NSB community and surrounding areas for over 40 years! We have a modern facility with an excellent reputation in our local community. We provide the following services and equipment to our patients and clients: • Internal/General medicine and soft tissue surgery • Surgical laser • Digital Radiography and on-site ultrasound • Dentistry and digital dental radiography • Paper light with Avimark • In house IDEXX vet lab and urinalysis machine and so much more!

What you will need to be successful here at GVH: • A positive attitude • Florida Veterinary License • Ability to work well under stress and in a fast-paced environment • Current DEA license • Dependable and knowledgeable of current veterinary techniques and protocols. • Familiarity with Avimark is a plus! We offer competitive wages commensurate upon experience and skill level. Please email your resume in confidence to bclinegvh@gmail.com to arrange for an immediate interview. (3/18: ID#1551) VETERINARIAN WANTED, CENTRAL FLORIDA: Veterinarian wanted for hospital in Central Florida. We are well equipped with ultrasound, in house labs, surgical and therapeutic lasers, dental x-rays and a great staff to help you. Highest level of medicine practiced. New graduates considered. Compensation based on experience. 72,000 -100,000 or beyond! Full or part-time and Mentorship given. All replies treated in outmost confidence. If you have suddenly become corporate and want out now is your chance. Email riveroaksvet@yahoo.com (3/18: ID#17580)

RELIEF VETERINARIAN

RELIEF VETERINARIAN – COCOA BEACH, FL: Eric Bostrom , relief veterinarian for the Cocoa Beach and surrounding areas , please email or call me at ericgator@hotmail.com , 801-499-0383, 25 years of experience , proficient with small animal medicine and surgery and reptiles. (3/18: ID#40805)

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RELIEF VETERINARIAN AVAILABLE – PALM BEACH, FL: Seasoned NY small animal practice owner with home in Palm Beach available for intermittent per-diem work from Mid Dec thru March. Accomplished surgeon, diagnostician, and care-giver. Alan Schwartz, DVM alandvm04@yahoo.com Compassionvet.com(3/18: ID#6499) RELIEF VETERINARIAN - FLORIDA: Experienced over 30 years practice owner, 10 years relief work. Small animal and Exotics. Travel throughout Florida State. Available Friday, Saturday, Sunday negotiable.

Reliable, good clinical skills, excellent producer. Fluent in English and Spanish. References available. Dr. Cesar Mena 786-258-2688 or docvetmena@gmail.com (3/18: ID#15333)

VET TECHNICIANS & STAFF

EXPERIENCED VETERINARY TECHNICIAN/NURSE - JUPITER, FLORIDA: Candidates must be willing to utilize Fear Free/low stresshandling methods. A Veterinary Technician/Veterinary Nurse's job is multi-faceted; they must assist veterinarians, help improve the quality of care given at this hospital and improve efficiency by relieving doctors of technical work and administrative detail. They must also able to perform laboratory tests, educate clients, and perform tasks in every aspect of the hospital including but not limited to patient care and handling, surgical assistance, radiography, venipuncture, catheterization, microscopy, and client education. Please send your resume to shanda@petvets.com.

(3/18: #1732) TECHNICIAN WANTED – TAMPA, FL: Mobile Euthanasia Regional Coordinator; Florida Home Euthanasia is adding compassionate, flexible, and independent veterinary technicians to join our growing team of home euthanasia providers in the Tampa area. Our team is dedicated to helping pets and their families say goodbye in the comfort of home. This position is ideal for someone looking for a change of pace and an opportunity to grow their career in a new and rewarding way. Duties include both traditional and unique practice management responsibilities. Our ideal candidate is compassionate and dependable, with excellent communication skills and a deep understanding of the bond between pets and their owners. Candidates must be comfortable working independently and doing a variety of tasks. Enjoy excellent compensation and a flexible work schedule. To learn more, visit www.dvmcenter.com and contact Dr. Heather at careers@dvmcenter.com or 612-808-9889. (3/18: #10622) VETERINARY TECHNICIAN – TALLAHASSEE, FL: Veterinary Technician needed for busy small animal practice in Tallahassee, Florida. Job duties include assisting veterinarians and other staff with animal restraint, examinations, etc. Other job duties include dental prophylaxis, surgical assisting and monitoring, venipuncture, running lab work in house, and various other veterinary technician duties. Job requires working an occasional Saturday, and late hours when needed.

CVT not required, but preferred. At least 1-2 years’ experience in veterinary medicine is preferred. Please send resumes to bhanchett@bradfordvilleanimalhospital.com or apply in person. Job Type: Full-time Salary: $12.00 to $14.00 /hour depending on experience (3/18: #4244)

PRACTICES FOR SALE OR LEASE

PROPERTY FOR SALE - ZEPHYRHILLS: A301 Hospital Zephyrhills (20 minutes from Tampa) P.P. $440,000, $4,000 down, $3,447.86/mo., 5% APR., Rent $1750/mo. with option purchase property. You may work there for a month or two to determine if this is a good fit. Please contact Dr. Larry Adkins at (407) 529-5651. (3/18; ID #28095) PRACTICE FOR SALE – ZEPHYRHILLS, FL: Well established small animal hospital & real estate for sale at appraisal values. Seller financing with very little down. Floyd 407-529-5651. (2,3/18; ID #28095) PRACTICE FOR SALE – WINTER PARK, FL: Winter Park FL, well established small animal hospital, for sale at appraised value. Seller financing with very little down. WP 407-529-5651. (2,3/18; ID #28095)

PS BROKER Florida Practices for Sale

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FL: NEW! Central FL: $624K+ gross, solo doctor practice. No emergencies, 5 day work week. (FL28A)

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FL: North Miami: $778K+ gross, small animal, solo doctor. Leased facility. (FL60M)

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GA: Doughtery County: Established 30+years, $753K+gross, small animal, solo doctor practice. (GA63A)

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PRACTICE OWNERS…now is the time to sell! Whether you’re pondering an associate sale, open market listing, or corporate sale, Simmons will help! The current practice sales market is dynamic with buyers, and commercial financing is readily available. Contact Dr. Doyle Watson at Simmons Southeast today, for a complimentary, nonobligatory consultation. The dialogue will be informative and time well spent. As the original pioneer of veterinary practice brokerage, we have been at this since 1977, so

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1610 Frederica Road, Saint Simons Island, GA 31522 Toll Free: (800) 333-1984 | www.simmonsinc.com | Email: southeast@simmonsinc.com

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Florida Practices for Sale Florida Practice Listings!

FL: NEW! Central FL: $624K+ gross, solo doctor practice.

No emergencies, 5 day work (FL28A) Under Contract-North Florida– Solo week.

Dr. small animal, 2017 gross $905k, Well established, new digital X-ray. High net...

GA: South Central GA:Practice $818K+with gross, upgross 15% of in $1.5mm+.

2017, Sold-Central Fl.– 2 Dr. 2017 1.5 sq. doctor practice.

2500 ft. office with(GA14F) 2800 sq.ft. pet resort.

Sold-Sarasota County– 1.5gross, Dr. Practice 2017 gross FL: North Miami: $778K+ small animal, soloabout $730K. Free standing office on major 4 lane. Booming area. doctor. Fl.– Leased (FL60M) Central Solofacility.

Dr. Practice with 2017 gross of $860k priced toFL: sell.Jacksonville: Established for about 40 years with greatsmall reputation. $1.2M+ gross, 36+ years, Central Dr. Practice, beautiful hospital, well equipped. animal,Fl.– 1.371.5 acres, major growth potential.

(FL25J) 2017 gross just under $1mm.

Florida– Very profitable weeknight and weekend GA: Doughtery County: Established 30+years,emergency clinic.

Nice hospital, well equipped 2017 gross $1.16mm $753K+gross, small animal, solo doctor practice.

(GA63A) New– Central Florida– Solo Dr. Practice in affluent area. Nice, free standing ~2800 sq. ft., 3 exam rooms. 2017 gross $580K. PRACTICE OWNERS…now the time to sell! Whether New– S.W. Florida– 2 to 2.5isDr. well established Prx w/ you’resq. pondering an associate sale, open market listing, or ~3000 ft., 3 exam rooms, well equipped and well staffed. corporate sale, Simmons will help! The current practice 2017 gross of $1.8mm. sales market is dynamic with buyers, and commercial Are Corporate Groups contacting you about your Practice? financing is readily available.

Contact Dr. buying Doyle Watson at If so, let us help you make sure you get your best deal!!!

Simmons Southeast today, for a complimentary, nonWeconsultation. are looking forThe quality practices in Florida. obligatory dialogue willtobelistinformative If your are considering selling your Practice, call us for a complimentary and time well spent. As the original pioneer of veterinary Consultation!!! practice brokerage, we have been at this since 1977, so

Veterinary Practice Real Estate Brokers, Licensed Nationwide Sales - Buyers Representation - Valuations

Helping people buy or sell veterinary practices is what we do

Florida Practice For Sale

Palm Beach County: Full service SA practice.

Appx. 2212 square foot lease facility with updated equipment in a bright, modern facility.

This practice has posted receipts in excess of $800k in five out of the last six years, with net income over $1 80k. The current owner is willing to stay on to aid in the transition.

South Florida fun 'n' sun! FL91

Visit psbroker.com to see our full list of practices, or call our experienced staff for a free, confidential conversation to help you find the right practice in the right location.

The PS Broker team includes a Certified Valuations Analyst and member of NAVCA. psbroker.com I 800.636.4740 I info@psbroker.com

Interested in selling your practice?

FREE Practice Appraisal

PANHANDLE / 30A, FL- SOLD! Posh, Dream location, Grossing $750K PANHANDLE, FL- COMING SOON! Solo Dr., Well Established Practice TALLAHASSEE, FL AREA– COMING SOON! Open to Corporate Options

Practice Sales | Valuations Associate Buy-Ins Buyer Representation

Contact Dr. Richard Alker for further practice information.

1610 850.814.9962 Frederica Road,orSaint Simons Island, GA 31522 Richard@tpsgsales.com Toll Free: (800) 333-1984 | www.simmonsinc.com | Showcase Properties of Central Florida, Broker Email: southeast@simmonsinc.com

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Florida Veterinary Medical Association 7207 Monetary Drive Orlando, FL 32809

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“Simmons & Associates’ advisors provided me with the insight necessary to be successful in this competitive profession.

Their dedication to our profession is unquestioned, as they daily demonstrate the highest degree of ethical standards and professionalism.

Colleagues enlisting their help are assured of a personal touch, a sincere effort to satisfy, and a team of hard-working professionals.”

– Richard Swanson, DVM, Past President, AVMA

Sales & Acquisitions | Valuations | Exit Strategy | Facilitation | Buyers Agency 1­800­333­1984 | www.SimmonsInc.com | Southeast@SimmonsInc.com 1610 Frederica Road, St. Simons Island, GA 31522